Simple Summary Veterinarians work in a very complex profession; they operate within a triad (veterinarian, animal and animal handler) to take care of the animal. Stress and confrontations with a large variety of demands lead to a high risk for mental health problems. To gather additional insights on stressors we conducted a systematic review using several scientific databases indexing published studies of the last decade. The aim of the process was to structure stressors and burdens based on existing models to see potential gaps in research and find starting points for interventions. After employing a variety of exclusion criteria, 30 studies published in the last decade were included in the review and stressors were be grouped in biological, psychological and social stressors. Overall, most stressors were found in the social category which include interactions with animal handlers. This result indicates that communication with animal handlers is one of the main stressors in the veterinarian practice. Veterinarians need interventions that are tailored to their need to lower the risks for mental health disorders and ultimately suicide. With regards to the results more training of communication techniques might be an example for a starting point to decrease the burden for veterinarians. Although several dynamics of stressors, how they interact, is still unclear, research has found enough evidence to develop more specifically designed health promotion measures. Abstract 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.

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

Ambulance services are changing, and the SARS-CoV-2 pandemic has been a major challenge in the past three years. Job satisfaction and work engagement are important characteristics for a healthy organization and success in one’s profession. The purpose of the current systematic review was to evaluate the predictors of job satisfaction and work engagement in prehospital emergency medical service personnel. Electronic databases, such as PubMed, Ovid Medline, Cochrane Library, Scopus, Web of Science, PsycINFO, PSYNDEX, and Embase, were utilized in this review. Predictors (ß coefficient, odds ratio, rho) of higher job satisfaction and work engagement were examined. Only prehospital emergency medical service personnel were considered. The review included 10 studies worldwide with 8358 prehospital emergency medical service personnel (24.9% female). The main predictor for job satisfaction was supervisors’ support. Other predictors were younger or middle age and work experience. Emotional exhaustion and depersonalization, as burnout dimensions, were negative predictors for higher job satisfaction or work engagement. Quality demands for health care systems are a significant challenge for future emergency medical services. The psychological and physical strengthening of employees is necessary and includes constant supervision of managers or facilitators.

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A Systematic Review of Associations and Predictors for Job Satisfaction and Work Engagement in Prehospital Emergency Medical Services—Challenges for the Future

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.

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

Introduction Altruism is considered a trait of veterinary and other health professionals, but the level of altruism in the veterinary profession is unknown. We designed a metric conjoint experiment to reveal other-orientation (an individual's caring concern for the wellbeing of others) and self-interest. We draw on the ‘Theory of Other-Orientation’, which states that individuals' decision-making heuristics can be impacted by their other-orientation independent of their self-interest. In patient-focused contexts, highly other-oriented or altruistic (veterinary) professionals may care too much for others and suffer immediate or cumulative financial and personal costs of such caring. At the same time, other-orientation can enhance job-related attitudes and outcomes, such as job satisfaction. Methods In a metric conjoint experiment, Australian final-year veterinary, science, nursing, entrepreneurship, and engineering students rated eight job scenarios with orthogonally arranged high and low levels of three job characteristics (n = 586) to provide observed measures of other-orientation and self-interest. Results A two-way MANOVA showed other-orientation or self-interest differed per discipline, but not gender. Veterinary (and engineering) respondents were less other-oriented than nursing respondents. Veterinary (and entrepreneurship) respondents were more self-interested than nursing respondents. K-Means cluster analysis confirmed four distinct profile groupings—altruistic/self-sacrificing, ‘both other-self’, self-interested and selfish—aligning with the discourse in the literature. Human nursing respondents stood out for the most members (50%) in the ‘both other-self’ profile compared to veterinary respondents (28%). Respondents of one of three veterinary schools stood out for the most members (19%) in the altruistic/self-sacrificing group. Discussion Our metric conjoint experiment illustrates an alternative to ‘self-report’ items with Likert-scaled responses. Our finding of the ‘both other-self’ group adds to the literature, which considers that other-orientation and self-interest are separate constructs that are difficult to co-exist in individuals. This mix of traits is deemed helpful by organizational psychology scholars, for sustainability and wellbeing, especially for healthcare professionals involved in high-frequency and intense, patient-focused interactions. Our findings highlight the need for more research on the potential role of other-orientation and self-interest in veterinary school admissions processes, the hidden or taught curricula, job-related attitudes and beliefs, and wellbeing and professional sustainability in the veterinary sector.

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Altruism or self-interest in tomorrow's veterinarians? A metric conjoint experiment and cluster analysis

Determinants of job satisfaction among faculty members of a veterinary university in India: an empirical study

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. 

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Stress and strain among veterinarians: a scoping review

The balance between stress perception and recovery of emergency medical service personnel during service and leisure time is an essential indicator of mental and physical health. It ensures success in emergency medical care and is also a health policy and economic factor for any organization. The aim of the study was to evaluate the recovery stress level of paramedics in the first and second waves of the SARS-CoV‑2 pandemic.The quantitative cross-sectional study included 1936 records of responders (334 women and 1602 men, mean age 34.9 ± 10.5 years). The online survey during the SARS-CoV‑2 pandemic was performed during the first wave in 2020 and the second wave in 2021. The short form EBF-24/A (test version S2) of the recovery stress questionnaire according to Kallus was analyzed.During the course of the two survey phases, the dimensions stress increased significantly (t1: 2.52 ± 0.98 and t2: 2.88 ± 1.04 points, p < 0.001) and recovery decreased significantly (t1: 2.98 ± 0.90 and t2: 2.64 ± 0.89 points, p < 0.001). Similar results were found for the corresponding subscales with the exception of the subscale "restful sleep" of the dimension recovery (t1: 2.81 ± 1.36 and t2: 2.72 ± 1.36 points).During the SARS-CoV‑2 pandemic, which has been ongoing since the beginning of 2020, the stress experienced by emergency responders increased from the first to the second wave, while the perception of recovery for emergency responders decreased. The study presents the current situation of recovery stress in German emergency medical service employees and allows predictions about performance and health in pandemic situations. 

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[Recovery-stress levels in paramedics during the first two waves of the SARS-CoV-2 pandemic].

Abstract Purpose Stressors due to the workload in the ambulance service are numerous and can be positively counteracted by work-related behaviors and experiences. We analyzed the subjective perceptions of workload and stress as a function of work-related behavior and experience patterns among emergency service personnel (EMP). Methods A total of 276 EMP (94.6% men) participated (average age: 39.3 ± 8.04 years). Data on the stress situations of ambulance service staff according to the Slesina questionnaire, the Recovery–Stress Questionnaire (EBF), and the Questionnaire for Physical, Psychological and Social Symptoms (KOEPS) were obtained. Participants were classified into four patterns (A, B, G, and S) based on the Work-Related Behavior and Experience Patterns (AVEM) questionnaire. Results Overall, 32% of EMP were classified into AVEM risk patterns A and B. For half of the stress factors examined (23/46), the data were significantly different among the AVEM groups. Individuals with AVEM risk patterns have higher stress and lower recovery scores on the EBF and more physical, psychological, and social-communicative impairments shown using the KOEPS (all variables p &lt; 0.001). Analyses showed moderate correlations among the AVEM dimensions (exceptions included striving for perfection, subjective importance of work, and work-related ambition), and the main scales of the EBF and KOEPS. Conclusion Work-related patterns of behavior and experience are used to determine how stress is handled, and it is possible to distinguish between patterns that promote health and those that hazardous to it. Individuals with AVEM patterns that are a risk to their health experience high stress, low recovery, and increased physical, psychological, and social-communicative impairments. Health-promoting work-related behaviors can be used to counteract stress. Companies developing preventive health promotion measures should focus on individuals with AVEM patterns that are a risk to their health. 

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Subjective perceptions of workload and stress of emergency service personnel depending on work-related behavior and experience patterns

Control center dispatchers (CCDs) are exposed to high levels of work-related mental stress, which are exacerbated by the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The aim of this study was to comparatively analyze the recovery and stress state of CCDs during the first and second waves of the SARS-CoV‑2 pandemic. A total of 490 CCDs (n = 440, t1 and n = 50, t2) with a mean age of 42.26 ± 8.79 years participated directly at the end of the first wave from June to August 2020 (t1) and during the second wave between January and February 2021 (t2) of the SARS-CoV‑2 pandemic. The short form (EBF-24/A; test form S2) of the Kallus recovery-stress questionnaire (EBF) was applied. Over the course of the two survey phases, the dimensions strain significantly increased (t1: 2.47 ± 1.08 vs. t2: 3.12 ± 0.93 points, p < 0.001) and recovery significantly decreased (t1: 3.03 ± 0.94 vs. t2: 2.50 ± 0.81 points, p < 0.001). Significant to highly significant differences were present in the EBF dimensions of the two waves in the majority of cases, even when taking the waves into account. For the variable "recovery in the social field", a medium effect was noticeable in the corrected model (η2 = 0.064). The SARS-CoV‑2 pandemic illustrates that the stress experience increased from the first to the second waves, and the recovery of CCDs decreased. These data provide a directional trend as the pandemic is ongoing, and stress and strain situations in control centers may continue to worsen. Immediate health promotion and prevention measures are essential. 

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Julia Botscharow

Papers

Stress and strain among veterinarians: a scoping review

[Recovery-stress levels in paramedics during the first two waves of the SARS-CoV-2 pandemic].

Subjective perceptions of workload and stress of emergency service personnel depending on work-related behavior and experience patterns

Recovery and stress of control center dispatchers in the first waves of the SARS-CoV-2 pandemic