The Effect of Personality on Occupational Stress in Veterinary Surgeons

Willing but Unable: Moral Distress and Burnout in Italian Veterinarians Working with Companion and Farm Animals

Veterinarians face ethical challenges during their careers, but despite evidence of work-related stress and burnout in veterinarians, moral distress has been poorly investigated. Using an online survey, professional experience, moral distress, and burnout were investigated in 704 Italian veterinarians caring for companion animals, farm animals, or both. The reliability of the moral distress questionnaire was optimal, and Factor analysis identified four factors for moral distress: I. Conflict with owner/farmer; II. Relationships with colleagues/superiors; III. Legal context/unsupportive Professional Institutions; IV. Unshared requests for euthanasia. Veterinarians reported rather low levels of moral distress but high levels of work-related stress/anxiety and a decline in empathy over time, mainly toward owners/farmers. More than 50% of veterinarians reported medium/high levels of burnout, and client-related burnout was significantly higher than animal-related burnout. Levels of work-related stress, moral distress, and burnout were higher in women, and experience exerted a protective effect. Moral distress was positively correlated with emotional exhaustion and depersonalization and, to a lesser extent, lower professional fulfillment. The relatively low level of moral distress that emerged in the study needs further investigation, especially considering the high levels of work-related stress and anxiety reported by veterinarians. Women's greater sensitivity to moral distress and burnout should not be overlooked given the progressive feminization of the veterinary profession worldwide.

High overcommitment and low reward as potential predictors for increased depressive symptoms, suicidal ideation, and suicide risk in German veterinarians

Higher rates of depression, suicidal ideation and suicide risk have been reported for veterinarians in Germany. In this study, several demographic and job-related factors were examined to determine whether they could be considered possible predictors of depression, suicidal ideation, and suicide risk. For this purpose, a survey was conducted among veterinarians in Germany. The demographic factors surveyed were gender, age, working status (employed/self-employed), income, field of work (practicing/non-practicing veterinarian), weekly working hours and community size. For assessing job-related factors, the Effort-Reward-Imbalance questionnaire (effort, reward, overcommitment), several subscales of the Copenhagen Psychosocial Questionnaire (quantitative demands, emotional demands, demands for hiding emotions, meaning of work, work-privacy-conflict, thoughts of leaving the job) and the Copenhagen Burnout Inventory were used. A hierarchical logistic regression analysis was performed with the demographic and job-related factors as independent variables and depressive symptoms, suicidal ideation, and suicide risk as dependent variables, respectively. A total of 3.118 veterinarians (78.8% female) between 22 and 69 years (mean age 41.3 years) were included in the study. The factors used resulted in the highest variance explanation for depressive symptoms (57%), followed by suicidal ideation (34%) and suicide risk (23%). Low reward and high overcommitment were found to be the most important predictors of depressive symptoms, suicidal ideation, and suicide risk. Significant relationships with depressive symptoms, suicidal ideation, and suicide risk were also found for burnout, demands for hiding emotions, and thoughts of leaving the job. The results of this study point to opportunities for changes in the veterinary working environment, for the development of prevention and intervention programs for veterinarians, and for the further development of the veterinary curriculum to strengthen the mental health of veterinarians in Germany.

Empathy and mental health in veterinary medicine

In veterinary medicine, the relationship between empathy and mental health presents a complex and important aspect of professional well-being. Veterinarians are frequently exposed to numerous work-related stressors and are therefore more likely to experience mental health disorders and commit suicide. Due to the specific nature of the profession, veterinarians deal with negative patient outcomes, inform owners of unfavourable news, handle heavy workloads, and professional isolation. Psychological stress is a result of all these factors coming together, and it can lead to anxiety, depression, burnout, and even frequently reported suicide. Animal euthanasia has been recognised as a unique professional risk factor that can have harmful psychological effects on veterinary professionals.This paper explores the role of empathy in the mental health of veterinarians and other veterinary staff, and how this might contribute to their vulnerability to psychological stress and suicidal ideation. Empathy plays an important role in interpersonal interactions, while also influencing human-animal relationships, which adds a whole new level of complexity to the doctor-patient dynamic in this field. Veterinarians are responsible for providing compassionate care for both the animals they treat and their owners. They must manage the emotionally demanding work while preserving their mental health by balancing between providing empathetic care and sustaining their own emotional boundaries. To alleviate the negative effects of psychological stress, veterinary professionals require interventions such as peer support groups, stress management training, and mental health support programmes.

Supporting Positive Learning Experiences for Veterinary Students on Rotations in Remote Indigenous Communities in Canada

Many health care programs in medicine, nursing, social work, and physiotherapy include practicum rotations near the end of students' studies. Increasingly, veterinary education programs also offer community-based rotations in underserved or remote communities. While these opportunities in veterinary medicine provide many learning benefits, they can also be stressful if the students do not feel adequately supported. The purpose of this study was to explore how veterinary students are and can be supported during rotations in remote Indigenous communities in Canada. Annually, four veterinary students from the University of Calgary Faculty of Veterinary Medicine travel with a small veterinary team to five communities in the Northwest Territories, Canada. During the 4-week rotation, students spend 2.5 weeks providing veterinary services to companion animals in these communities. In this study, 11/20 veterinary students who participated in this rotation between 2015 and 2020 completed online surveys. Results from this study suggest that participants of the rotation often felt welcomed and supported by the communities they served and were well supported by and connected to the members of the veterinary team. Findings are applicable across community-based veterinary student learning experiences and highlight the importance of building relationships with the communities being served, picking the right team, and implementing debriefing and decompressing activities during downtime.

Prevalence of mental health symptoms in Austrian veterinarians and examination of influencing factors

Although previous studies point to a high mental health burden in veterinarians, little is known about mental health in Austrian veterinarians as well as potential underlying factors of poor mental health. We assessed mental health in Austrian veterinarians, compared it to the mental health of the general population, and explored potential risk factors for poor mental health in veterinarians. A total of n = 440 veterinarians (72.0% women; mean age: 44.53 ± 11.25 years) took part in an online survey in 2022 in which validated screening tools for symptoms of depression (PHQ-9), anxiety (GAD-7), sleep disorders (ISI-2), perceived stress (PSS-4), and alcohol abuse (CAGE) were applied. Multivariable logistic regression revealed higher adjusted odds for exceeding cut-offs for clinically relevant depressive, anxiety, and insomnia symptoms in veterinarians (1.35-2.70) compared to the general population. Mental health symptoms in veterinarians were associated with female gender, physical inactivity, higher smartphone usage, higher working hours, less professional experience, and working with pets. In conclusion, it appears that veterinarians encounter mental health challenges that are more pronounced than those experienced in the general population. The teaching of strategies to improve mental hygiene as part of the curricula of veterinary education and targeted training and mentoring of employers and their team should be implemented to improve mental health in the veterinary profession.

Stress factors in veterinary medicine-a cross-sectional study among veterinary students and practicing vets in Austria

Background

Although the issue of high mental health burden among veterinarians is well-documented in previous studies, little is known about the specific occupational stress factors associated with mental health issues. Therefore, the aims of this study were twofold: (1) to assess occupational stress factors within the veterinary profession, with a particular emphasis on comparing the expectations of veterinary students with the experiences of practicing veterinarians and (2) to link the experienced stress with mental health indicators in veterinarians.

Methods

All registered veterinarians and veterinary-medicine students in Austria were invited to participate in a cross-sectional online survey. The data collection took place during the winter of 2022/2023 and included standardized questionnaires on mental well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), stress (PSS-4), and insomnia (ISI-2). Additionally, participants were asked about various estimated (students) or experienced (vets) occupational stress factors, which were to be rated on a 5-point Likert scale ranging from "not at all" to "very strongly". An open question invited respondents to identify in free text further experienced/anticipated sources of work-related stressors in veterinary practice.

Results

A total of 430 students and 440 veterinarians participated in the study. The results of a repeated measures analysis of variance (ANOVA) indicate that the burden of bureaucracy is perceived as less stressful by students than experienced by veterinarians, all other areas are perceived as more stressful by students than by veterinarians. In veterinarians, bureaucracy is experienced as the most burdensome, followed by animal suffering, and communication with animal owners. Further analysis of possible associations between the extent of perceived stressors and indicators of mental health shows that while bureaucracy is the most burdensome, it has the smallest correlation with mental health indicators. On the other hand, financial concerns, which are not ranked among the main stressors, have the strongest correlation with impaired mental health.

Conclusion

The results suggest that financial security for veterinarians is crucial to safeguard their mental health. The training of veterinary medicine students and practicing veterinarians in the areas of administration, time management, handling animal suffering, and communication with animal owners might be beneficial in reducing their job-related stressors.

Examination of Motivational Influences on Clinical-Year Veterinary Students' Career Decisions

The purpose of this study was to identify motivations for fourth-year veterinary students to choose future career paths based on post-graduation employment or post-graduation education. Approximately 500 students from four institutions were invited to participate in an online survey. Surveys were based on the cognitive evaluation theory, a minitheory within the self-determination macrotheory framework developed by Deci and Ryan. Intrinsic motivational factors were categorized by autonomy, competence, and relatedness, and extrinsic motivators were categorized by environmental and interpersonal factors. Students pursuing post-graduation education have intrinsic motivators that aligned with competence and were extrinsically motivated by a mentor, while students interested in post-graduation employment had intrinsic motivators that were more focused on autonomy with extrinsic motivational influences of debt/finances and geographic location.

Suicide in veterinary medicine: A literature review

Veterinarians are commonly exposed to occupational stressors, including excessive workload and financial constraints. These stressors can lead to psychological distress, which typically results in mental health disorders such as depression, anxiety, and burnout and can even culminate in suicide attempts or suicide deaths. Risk factors associated with poor mental health and high rates of suicide in veterinary practitioners include continuous exposure to challenging scenarios, such as interpersonal conflicts, performing euthanasia, and easy access to lethal means of suicide, such as opioids and anesthetics. The previous studies highlight the urgent need for a better understanding of predisposing factors, mental health-related improvements in the professional environment, and the subsequent establishment of primary mental health-related care policies. Effective ways to promote mental health and prevent suicide may include social support, resilience, developing coping skills, promoting a healthy work environment, and discouraging perfectionist behaviors. This review aimed to summarize findings in studies that have investigated mental health and suicide in veterinarians and veterinary students and highlight measures that could be implemented as options for mental health promotion and suicide prevention.

Assessment of Burnout, Professional Fulfillment, and Strategies for Improvement in Veterinary Faculty at a Large Academic Department

Retention and recruitment of clinical faculty is crucial for the success of quality veterinary education. Clinical faculty in busy teaching hospital environments have the potential to experience significant burnout, though few studies have focused on identifying stressors in this group. The objective of this study was to measure burnout and professional fulfillment in clinical faculty using a recently validated instrument, the Stanford Professional Fulfillment Index (PFI). The survey was distributed to faculty in July 2020, a time that coincided with the COVID-19 pandemic. The survey was completed by 80% (52/65) of survey recipients. Scores for Overall Burnout were significantly higher (p = .027) and Professional Fulfillment scores significantly lower (p < .001) for veterinary faculty when compared with a reference group of academic physicians; 61.7% (29/47) of the faculty met the criteria for burnout, and 20.4% (10/49) met the criteria for professional fulfillment. Overall Burnout and Professional Fulfillment scores were not affected by faculty rank or gender, although interpersonal disengagement was greater in faculty who had worked > 6 years at the institution (p = .032). Responses indicated that faculty valued their work and their patients but faced an excessive workload and lacked autonomy to make changes. Faculty proposed improving efficiency, increasing staffing, and distributing work to technical staff. The PFI is a brief, no-cost instrument validated for measuring burnout and fulfillment in health care workers that can be used to assess well-being among veterinary faculty. Involving faculty in suggesting interventions may yield a variety of creative and actionable options.

Intra-professional stress-demonstrating veterinarian identity in Hong Kong

OBJECTIVE

Little is known about the contributing factors of mental health among veterinarians in Hong Kong. This qualitative study aimed to examine potential contributing factors that lead to their stress and poor mental health.

PROCEDURES

Potential participants were screened and recruited using purposive and snowball sampling to maximise variations. Semi-structured interviews were conducted between December 2020 and April 2021. The data collection and analysis adopted the constructivist grounded theory's three-stage coding process and were thematically coded and analysed.

RESULTS

Eighteen veterinarians took part in the study. Intra-professional stress was classified by stressors from individual veterinarians, expectations of their workplace, and shared values among the profession. Participants expected themselves to exhibit professionalism when under low-quality workplace leadership with restrictions from the profession's institutional regulations and resources. The urbanised culture and cyberbullying phenomenon in Hong Kong contributed significantly to the stress and impacted their mental well-being.

CONCLUSION AND RELEVANCE

The quality of communication and the feasibility of meeting expectations were overarching concepts associated with intra-professional stressors. While this paper focuses on stressors residing within the veterinary community, veterinarians' responses to expectations of the animal-health enthusiast community were equally influential. This study enabled an international comparison of the profession's distress from non-Anglosphere, urbanised city, and will shed light on the development of future research and practice to improve the mental health of veterinarians, which directly influences the well-being of the animals and their owners in Hong Kong.

Reviewing a Decade of Change for Veterinarians: Past, Present and Gaps in Researching Stress, Coping and Mental Health Risks

Veterinary medicine is a highly complex profession that includes a very specific set of stressors that range from individual to social aspects, with several of them being relevant risk factors for a variety of conditions. The aim of this systematic review was to identify and cluster the material on stressors and suicidality in the veterinarian practice published during the last 10 years. The systematic review was conducted employing the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, PsycNet, Google Scholar, Medline, PsycINFO, PSYNDEX and Web of Science (2012-present) by two independent researchers resulting in the inclusion of 30 quantitative and mixed methods studies. Results of these studies on stressors were categorized using the bio-psycho-social model showing that social stressors play a prominent role. This category includes the largest number of stressors indicating that the human-human interactions in the veterinarian practice are the main stressor, underlining that training in communication techniques is a potential starting point for interventions. In addition to stressors, the results showed an additional category "psychological consequences" describing mental health disorders and suicide. Although there are still gaps in research there is enough evidence to establish more tailored health promotion measures for veterinarians.

Stress and strain among veterinarians: a scoping review

The aim of this review is to systematically review studies on work-related stress that may affect the mental health of veterinarians. Studies have indicated a high prevalence of various risk factors for mental disorders among practicing veterinarians. In addition to a high risk of suicide, there is increasing evidence of burnout and depression. A scoping review was conducted using the PubMed, MEDLINE, Scopus, Cochrane Library, Web of Science, PubPsych and PSYNDEX databases. Twenty-one studies (plus seven studies with nonstandardized questionnaires) published between 2000 and 2021 were found that presented data on the effect of workload on the mental wellbeing of veterinarians. All of the included studies indicate a high prevalence of psychological stressors in veterinary practice. The risks of burnout, anxiety and depressive disorders are higher in this occupational group than in the general population and other occupational groups. Subjectively, female veterinarians perceive their psychological workload to be higher than that of their male counterparts. Working hours and ethical dilemmas stand out as major sources of stress. There is a need to improve overall psychological wellbeing of veterinarians. Organizational support services and developing personal strategies for coping with work-related stress can prove helpful.

Medical errors: Experiences, attitudes and perspectives of incoming and outgoing final-year veterinary students in the USA

BACKGROUND

Medical errors have an impact on veterinary patient safety. Studies in human medicine suggest that students can help prevent medical errors. However, there are no studies that address the role of veterinary students in patient safety.

METHODS

An electronic survey was distributed to incoming final-year (IFY) and outgoing final-year (OFY) students at the Washington State University College of Veterinary Medicine. Response data were compared between class year groups with a Fisher's exact test and Mann-Whitney U test.

RESULTS

The response rate was 26.8% (70/261). Most respondents (85.7%) reported being present during a medical error, and 60% reported causing a medical error. The OFY group indicated lower agreement with documenting an error in the patient record and whether all errors should be disclosed. The IFY group felt more distress surrounding potential errors and sequential career implications. Compared with the IFY group, the OFY group agreed more that errors occur frequently in veterinary medicine and disagreed more that hospital staffing is adequate to ensure patient safety. Open responses recognised a need for communication training and identified that the OFY group regarded errors more actionably, whereas the IFY group viewed errors more emotionally.

CONCLUSION

Most veterinary students will experience medical errors prior to graduation, but some lack clarity around appropriate disclosure and documentation. Additional training on medical errors and error disclosure should be provided to veterinary students.

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.

What Factors Influence the Perceptions of Job Satisfaction in Registered Veterinary Nurses Currently Working in Veterinary Practice in the United Kingdom?

The Royal College of Veterinary Surgeons is dedicated to empowering registered veterinary nurses (RVNs) and ensuring that they are valued members of the workforce within the United Kingdom. However, this is not always reported by the RVNs themselves, who state that although they derive satisfaction from working with animals and within a profession that makes a difference, there are areas in which they are not currently satisfied, such as pay scale and recognition. Responses to a questionnaire were analyzed using a mixed-methods design to determine current factors affecting job satisfaction utilizing a deductive and inductive approach. The questionnaire reached 205 RVNs currently working in practice within the UK; respondents were divided between remaining at their current practice (n = 101) and finding alternative employment (n = 80). Those who stated that they were happy in their job role were more likely to want to remain there. Themes relating to positive and negative job satisfaction were reported and used to devise strategies employers and employees could use to increase or maintain RVNs' overall satisfaction. More focus is needed on support and communication within veterinary practices, support for appropriate delegation linked to recognition of the RVN role, and support from educators to prepare students for the RVN role. Although the questionnaire did not reach the targeted sample size, responses agree with previous data indicating that changes made to the RVN role in the UK have not sufficiently improved job satisfaction scores.

A randomized controlled trial of three-dimensional versus two-dimensional imaging system on duration of surgery and mental workload for laparoscopic gastropexies in dogs

OBJECTIVE

To evaluate the effect of three-dimensional (3D) laparoscopy compared to two-dimensional (2D) laparoscopy when evaluating duration of surgery for canine intracorporeally sutured gastropexy.

STUDY DESIGN

Randomized controlled clinical trial.

ANIMALS

Thirty client-owned dogs.

METHODS

Dogs were randomized into 2D or 3D groups and underwent a three-port laparoscopic intracorporeally sutured incisional gastropexy with barbed suture. Procedures were performed by a single board-certified surgeon. Duration of surgery was recorded and workload was assessed immediately after surgery using the NASA Task Load Index (TLX).

RESULTS

Median duration of surgery was 3 min shorter for 3D versus 2D (95%CI -10 to 13; p = .51). Surgical component durations, total and component TLX scores, and intraoperative complications also did not differ between groups. In a subgroup analysis excluding the first eight cases due to presumption of a learning curve with suturing technique, total TLX score (p = .004) and all component scores were lower for 3D as compared to 2D laparoscopy, although duration of surgery did not differ (p = .20).

CONCLUSION

The use of 3D laparoscopy was not associated with shorter duration of surgery when compared to 2D laparoscopy.

CLINICAL SIGNIFICANCE

3D laparoscopy requires further investigation in veterinary medicine to determine its utility in decreasing surgical duration, surgical complications or surgeon mental or physical workload.

A preliminary study on assessment of wellbeing among veterinary medical house officers

Mental wellness is an important topic among practicing veterinarians. Peer reviewed studies focusing on veterinary house officers' wellbeing are lacking in veterinary medicine. The aim of this study was to assess wellbeing of house officers using validated surveys for anxiety, burnout, depression, and quality of life. A cross-sectional survey of 103 house officers (residents, interns, and fellows) was performed. Respondents were invited to voluntarily complete the online surveys. Anxiety, burnout, depression, and quality of life were assessed using the Generalized Anxiety Disorder (GAD-7), Maslach Burnout Inventory (MBI), Patient Health Questionnaire (PHQ-9), and Short Form-8 (SF-8), respectively. Descriptive statistics were calculated. For qualitative analysis, respondents were requested to rate their perception of the level of stress regarding various work-related stressors. The first survey was completed in 2017 with 60 respondents of which 51 (85%) identified as females and nine (15%) identified as males. The second survey was completed in 2018 with 43 respondents of which 35 (81.4%) identified as females and 8 (18.6%) identified as males. Respondents reported high levels of burnout characterized by high levels of emotional exhaustion and lack of personal accomplishment but reported mild levels of anxiety and depression. The mental component of their quality of life score was lower than the general US population, whereas the physical component score was consistent with the general US population. Respondents indicated moderate scores of stress for concerns regarding patient management, research, teaching, work-life balance, relationships, organizational skills, time management, finances, and the mental and emotional impact of the work environment. The high levels of burnout, and low mental quality of life in house officers require specific intervention programs to improve wellbeing.

Factors associated with job satisfaction and engagement among credentialed small animal veterinary technicians in the United States

OBJECTIVE

To investigate job satisfaction and engagement among credentialed veterinary technicians (CVTs) employed in the United States.

SAMPLE

873 CVTs who responded to an internet-based survey in 2017.

PROCEDURES

A survey was conducted to collect information on demographics, individual engagement, and job satisfaction among a convenience sample of CVTs in the United States. Only responses from those employed in small animal practice were included. Demographic and job-related factors were evaluated for associations with individual engagement and job satisfaction.

RESULTS

The mean (SD) score for overall individual engagement (7-point Likert scale, with 7 representing strong engagement) was 4.9 (1.0) and for job satisfaction (7 representing extreme satisfaction) was 5.4 (1.5). Factors associated with lower individual engagement and lower job satisfaction included most frequently working overnight shifts and having more veterinarians in the respondent's practice, whereas holding a supervisory role, receiving a higher hourly wage, and having more veterinary technicians in the practice were significantly associated with higher individual engagement and higher job satisfaction, with other variables held constant. Having a veterinary technician specialist designation was not associated with individual engagement or job satisfaction.

CONCLUSIONS AND CLINICAL RELEVANCE

To the authors' knowledge, this was the first study to investigate factors associated with individual engagement and job satisfaction among CVTs in the United States. Employers should review these factors and support and enhance those associated with enhanced engagement and increased job satisfaction. Employers should regularly review factors identified as negatively associated with job satisfaction and engagement and do their best to mitigate them.

Evaluation of team effectiveness and personal empathy for associations with professional quality of life and job satisfaction in companion animal practice personnel

OBJECTIVE

To examine variables of veterinary team effectiveness and personal empathy for associations with professional quality of life (ie, compassion satisfaction, burnout, and secondary traumatic stress) and job satisfaction in companion animal practice personnel.

DESIGN

Cross-sectional survey.

SAMPLE

Data from 232 surveys completed by personnel from 10 companion animal veterinary practices in 2 regions of the United States between April 7 and December 20, 2016.

PROCEDURES

Online surveys were used to collect practice-level data (eg, practice type, setting, and staffing) and individual-level data (eg, demographics, job position, and years in the position and profession). Instruments used in developing the surveys included the Team Effectiveness Instrument, Davis Interpersonal Reactivity Index, Professional Quality of Life Scale, and a measure for job satisfaction. Data were evaluated for associations with professional quality of life and job satisfaction.

RESULTS

Individual engagement was positively associated with job satisfaction, negatively associated with secondary traumatic stress, and moderated by levels of personal distress for compassion satisfaction and burnout. Toxic team environment was positively associated with burnout and negatively associated with job satisfaction. Empathetic concern and personal distress were both positively associated with secondary traumatic stress. Empathetic concern was moderated by team engagement for compassion satisfaction.

CONCLUSIONS AND CLINCAL RELEVANCE

Results indicated that variables influencing professional quality of life and job satisfaction were multimodal and included aspects of team effectiveness and empathy; therefore, workplace strategies that enhance individual and team engagement and mitigate toxic team environments could potentially improve professional quality of life and job satisfaction in veterinary personnel.

Characteristics of Veterinary Students: Perfectionism, Personality Factors, and Resilience

Perfectionism is a topic relevant to veterinary medicine and has previously been found to be related to higher levels of stress and poorer mental health outcomes. However, many aspects of perfectionism have yet to be researched among veterinary students. This research investigates the relationship between perfectionism and the "Big Five" personality factors. Additionally, the relationship between resilience and neuroticism is addressed. This research includes a sample of 99 veterinary students enrolled at a College of Veterinary Medicine in the southeastern United States. Students completed the Multidimensional Perfectionism Inventory (MPI), the Big Five Inventory (BFI), and the Brief Resilience Scale (BRS). Results show that perfectionism is significantly correlated with personality factors; specifically, self-oriented perfectionism and socially prescribed perfectionism are associated with neuroticism, socially prescribed perfectionism is associated with agreeableness, and self-oriented perfectionism is associated with conscientiousness. Neuroticism was found to have a significant negative correlation with resilience. Findings indicate that veterinary mental health professionals and educators should consider implementing specific strategies to help students develop a healthy balance in their perfectionistic beliefs and have targeted interventions to promote student resilience.

Veterinary Technicians and Occupational Burnout

Burnout and compassion fatigue are common conditions affecting health care providers. Unique occupational conditions in veterinary medicine make technicians especially susceptible to burnout. A total of 1,642 practicing veterinary technicians completed an anonymous online survey comprised of demographic questions, and two tools to assess burnout: the Maslach Burnout Inventory-General Survey (MBI-GS) and the Stanford Professional Fulfillment Index (PFI). Over half of participants (862/1479, 58.3%) had EE scores over the 3.0 threshold for burnout. On the PFI, the total score for the 10 burnout questions was x = 1.54 (SD = 0.75), which is above the 1.33 cutoff for burnout. The mean score of 2.26 (SD = 0.81) on the professional fulfillment scale is also indicative of burnout. The relationship between enabling resources and scores on each MBI-GS scale was analyzed. Schedule control was the most significant predictor of lower EE scores. The perception of adding value to the practice was associated with lower scores on the CY scale and higher scores on the PE scale. Given the correlation between burnout and environmental factors, veterinary practices are encouraged to explore non-monetary mechanisms for enhancing job satisfaction. This includes giving technicians greater control over their schedules, recognizing their contributions to the team, and providing opportunities for professional development. From a morale standpoint, destigmatizing the dirty work done by technicians can also help combat burnout among veterinary technicians.

Cross-Sectional Assessment of the Emotional Intelligence of Fourth-Year Veterinary Students and Veterinary House Officers in a Teaching Hospital

Emotional intelligence (EI) is the recognition and management of emotions. This skill set is important to work relationships and professional success. In this cross-sectional, observational study, we investigated EI scores of 4th-year veterinary students, interns, and residents in a teaching hospital, using a psychometric tool with professional population norms. Participants' EI scores were compared with professional norms and between the sample groups. Scores were examined on the basis of demographics and residency program type. Twenty-four 4th-year students and 43 interns and residents completed the survey. Total, composite, and subscale scores for all groups were lower than professional means. We noted no statistically significant differences in EI scores between training levels, but evaluation of effect sizes showed a medium negative effect of higher training levels on Self-Perception Composite, Self-Regard, Emotional Expression, Interpersonal Composite, Flexibility, and Optimism and a medium positive effect of higher training levels on Impulse Control. Medium effects for residency type were found for Stress Tolerance, Flexibility, and Stress Management, with higher scores for residencies with heavy inpatient loads. Medium effects for residency type were found on Flexibility scores, with higher scores for residents in disciplines with a perceived high stress level. We found that baseline EI scores of 4th-year veterinary students, interns, and residents at a teaching hospital were similar to, but uniformly lower than, those of other professionals and did not increase with training level. These results may be used to build on strengths and address weaknesses associated with EI of students and house officers at this institution.

Suicide among veterinarians in the United States from 1979 through 2015

OBJECTIVE To assess proportionate mortality ratios (PMRs) for suicide among male and female US veterinarians from 1979 through 2015. DESIGN PMR study. SAMPLE Death records for 11,620 veterinarians. PROCEDURES Information for veterinarians who died during 1979 through 2015 was obtained from AVMA obituary and life insurance databases and submitted to a centralized database of US death records to obtain underlying causes of death. Decedent data that met records-matching criteria were imported into a software program for calculation of PMRs for suicide stratified by sex and indirectly standardized for age, race, and 5-year calendar period with 95% confidence intervals. RESULTS 398 deaths resulted from suicide; 326 (82%) decedents were male, 72 (18%) were female, and most (298 [75%]) were ≤ 65 years of age. The PMRs for suicide for all veterinarian decedents (2.1 and 3.5 for males and females, respectively), those in clinical positions (2.2 and 3.4 for males and females, respectively), and those in nonclinical positions (1.8 and 5.0 for males and females, respectively) were significantly higher than for the general US population. Among female veterinarians, the percentage of deaths by suicide was stable from 2000 until the end of the study, but the number of such deaths subjectively increased with each 5-year period. CONCLUSIONS AND CLINICAL RELEVANCE Results of the study indicated that PMRs for suicide of female as well as male veterinarians were higher than for the general population. These data may help to inform stakeholders in the creation and implementation of suicide prevention strategies designed for veterinarians.

Development and validation of a Burden Transfer Inventory for predicting veterinarian stress related to client behavior

OBJECTIVE To develop and validate a Burden Transfer Inventory (BTI) of stressful client behaviors and to evaluate whether those behaviors are associated with client caregiver burden and contribute to veterinarian stress and burnout. DESIGN 3-stage cross-sectional psychometric validation study. SAMPLE 1,151 small animal veterinarians and 372 dog and cat owners. PROCEDURES During stage 1, a pool of 34 items representing stressful client behaviors was created through open-ended surveys of practicing veterinarians and 3 phases of pilot testing. During stage 2, 1,151 veterinarians recruited through the Veterinary Information Network completed a survey including those behavior items and validated measures of stress and burnout. Completed surveys were randomly assigned to either a measure development or validation database for factor and item analyses. Data were then combined to determine whether the BTI was correlated with measures of stress and burnout. During stage 3, owners of dogs and cats with a serious illness completed an online survey to assess how frequently they engaged in each BTI item as well as a validated measure of caregiver burden. RESULTS For dog and cat owners, there was a significant positive correlation between caregiver burden and the frequency that those owners reported engaging in BTI items. The frequency that veterinarians reported encountering BTI items was positively correlated with measures of stress and burnout, which suggested burden transfer from owners to veterinarians. The extent to which veterinarians reported being bothered by BTI items was a more robust predictor of stress and burnout than the frequency with which those items occurred. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated the BTI can be used to understand how client behaviors associated with caregiver burden affect veterinarian stress and burnout. The BTI may be useful to identify specific stressors affecting individual veterinarians and how they react to those stressors.

The Validity of Daily Self-Assessed Perceived Stress Measured Using Smartphones in Healthy Individuals: Cohort Study

Background

Smartphones may offer a new and easy tool to assess stress, but the validity has never been investigated.

Objective

This study aimed to investigate (1) the validity of smartphone-based self-assessed stress compared with Cohen Perceived Stress Scale (PSS) and (2) whether smartphone-based self-assessed stress correlates with neuroticism (Eysenck Personality Questionnaire-Neuroticism, EPQ-N), psychosocial functioning (Functioning Assessment Short Test, FAST), and prior stressful life events (Kendler Questionnaire for Stressful Life Events, SLE).

Methods

A cohort of 40 healthy blood donors with no history of personal or first-generation family history of psychiatric illness and who used an Android smartphone were instructed to self-assess their stress level daily (on a scale from 0 to 2; beta values reflect this scale) for 4 months. At baseline, participants were assessed with the FAST rater-blinded and filled out the EPQ, the PSS, and the SLE. The PSS assessment was repeated after 4 months.

Results

In linear mixed-effect regression and linear regression models, there were statistically significant positive correlations between self-assessed stress and the PSS (beta=.0167; 95% CI 0.0070-0.0026; P=.001), the EPQ-N (beta=.0174; 95% CI 0.0023-0.0325; P=.02), and the FAST (beta=.0329; 95% CI 0.0036-0.0622; P=.03). No correlation was found between smartphone-based self-assessed stress and the SLE.

Conclusions

Daily smartphone-based self-assessed stress seems to be a valid measure of perceived stress. Our study contains a modest sample of 40 healthy participants and adds knowledge to a new but growing field of research. Smartphone-based self-assessed stress is a promising tool for measuring stress in real time in future studies of stress and stress-related behavior.

Moral distress in veterinarians

Moral distress is a psychological state of anguish that has been widely studied in healthcare professionals. Experiencing moral distress can lead to problems including avoidance of patients and increased staff turnover. Moral distress in veterinarians has not yet been explored to the extent seen in the human medical field, and there is limited data regarding moral distress in veterinarians. However, it is expected to be prevalent in these professionals. So far, it has been reported that veterinarians commonly experience moral conflict, ethical challenges and ethical dilemmas during their career. These conflicts in association with other modifying factors such as personality traits can lead to the experience of moral distress. In a profession with known levels of occupational stress and reported mental health problems, exploring the area of moral distress and its effects on the professional wellbeing of veterinarians is important. Further studies such as developing a moral distress scale to measure this issue are needed in order to evaluate the incidence of this problem in veterinary professionals. Furthermore, assessing a possible relationship between moral distress, mental illness and attrition in veterinarians would be useful in developing intervention strategies to minimise the experience of moral distress and its associated negative consequences in veterinarians.

Sources of work stress in veterinary practice in the UK

The veterinary profession recognises the importance of addressing work-related stress for veterinary surgeons' wellbeing. Identifying aspects of veterinarians' work that are sources of stress is a key step in implementing appropriate stress management interventions for the profession. However, little systematic research on the causes of stress in veterinary work has been carried out. A qualitative interview study was conducted with 18 veterinarians practising in the UK to explore aspects of their work that are stressful. Thematic analysis revealed principal stressors to be poor work-life balance, interaction with animal owners, specific aspects of euthanasia, dealing with poor animal welfare and staff management responsibilities. Injury risk, supervision arrangements for newly qualified veterinarians and lack of control over work were stressors for some. The practical implications of the findings for stress management in veterinary work are considered. Comments by several participants indicated a strong achievement focus and possible perfectionism. It is proposed that veterinarians with perfectionist traits might experience greater psychological distress in the face of some specific stressors in veterinary practice, and further investigation of possible interactive effects of work stressors and perfectionism on veterinarians' wellbeing is merited.

Psychological and social outcomes of sport participation for older adults: a systematic review

Sport participation is well known to promote health outcomes for children and adolescents. Nevertheless, there is insufficient evidence about the psychological and social outcomes of sport participation for older adults. This article provides the results of a systematic review of the psychological and social outcomes of sport participation for older adults. A systematic review of seven electronic databases was conducted and a total of 21 studies published that attended to psychological and/or social health benefits from sport participation of older adults (50 years old and over) were included. The outcomes of older adults’ sport participation included life satisfaction, depression, anxiety, stress, mood state, hedonistic values, socialisation, competition, and personal psychological outcomes such as personal empowerment, self-confidence, self-esteem and resistance to the negative view of ageing. Future studies are needed to conceptualise and operationalise the different levels of involvement of sport participation.

Being Nice Is Not Enough-Exploring Relationship-Centered Veterinary Care With Structural Equation Modeling. A Quantitative Study on German Pet Owners' Perception

During the last years, the philosophy of relationship-centered care gained increasing attention in veterinary medicine. Relationship-centered care is based on a joint venture between pet owner and veterinarians and therefore offers the opportunity to satisfy the pet owners' need for participation in medical decision-making and to provide the best care for the patient. Although research on relationship-centered care in the veterinary consultation is still limited, the available findings suggest that the characteristics of relationship-centered care reflect the pet owners' expectations on satisfactory veterinary care. In this study a quantitative survey was conducted among German pet owners that collected information regarding their perception of the veterinarians' communication during the last appointments. Questionnaires were available online and paper-based. Data were analyzed using exploratory factor analysis and structural equation modeling using SAS. First aim of the study was to explore structural equation modeling (SEM) as an opportunity to evaluate quantitative data in the field of research on relationship-centered care. Further, SEM was used to evaluate associations between the implementation of different characteristics of relationship-centered care in the veterinary practice (empathic communication, partnership-building) and latent outcome variables regarding the pet owners (pet owners' need for further information, consultation of competing health care providers). N = 1,270 valid questionnaires were completed. Participants owned small companion animals (55.6%), horses (7.6%), or both (36.9%) within the last 2 years. Results of SEM suggest that partnership-centered and empathic communication decreased the pet owners' needs for further information (e.g., from online sources) and their need to consult alternative health providers (e.g., homeopaths). Especially addressing the pet owners' worries and fears, discussing pros and cons of diagnostic and therapeutic options as well as providing the required amount of information were shown to be large influence factors within the model. Therefore, veterinarians are recommended to implement the concept of partnership-centered care in their daily practice, for it may increase pet owners' loyalty and satisfaction. Results may motivate future research in this field. Further development of the proposed model assumptions may enable valuable progress in the field of quantitative research on relationship-centered care.

Evaluation of a coaching workshop for the management of veterinary nursing students' OSCE-associated test anxiety

Background

High stress levels amongst undergraduates (particularly in relation to assessment) and efforts to improve mental wellbeing have been increasingly reported in the veterinary educational literature. However reports to date have primarily focused on the experiences of students of veterinary medicine, rather than veterinary nursing students.

Methods

The purpose of this mixed method sequential explanatory study was to establish the "Big-five" personality traits and quantify the level of test anxiety associated with objective structured clinical examinations (OSCEs) amongst a cohort of 23 final year veterinary nursing students at an Irish third level college. The 12 item Brief FRIEDBEN Test Anxiety Scale (B-FTAS) and the 20 item mini International Personality Item Pool (mini-IPIP) were used to identify test anxiety levels and personality traits in this cohort. Focus groups were then employed to examine the effectiveness of a coaching intervention in ameliorating this test anxiety.

Results

The initial, quantitative, phase found these students to have higher levels of test anxiety than previously reported for undergraduates sitting written examinations. No association was found between test anxiety and neurotic personality traits in this student cohort. In the qualitative follow up phase the coaching intervention was reported to have been helpful in equipping the students to better manage test anxiety. The OSCE stressors identified in this study closely resembled those previously reported by nursing and midwifery students.

Conclusions

The shared experience of the coaching intervention and formative OSCE was reported to have been helpful in empowering the students to manage assessment-associated anxiety. Implications and recommendations for educators were identified.