Mental health in female veterinarians: effects of working hours and having children

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.

A comparison between veterinary small animal general practitioners and emergency practitioners in Australia. Part 1: demographic and work-related factors

Occupational stressors are commonly encountered in small animal veterinary practice and have been associated with burnout. The working context of veterinarians differs by specialty, and this can potentially lead to variable exposures to risk factors for burnout. The aim of this study was to explore differences in demographic and working conditions of veterinary general practitioners (GPs) and emergency practitioners (EPs) to compare exposure to different potential stressors. An anonymous, online survey was administered to veterinary GPs and EPs practicing in metropolitan regions of Australia. In total, 320 participant responses were analyzed (n = 237, 74.2% GPs and n = 83, 25.9% EPs). Significant differences (P < 0.05) in the demographics and work-related exposures were found between the two groups. GPs were found to be older than EPs with a greater number of years of experience in their field (P < 0.001). Most veterinary GPs worked only day shifts (207/236, 87.7%); where EPs worked a greater variety of shift patterns, with "only day shifts" being the least common shift pattern (P < 0.001). Most GPs worked a set and predictable roster pattern (195/236, 83.6%), while most EPs did not (51/83, 61.5%). EPs worked more weekends and public holidays (P < 0.001). The EP group performed more hours of work each week but worked less overtime. The main contributing factors for overtime were scheduling factors for GPs and staffing issues for EPs. EPs were commonly not able to take meal-breaks and GPs' meal-breaks were commonly interrupted by work. EPs were more frequently exposed to patient death, euthanasia (including for financial reasons), emotionally distressed clients and delivering negative news (P < 0.001). Both groups indicated that most work environments were collegiate and supportive, and a minority reported toxic colleagues (11.8%) or management teams (26.9%). Just under one-half of respondents reported having witnessed or experienced workplace bullying. Of our respondent group, 52.0% (166/319) were not satisfied with their remuneration. Desire to leave their principal area of practice was prevalent among this survey group (192/319, 60.2%) with approximately one-third considering leaving the veterinary profession. We discuss the implications of these workplace factors, including mitigation strategies.

Hong Kong veterinarians' encounters with client-related stress - a qualitative study

Aims

Limited research has explored the stressors experienced by veterinarians in East Asia. Metropolitan cities like Hong Kong may have overlooked factors that significantly contribute to veterinarians' stress. This paper examines how client-related stressors and contextual factors contribute to the stress levels of Hong Kong-based veterinarians.

Methods

Veterinarians from small domestic animal practices in Hong Kong were recruited using purposive and targeted snowball samplings until thematic saturation was achieved. Semi-structured in-depth interviews were conducted, audio-recorded, transcribed, coded, and analysed using reflexive thematic analysis with an interpretivist paradigm based on Heidegger's phenomenological approach.

Results

A total of 18 participating veterinarians described the expectations of and communication with the animal-health enthusiast (AHE) community, including clients, pet owners, and animal lovers, as their primary source of stress. Discrepant expectations and miscommunication between the AHE and veterinary communities, along with contextual factors, such as convenience in clinic switching, negative online reviews, and the relatively short history of the veterinary profession in the multilingual city, were identified as contributing factors to their stress. Recent socio-political events and the pandemic further intensified societal emotions, leading some clients to project frustrations onto perceived authority figures, including health professionals.

Conclusion

The study highlights that client-related stress extends beyond the health of animal patients, encompassing the expectations of the AHE community, which requires professional-level communication skills to build a mutually respectful three-party relationship. Besides, Hong Kong's unique contextual and historical factors subtly but chronically impact veterinary practices, which can be easily overlooked. Recognising these influences and how they interact is crucial for collaboration, within and beyond the profession, at the policy level to improve veterinary training and practices.

Implications

Our findings highlight the importance of expectation management and improving communication quality to foster healthy relationships among animals, the AHE community, and veterinary professionals. These efforts are believed to alleviate veterinarians' stress and enhance the well-being of all parties involved. We recommend incorporating effective communication and self-care discussions into the veterinary curriculum and advocating ongoing training for practising veterinarians. At the community level, encouraging open dialogues between animal caregivers and veterinary professionals can help address expectation discrepancies.

Veterinarian burnout demographics and organizational impacts: a narrative review

Burnout is a work-related syndrome of physical and emotional exhaustion secondary to prolonged, unresolvable occupational stress. Individuals of different demographic cohorts may have disparate experiences of workplace stressors and burnout impacts. Healthcare organizations are adversely affected by burnt out workers through decreased productivity, low morale, suboptimal teamwork, and potential impacts on the quality of patient care. In this second of two companion reviews, the demographics of veterinary burnout and the impacts of burnout on affected individuals and work environments are summarized, before discussing mitigation concepts and their extrapolation for targeted strategies within the veterinary workplace and profession.

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

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.

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.

Factors that impact recruitment and retention of veterinarians in emergency practice

OBJECTIVE

To examine factors that impact emergency veterinarians' decisions in selecting a place of employment and their perceptions of factors important in fostering a work environment conducive to long-term employment.

SAMPLE

433 Veterinary Information Network members who reported practicing emergency medicine in the US and were not diplomates of the American College of Veterinary Emergency and Critical Care.

PROCEDURES

An electronic survey distributed via the Veterinary Information Network data collection portal, made available from May 25, 2022, through June 15, 2022.

RESULTS

Factors rated as most important in selecting a place of employment included working with a highly trained support staff and collegiality of coworkers. Factor analysis was used to extract factors that can influence emergency medicine practitioners' views of a work environment conducive to long-term employment. The factor found to be most important was leadership. All factors, except for professional growth, were rated as more important by female practitioners when compared to male practitioners.

CLINICAL RELEVANCE

Aspects promoted in emergency medicine veterinarian recruitment efforts should include, in addition to the innate nature of the position, the elements identified as most attractive to current practitioners. By better understanding the impact of gender, children status, and years practicing emergency medicine on the relative importance in creating workplace environments conducive to long term employment, hospitals can be better equipped to meet the needs of both their current employees as well as potential new hires.

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.

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.

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.

Physiological recovery among workers in long-distance sleddog races: A case study on female veterinarians in Finnmarksløpet

BACKGROUND: During Finnmarksløpet (FL, one of the longest distance sleddog races in the world), veterinarians are exposed to extreme environmental conditions and tight working schedules, with little and fragmented sleep. OBJECTIVE: The aim of this case study was to examine cardiovascular parameters and sleep-wake patterns among veterinarians working within FL, during and after (for a month) the end of the race. METHODS: Six female veterinarians volunteered for the study. The participants wore a wrist device for a total of eight weeks in order to passively and semi-continuously record physiological responses throughout the day (i.e., heart rate, heart rate variability, number of steps, and sleep quality). Moreover, perceived sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI) at three time-points. RESULTS: During and for one month after completion of the FL, most veterinarians presented an alteration of cardiovascular parameters and sleep quality. The heart rate circadian rhythm returned to pre-race values within about two weeks. CONCLUSIONS: The long-lasting alteration of the veterinarians’ cardiovascular parameters and sleep-wake patterns might have negative consequences for their health in the long-term, especially if similar experiences are repeated more times though the course of a year or season. More research is needed in order to understand the health risks, as well as how to prevent them, among veterinarians in long-distance sleddog races or other similar events.

Effects of gender on income and family planning for diplomates of the American College of Zoological Medicine

OBJECTIVE

To evaluate income and family planning decisions of American College of Zoological Medicine (ACZM) diplomates.

SAMPLE

98 ACZM diplomates.

PROCEDURES

An online survey was sent to 201 ACZM diplomates. Participation was voluntary.

RESULTS

98 (49%) diplomates responded to the survey. The most commonly reported income categories were $90,000 to $94,999, $100,000 to $104,999, and $110,000 to $114,999. Overall, the mean of the salary-category midpoint responses was $105,357 but was $122,917 for those in academia and $94,508 for those working in zoos and aquaria. When incomes of males and females were matched (24 pairs matched for gender and age), no difference in income was observed. There were no significant differences in income between males and females with and without children. Diplomates who did not complete a residency had significantly higher incomes than diplomates who did. Sixteen of 21 (76%) females and 9 of 19 (47%) males reported delaying having children because of their career. Additionally, a higher percentage of females with children (13/20 [65%]) than males with children (3/19 [16%]) felt that having children had had a negative effect on their career. Thirty-five of 41 (85%) females without children and 4 of 9 (44%) males without children thought having children would have negatively affected their careers.

CLINICAL RELEVANCE

Although substantial differences in income between female and male ACZM diplomates were not identified, differences in family planning and perceptions of the impact of having children on their careers did exist.

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.

Veterinary Student Opinions Regarding Ethical Dilemmas Encountered by Veterinarians and the Benefits of Ethics Instruction

Recognizing and addressing ethical conflicts is an emerging concern for veterinarians. Veterinary students (N = 284) from four US schools were surveyed regarding their opinions on ethical dilemmas encountered by veterinarians and the benefits of ethics instruction. The majority of respondents had encountered all clinical scenarios that may be associated with ethical dilemmas that were provided. The most common ethical dilemma experienced was compromise of patient care because of financial limitations. Students with at least 12 months of experience were more likely to believe that practitioners encounter ethical dilemmas regularly. Although 92% of 271 respondents indicated that veterinarians should prioritize patient interests when the interests of clients and patients conflict, 84% of respondents reported that veterinarians most often prioritize client interests. Most (78%) respondents indicated having received training in ethical theories and approaches to address ethical dilemmas. The majority of respondents agreed that they feel better prepared to identify (80%) and address (55%) ethical dilemmas as a result of their ethics training. Most respondents (81%) identified experiencing moral stress in relation to how animals were treated. Only 46% of respondents reported receiving training in tools for coping with moral stress. Most of these respondents (54%) agreed that such training would be effective in helping to manage moral stress. Results suggested that educators should prepare students for the contrast in advocacy preferences they are apt to encounter when they enter practice. It is recommended that ethics training and tools for coping with moral stress be core components of the veterinary curriculum.

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.

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.

Characteristics associated with negative attitudes toward mental illness among US veterinarians

OBJECTIVE

To explore associations between demographic, occupational, and mental health characteristics and negative attitudes toward mental illness among veterinarians.

DESIGN

Cross-sectional survey.

SAMPLE

9,522 veterinarians employed in the United States.

PROCEDURES

Data from a previously conducted voluntary, anonymous, web-based survey were used. Negative attitude was defined as slight or strong disagreement with 2 statements: "Treatment can help people with mental illness lead normal lives" (treatment effectiveness) and "People are generally caring and sympathetic to people with mental illness" (social support). Multivariable logistic regression was used to identify variables associated with negative attitudes.

RESULTS

Of the 9,522 respondents, 6,585 (69.2%) were female, 4,523 (47.5%) were 40 to 59 years old, 291 (3.1%) had a negative attitude toward treatment effectiveness, and 4,504 (47.3%) had a negative attitude toward social support. After adjusting for other variables, negative attitude toward treatment effectiveness was significantly more likely in males, those with 10 to 19 (vs 1 to 9) years of practice experience, solo practitioners, those in government (vs "other") practice, those with evidence of serious psychological distress, and those reporting suicidal ideation after veterinary school and significantly less likely in those receiving mental health treatment. A negative attitude toward social support was significantly less likely in males and significantly more likely in 40 to 59 (vs 20 to 39) year olds, childless respondents, solo practitioners, those without membership in a veterinary association, those with evidence of serious psychological distress, those reporting depression during or after veterinary school, and those reporting suicidal ideation after veterinary school.

CONCLUSIONS AND CLINICAL RELEVANCE

Characteristics such as age, sex, practice setting, and mental illness history might be useful to consider when targeting interventions to support and educate veterinarians about mental illness.

Veterinarians Experience Animal Welfare Control Work as Stressful

The aim of the study was to evaluate the job satisfaction of official veterinarians working in the field of animal welfare control and identify both positive features and challenges of their work. An electronic questionnaire was designed to evaluate job satisfaction. The questionnaire was responded to by 73 of the 98 Finnish official veterinarians working in the field of animal welfare control. The Spearman's rank correlation coefficient was used to evaluate the relation between stress and different work-related factors. More than half of the respondents reported work-related stress or fatigue. Threatening situations, disturbed work–private life balance and a high amount of overtime work were found to be frequent underlying causes of stress. Fieldwork, especially when working alone, was perceived as the most challenging part of the work. Of the respondents, three out of four performed animal welfare inspections mainly alone. Although the respondents reported getting additional help to perform an inspection most of the times they needed it, a wish to work in a pair was highlighted. The results of the present study indicate that official veterinarians often experience work-related stress and fatigue. By testing interventions shown to be beneficial, such as providing adequate support within the work community, decreasing the workload and enabling inspections to be done in pairs, job satisfaction could be improved.

Feminization and Stress in the Veterinary Profession: a Systematic Diagnostic Approach and Associated Management

Within the field of veterinary medicine the gender distribution has changed, since most graduates are now females. Studies show that female veterinarians represent a vulnerable group for stress and stress-related illnesses. The goal of the study was to identify typical profiles of stress management strategies and to clarify if vets are well-equipped to cope with occupational stressors. Within a cross-sectional design 78 female veterinarians from Austria and Germany were surveyed using a self-report test-battery assessing twenty different coping styles. Statistical analysis included one sample t-tests and Cohen`s d as a concurrent effect size measure. The results showed that female veterinarians are significantly more likely to use negative coping styles for their stress e.g. rumination (t(74) = 6.733, p = < 0.001, d = 0.726) or escapism (t(72) = 2.173, p = 0.033, d = 0.281) when compared to the norm population. Amongst other studies these findings contribute to a systematic diagnosis which is necessary for the development and implementation of standardized stress management interventions for the veterinary education and training e.g. courses for improving communication and stress management skills and regular supervision or intervision (exchange with professional peers). Due to existing stigmatization concerning mental health, low-barrier counseling services should be provided for veterinarians who already feel stressed.

Perceptions of support and policies regarding pregnancy, parenting, and family planning during veterinary training at United States veterinary medical training institutions

OBJECTIVE To gather information about issues associated with pregnancy, lactation, and parenting for US veterinary students and house officers (trainees) and their perception of pregnancy and parenting support services available at US veterinary training institutions. DESIGN Cross-sectional mixed-method survey. SAMPLE 2,088 veterinary students and 312 house officers from 27 US veterinary training institutions. PROCEDURES An email with a link to an online survey was sent to the associate dean for academic affairs at each of the 30 AVMA-accredited US veterinary training institutions with a request that it be forwarded to all veterinary students and house officers (interns and residents). RESULTS Among the 2,400 respondents, 185 (7.7%) reported that they were a parent, were pregnant, or had a significant other who was pregnant. Several significant differences in attitudes and perceptions of pregnancy and parenting support services provided by veterinary training institutions were identified between males and females, veterinary students and house officers, and respondents who were and were not parents. CONCLUSIONS AND CLINICAL RELEVANCE Results provided crucial information about an important facet of well-being for veterinary trainees and suggested that veterinary students and house officers face substantial challenges in becoming parents during their training programs and that perceptions of those challenges differ between males and females.

Current Policies and Support Services for Pregnant and Parenting Veterinary Medical Students and House Officers at United States Veterinary Medical Training Institutions

Wellness and work-life balance are prominent concerns in the veterinary profession and data suggest that personal relationship-building with peers and family assist veterinary trainees and veterinarians with wellness. The demographics of veterinary medical trainees (students, interns, and residents) have shifted to a female-dominated cohort and veterinary training overlaps with peak reproductive age for the majority of trainees. Despite a robust body of literature in the human medical profession surrounding pregnancy, parenting, and family planning (PPFP) among human medical students, interns, and residents, no comparable data exist within the United States veterinary medical community. This study reviewed policies and support services in place to support PPFP at accredited United States veterinary medical training institutions through the use of an online administrator survey and the review of handbooks and relevant written material. Results from this study highlight a lack of consistency across veterinary medical training institutions for policy and support services for PPFP for trainees, especially related to lactation support and parental leave. Our data can help facilitate the development of standards or best practices for policies and support services that support PPFP among veterinary medical trainees, and opens the dialogue to consider the unique needs of our shifted trainee demographics.

Adverse Childhood Experiences among Veterinary Medical Students: A Multi-Site Study

This research explores Adverse Childhood Experiences (ACEs) among veterinary medical students across six academic institutions of veterinary medicine, and their relationship with depression, stress, and desire to become a veterinarian. Between April 1, 2016, and May 23, 2016, 1,118 veterinary medical students in all 4 years of the curriculum (39% response rate) completed an anonymous web-based questionnaire about ACEs, depression using the Center for Epidemiological Studies Depression scale (CESD), stress using the Perceived Stress Scale (PSS), and the age at which they wanted to become a veterinarian. Sixty-one percent (677) of respondents reported having at least one ACE. The most prevalent ACE reported was living with a household member with a mental illness (31%). Students who had experienced four or more ACEs had an approximately threefold increase in signs of clinical depression and higher than average stress when compared to students who had experienced no ACEs. The number of ACEs showed an overall graded relationship to signs of clinical depression and higher than average stress. There was no statistically significant relationship between age at which a student wanted to become a veterinarian and exposure to ACEs. Veterinary students report being exposed to ACEs before age 18 at a rate similar to that of other population-based studies. These findings do not suggest that veterinary students enter the veterinary medical education system more at risk for poor mental health due to ACEs than the general population.

Finding the Balance: Uncovering Resilience in the Veterinary Literature

Resilience is an issue of emerging importance in veterinary education and research, as in other professional contexts. The aim of this study was to perform an appraisal of how resilience is portrayed in the contemporary (1995-present) research and education literature around veterinary mental health, and to attempt a provisional synthesis informing a conception of resilience in the veterinary context. Qualitative analysis of the literature (59 sources included) revealed a dominant emphasis on mental health problems, particularly stress, which outweighs and potentially obscures complementary approaches to well-being and resilience. We found the construct of resilience underdeveloped in the veterinary literature and in need of further research, but provide a preliminary synthesis of key themes emerging from the current literature (emotional competence, motivation, personal resources, social support, organizational culture, life balance, and well-being strategies). We advocate for greater balance between complementary perspectives in veterinary mental health education and research, and propose that an increasing focus on resilience (here endorsed as a dynamic and multi-dimensional process involving personal and contextual resources, strategies, and outcomes) will help to address this balance.

The Art of Staying Engaged: The Role of Personal Resources in the Mental Well-Being of Young Veterinary Professionals

Health care professionals perceive transitions (e.g., from university to professional practice) to be challenging and stressful. The aim of the present research was to identify person-related characteristics that, in addition to work-related aspects, affect the mental well-being and performance of recently graduated veterinary professionals, and to reach a greater understanding of the role of personal resources in mental health and well-being. Based on the Job Demands-Resources (JD-R) model, a questionnaire measuring work engagement as well as burnout and its potential predictors was developed and distributed to 1,760 veterinarians who graduated in the Netherlands between 1999 and 2009 (response rate 41%, of which 73% were females). An intervention aiming at increasing personal resources was evaluated using qualitative and quantitative methods. The intervention was designed so that participants could set their own learning objectives toward which they could work during a yearlong multimodular program. The results show that gender and the number of years after graduation have a small effect on exhaustion resulting in 16% of the veterinarians (18% for females) meeting the criteria for burnout in the first 5 years after graduation. Thirteen percent of respondents could be classified as being highly engaged. While burnout resulted mostly from job characteristics (demands and resources), work engagement resulted mostly from job resources and personal resources. Personal resources appear to have an important mediating and initiating role in work engagement and performance. Self-reported ratings of reflective behavior, proactive behavior, and self-efficacy were significantly increased after a yearlong resources development program. Practical implications are discussed.

Suicide in veterinarians and veterinary nurses in Australia: 2001-2012

BACKGROUND

Whether veterinarians have an elevated suicide rate compared with the general population is controversial.

METHODS

Reported cases of suicide among veterinarians and veterinary nurses in Australia over the period 2001 to 2012 were investigated in a retrospective case-series study.

RESULTS

The standardised mortality ratio of veterinarians (n = 18) was 1.92 (95% CI 1.14-3.03) and that of veterinary nurses (n = 7) to the general population was 1.24 (95% CI 0.80-1.85). Overdosing on drugs (pentobarbitone) was the main method of suicide in these occupations.

CONCLUSION

The reasons for veterinary suicides are likely to be multifactorial, including work- and life-related stressors, and individual characteristics. This research highlights the need for targeted suicide prevention and intervention for veterinarians.

A study of handling cytotoxic drugs and risk of birth defects in offspring of female veterinarians

We examined the association of occupational exposure to handling cytotoxic drugs at work with risk of birth defects among a cohort of female veterinarians. This study is a follow up survey of 321 female participants (633 pregnancies) who participated in the Health Risks of Australian Veterinarian project. Data on pregnancies and exposure during each pregnancy was obtained by self-administered mailed questionnaire. Female veterinarians handling cytotoxic drugs during their pregnancy had a two-fold increased risk of birth defects in their offspring (RR = 2.08, 95% CI (1.05–4.15)). Results were consistent in subgroup analysis of those who graduated during the period of 1961 to 1980 (RR = 5.04, 95% CI (1.81, 14.03) and in those working specifically in small and large animal practice. There was no increased risk in the subgroup that graduated after 1980. Women with unplanned pregnancies were more likely to handle cytotoxic drugs on a daily basis (RR = 1.86, 95% CI, 1.00–3.48) and had a higher increased risk of birth defects than those who planned their pregnancies in recent graduates and in those who worked specifically in small animal practice (RR = 2.53, 95% CI, 1.18–5.42). This study suggests that the adverse effects of handling cytotoxic drugs in pregnant women may include an increased risk of birth defects. Pregnancy intention status is an important health behavior and should be considered in prenatal programs.