Corrigendum: The Complex Relationship Between Veterinarian Mental Health and Client Satisfaction.

[This corrects the article DOI: 10.3389/fvets.2020.00092.].

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

OBJECTIVE: To investigate the association of demographic, career, and lifestyle factors with resilience and the association of resilience with mental health outcomes in Canadian veterinarians. SAMPLE: 1,130 veterinarians in clinical practice across Canada. PROCEDURES: An online questionnaire was used to collect participant data and included 5 validated psychometric scales to evaluate resilience (through the Connor-Davidson Resilience Scale [CD-RISC]), perceived stress (through the Perceived Stress Scale), emotional distress (through the Hospital Anxiety and Depression Scale), burnout (through the Maslach Burnout Inventory), and secondary traumatic stress (through the Professional Quality of Life Scale). A multivariable linear regression model was used to investigate associations between CD-RISC scores and demographic, career, and lifestyle characteristics. Univariable linear regression models were used to assess the relationship between resilience scores and other mental health outcomes. RESULTS: The strongest positive association was between CD-RISC score and overall health. The level of satisfaction with support from friends and workplace resources had positive associations with the CD-RISC score. The presence of mental illness had the strongest negative association with the CD-RISC score. Being married, working in a small animal practice, or having an associate role were negatively associated with the CD-RISC score. The CD-RISC score had negative associations with scores for perceived stress, anxiety, depression, burnout, and secondary traumatic stress. CONCLUSIONS AND CLINICAL RELEVANCE: Models provided evidence for the role of resilience in protecting against negative mental health outcomes in veterinarians. Both personal and workplace factors were associated with resilience, presenting opportunities for intervention at each of these levels.

The Complex Relationship Between Veterinarian Mental Health and Client Satisfaction.

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

A survey of veterinarian mental health and resilience in Ontario, Canada.

Our goal was to help address a lack of mental health research on Canadian veterinarians through estimation of the prevalence of depression, anxiety, compassion fatigue, burnout, and resilience in veterinarians in Ontario. We conducted a cross-sectional study using an online survey that investigated demographics, mental health, self-reported overall health, and satisfaction with sources of support. Validated, psychometric scales were used to measure depression, anxiety, burnout, compassion fatigue, and resilience. The mental health indices of participating veterinarians were in line with those of veterinarians in other regions, and reflective of poorer mental health compared to the general population. The scores for females tended towards poorer mental health relative to males. Reported levels of burnout and secondary traumatic stress were of particular concern. These results can be used to support evidence-based interventions to help veterinarians and veterinary students build their resilience so that they may better thrive in the face of occupational stresses.

Enquête sur la santé mentale et la résilience des vétérinaires en Ontario, Canada. Notre objectif était d'aider à résoudre un manque de recherche en santé mentale chez les vétérinaires canadiens par une estimation de la prévalence de dépression, anxiété, fatigue de compassion, épuisement, et résilience chez les vétérinaires en Ontario. Nous avons mené une étude transversale en utilisant un sondage en ligne qui examinait les données démographiques, la santé mentale, l'état de santé général auto-rapporté, et la satisfaction avec les sources de soutien. Des échelles psychométriques validées furent utilisées pour mesurer la dépression, l'anxiété, l'épuisement, la fatigue de compassion, et la résilience. Les indicateurs de santé mentale des vétérinaires participants étaient conformes avec ceux de vétérinaires dans d'autres régions, et révélateurs d'une moins bonne santé mentale comparativement à la population générale. Les pointages pour les femmes tendaient vers une moins bonne santé mentale relativement aux hommes. Les niveaux rapportés d'épuisement et de stress traumatique secondaire étaient particulièrement inquiétants. Ces résultats peuvent être utilisés pour soutenir des interventions factuelles afin d'aider les vétérinaires et les étudiants vétérinaires à développer leur résilience afin qu'ils soient en mesure de mieux se développer vis-à-vis les stress occupationnels.(Traduit par Dr Serge Messier).

Prevalence of mental health outcomes among Canadian veterinarians.

OBJECTIVE: To estimate the prevalence of perceived stress, burnout, depression, anxiety, compassion fatigue, compassion satisfaction, resilience, and suicidal ideation among Canadian veterinarians and compare results with those for other populations. SAMPLE: 1,403 veterinarians across Canada. PROCEDURES: The study represented a cross-sectional online survey. The questionnaire incorporated validated psychometric instruments to measure perceived stress, burnout, depression, anxiety, compassion fatigue, and resilience as well as questions regarding suicidal ideation. Means and relative proportions in categories of severity were compared between genders as well as with normative data for the general population and results for veterinarians in the United Kingdom. RESULTS: Approximately 10% of Canadian veterinarians (n = 1,403) completed the survey. Relative to the general population, survey participants had significantly higher mean scores for subscales of burnout and compassion fatigue, anxiety, and depression and significantly lower mean resilience. Relative to males, females had significantly higher mean scores for perceived stress, emotional exhaustion, burnout, secondary traumatic stress, anxiety, and depression and significantly lower mean resilience. Participants also had higher mean scores for anxiety and depression relative to results for United Kingdom veterinarians. The 12-month prevalence of suicidal ideation for participants was 26.2%, which was substantially higher than the estimated prevalence for the general international population (2.1% to 10.0%). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the mental health of Canadian veterinarians was poor, compared with the mental health of the general population. These results should serve as a call to action for tools and educational programs directed at supporting veterinarian mental wellness in Canada, with special attention paid to the disparate needs of the genders.

Stress, anxiety, depression, and resilience in Canadian farmers.

PURPOSE: To estimate the prevalence of stress, anxiety, depression, and resilience amongst Canadian farmers. METHODS: An online cross-sectional survey using validated psychometric scales [Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale] conducted with farmers in Canada between September 2015 and February 2016. RESULTS: 1132 farmers participated in the study. The average PSS score was 18.9. Approximately 57% and 33% of participants were classified as possible and probable cases for anxiety, respectively; the respective proportions for depression were 34% and 15%. The average resilience score was 71.1. Scores for stress, anxiety, and depression were higher, and resilience lower, than reported normative data. Females scored less favorably on all mental health outcomes studied, highlighting important gender disparities. CONCLUSIONS: These results highlight a significant public health concern amongst farmers, and illustrate a critical need for research and interventions related to farmer mental health. These findings are important for policymakers, physicians, and public and mental health service providers, and can help to inform decision-making, policy recommendations, resource allocation, and development and delivery of training programs for farmers.

Occupational stressors and desired changes for wellness amongst employees at a Canadian animal welfare organization.

While occupational stressors in human caregiving environments have been well-explored, little is known about these stressors in the animal caregiving professions. To address this, a cross-sectional survey was conducted (June and July, 2016) with employees at a Canadian animal welfare organization to explore perceived occupational stressors and desired wellness resources. Responses to open-ended questions were analyzed via thematic network analysis. Themes related to employee stress included: inability to provide desired level of animal care, poor team environment, overwork, challenges working with the public, and personal safety and vulnerability. Desired resource themes were: reduce overwork and address staffing issues, team building, creation of a wellness culture, and mental health training. These results shed light on occupational stressors facing animal welfare employees at a Canadian animal welfare organization. Recommendations to promote positive mental health and wellness within this, and potentially similar, organizations are discussed.

Facteurs de stress au travail et changements souhaités pour le bien-être parmi les employés d'une organisation canadienne de bien-être animal. Même si les facteurs de stress au travail dans les milieux de prestation de soins aux humains ont été bien explorés, on en sait encore peu dans les professions de prestation de soins aux animaux. Pour aborder cette situation, une enquête transversale a été réalisée (en juin et en juillet 2016) auprès d'employés dans une organisation canadienne de bien-être animal afin d'explorer les facteurs de stress au travail perçus et les ressources de bien-être souhaitées. Les réponses à des questions ouvertes ont été analysées à l'aide d'une analyse de réseaux thématiques. Les thèmes reliés au stress des employés mentionnés incluaient notamment : incapacité de fournir le niveau souhaité de soins aux animaux, mauvais environnement d'équipe, surcharge de travail, difficultés de travail avec le public ainsi que sécurité personnelle et vulnérabilité. Les thèmes de ressources souhaitées étaient : réduction de la surcharge de travail et gestion des problèmes de dotation en personnel, consolidation d'équipe, création d'une culture de bien-être et formation en santé mentale. Ces résultats mettent en lumière les facteurs de stress au travail auxquels font face les employés dans une organisation canadienne de bien-être animal. Les recommandations afin de promouvoir une santé mentale et un bien-être positifs dans cette organisation et des organismes semblables sont discutées.(Traduit par Isabelle Vallières).

Referring equine veterinarians' expectations of equine veterinary specialists and referral centers.

OBJECTIVE To explore referring equine veterinarians' expectations of equine veterinary referral centers and specialists. DESIGN Qualitative, focus group interview-based study. SAMPLE 6 focus groups comprised of equine practitioners with experience in referral of clients and patients to equine specialists or referral centers (48 referring veterinarians [rDVMs]). PROCEDURES Focus group sessions were conducted independently and followed a standardized discussion guide consisting of open-ended questions and follow-up probes. Discussions were recorded, and thematic analysis was performed on the content. RESULTS The overarching theme of participants' discussions was that specialists and referral centers are an extension of the care that rDVMs provide to their clients and patients. The 5 areas that participants described as important to this expectation were rDVM-client relationships, rDVM involvement during referral care, collegial rDVM-specialist relationships, communication between rDVMs and specialists, and the boundaries of referral care. Participating practitioners wanted to be involved during the referral process, which was seen as being facilitated by having a collegial relationship with the specialist and through effective communication during the course of referral care. CONCLUSIONS AND CLINICAL RELEVANCE Relationships and communications between rDVMs and specialists are important aspects of equine veterinary medicine. Both rDVMs and specialists are likely to benefit from pursuing opportunities to further their relationship by using up-front communication to establish clear role expectations and clear processes for sharing information.