Second Victims in Industries beyond Healthcare: A Scoping Review

The second victim phenomenon (SVP) refers to workers negatively impacted by involvement in unanticipated adverse events or errors. While this phenomenon has been extensively studied in healthcare since its acknowledgment over 20 years ago, its presence and management in other high-risk industries have remained unclear. We conducted a scoping review aiming to map the SVP in non-healthcare industries, as well as to explore the available interventions or support programs addressed to help second victims (SVs). A total of 5818 unique records were identified and, after the screening process, 18 studies from eight sectors were included. All industries acknowledged the existence of the SVP, though many did not use a specific term for defining the SV. Similarities in psychological and emotional consequences were found across sectors. Support strategies varied, with the aviation sector implementing the most comprehensive programs. Self-care and peer support were the most reported interventions, while structured clinical support was not mentioned in any industry. Our review highlighted a lack of standardized terminology and industry-specific, evidence-based support interventions for the SVP outside of healthcare. Healthcare appears to be at the forefront of formally recognizing and addressing the SVP, despite traditionally learning from other high-reliability industries in safety practices. This presents opportunities for reciprocal learning and knowledge transfer between healthcare and other high-risk sectors.

An Investigation of Veterinary College Websites in the US and Canada: Representations and Content of Equity, Diversity, and Inclusion

University websites are often a first point of contact for prospective students. Portrayals of diversity on the website can influence current and future students' perceptions. Using content and statistical analysis, all 38 veterinary college websites in Canada and the US were systematically coded for representations of people in photos and content related to equity, diversity, and inclusion (EDI). In both Canada and the United States, people perceived as male or Black, Indigenous, and/or People of Color (BIPOC) were more likely to be portrayed without animals, and fewer photos with males depicted engagement in an activity compared with those depicting females. Compared with the self-identified data reported by US colleges to the American Association of Veterinary Medical Colleges, BIPOC students were under-depicted by approximately 16.3% (95% confidence interval [CI] = 11.1%-21.7%) on some college websites and over-depicted on others by approximately 23.4% (95% CI = 15.4%-31.2%). A land acknowledgment or a link for a land acknowledgment was found on only six websites (16%). These results provide evidence and support that veterinary colleges should monitor their websites for depictions of people and content related to EDI, providing the opportunity to attract a diverse student audience.

Measuring mental ill-health in the veterinary industry: A systematic review

Many instruments have been developed to examine and quantify symptoms of psychopathology. The main objective of this systematic review was to examine the instrument choice employed to measure mental ill-health in professionals working in the veterinary industry and reporting of psychometric testing of these instruments by researchers. 78 papers were reviewed. A total of 73 different instruments used to measure 19 symptoms of mental ill-health were identified. Quality assessment of included papers indicated 9 were low, 63 were moderate, and 6 were high quality. Reliability testing was conducted and reported in 36 papers and validity testing was reported in 23 papers. There is considerable heterogeneity in instrument choice measuring symptoms of mental ill-health in this population and inconsistency in conducting and reporting psychometric testing of instruments across studies. Adopting commonly employed instruments that yield high quality data in psychometric testing of instruments would be beneficial at advancing understanding in this field.

Overcommitment, Work-Related Behavior, and Cognitive and Emotional Irritation in Veterinarians: A Comparison of Different Veterinary Working Fields

Mental health is a serious problem among veterinarians. The aim of this study was to analyze work-related behaviors and experience (AVEM), overcommitment (OC), and cognitive and emotional irritation (IS) in different veterinary working fields. The survey included 724 German veterinarians (average age 41.0 ± 9.72 years). Validated questionnaires were used to assess overcommitment, work-related behavior and experience patterns (health-promoting pattern G or S; health-hazardous risk pattern A or B), and irritation in several working fields. A correlation analysis and a multivariate test were performed. Increased OC was observed in 35.8% of veterinarians (mixed animals vs. inspectors, p = 0.042; small vs. mixed animals, p = 0.001). A total of 66% of veterinarians exhibited AVEM risk pattern A or B. There was no significant association of AVEM risk patterns and veterinary specialty. Only the AVEM dimension "tendency toward resignation in the face of failure" differed among working fields (p = 0.04). Regardless of direct animal contact, German veterinarians showed increased psychological stress. Inadequate compensation and prolonged stress are significant factors that can lead to burnout or depression. These risks should be considered in the context of occupational healthcare.

Predictors of suicidal ideation in Italian veterinarians

Suicide represents a significant problem for healthcare professionals such as veterinarians. Previous studies showed that contextual and individual risk factors can contribute to suicidality among veterinarians. In the present study, self-report measures on exposure to animal euthanasia, substance abuse, reflective functioning, and suicidal ideation were administered to 1556 Italian veterinarians aged 24-74 years old. Structural equation modelling revealed that failures in reflective functioning and substance abuse were associated with suicidal ideation. Prevention programs focusing on improving reflective functioning and decreasing substance abuse might reduce suicide risk among veterinarians.

Career transition plans of veterinarians in clinical practice

Objective

Gain an understanding of the career transition plans of veterinarians in clinical practice.

Sample

Veterinary members of the Veterinary Information Network (VIN) working as small animal clinicians.

Procedures

An electronic survey distributed via the VIN data collection portal.

Results

A total of 1,256 responses from veterinarians in clinical practice were analyzed, with 61% indicating they plan to decrease their clinical work, and 31% to stop entirely within the next 5 years. The most common reasons for these choices were to have more free time for oneself and/or family/friends (76%), to maintain good health (59%), and feeling burned out (50%). Factors that might entice them to retain their current number of clinical hours included reduced workload or shorter hours (42%), financial incentivization (38%), and improved working conditions (26%). Concerns related to retirement were common with 47% of participants in our study reported feeling concerned about the loss of professional identity, 34% reported concern about reduced social connections, and 28% reported concern as to how they would fill their time.

Conclusions and clinical relevance

The reported desire to reduce/stop one's clinical work within the next 5 years by 42% of veterinarians ≤44 years of age, with burnout a primary predictor, offers insights into the necessity of change at the organizational, systemic (versus individual) level. The fact that many participants reported concerns related to retirement and 32% reported that they did not have adequate retirement information suggests a need for supportive services to help ensure a successful transition.

Survey on Psychosocial Conditions of Official Veterinarians in Germany: Comparison with Other Professions and Differences between Age Groups, Gender, and Workplace Characteristics

BACKGROUND

Even though the mental health of veterinarians has raised concerns, little is known about the wellbeing of official veterinarians ensuring animal welfare, food safety, and control of infectious diseases and performing other tasks for veterinary public health. Therefore, the aim of this study was to assess the psychosocial conditions of official German veterinarians and to compare them with those of other employees.

METHODS

An online survey was conducted including 82 items of the Copenhagen Psychosocial Questionnaire (COPSOQ III) and additional questions on workplace and demographics.

RESULTS

The answers of 838 respondents were analyzed, representing 26% of the target population. The average values for the dimensions Quantitative Demands, Emotional Demands, and Burnout Symptoms were substantially higher than those for German employees in other professions. Official veterinarians mainly working in animal welfare frequently experienced physical violence (6.7%) or threats of violence (53%). However, the profession also provides advantages: official veterinarians reported higher average values concerning the dimensions Control over Working Time and Influence at Work than other employees. Most participants stated that they experienced their work as meaningful, and the Job Insecurity dimension was low.

CONCLUSIONS

Official veterinarians frequently experience offensive behavior and high-level demands. Therefore, measures to support and protect official veterinarians are needed. The positive aspects of this job should be emphasized to recruit and retain veterinarians in this field of the profession.

Suicide Risk in Veterinary Professionals in Portugal: Prevalence of Psychological Symptoms, Burnout, and Compassion Fatigue

Mental health problems and suicide risk among veterinarians and veterinary nurses are well documented in the literature. Data on veterinary assistants have been overlooked, however. In addition, information on Portuguese veterinary professionals is lacking. An online sample of 833 Portuguese veterinary professionals (443 veterinarians, 287 nurses, and 103 assistants) completed self-report questionnaires about suicide risk and mental health between December 2022 and March 2023. Descriptive analysis revealed that 3.5% of respondents attempted suicide during their lifetime; 17.2% experienced extremely severe depression and suicidal ideation; 17.8% and 27.0% experienced extremely severe stress and anxiety, respectively; and 27.4% and 27.7% reported burnout and compassion fatigue, respectively. Multiple linear regression analysis revealed that professionals with a history of mental illness history; with current clinical symptoms of depression, anxiety, and stress; and working more than 40 hours per week experienced greater levels of burnout, compassion fatigue, and suicide ideation. Other variables such as being a woman, being a veterinary assistant, and disagreeing with motives for euthanasia also predicted some mental health problems. Mental health problems in the Portuguese veterinary professionals are a major health concern. These professionals are at higher risk for suicide, and clinical implications and guidelines are discussed.

Veterinarian-Chasing A Dream Job? A Comparative Survey on Wellbeing and Stress Levels among European Veterinarians between 2018 and 2023

Whilst recognizing the abundantly positive aspects within the different domains of the veterinary profession, the challenging socio-economic and cultural working climate has been identified as a source of veterinary mental wellbeing issues. This mixed methods study provides an overview of the mental state of veterinarians across Europe via two cross-sectional surveys in 2018/2019 (n = 14,559 veterinarians) and in 2022/2023 (n = 12,393 veterinarians). Mental wellbeing was assessed using 3 indicators: self-reported stress levels, the need for medical leave due to reduced mental wellbeing (22% and 23%, resp., in 2018/2019 and 2022/2023) and the seven-question Warwick-Edinburgh Mental Wellbeing Scale (2018/2019: 25, 2022/2023: 24.8). In both surveys, important differences were spotlighted between countries, but early-career veterinarians and female veterinarians were most at risk of decreased mental wellbeing all over Europe for all indicators. In conclusion, stress levels and need for medical leave due to reduced mental wellbeing remained at comparatively high levels across the two surveys and standardized mental wellbeing scores remained equally low. Notwithstanding the increased attention given to veterinary wellbeing in the last decade, our results underline that major efforts remain necessary, by creating more supportive and attractive workplaces that prioritize wellbeing, a good work/life balance, and providing job satisfaction.

Perceived role of the veterinarian in promoting dairy cattle welfare

Improving the lives of animals in agricultural systems has primarily focused on minimizing negative experiences. Research is needed on the promotion of positive experiences (pleasure, enjoyment, play, choice, happiness) for animals and the role of veterinarians in their promotion. Our aims were to describe how Canadian bovine veterinarians and veterinary students perceive the role of a veterinarian in positive vs. negative experiences for dairy cows and to analyze the rationale provided to explain their answers. Canadian veterinary practitioners (n = 78) and veterinary students (n = 148) responded to an online cross-sectional survey and were asked, on a 7-point scale, how important the role of a veterinarian is to promote practices that influence the experience of dairy cows. We used qualitative description to analyse participants' open-ended text responses. Practices to minimize negative experiences were most important (mean ± SE; 6.8 ± 0.03), a balance of positive and negative experiences was less important (6.4 ± 0.05), and encouragement of positive experiences scored lowest (6.0 ± 0.06), although all scored highly. Four themes were identified to explain participants' reasoning regarding their perceived role of a veterinarian in the promotion of dairy cattle welfare, centered on: the animal, the producer, the veterinarian, and society. Participants indicated that promoting positive experiences was less important than decreasing negative experiences (5.9 ± 0.09). There were four themes identified to explain participants' reasoning regarding the relative importance of promotion of positive experiences versus decreasing negative experiences which centered on: frameworks to compare positive and negative experiences, impacts on the animal, the participant's view of their role, and the practicality of implementation. These results indicate modest differences in valuing avoidance of negative vs. promotion of positive welfare. There were no differences in the quantitative analyses between veterinarians and veterinary students. We conclude that veterinarians are favorably disposed to positive aspects of welfare for dairy cows but may be more focussed on avoidance of negative aspects of welfare.

Student Veterinarian Perceptions of Community-Based Primary Care Veterinary Clinics in Indigenous Communities in Southern Ontario, Canada

Community-based primary care veterinary clinics represent an opportunity to benefit multiple populations. Student veterinarians are afforded the opportunity to build technical and non-technical professional skills, while underserved communities are provided with access to companion animal care. The Ontario Veterinary College (OVC), as with many other veterinary colleges across Canada and the United States, has hosted community-based primary care veterinary clinics, including in local Indigenous communities. As these clinics continue and grow, it is critical to evaluate their operation to ensure that they align with community goals and values, adequately support student learning, and do not perpetuate racism and implicit bias. The objective of this study was to explore the perceptions of student veterinarians who had volunteered at community-based primary care veterinary clinics in First Nations communities in southern Ontario, Canada. We used an online survey that consisted of multiple choice and short answer questions focused on motivating factors for involvement, supports available before and during the clinics, exposure to Indigenous cultures, and the challenges and rewards associated with volunteering. Forty-one student veterinarians from OVC completed the survey in January 2020. Most students were motivated to volunteer to make a positive difference in the lives of people and animals and improve their clinical skills. In general, respondents felt adequately prepared for and supported during their experiences but did recommend additional pre-departure instructions on roles and responsibilities. Participants were ambivalent as to whether they had learned about Indigenous culture, with several strongly recommending more cultural sensitivity training. Most students found their experiences rewarding because of the gratitude expressed by clients and the feeling that they had made a difference. We reflect on the potential benefits and challenges of community-based primary care veterinary clinics in light of student responses.

Predictors of Suicide Risk and Mental Health Outcomes among Hong Kong Veterinarians: A Cross-Sectional Study

The professional quality of life (ProQOL) in the veterinary profession has gained increasing attention, yet little is known about its association with the mental health status of Hong Kong veterinarians. This study aimed to examine the impact of elements that make up ProQOL on the risk of suicide, depression, and anxiety among Hong Kong veterinarians. All veterinarians registered and practicing in Hong Kong at the time of recruitment were eligible to take part in the e-survey study between 1 January and 31 March 2022. Binary logistic regression was used to analyze the data from 56 participants. The results showed that 22.0% of the participants were at risk of suicide, 19.6% had current suicidal ideation, 29.4% had depression, and 29.4% had anxiety symptoms. The findings suggested poor mental health status among Hong Kong veterinarians and were comparable to or more prevalent than those reported in Anglophone and European countries. Results from the binary logistic regression suggested that burnout was a predictor of depressive symptoms, and that secondary traumatic stress showed potential in predicting suicide risk. Our study, however, did not find conclusive evidence supporting compassion satisfaction as a predictor of reduced symptoms of common mental issues. Further investigation into contextual factors affecting the mental health of veterinarians in Hong Kong is warranted. Improving the profession's mental health literacy and self-efficacy should be prioritized as a suicide prevention strategy to enhance mental health awareness.

An anthropologist's voice in a veterinarian's noise: gearing up for new cultural realities

Over the past three decades, the veterinary profession has faced a cultural shift towards postspeciesism that requires a reassessment of the foundations of the existing distinctions between human and non-human animals proclaimed by the speciesism paradigm, which represents institutionalized discrimination against species and recognizes only the subjectivity of humans. Based on ethnographic observations in anthropological fieldwork and using speciesism/postspeciesism distinction, we aimed to explain the main causes of small animal practitioners' work-related stress and apply humanistic knowledge to recommend ways to alleviate the negative effects of the work environment. The explanatory model of disease, illness, and sickness, the example of the concept of family, and the circumstances of the feminization of the veterinary profession are discussed to illustrate the divergence between speciesist naturalistic veterinary knowledge and the postspeciesist cultural framework and its consequences. By failing to accommodate the changing values towards animals and by failing to challenge the anthropocentric hierarchy of values, the speciesist rationale of the veterinary profession contributes to many of the problems faced by practicing veterinarians. The incorporation of a modern moral-philosophical mindset towards animals may not even be possible because veterinary science is subject to a paradigm that is irreversibly tied to institutional discrimination against species and defies reflection on veterinary science itself. However, the veterinary profession has a privileged position in establishing an alternative ontological thinking and an alternative conception of "animal life." Anthropological knowledge was applied to anticipate further intervention of social and cultural sciences in the problems of small animal practitioners. Rather than further diversifying and increasing expectations towards veterinarians by expecting them to acquire additional skills, we propose another practitioner who can support, mediate, and enhance veterinary performance - the cultural anthropologist. With their deep knowledge of cultural differences and social dynamics, they can collaborate with veterinarians to act as a liaison between cultures, paradigms, and species.

Burnout symptoms and workplace satisfaction among veterinary emergency care providers

OBJECTIVES

To measure symptoms of burnout among veterinary emergency care providers (VECPs), determine how burnout symptoms among VECPs compare to human emergency care providers, and identify what demographic and workplace variables are associated with these symptoms.

DESIGN

Cross-sectional study using an online survey and convenience sampling.

SUBJECTS

A total of 1204 VECPs including mostly veterinarians and technicians.

INTERVENTIONS

An online questionnaire using the Maslach Burnout Inventory and Areas of Worklife Survey was distributed between May and July 2018 via an email list and social media. VECPs working less than part-time (<20 h/week) and incomplete survey responses were excluded.

MEASUREMENTS AND MAIN RESULTS

VECPs had higher total emotional exhaustion and depersonalization scores and lower total personal accomplishment scores compared to emergency department human healthcare professionals (P < 0.001). Subsets of VECPs with the highest burnout symptom scores included females, residents, those working in private or corporate referral hospitals, and those with off-shift duties. Workplace variables positively associated with burnout symptom scores among these groups typically included perceptions of an unmanageable workload, lack of control over work, little reward (recognition) for work, or an unfair allocation of resources at work. Conversely, VECPs working >20 years and those married or with children at home had lower burnout symptom scores. Workplace variables negatively associated with burnout symptom scores among respondents included perceptions of having a manageable workload, control over work, reward for work, or a fair allocation of resources at work. Multivariable analysis revealed that the variable most positively associated with emotional exhaustion and depersonalization was workload, whereas reward was most positively associated with personal accomplishment (P < 0.001).

CONCLUSIONS

Burnout symptom scores are higher among VECPs compared to human emergency department teams. Targeting workplace variables such as workload and reward is warranted in future studies to determine strategies for reducing burnout among VECPs.

A qualitative study exploring the perceived effects of veterinarians' mental health on provision of care

Introduction

Veterinary medicine is a rewarding, yet demanding profession with a myriad of occupational stressors that can impact the mental health of veterinarians. Stress, mental health outcomes, and associated risk factors amongst veterinarians have been well-researched. Much less research has investigated how high stress and/or poor mental health can impact veterinarians' provision of care.

Methods

One-on-one research interviews were conducted with 25 veterinarians at a Canadian veterinary conference in July 2016 and verbatim transcripts were produced from the audio recordings. The research team collaboratively analyzed the interviews using thematic analysis.

Results

Five themes described the perceived impacts of high stress and/or poor mental health: perceived negative impacts on interactions with (1) co-workers and (2) clients; (3) reduced concentration; (4) difficulty in decision making; and (5) reduced quality of care.

Discussion

These results highlight the perceived impacts of self-reported high stress and/or poor mental health on veterinary team dynamics, the potential to impact case outcomes, and possibly endanger patient safety. Interventions to help mitigate the impacts of high stress and poor mental health are discussed.

Mental health in the veterinary profession: an individual or organisational focus?

The veterinary profession is experiencing a shortage of veterinarians, with attrition recognised as a substantial contributor. Research has also indicated increased levels of mental ill health and alarming suicide rates in practitioners. The primary aim of this study was to investigate the impact of eleven modifiable workplace factors on mental health outcomes, job appreciation and intention to leave the veterinary profession. The second aim was to ascertain whether workplace factors influence mental health outcomes after controlling for individual resilience. An online survey was completed by 73 practising Australian veterinarians. Unfavourable workplace factors correlated with adverse outcomes including depression, stress, reduced job appreciation and increased likelihood of leaving both the role and the profession. Workplace factors remained linked with the outcomes of job appreciation, depression and stress whilst controlling for practitioner resilience. Job appreciation was a significant predictor of intention to leave both the current role and the profession. Via multiple linear regression, two categories were identified as associated with improved psychological outcomes and job appreciation. These were workplace factors that represent breaks from workload and control or decision latitude in the workplace. Whilst resilience represents a key area for intervention, workplace factors potentially represent an easier-to-modify area for intervention.

Latent burnout profiles of veterinarians in Canada: Findings from a cross-sectional study

BACKGROUND

Although burnout is often discussed as 'present' or 'not-present', the conceptual framework of an engagement-burnout continuum is more accurate and useful. Recognition of individuals' transitional states of burnout also allows for earlier detection of issues and tailored interventions to address the full burnout spectrum.

METHODS

Previously reported Maslach Burnout Inventory-Human Services Scale (MBI-HSS) data from a 2017 national survey of 1272 veterinarians across Canada were re-analysed using a latent profile analysis to classify individuals along the engagement-burnout continuum.

RESULTS

Four clusters were identified: engaged (10.8%), ineffective (18.9%), overextended (29.6%) and burnout (40.7%). These results indicate that most participants (89.2%) had one, or a combination, of high exhaustion, high depersonalisation and low professional efficacy.

LIMITATIONS

This cross-sectional study represents data from one point in time and may be subject to response bias.

CONCLUSION

We discuss strategies-particularly long-term, organisational-level interventions-to promote engagement and help address workplace issues contributing to inefficacy, overextension and burnout in the veterinary profession. We also recommend MBI data be analysed via latent profiles to provide a more nuanced view of burnout, allow for earlier recognition of workplace issues and facilitate more meaningful interventions and comparisons across populations.

Professional quality of life among Spanish veterinarians

Background

In Spain, the perceived professional quality of life among veterinarians has not been explored.

Methods

Veterinarians were invited to complete an online questionnaire in which they answered the Professional Quality of Life scale, the Medical Outcomes Study Social Support Survey and the Warwick-Edinburgh Mental Well-Being Scale. Participants were asked whether they were receiving psychological therapy or were taking anxiolytics, hypnotics or antidepressant medication. Alcohol consumption was measured using the Alcohol Use Disorders Identification Test and nicotine dependence was assessed using the Fagerström test; participants were asked whether they took illegal drugs.

Results

The study sample comprised a total of 602 veterinarians, most of whom reported average levels of compassion satisfaction, secondary stress trauma and burnout. Emotional support and mental wellbeing influenced participants' professional quality of life. The percentage of veterinarians in psychological therapy and/or taking anxiolytics was higher than in the general population.

Conclusions

A considerable number of clinical veterinarians in Spain may be suffering from work-related stress. Our study identifies salary, emotional support and mental wellbeing as important factors that affect the professional quality of life. Interventions to improve veterinary clinicians' professional quality of life should therefore focus on these factors.

Discussion of cost continues to be uncommon in companion animal veterinary practice

OBJECTIVE

To determine the prevalence and nature of cost conversations occurring during veterinarian-client-patient interactions within companion animal practice.

SAMPLES

60 randomly selected, practicing veterinarians working in 55 practices across southern Ontario, Canada, and 909 of their clients, sampled by convenience.

PROCEDURES

A cross-sectional descriptive study including 917 video-recorded appointments. Associations between veterinarian, client, or appointment-level factors and occurrence of a cost conversation were evaluated using multi-level logistic regression.

RESULTS

215 of 917 (23.4%) videos included a discussion of cost between the veterinarian and client. Cost conversations involving veterinarians primarily focused on conveying the price in relation to the time or service being offered (74.0% [159/215]), whereas the benefit to the future health and wellness of the patient was conveyed in 14.4% (31/215) of veterinarians' cost conversations. Costs were most frequently discussed by veterinarians in relation to diagnostic testing (44.2% [96/215]). The odds of a cost discussion occurring were greater during problem appointments versus wellness (P = .011) or recheck (P = .029) appointments, for feline versus canine patients (P = .037), as appointment duration increased (P < .001), and as a client's number of visits in the past year decreased (P = .049).

CLINICAL RELEVANCE

Discussing cost of care in veterinary practice continues to be relatively uncommon. Opportunities exist for veterinary professionals to frame their communication of the cost of veterinary care in relation to the benefits offered to the future health and wellbeing of the veterinary patient.

Benefits of practice ownership among US private practice veterinarians extend to professional quality of life

Objective

To estimate the effects of practice ownership on wellbeing of US private practice veterinarians.

Sample

1,217 practice owners and 1,414 associate veterinarians (ie, nonowners) who participated in the 2021 AVMA Census of Veterinarians and Practice Owners Survey.

Procedures

A professional quality of life instrument was used to measure compassion satisfaction (CS; a positive attribute), burnout (BO), and secondary traumatic stress (STS) in practice owners and nonowners both as scores and as score categories (low, moderate, and high CS, BO, and STS). For hypothesis tests, propensity score matching was used, with owners (n = 595) matched to nonowners (595) on several demographic and employment factors.

Results

Owners had significantly (P < .001) higher CS scores (mean ± SE, 34.1 ± 0.3) and lower BO scores (26.1 ± 0.3) than nonowners (32.8 ± 0.3 and 26.9 ± 0.3, respectively), but STS scores were comparable between groups (27.4 ± 0.3 and 27.5 ± 0.3; P = .55). The prevalence of low CS scores and high BO scores was significantly (P < .001) higher for nonowners versus owners (53.8% vs 42.7% and 51.6% vs 46.4%, respectively). Both owners and nonowners had a high prevalence of high STS scores (81.8% and 83.2%, respectively; P = .53).

Clinical Relevance

Results suggested that practice ownership confers a benefit to private practice veterinarians in terms of CS and BO, but not STS. The prevalence of poor CS, BO, and STS scores was higher than reported previously for 2016 to 2018, suggesting an impact of the COVID-19 pandemic. The high prevalence of high STS scores in both groups warrants attention and action to protect the welfare of the veterinary workforce and support optimal patient care.

Mental well-being and diversity, equity, and inclusiveness in the veterinary profession: Pathways to a more resilient profession

Mental well-being (MWB) and diversity, equity, and inclusiveness (DEI) continue to be critical within the veterinary profession but there is less information regarding how professional associations around the world tackle these issues. A mixed-method study including an international online survey in English (n = 137 responses via snowball sampling), fourteen interviews, and two webinars was used to identify the availability and impact of MWB and DEI support programs for veterinarians. Survey results showed that more veterinary organizations designated MWB and DEI challenges (54%, n = 43/79 and 58%, n = 45/78, respectively) as a key priority area than veterinary clinics (26%, n = 15/57 and 33%, n = 19/57, respectively). Whereas, MWB support programs were available in a moderate number of mainly English-speaking countries, DEI support programs were available in only a few countries and focused primarily on specific groups, with an unknown impact due to their recent implementation. Universally, survey respondents believed activities for specific groups, such as MWB webinars, training, and awareness campaigns, as well as MWB/DEI helplines and DEI peer-to-peer support programs had a high impact (median 3.5–4/5) yet were underemployed by both veterinary organization and veterinary clinics. Further feedback from respondents during focused interviews indicated that requiring initial and continuing training as well as tailored group activities would be most beneficial to improve MWB/DEI throughout the veterinary professional career. There are many areas of the intersection between MWB and DEI that remain to be elucidated in the future studies. Having a sufficient sample size, improving accessibility, and addressing varying cultural perceptions are the main challenges, as seen in our study. To truly address MWB and DEI disparities, change is also needed in veterinary workplace culture and environment. In conclusion, raising awareness for an inclusive profession, including increasing openness and acceptance to enhance DEI and destigmatizing MWB challenges, is needed to ensure a thriving, modern veterinary profession.

Professional help-seeking behaviour for mental health problems among veterinarians in Norway: a nationwide, cross-sectional study (The NORVET study)

Background

Veterinarians have a relatively high prevalence of mental health problems; however, research on professional help-seeking is limited. The main purpose of the present study was to investigate the prevalence of mental health problems and professional help-seeking behaviour for such problems, and the independent factors associated with help-seeking behaviour among veterinarians in Norway.

Method

This cross-sectional study included all veterinarians in Norway (response rate 75%, 70% women). Logistic regression was used to calculate odds ratios (OR) for professional help-seeking for mental health problems. Analyses were controlled for socio-demographic, individual (personality trait reality weakness, SCL-5, attitudes toward mental illness), and work-related factors (work field, job stress).

Results

The prevalence of self-reported mental health problems in need of treatment was 30% (746/2494), significantly higher among women than men (36% vs. 15%). Fifty-four percent had sought professional help, women significantly more often (56%) than men (41%). Among veterinarians with serious suicidal thoughts, 50% (69/139) had sought help. Veterinarians most frequently related mental health problems to work problems (47%), women significantly more often (49%) than men (34%). Factors significantly associated with help-seeking were being female, OR = 2.11 (95% CI: 1.24–3.60), working with production animals, OR = 0.35 (0.13–0.98), public administration, OR = 2.27 (1.15–4.45), academia/research, OR = 4.78 (1.99–11.47) or ‘other’ fields, OR = 2.79 (1.23–6.32), and attitudes toward mental illness, OR = 1.32 (1.03–1.68).

Conclusions

Thirty percent of veterinarians in Norway reported mental health problems in need of treatment, and only half of them had sought professional help. A low degree of help-seeking was also seen among those with serious suicidal thoughts. Being female, positive attitudes toward treatment of mental illness, working in public administration, academia/research and ‘other’ field were associated with more help-seeking, while working in production animal practice was associated with less help-seeking. Interventions to increase help-seeking behaviour for mental health problems among veterinarians are warranted.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13710-y.

Female veterinarians' experiences with human clients: the link to burnout and depression

Purpose

Previous research studies have noted that veterinarians are up to four times more likely to die by suicide than the general population. Studies have indicated possible catalysts for this increased risk, including exposure to euthanasia, depression, burnout, compassion fatigue, occupational stress, work–life imbalance and anxiety. With female veterinarians reporting higher rates of mental health issues and the fact that the ratio of female to male veterinarians is almost 2:1, the study focused on the female veterinarian population. Few research studies have been conducted to examine stressors directly related to human factors. The present study aims to examine the path to depression and burnout as it relates to positive versus negative interactions with human clients (owners of animal patients).

Design/methodology/approach

The study recruited 222 female veterinarians online (average age = 36.89). The participants completed three scales measuring (1) burnout; (2) depression, anxiety and stress; and (3) positive and negative experiences with human clients.

Findings

Using the structural equation modeling (SEM), the results showed contrasting patterns of positive versus negative client-related experience in relation to burnout and depression. Positive client experience showed a direct path to the lower levels of depression and client-related burnout while negative client experience revealed a non-direct path to depression but a direct path to more specific burnout such as client-related and work-related burnout.

Originality/value

Results of the study offered insight into the unique contribution of client-related experience in burnout and depression as positive versus negative client experience took on differential paths to depression and burnout.

A taxonomy of occupational and organisational stressors and protectors of mental health reported by veterinary professionals in Australasia

AIM

To develop a taxonomy of positive and negative occupational and organisational factors reported that impact the mental health of veterinary professionals.

METHODS

Veterinary professionals working in Australasia were surveyed between February and June of 2021. The survey comprised two questions related to participants' perceptions of the positive and negative aspects of their job role that impact their mental health and wellbeing. Reflexive thematic analysis was employed to analyse the responses and generate two taxonomies of occupational and organisation stressors and protectors reported by participants.

RESULTS

Fifty-three responses from veterinary professionals were analysed. The final stressor taxonomy generated contained 9 overarching themes and 36 subthemes. The most common of these were negative work conditions, challenging relationships with clients, and adverse events and patient outcomes. The taxonomy of protectors contained 11 overarching themes and 32 subthemes, with the most common including fulfillment and satisfaction, positive work conditions, and relationships with colleagues.

CONCLUSION

This study is the first to examine both positive and negative factors in the veterinary industry reported by veterinary professionals in Australasia. The results highlighted stressors that can be addressed on both an individual and organisational level to promote the mental and health well-being of professionals working in the animal care industry.

Mental Health Impact of Mass Depopulation of Swine on Veterinarians During COVID-19 Infrastructure Breakdown

This study was designed to assess the mental health of swine veterinarians involved with mass depopulation events related to COVID-19 and compare them to swine veterinarians not involved in mass depopulation. Additionally, we assessed the well being, quality of life, psychological distress, burnout, and resilience in veterinarians who conducted depopulation events and the potential impact of depopulation methods on these factors. Finally, we identified coping methods utilized by swine veterinarians for improved well being. The study involved the distribution of an anonymous online survey, available December 2020 to January 2021, to swine veterinarians practicing in the United States. A total of 134 responses were analyzed. Stress related to the depopulation effort was predominantly an outcome of two factors: ethics of care (people and pigs) and perception of others (public, colleagues, family, friends, neighbors). Depopulation involvement was associated with burnout (p = 0.001). The depopulation method utilized significantly impacted depopulation distress (p = 0.007), perception of others (p < 0.001), and burnout (p < 0.001). Nearly one-third (29%) of all participants reported moderate levels of burnout. Based on these results, the call to action is to enhance the availability and visibility of existing mental health services and take necessary steps to destigmatize mental health. Additionally, it is critical to support the development of mental health programs for swine veterinarians through education, training, research, and transparent communication.

Veterinary house officer perceptions of dimensions of well-being during postgraduate training

OBJECTIVE

To describe veterinary house officers’ perceptions of dimensions of well-being during postgraduate training and to identify potential areas for targeted intervention.

SAMPLE

303 house officers.

PROCEDURES

A 62-item questionnaire was generated by use of an online platform and sent to house officers at participating institutions in October 2020. Responses were analyzed for trends and associations between selected variables.

RESULTS

239 residents, 45 rotating interns, and 19 specialty interns responded to the survey. The majority of house officers felt that their training program negatively interfered with their exercise habits, diet, and social engagement. House officers reported engaging in exercise significantly less during times of clinical responsibility, averaging 1.6 exercise sessions/wk (SD ± 0.8) on clinical duty and 2.4 exercise sessions/wk (SD ± 0.9) when not on clinical duty (P < 0.001). Ninety-four percent of respondents reported experiencing some degree of anxiety regarding their physical health, and 95% of house officers reported feeling some degree of anxiety regarding their current financial situation. Overall, 47% reported that their work-life balance was unsustainable for > 1 year; there was no association between specialty and sustainability of work-life balance. Most house officers were satisfied with their current training program, level of clinical responsibility, and mentorship.

CLINICAL RELEVANCE

Veterinary house officers demonstrated a poor balance between the demands of postgraduate training and maintenance of personal health. Thoughtful interventions are needed to support the well-being of veterinary house officers.

Caring for sick kids: An integrative review of the evidence about the prevalence of compassion fatigue and effects on pediatric nurse retention

PROBLEM

Compassion Fatigue (CF) in healthcare professionals has been explored in multiple studies, but few focused on hospital-based pediatric nurses. The purpose of this integrative review is to synthesize the evidence about CF prevalence in nurses caring for pediatric patients, and to describe its effects on retention and job satisfaction.

ELIGIBILITY CRITERIA

Included studies were in English from any date describing research or quality improvement studies about CF in pediatric nurses.

SAMPLE

An integrative review of nine electronic databases yielded 13 articles about 1921 nurses. Data were synthesized from four qualitative and nine quantitative studies separately before integrating results. A risk of bias analysis was included for evidence level and quality.

RESULTS

Overall CF prevalence was low, but 14% of nurses were at high risk of burnout and 10% were at high risk for secondary traumatic stress. Studies examining the effects of CF on retention found no significant relationship. Most studies were about critical care or oncology nurses.

CONCLUSIONS

A subset of pediatric nurses is highly vulnerable to CF, but more high-quality evidence is needed to fully address this topic. Leaders should study CF prevalence, protective and exacerbating factors, relationships between CF and retention, and targeted strategies to resolve CF in high-risk nurses.

The Economic Cost of Burnout in Veterinary Medicine

The purpose of this study is to estimate the economic cost of burnout in the veterinary profession and highlight the financial reasons why the industry should address the burnout crisis from an organizational perspective. Using data from 5,786 associate veterinarians in private practice, information was obtained using employment information related to compensation, work hours, hour preferences, and job turnover. Burnout was measured using the Professional Quality of Life Scale and used to calculate conditional probabilities on turnover and reduced working hours due to burnout. Lost revenue from each outcome (turnover and reduced working hours) was then used to calculate the economic costs to the veterinary services industry. The attributable cost of burnout of veterinarians to the US industry is between $1 and 2 billion annually in lost revenue, though there is a large amount of uncertainty. The cost is dependent on whether veterinary technicians are included in the analysis. The highest economic cost per veterinarian is among food animal practitioners, while the lowest is among equine. This study demonstrates that there are significant economic costs due to burnout among veterinarians and veterinary technicians. We suggest pursuing organizational interventions as these have shown the most impact in decreasing burnout and increasing satisfaction among human health physicians.

Use of health parameter trends to communicate pet health information in companion animal practice: A mixed methods analysis

BACKGROUND

Reviewing patient health parameter trends can strengthen veterinarian-client-patient relationships. The objective of this study is to identify characteristics associated with veterinarians' communication of health parameter trends to companion animal clients.

METHODS

Using a sequential exploratory mixed methods design, independent pet owner (n = 27) and veterinarian (n = 24) focus groups were conducted and analysed via content analysis to assess perceptions of how health parameter trends are communicated by veterinarians. Subsequently, a quantitative assessment of video recorded veterinary appointments (n = 917) compared characteristics identified in focus groups with health parameter trend discussions in practice. A mixed logistic model was used to assess characteristics associated with the occurrence of weight trend discussions.

RESULTS

Fifteen characteristics relating to veterinarians' use of health parameter trends were identified across focus groups. Veterinarians discussed 77 health parameter trends in relation to bodyweight (57/77), blood work (15/77) and other health parameters (5/77), within 73 (73/917) appointments. The odds of a weight trend discussion were higher if the veterinarian identified the pet as overweight or obese compared to an ideal bodyweight (odds ratio (OR) = 2.17; 95% confidence interval (CI) = 1.15-4.09; p = 0.016).

CONCLUSION

Mention of a health parameter trend was uncommon and rarely included use of visual aids. Health parameter trends related to bodyweight were discussed reactively, rather than proactively.

Prevalence and individual and work-related factors associated with suicidal thoughts and behaviours among veterinarians in Norway: a cross-sectional, nationwide survey-based study (the NORVET study)

OBJECTIVES

Several studies have shown increased suicide rates among veterinarians. We investigated the self-reported prevalence of suicidal thoughts and behaviours and contributing and independent factors associated with suicidal thoughts and behaviours among veterinarians in Norway.

DESIGN

Cross-sectional, nationwide survey.

PARTICIPANTS

2596 veterinarians in Norway (response rate: 75%).

MAIN OUTCOME MEASURE

Paykel's five-item questionnaire.

RESULTS

In total, 27% (n=682/2567) of veterinarians in Norway felt that life was not worth living during the last year, 5% (n=139/2562) had serious suicidal thoughts, and 0.2% (n=6/2537) had attempted suicide. Female veterinarians reported significantly higher prevalence of suicidal feelings and thoughts than males. For serious suicidal thoughts, women had nearly twice the prevalence as their male colleagues (6.2% (n=108/1754) vs 3.6% (n=28/766), χ²: 6.5, p=0.011). Independent factors associated with serious suicidal thoughts were being single (OR 1.76, 95% CI 1.13 to 2.72, p<0.05), negative life events (OR=1.43, 95% CI 1.22 to 1.68, p<0.001) and the presence of mental distress (OR 2.75, 95% CI 2.14 to 3.52, p<0.001). The veterinarians related their serious suicidal thoughts to work and personal problems, and a lesser degree to family, social and other problems. Nearly twice as many women (53%, n=57/108) as men (28%, n=7/25) reported work problems as the most important contributing factor to their serious suicidal thoughts (χ²: 4.99, p=0.03). 4% (n=6/139) reported work problems as the only factor of importance.

CONCLUSIONS

Veterinarians in Norway have relatively high prevalence of suicidal feelings and thoughts, including serious suicidal thoughts. In multivariable analyses, the individual factors were more important than work-related ones, while work problems were the most reported contributing factor to serious suicidal thoughts by the veterinarians themselves. The role of gender and specific work-related factors should be further investigated to better understand the complexity of suicidal behaviour among veterinarians.

High Psychosocial Work Demands, Decreased Well-Being, and Perceived Well-Being Needs Within Veterinary Academia During the COVID-19 Pandemic

Higher psychosocial work demands in veterinary and academic professions are associated with decreased occupational, physical, and mental well-being. COVID-19 introduced far-reaching challenges that may have increased the psychosocial work demands for these populations, thereby impacting individual- and institutional-level well-being. Our objective was to investigate the psychosocial work demands, health and well-being, and perceived needs of faculty, staff, residents and interns at the Ontario Veterinary College, in Ontario, Canada, during COVID-19. A total of 157 respondents completed a questionnaire between November 2020 and January 2021, that included the Third Version of the Copenhagen Psychosocial Questionnaire (COPSOQ-III) and open-text questions on perceived needs for well-being. Results showed that COPSOQ-III dimensions of quantitative demands, recognition, sense of community, burnout, stress, and depressive symptoms, were significantly worse in our study population than the Canadian norm. Quantitative and emotional demands, health and well-being (including depressive symptoms, stress, cognitive stress, somatic stress, and burnout), and work-life conflict were also reported to have worsened since the COVID-19 restrictions for most respondents. Females and caregivers had higher odds of experiencing increased work demands, and decreased health and well-being, compared to males and non-caregivers. However, male caregivers experienced worsened supervisor relations, compared to female caregivers. Social capital also worsened for clinical and part-time employees, compared to full-time and non-clinical employees. Respondents identified increased workload support, community-building, recognition of employees' capacities and personal needs, flexible work schedules, and consistent communication, as strategies to increase well-being during COVID-19 and generally. Overall, our findings suggest that COVID-19 has increased occupational demands, work-life conflicts, and decreased well-being in veterinary academia. Institutional-level interventions are discussed and recommended to aid individual and institutional well-being.

Compassion satisfaction, burnout, and secondary traumatic stress among full-time veterinarians in the United States (2016-2018)

OBJECTIVE

To determine prevalences of low compassion satisfaction (CS), high burnout (BO), and high secondary traumatic stress (STS) scores among full-time US veterinarians and estimate effects of selected demographic, employment-related, and education-related factors on those scores.

SAMPLE

5,020 full-time veterinarians who participated in the 2016, 2017, and 2018 AVMA Census of Veterinarians surveys.

PROCEDURES

Data were obtained from census surveys regarding demographic, employment-related, and education-related factors, and scores assigned to items from a professional quality-of-life instrument designed to measure CS and compassion fatigue (ie, BO and STS) were compared between and among various demographic and employment groups.

RESULTS

Overall, 35.5% of veterinarians were classified as having low CS scores, 50.2% as having high BO scores, and 58.9% as having high STS scores. Controlling for other variables, high educational debt was associated with low CS, high BO, and high STS scores. Veterinarians who spent ≥ 75% of their time working with dogs or cats had higher BO and STS scores than did those who spent < 25% of their time. Veterinarians with more experience and higher annual incomes had higher CS scores and lower BO and STS scores. Women had higher BO and STS scores than did men, but no gender differences were observed in CS scores.

CONCLUSIONS AND CLINICAL RELEVANCE

Several variables were identified that may put veterinarians at higher risk than others for compassion fatigue and low CS. These findings may be useful in the development of resources and targeted initiatives to support and defend veterinarian well-being.

Association of demographic, career, and lifestyle factors with resilience and association of resilience with mental health outcomes in veterinarians in Canada

OBJECTIVE

To investigate the association of demographic, career, and lifestyle factors with resilience and the association of resilience with mental health outcomes in Canadian veterinarians.

SAMPLE

1,130 veterinarians in clinical practice across Canada.

PROCEDURES

An online questionnaire was used to collect participant data and included 5 validated psychometric scales to evaluate resilience (through the Connor-Davidson Resilience Scale [CD-RISC]), perceived stress (through the Perceived Stress Scale), emotional distress (through the Hospital Anxiety and Depression Scale), burnout (through the Maslach Burnout Inventory), and secondary traumatic stress (through the Professional Quality of Life Scale). A multivariable linear regression model was used to investigate associations between CD-RISC scores and demographic, career, and lifestyle characteristics. Univariable linear regression models were used to assess the relationship between resilience scores and other mental health outcomes.

RESULTS

The strongest positive association was between CD-RISC score and overall health. The level of satisfaction with support from friends and workplace resources had positive associations with the CD-RISC score. The presence of mental illness had the strongest negative association with the CD-RISC score. Being married, working in a small animal practice, or having an associate role were negatively associated with the CD-RISC score. The CD-RISC score had negative associations with scores for perceived stress, anxiety, depression, burnout, and secondary traumatic stress.

CONCLUSIONS AND CLINICAL RELEVANCE

Models provided evidence for the role of resilience in protecting against negative mental health outcomes in veterinarians. Both personal and workplace factors were associated with resilience, presenting opportunities for intervention at each of these levels.

Comparison of food-animal veterinarians' and producers' perceptions of producer-centered communication following on-farm interactions

BACKGROUND

Human medicine has demonstrated that a patient-centered physician-patient relationship is more effective than the traditional physician-centered model. Objectives were to explore food-animal veterinarians' and producers' perceptions of producer-centered communication (VPPC and PPPC), during on-farm interactions and examine associated factors.

METHODS

A cross-sectional sample of food-animal veterinarians and their clients were recruited in Ontario, Canada. Immediately following on-farm veterinarian-producer interactions, the producer and veterinarian independently completed a questionnaire assessing PPC. Symmetry of paired responses between veterinarians and producers was examined. Employing listwise deletion, independent mixed linear regression models were developed to determine factors associated with PPPC and VPPC, respectively.

RESULTS

Two hundred and three paired veterinarian and producer survey responses were analysed. Significant asymmetry (p-value < 0.05) was observed, with veterinarians assessing PPC lower than producers. Based on data from 32 veterinarians and 159 producers, the only factor associated with PPPC was veterinarian burnout (PPPC decreased with burnout). Based on data from 32 veterinarians and 155 producers, factors positively associated with VPPC included veterinarian compassion satisfaction (VPPC increased with compassion satisfaction), length of interaction (VPPC increased with length of interaction) and producers identifying as female (VPPC higher with female producers).

CONCLUSION

Producer's positive PPPC is encouraging, yet veterinarians should be aware that mental health parameters may impact producers' and their own perceptions of PPC. Further examining veterinarians' delivery of PPC is important for food-animal practice.

Disclosure of disability or misconduct in veterinary graduate registration: balancing confidentiality, equity and stakeholder interests

BACKGROUND

Veterinary registration processes, including disclosure of disability or misconduct, vary across jurisdictions in Australasia, and there is currently no clear mechanism for the communication of registration requirements to prospective or current students. Procedures for registration of graduating students are evolving but are not necessarily responsive to conflicting imperatives for confidentiality, protection of stakeholder interests and graduate support.

OBJECTIVE

To obtain opinions from members of the veterinary profession in Australasia on issues relating to graduate registration, including communication between veterinary schools and registration bodies.

METHOD

This was an online survey.

RESULTS

Responses were received from 245 members of the profession, including employers, educators, current students, recent graduates and board members. Respondents agreed on the importance of the survey topic to all stakeholder groups, and responses reflected the complex, contestable and nuanced nature of inherent concepts. Responses were strongly polarised between individuals with an appetite for reform, improved discourse around disability and remediation of unprofessional conduct and those with concerns and experiences suggesting boards and educators could not responsibly manage processes that included increased disclosure of disability or prior conduct.

CONCLUSION

Issues related to disability and misconduct should be addressed separately in any change to registration processes. A harmonisation of registration processes across jurisdictions is desirable, but the legal implications of any potential changes require careful consideration. There is a need for improved support of disability, remediation of misconduct and a desire to promote diversity within the profession. The survey evoked strong emotions, and future discussion requires sensitivity, empathy and insight.

Exposure to animal suffering, adult attachment styles, and professional quality of life in a sample of Italian veterinarians

Contextual and individual risk factors of veterinarians’ professional quality of life are being debated. Research suggests that attachment styles are relevant predictors of professional quality of life; however, their role in work-related well-being of veterinarians is yet to be ascertained. In the present study, self-report measures on exposure to animal suffering, adult attachment styles, and professional quality of life were administered to 1,445 Italian veterinarians (70% females) aged 24 to 74 years old; sociodemographic information and information on workload were also collected. Female gender, higher levels of ordinary workload, on-call hours per week, exposure to animal suffering, together with fearful and preoccupied attachment styles were significantly associated with lower levels of veterinarians’ quality of life. This suggests that work-related factors may combine with individual psychological features in promoting or disadvantaging the professional quality of life of veterinarians. Implications of these findings for promoting veterinarians’ quality of life and directions for future research are discussed.

Public Perceptions of Veterinarians from Social and Online Media Listening

The public perception of the veterinary medicine profession is of increasing concern given the mounting challenges facing the industry, ranging from student debt loads to mental health implications arising from compassion fatigue, euthanasia, and other challenging aspects of the profession. This analysis employs social media listening and analysis to discern top themes arising from social and online media posts referencing veterinarians. Social media sentiment analysis is also employed to aid in quantifying the search results, in terms of whether they are positivity/negativity associated. From September 2017-November 2019, over 1.4 million posts and 1.7 million mentions were analyzed; the top domain in the search results was Twitter (74%). The mean net sentiment associated with the search conducted over the time period studied was 52%. The top terms revealed in the searches conducted revolved mainly around care of or concern for pet animals. The recognition of challenges facing the veterinary medicine profession were notably absent, except for the mention of suicide risks. While undeniably influenced by the search terms selected, which were directed towards client–clinic related verbiage, a relative lack of knowledge regarding veterinarians’ roles in human health, food safety/security, and society generally outside of companion animal care was recognized. Future research aimed at determining the value of veterinarians’ contributions to society and, in particular, in the scope of One Health, may aid in forming future communication and education campaigns.

The Complex Relationship Between Veterinarian Mental Health and Client Satisfaction

A relatively high risk of poor mental health has been described among Canadian veterinarians, but no published studies have explored the impact that veterinarian mental health may have on veterinary clients and patients. In order to investigate the association between veterinarian mental health and veterinary client satisfaction, veterinarians were randomly sampled and recruited throughout southwestern Ontario, Canada, from November, 2017, through January, 2019. Sixty participating veterinarians completed an enrollment survey that included psychometric scales measuring resilience, perceived stress, anxiety, depression, emotional distress, emotional exhaustion, depersonalization, personal accomplishment, burnout, secondary traumatic stress, and compassion satisfaction. Nine hundred and ninety-five companion animal clients of these veterinarians were recruited in-clinic over 2–3 days and completed a post-appointment survey including the Client Satisfaction Questionnaire. The associations between clients' satisfaction scores (as the outcome variable) and each of the veterinarians' mental health measures (as the explanatory variables) were assessed using separate, multilevel, multivariable linear regression models. The associations between client satisfaction and veterinarian mental health measures were non-linear and complex; in several of the models, relatively higher client satisfaction was unexpectedly associated with poor veterinarian mental health states, while lower client satisfaction was associated with mental health scores suggesting wellness. Given that client satisfaction may impact client adherence to medical recommendations, client loyalty, and business income, the association with veterinarian mental health may have broad implications and warrants further investigation.