Psychological well-being of Australian veterinarians

Objective   To use established psychological scales to measure levels of distress, anxiety and depression in veterinarians, and compare these levels between different veterinary subgroups and other professional groups.
Methods   A cohort of veterinarians was identified through contact with veterinary schools in Australia. Participants completed a self-reporting questionnaire that included queries about general health and demographics, psychological well-being, job-specific perceptions of health, dispositional characteristics and social support.
Results   Of the 2125 respondents who completed the psychological questionnaire, approximately one-third reported poor psychological health. Increasing age, increasing time in current job, increasing years since graduation and male gender was associated with fewer signs of distress, anxiety and depression. Compared with the general population, veterinarians experienced more negative emotions at work, but were similar to other professional groups.
Conclusions   Poor psychological health is common in the profession and professional veterinary bodies may wish to consider providing training in dealing with work-related distress, anxiety and depression.     

Failure to acknowledge high suicide risk among veterinarians

A high suicide risk has been reported among veterinarians in comparison to the general population. Postulated causes have included depression, substance abuse, work-related stress, reluctance to admit psychiatric problems, and access to lethal drugs and/or familiarity with euthanasia. Members of the Student Chapter of the American Veterinary Medical Association (AVMA), all veterinarians licensed in Alabama, and all US veterinary-association executive directors were surveyed regarding their attitudes concerning mental health issues, including veterinarian suicide. Only 10% of veterinary student respondents (N=58) believed that suicide risk is higher among veterinarians than in the general population. Of the 22 state associations' executive directors who participated in the survey, 37% believed that suicide is a significant concern for veterinarians and only 44% indicated that a veterinary wellness program was available in their respective states. Of the 1,455 licensed veterinarians in Alabama, 701 responded to the survey; 11% of respondents believed that suicide among veterinarians was a problem. In addition, 66% of respondents indicated that they had been "clinically depressed," but 32% of those with depression had not sought treatment. More females (27%) than males (20%) admitted that they had "seriously considered suicide" (p<.01). Female veterinarians were more likely than male veterinarians (15% versus 7%) to indicate that they were "not sure they'd made the right career choice" (p<.001), and 4% of all respondents indicated "definitely not being happy with their career." It is of concern that veterinarians not only have a higher risk of suicide but that they also have fewer support structures. The wide discrepancies between the published risk of suicide for veterinarians and their own views of their risk suggests an inadequate awareness of their own mental health vulnerability which could put them at higher risk.     

Musculoskeletal disorders and psychosocial risk factors among veterinarians in Queensland, Australia

Objective   Although musculoskeletal disorders (MSD) represent one of the most important occupational health issues in contemporary society, few studies have specifically investigated this problem among veterinarians.
Design   An anonymous questionnaire survey mailed to all veterinarians registered with the Veterinary Surgeons Board of Queensland during 2006.
Results   Almost two-thirds of respondents (63%) had experienced MSD of the lower back, 57% had experienced neck-related MSD, 52% had experienced shoulder-related MSD and 34% had experienced MSD of the upper back during the previous 12 months. MSD was statistically correlated with a range of psychosocial factors, including stress associated with career structure, time pressures, client's attitude, lack of recognition by the public, lack of recognition by colleagues, lack of understanding from family or partners and work stress because of insufficient holidays each year.
Conclusion   Overall, this study has demonstrated significant correlations between MSD and psychosocial risk factors among a large cohort of veterinarians, apparently for the first time in the published literature. The results also suggest that personal and workplace issues may contribute more to the development of MSD among veterinarians than many of the previously recognised ergonomic risk factors.     

Workplace stress, mental health, and burnout of veterinarians in Australia

Objective To determine the frequency of the states of depression, anxiety, stress and burnout using internationally validated methods and to relate these to the demographic characteristics of veterinarians in Australia. Methods A postal survey of registered veterinarians with at least one year's experience and whose address was available; 1947 returned the questionnaire providing data for analysis. Results Overall, veterinarians describe higher levels of depression, anxiety, stress and burnout than the general population. The severity of these states was determined by gender, background, type of practice and years after graduation. Conclusions Modifying the curricula of veterinary schools to include the teaching of personal cognitive and coping skills to undergraduate veterinary students, the provision of the opportunity to enhance these skills throughout their veterinary career and changes in the veterinary workplace could result in improved mental health, increased job engagement and work satisfaction.     

Workplace bullying and relationships with health and performance among a sample of New Zealand veterinarians

AIM: To examine the relationships between workplace bullying, destructive leadership and team conflict, and physical health, strain, self-reported performance and intentions to quit among veterinarians in New Zealand, and how these relationships could be moderated by psychological capital and perceived organisational support.

METHODS: Data were collected by means of an online survey, distributed to members of the New Zealand Veterinary Association. Participation was voluntary and all responses were anonymous and confidential. Scores for the variables measured were based on responses to questions or statements with responses categorised on a linear scale. A series of regression analyses were used to assess mediation or moderation by intermediate variables on the relationships between predictor variables and dependent variables.

RESULTS: Completed surveys were provided by 197 veterinarians, of which 32 (16.2%) had been bullied at work, i.e. they had experienced two or more negative acts at least weekly over the previous 6 months, and nine (4.6%) had experienced cyber-bullying. Mean scores for workplace bullying were higher for female than male respondents, and for non-managers than managers (p<0.01). Scores for workplace bullying were positively associated with scores for destructive leadership and team conflict, physical health, strain, and intentions to quit (p<0.001). Workplace bullying and team conflict mediated the relationship between destructive leadership and strain, physical health and intentions to quit. Perceived organisational support moderated the effects of workplace bullying on strain and self-reported job performance (p<0.05).

CONCLUSIONS: Relatively high rates of negative behaviour were reported by veterinarians in this study, with 16% of participants meeting an established criterion for having been bullied. The negative effects of destructive leadership on strain, physical health and intentions to quit were mediated by team conflict and workplace bullying. It should be noted that the findings of this study were based on a survey of self-selected participants and the findings may not represent the wider population of New Zealand veterinarians.     

Sources and frequency of use of pet health information and level of confidence in information accuracy, as reported by owners visiting small animal veterinary practices

OBJECTIVE: To gain a better understanding of sources and frequency of use of pet health information accessed by owners and assess the level of confidence in information accuracy as reported by pet owners who visit their veterinarians. DESIGN: Prospective study. SAMPLE POPULATION: 412 participants from 17 small animal veterinary clinics. PROCEDURES: Questionnaires pertaining to pet owners' habits related to pet health information (sources and frequency of their use and confidence in accuracy of information accessed) were distributed by front desk staff at 17 participating veterinary clinics. A cover letter was included with each survey that offered instructions for completion and assured respondents of their anonymity. All completed surveys were placed in an envelope and returned to the researchers for analysis. RESULTS: Results indicated that pet owners who visited their veterinarians acquired pet information from veterinarians via the telephone or in person and from family or friends more frequently than they acquired such information from the World Wide Web. Pet owners also reported more confidence in information received from veterinarians (in person and via telephone conversations), compared with information from any other accessible source. CONCLUSIONS AND CLINICAL RELEVANCE: The use of Web sites by owners as sources of pet health information will undoubtedly continue to grow. Veterinarians can play a more proactive role in helping pet owners to access reliable Web sites that provide useful pet health information, thereby providing a benefit to all parties.     

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.     

Difficult interactions with veterinary clients: working in the challenge zone.

As veterinarians, effective interactions with clients and coworkers are fundamental to our professional satisfaction and success. This article first reviews the basis of a difficult interaction and provides specific communication skills to help the veterinarian more successfully manage situations that he or she may find difficult. Then, the authors offer exercises to assist veterinarians in practicing these skills. The information in this article relies closely on the work provided through the Bayer Animal Health Communications Project.     

Perceived importance and integration of the human-animal bond in private veterinary practice

OBJECTIVE: To determine perceptions of the human-animal bond (HAB) among veterinarians in private practice and evaluate how these veterinarians incorporate the HAB in their practices. DESIGN: Survey. SAMPLE POPULATION: 1,602 veterinarians in private practice in Washington state. PROCEDURE: Participants were contacted and asked to complete a survey. RESULTS: Response rate was 26% (415/1,602). Most respondents agreed that veterinarians will be more successful if they recognize and facilitate the HAB, that facilitating the HAB was important to their practices, that they actively evaluated the degree of bonding between clients and their animals, and that the bonding between a client and his or her animal affected the way they practiced medicine. However, > 50% of respondents did not train veterinary technicians and front office staff members in the HAB or encourage veterinary technicians or front office staff members to learn about the HAB. Fifty-one percent of respondents offered few or no HAB resources to clients. When asked to quantify the importance of 10 nontechnical skills associated with private veterinary practice, respondents ranked communication skills, ethical reasoning, and business management first, second, and third; the HAB was ranked fifth. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that for veterinarians in private practice in Washington state, there is a dichotomy between how important they consider the HAB to be in their practice and the degree to which they facilitate the HAB with regard to communication, training, and client resources. More research on the HAB is necessary to better understand what the HAB encompasses and its implications for private practitioners.     

Perceptions of Livestock Owners of Private Veterinary Practice in Ghana

Using the participatory appraisal approach, a study was designed to assess the perceptions of livestock owners on private delivery of veterinary services in two districts in the major livestock-producing area in Ghana. A significant proportion (74%, n = 180) were willing to patronize locally established veterinary practices. However, the respondents emphasized that the fees charged had to be reasonable and affordable. Factors identified as likely to discourage the use of the private provider included the inability of the provider to speak the local language; non-availability of credit facilities for services rendered by the provider; unreliability of personnel; poor interpersonal skills; lack of technical know-how; inability of the provider to make house calls or farm visits; and poor personal and work ethics. These findings provide information for prospective private veterinarians on the expectations of their clients and could be used in the preparation of veterinarians for private practice.     

A cross-sectional survey on wounds in horses in New Zealand

AIM: To determine the frequency and type of skin wounds encountered by New Zealand veterinarians in their equine patients, the duration and estimated costs of treatment as well as the expected outcomes for these wounds.

METHODS: An online survey was sent to all veterinarians registered with the New Zealand Equine Veterinary Association. The survey comprised questions on the location and experience of respondents, the number of wound-related cases in relation to the total equine caseload, the type and anatomical location of wounds treated, the frequency, duration and costs of treatments, the outcome of wound treatment and an estimate of the most common causes of death or euthanasia in their equine patients.

RESULTS: The survey response rate was 110/262 (41.9%). The median number of equine cases seen by respondents was 20 (interquartile range (IQR) 6–60) per month; of these, five (IQR 2–10) were wound related. Wounds ranked third after lameness and respiratory disease for the relative frequency with which respondents encountered them. Of 102 respondents 59 (58%) reported that their clients frequently treated wounds incurred by their horse without consulting a veterinarian. Wounds on the distal limb, whether involving only the skin or also deeper structures, were reported by 86/101 (85%) respondents as the most frequently encountered. Wounds in this location also incurred the longest treatment period and were the most prone to develop complications. Finally, wounds ranked second, after colic, as the most common cause of death/euthanasia in the veterinary respondents’ equine patients.

CONCLUSIONS: The data obtained via the survey indicate that skin wounds, particularly on the distal limb, are a common occurrence in horses in New Zealand and, when they involve structures underlying the skin, are costly and time-consuming to manage and may lead to decreased performance, retirement or euthanasia. Consequently, we recommend that more effort be devoted to the education of equine veterinarians and owners, and that appropriate research funds be allocated to help improve patient outcomes.     

A. Leslie,F.R.C.V.S.

Extract

In the passing of Allan Leslie, New Zealand veterinarians have lost one of their most capable protagonists and friends.     

Australian veterinarians who work with horses: attitudes to work and career

OBJECTIVE: To describe the attitudes to their work and career of those Australian veterinarians who work with horses. METHOD: Questionnaires were mailed to 866 veterinarians who had been identified as working with horses, and 87% were completed and returned. Data were entered onto Excel spreadsheets, and analysed using the SAS System for Windows. RESULTS: The main attractions of veterinary work with horses were the horses themselves and the equine industries, but working outdoors and with rewarding clients, and the satisfaction of successful outcomes were attractions for many. The list of disadvantages was longer, and included unreasonable and disagreeable clients as well as those who provided inadequate facilities, could not control their horses or did not care for them. The physical demands and risks of injury, the amount of time required, low rates of return and difficulties in collecting payment, were other major disadvantages. Some mentioned concerns about litigation, unethical behaviour, and recruiting and retaining veterinarians competent with horses. For many in mixed practice, the difficulties in affording modern equipment, and of developing and maintaining their own competence with horses, was a real concern. More than three-quarters of the respondents reported that their careers had lived up to expectations and that they would become veterinarians again; 70% of equine veterinarians would become an equine veterinarian again. Almost all (93%) of the respondents were either very glad, or 'generally glad though with some misgivings' that they had done the veterinary course. Older veterinarians reported suffering less stress, and being more content with their career, than younger colleagues. CONCLUSIONS: The advantages of doing veterinary work with horses outweigh the disadvantages for most veterinarians, especially those well advanced in their careers.     

Skills required of dairy veterinarians in western Canada: A survey of practicing veterinarians

This study determined skills required of entry-level veterinarians for dairy practice in western Canada and compared mixed and dairy practitioners in the skills that they perform. We surveyed western Canadian veterinarians involved in dairy practice, focusing primarily on clinical activity of respondents. Response rate was 39.4% (281/714). Respondents were classified as either mixed practitioners (< 10% time in dairy practice) or dairy practitioners (> 75% time in dairy practice). For both groups, individual animal medicine and surgery skills were performed more commonly than herd health skills. The most important skills identified were those required for basic theriogenology, physical examination, treatment of common disorders, and general surgery. These results underscore the continued importance of individual animal skills in food animal practice in western Canada.     

Animal abuse and family violence: survey on the recognition of animal abuse by veterinarians in New Zealand and their understanding of the correlation between animal abuse and human violence

AIMS: To establish the incidence, frequency and type of deliberate animal abuse seen in veterinary practice in New Zealand, and ascertain veterinarians' knowledge of human abuse within the families where animal abuse was occurring. To explore attitudes of veterinarians to and knowledge about the correlation between animal abuse and human violence, and their perceived role in dealing with such issues. METHODS: A postal questionnaire was sent to practising veterinarians in New Zealand. It covered demographics, frequency and type of animal abuse cases seen, awareness of violence towards humans, within families where animal abuse was seen, the methods used for managing animal and human abuse, the incidence of psychological abuse of animals, and the attitudes of veterinarians towards and their beliefs about the link between animal abuse and human violence. RESULTS: A total of 383/1,412 (27% response rate) questionnaires with useable data were returned. Within the group of respondents, the sexes were evenly represented; 40% of respondents worked in small-animal practice, 50% in mixed practice and 10% in large-animal practice. Deliberate animal abuse had been seen by 63% of respondents in the last 5 years; 37% of these had seen such cases once a year or less, while 9% had seen abuse cases at least four times a year. Dogs were the species most commonly reported as abused, followed, in numerical order, by cats, cattle and horses. Among respondents who had seen deliberate animal abuse, 16% either knew of (4%) or suspected (12%) human abuse within the families of the abused animals. A clear majority of responding veterinarians agreed with the statement that people who abuse their animals are more likely to abuse their children (77%) or spouse (70%). CONCLUSIONS: The survey indicated that the majority of respondents had seen cases of animal abuse within the previous 5 years, and dogs were the species most often reported abused. Responding veterinarians felt a strong ethical duty to deal with cases of animal abuse, but they were less comfortable about issues of human abuse, even though the awareness of the link between abuse of animals and abuse of humans was relatively high. CLINICAL RELEVANCE: The greater the awareness of animal abuse and its linkage with human abuse, the greater the possibility that veterinarians can contribute in a meaningful way to the reduction of violence in society.     

Current attitudes to,and use of,peri-operative analgesia in dogs and cats by veterinarians in New Zealand

AIM: To investigate the attitudes of veterinary practitioners in New Zealand to pain and analgesia, and their use of analgesic drugs, in dogs and cats.

METHODS: A questionnaire posted to 1,200 practising veterinarians was used to gather information about the use of analgesia in dogs and cats, assessment of pain, attitudes to pain relief, analgesic drugs and procedures used, factors affecting choice of analgesic agent, and veterinary demographics, continuing education and staffing.

RESULTS: Three hundred and twenty questionnaires with useable data were returned, a response rate of 28%. Male and female veterinarians were evenly represented. The analgesic agents most commonly used were morphine (opioids) and carprofen (a non-steroidal anti-inflammatory drug; NSAID). Use of peri-operative pain relief ranged from 50% for castration of cats to 91% for fracture repair in dogs. For most procedures, female veterinarians scored pain at a significantly higher level than their male colleagues. Fifty-eight percent of respondents considered their knowledge in the area of assessment and treatment of pain was adequate.

CONCLUSIONS: This survey was considered representative of veterinarians working in companion animal practice in New Zealand. Results indicated a relatively high use of peri-operative analgesia, including both pre-emptive and multi-modal analge- sia, in cats and dogs, although there was still some disparity between the perception of how painful a procedure was and the consequent use of pain relief.

CLINICAL RELEVANCE: The establishment of current attitudes and practices indicates to practising veterinarians how their own use of analgesics compares with that of their colleagues. It also provides information to educators on potential areas of focus, given that 42% of respondents felt their knowledge in the area of assessment and treatment of pain was inadequate.     

Current attitudes to, and use of, peri-operative analgesia in dogs and cats by veterinarians in New Zealand

AIM: To investigate the attitudes of veterinary practitioners in New Zealand to pain and analgesia, and their use of analgesic drugs, in dogs and cats. METHODS: A questionnaire posted to 1,200 practising veterinarians was used to gather information about the use of analgesia in dogs and cats, assessment of pain, attitudes to pain relief, analgesic drugs and procedures used, factors affecting choice of analgesic agent, and veterinary demographics, continuing education and staffing. RESULTS: Three hundred and twenty questionnaires with useable data were returned, a response rate of 28%. Male and female veterinarians were evenly represented. The analgesic agents most commonly used were morphine (opioids) and carprofen (a non-steroidal anti-inflammatory drug; NSAID). Use of peri-operative pain relief ranged from 50% for castration of cats to 91% for fracture repair in dogs. For most procedures, female veterinarians scored pain at a significantly higher level than their male colleagues. Fifty-eight percent of respondents considered their knowledge in the area of assessment and treatment of pain was adequate. CONCLUSIONS: This survey was considered representative of veterinarians working in companion animal practice in New Zealand. Results indicated a relatively high use of peri-operative analgesia, including both pre-emptive and multi-modal analgesia, in cats and dogs, although there was still some disparity between the perception of how painful a procedure was and the consequent use of pain relief. CLINICAL RELEVANCE: The establishment of current attitudes and practices indicates to practising veterinarians how their own use of analgesics compares with that of their colleagues. It also provides information to educators on potential areas of focus, given that 42% of respondents felt their knowledge in the area of assessment and treatment of pain was inadequate.     

Discussing overweight in dogs during a regular consultation in general practice in the Netherlands

In previous studies, it has been demonstrated that, similar to general practitioners, veterinarians find it difficult to discuss overweight in dogs. This study aimed to provide insight in the barriers and motivators for veterinarians to discuss overweight in dogs and to compare the results with findings from human medicine. Sub-hypotheses were postulated based on existing literature to investigate if lack of time, fear of offending clients, or lack of skills were potential barriers, and if feeling responsible and feeling compassion were potential motivators for veterinarians to discuss overweight in dogs. To this end, an online survey (n = 59) was conducted. Furthermore, 15 small animal clinicians working in general practice were interviewed by semi-structured face-to-face interviews. Results from the online survey indicated that veterinarians find it sometimes difficult to discuss overweight in dogs. Veterinarians who responded to the online survey did not experience strong barriers but did make use of motivators (e.g. feeling responsible and feeling compassion) when discussing overweight in dogs. Interestingly, results from the semi-structured face-to-face interviews showed that the responding veterinarians did experience strong barriers, as well as motivators, when discussing overweight in dogs with their clients. The most prominent barrier was customer dissatisfaction, whereas lack of time and lack of skills were also experienced. The most prominent motivator was feeling responsible for animal health and preventive veterinary medicine. These findings were strikingly similar to previous research on discussing childhood overweight by general practitioners. To improve treatment and prevention of overweight in dogs, veterinarians need more communication skills and should be more aware of the motivators that drive their self-motivation. Improving awareness on overweight and its comorbidities should be a One Health issue.