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  • Author or Editor: Mark D. Carlson x
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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.

Full access
in Journal of the American Veterinary Medical Association


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.

Full access
in Journal of the American Veterinary Medical Association