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Abstract
OBJECTIVE To describe self-reported use of x-ray personal protective equipment (PPE) by veterinary workers in Saskatchewan, Canada, and to examine factors that affected their use of x-ray PPE.
DESIGN Cross-sectional survey.
SAMPLE 331 veterinary workers.
PROCEDURES A questionnaire was distributed to Saskatchewan veterinary workers electronically and by conventional mail. Recipients were encouraged to share the questionnaire with colleagues. The questionnaire consisted of questions regarding radiation safety practices used during small animal radiographic procedures, including frequency of use of dosimeters and lead aprons, thyroid shields, eyeglasses, and gloves. Respondents were also requested to provide suggestions for increasing use of PPE.
RESULTS 460 questionnaires were completed, of which 331 were returned by workers involved with performing radiographic procedures. Two hundred eighty-five of 331 (86%) respondents reported that at least 1 worker was always in the room during x-ray exposure, and 325 (98%), 291 (88%), and 9 (3%) respondents reported always wearing a lead apron, thyroid shield, and protective eyeglasses, respectively, during radiographic imaging. Two hundred seventeen of 327 (66%) respondents used lead gloves correctly less than half the time. Mean percentage of time that gloves were worn correctly was higher for workers who were required to do so by their employers than for those who were not.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested use of PPE during radiographic procedures can be increased by employers making PPE use mandatory. Other respondent-identified factors that would increase PPE use included the availability of properly fitting and functional PPE and education of workers about health risks associated with ionizing radiation exposure.
Abstract
OBJECTIVE To investigate caregiver burden and its potential associations with psychosocial function and veterinary service use among dog and cat owners and with factors related to treatment plan adherence among owners of animals with chronic or terminal disease.
DESIGN Cross-sectional, observational study.
SAMPLE 124 clients of a small animal hospital.
PROCEDURES Study participants were recruited by email. Owners of sick animals were blindly matched with owners of healthy animals (62/group) by age, gender, and companion animal species. Respondents completed electronic questionnaires related to demographics and previously described measures of caregiver burden, psychosocial function, and treatment plan adherence. Veterinary medical records were reviewed to verify animal health status and assess veterinary service use (billable and nonbillable contacts with veterinary staff) in the 12 months prior to study enrollment. Variables were tested for association by statistical methods.
RESULTS Questionnaire scores reflected greater caregiver burden; greater symptoms of depression, anxiety, and stress; and poorer quality of life for respondents with sick animals than for respondents with healthy animals. Greater caregiver burden was associated with scores reflecting poorer psychosocial function and with greater veterinary service use. The number of nonbillable, but not billable, contacts was greater for respondents with high caregiver burden than for those without this finding. Treatment plan factors associated with greater caregiver burden included changes in routine because of the animal's condition and perception that following new rules and routines for management of the condition was challenging.
CONCLUSIONS AND CLINICAL RELEVANCE Awareness of potential caregiver burden and psychosocial distress in clients with sick companion animals may help veterinarians identify opportunities for an empathic response. Future research should assess directionality of the relationship between these factors.
Abstract
OBJECTIVE To develop and evaluate a high-fidelity simulated laparoscopic ovariectomy (SLO) model for surgical training and testing.
DESIGN Evaluation study.
SAMPLE 15 veterinary students (novice group), 5 veterinary surgical interns or residents (intermediate group), and 6 veterinary surgeons (experienced group).
PROCEDURES Laparoscopic surgery experience was assessed by questionnaire and visual analog scales. Basic laparoscopic skills were assessed with a commercial training model. A commercial canine abdomen model was customized with a high-fidelity simulated canine female genital tract. Each subject's SLO performance (laparoscopic entry, dissection along marked planes, and left ovariectomy) was evaluated by measurement of surgical time and errors (splenic puncture and deviation from dissection marks) and with global and operative component rating scales. Construct and concurrent validity were assessed by correlation of SLO results with self-estimated measures of experience level and with basic laparoscopic skills test results, respectively. Face validity was assessed with a questionnaire completed by intermediate and experienced group participants.
RESULTS 13 participants (3/15, 5/5, and 5/6 in the novice, intermediate, and experienced groups, respectively) completed SLO within the preset time. No difference in errors was found among groups. Completion time was significantly correlated with self-estimated experience level (r = −0.626), confirming construct validity, and with basic laparoscopic skills scores (r = −0.552) and global (r = −0.624) and operative component (r = −0.624) rating scale scores, confirming concurrent validity. Overall mean face validity score was low (64.2/100); usefulness of the model for surgical training received the highest score (8/10).
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested the SLO model may be a useful surgical training tool. Further studies are needed to confirm usefulness of the model in veterinary laparoscopy training.
Abstract
OBJECTIVE To develop and validate a Burden Transfer Inventory (BTI) of stressful client behaviors and to evaluate whether those behaviors are associated with client caregiver burden and contribute to veterinarian stress and burnout.
DESIGN 3-stage cross-sectional psychometric validation study.
SAMPLE 1,151 small animal veterinarians and 372 dog and cat owners.
PROCEDURES During stage 1, a pool of 34 items representing stressful client behaviors was created through open-ended surveys of practicing veterinarians and 3 phases of pilot testing. During stage 2, 1,151 veterinarians recruited through the Veterinary Information Network completed a survey including those behavior items and validated measures of stress and burnout. Completed surveys were randomly assigned to either a measure development or validation database for factor and item analyses. Data were then combined to determine whether the BTI was correlated with measures of stress and burnout. During stage 3, owners of dogs and cats with a serious illness completed an online survey to assess how frequently they engaged in each BTI item as well as a validated measure of caregiver burden.
RESULTS For dog and cat owners, there was a significant positive correlation between caregiver burden and the frequency that those owners reported engaging in BTI items. The frequency that veterinarians reported encountering BTI items was positively correlated with measures of stress and burnout, which suggested burden transfer from owners to veterinarians. The extent to which veterinarians reported being bothered by BTI items was a more robust predictor of stress and burnout than the frequency with which those items occurred.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated the BTI can be used to understand how client behaviors associated with caregiver burden affect veterinarian stress and burnout. The BTI may be useful to identify specific stressors affecting individual veterinarians and how they react to those stressors.
Abstract
OBJECTIVE To understand the experiences of owners of dogs with chronic pain and explore owner perceptions of their pets' pain.
DESIGN Observational study.
SAMPLE 10 owners of dogs with chronic pain.
PROCEDURES Owners were interviewed by means of a semistructured and conversational technique. Interviews were then transcribed and analyzed with standard qualitative methodology to code for major themes.
RESULTS Major themes that were identified included changes in owner schedule, effects on owner relationships, and necessary resources when owning a pet with chronic pain. Owners discussed their perceptions of their pets' pain, and several participants referred to empathizing with their pet owing to their own experiences with pain. Owners also suggested ways that veterinarians can support them during the experience of owning a dog with chronic pain.
CONCLUSIONS AND CLINICAL RELEVANCE By understanding the impact of chronic pain on dog owners and appreciating how owners perceive pain in their pets, veterinarians may be able to provide better care for patients and clients.
Abstract
OBJECTIVE To assess proportionate mortality ratios (PMRs) for suicide among male and female US veterinarians from 1979 through 2015.
DESIGN PMR study.
SAMPLE Death records for 11,620 veterinarians.
PROCEDURES Information for veterinarians who died during 1979 through 2015 was obtained from AVMA obituary and life insurance databases and submitted to a centralized database of US death records to obtain underlying causes of death. Decedent data that met records-matching criteria were imported into a software program for calculation of PMRs for suicide stratified by sex and indirectly standardized for age, race, and 5-year calendar period with 95% confidence intervals.
RESULTS 398 deaths resulted from suicide; 326 (82%) decedents were male, 72 (18%) were female, and most (298 [75%]) were ≤ 65 years of age. The PMRs for suicide for all veterinarian decedents (2.1 and 3.5 for males and females, respectively), those in clinical positions (2.2 and 3.4 for males and females, respectively), and those in nonclinical positions (1.8 and 5.0 for males and females, respectively) were significantly higher than for the general US population. Among female veterinarians, the percentage of deaths by suicide was stable from 2000 until the end of the study, but the number of such deaths subjectively increased with each 5-year period.
CONCLUSIONS AND CLINICAL RELEVANCE Results of the study indicated that PMRs for suicide of female as well as male veterinarians were higher than for the general population. These data may help to inform stakeholders in the creation and implementation of suicide prevention strategies designed for veterinarians.
Abstract
OBJECTIVE To identify geographic areas in the United States where food animal veterinary services may be insufficient to meet increased needs associated with the US FDA's Veterinary Feed Directive.
DESIGN Cross-sectional study.
SAMPLE Data collected between 2010 and 2016 from the US Veterinary Medicine Loan Repayment Program, the National Animal Health Monitoring System Small-Scale US Livestock Operations Study, and the USDA's National Veterinary Accreditation Program.
PROCEDURES Each dataset was analyzed separately to identify geographic areas with greatest potential for veterinary shortages. Geographic information systems methods were used to identify co-occurrence among the datasets of counties with veterinary shortages.
RESULTS Analysis of the loan repayment program, Small-Scale Livestock Operations Study, and veterinary accreditation datasets revealed veterinary shortages in 314, 346, and 117 counties, respectively. Of the 3,140 counties in the United States during the study period, 728 (23.2%) counties were identified as veterinary shortage areas in at least 1 dataset. Specifically, 680 counties were identified as shortage areas in 1 dataset, 47 as shortage areas in 2 datasets, and 1 Arizona county as a shortage area in all 3 datasets. Arizona, Kentucky, Missouri, South Dakota, and Virginia had ≥ 3 counties identified as shortage areas in ≥ 2 datasets.
CONCLUSIONS AND CLINICAL RELEVANCE Many geographic areas were identified across the United States where food animal veterinary services may be inadequate to implement the Veterinary Feed Directive and meet other producer needs. This information can be used to assess the impact of federal regulations and programs and help understand the factors that influence access to food animal veterinary services in specific geographic areas.
Abstract
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.
Abstract
OBJECTIVE To determine how veterinarians' attire affected clients' perceptions and trust in the small animal emergency medicine setting.
DESIGN Cross-sectional study.
SAMPLE 154 clients of a 24-hour small animal emergency clinic in a rural location.
PROCEDURES A survey was administered to clients in the waiting room over a 1-month period to elicit their impressions of veterinarians' attire in various clinical scenarios and whether that attire would affect their perceptions. Respondents completed the survey after examining photographs of 1 male and 1 female veterinarian in 5 styles of attire (business, professional, surgical, clinical, and smart casual).
RESULTS 83 (53.9%) respondents were female, and 71 (46.1%) were male; age was evenly distributed. Across all clinical scenarios, the most common response was no preference regarding the way a male or female veterinarian was dressed and that this attire would have no effect on the respondents' trust in their veterinarian. Most respondents were indifferent or preferred that their veterinarians not wear neckties and white coats. Twenty-six percent (40/154) of respondents indicated that they believed their veterinarian's attire would influence their opinion of the quality of care their pet received.
CONCLUSIONS AND CLINICAL RELEVANCE In this small animal emergency medicine setting, most clients indicated no preference regarding their veterinarian's attire, yet approximately one-fourth indicated this attire would influence their perception of the quality of care their pet received. Further studies are warranted in other practice settings and locations to determine whether these findings are generalizable or unique to this particular setting.
Abstract
OBJECTIVE To determine the most effective hemostatic knot configuration performed by veterinary students following a brief training session with an experienced surgeon and a subsequent deliberate self-training period.
DESIGN Experiment.
SAMPLE 24 fourth-year veterinary students with no previous surgical knot–tying experience.
PROCEDURES In a 1-hour training session, an experienced surgeon showed veterinary students how to perform 5 hemostatic knot configurations (giant, slip, strangle, surgeon's, and transfixing), which they then practiced at home on a hemostasis simulator for 2 weeks. Thereafter, students performed each knot 4 times (twice each with monofilament and multifilament suture) on a hemostasis simulator. An experienced surgeon evaluated the correct execution of knots and measured their effectiveness by use of a manometer to measure vessel pressure distal to the ligature. Each student completed a questionnaire regarding their perceived learning and execution difficulty and sealing security for each knot. Responses were compared among knots and suture materials.
RESULTS Overall, students considered the surgeon's knot the easiest to learn and the strangle knot the most difficult. The slipknot was also considered the easiest knot to perform, and the giant knot was considered the most difficult. The strangle knot was deemed the most effective in reducing vessel pressure distal to the ligature.
CONCLUSIONS AND CLINICAL RELEVANCE The strangle knot was the most effective hemostatic knot in inexperienced hands, although veterinary students considered it more difficult to learn than other, perhaps more commonly taught, knots. Therefore, teaching of the strangle knot should be encouraged in veterinary schools.
