An investigation of the prevalence of compassion fatigue, compassion satisfaction and burnout in those working in animal-related occupations using the Professional Quality of Life (ProQoL) Scale

Rebekah L Scotney
Sunday, June 2, 2019

Background: Animal-related occupational stress and compassion fatigue are important issues as they can have a negative impact on employee mental wellbeing, workplace productivity and morale. The impacts of these conditions are notable and have become more recognised by those who are employed in animal-related occupations. Aims: This study aims to investigate the incidence of compassion satisfaction and compassion fatigue (burnout and secondary traumatic stress) in those working in animal-related occupations using the Professional Quality of Life (ProQoL) Scale. Methods: Data were collected from 229 employees from a range of animal-related occupations using an anonymous self-report survey. Results: Most respondents were employed in veterinary practice (either veterinarians or veterinary nurses/technicians) and 85% of all respondents were female. 42% of participants were between 26 and 35 years of age and, 71% had been working in animal-related occupations between 1 and 10 years. Most participants scored in the mean or top quartile on the compassion satisfaction scale; however, about a quarter reported a score which indicated that they were deriving less satisfaction from their work. Low burnout was reported by 78% of participants; however, 21% of participants had a score which indicated that they were at higher risk of burnout. Low or average symptoms of secondary traumatic stress was reported by 74% of participants; however, 25.8% were at risk of secondary traumatic stress. While most of the surveyed population scored in the mean or top quartile on the compassion satisfaction scale, all of the occupational categories reported experiencing the negative aspects of caring: burnout and secondary traumatic stress. Conclusion: The prevalence of compassion fatigue demonstrated in these results should be a major concern in animal-related occupations and thus, be used as a beneficial, contextualised resource to inform resilience training programmes and preventative strategies specifically targeted towards those working in animal-related occupations.

There has been an increase in recognition of work-related mental health disorders affecting all industries and professions worldwide (Australian Safety and Compensation Council, 2006). With an estimated cost of AUD$200 million dollars annually (USD$142M), workers' compensation claims for stress-related mental disorders in Australia are on an upward trajectory. Data collected by Work Safe Australia show not only an increase in workers' compensation claims for stress-related conditions and mental disorders (5700 in 1997/98 to 8260 in 2004/05), but also in the duration of claims where median time lost for mental disorders suffered at work rose from 6.8 weeks in 1997/98 to 9.7 weeks per claim in 2004/05 (Guthrie et al, 2010). Mental stress is understood to be the foremost causative factor of work-related mental disorders in Australia, with ‘exposure to a traumatic event’ and ‘work pressure’ being the most commonly reported mechanisms (Australian Safety and Compensation Council, 2006).

The National Data Set for Compensation-based Statistics (NDS) lists a standard set of data items, concepts and definitions for inclusion in workers' compensation systems operating in Australia. The NDS has been implemented in workers' compensation-based collections administered by state, territory and Australian government agencies to enable the production of national and nationally comparable workers' compensation-based data (Safe Work Australia, 2008). According to the NDS, the industries with the highest claims or incidence were health and community services and education and personal and other services. The highest claims according to occupational groups were professionals, and intermediate clerical, sales and service workers. However, extremely high incidence rates were also evident for police officers, prison officers and social welfare professionals and school teachers (Australian Safety and Compensation Council, 2006). These findings are consistent with the extensive literature published in the human healthcare and social sciences sector.

Martins Pereira et al (2011) stated that the experience of working with high levels of death and dying puts those who work in palliative care at particular risk of burnout and compassion fatigue. Similarly, those who work in emergency, oncology and other care-giving occupations also have a high prevalence of occupational stress and compassion fatigue (Najjar et al, 2009; Hooper at al, 2010; Potter et al, 2010; Ray, 2013). Nonetheless, it appears that job satisfaction remains comparatively high in these occupations. While there are a great number of articles and published research examining compassion fatigue, burnout and compassion satisfaction in human healthcare occupations, there is little focus on those working in animal healthcare and other animal-related occupations.

Compassion fatigue, as introduced by Carla Joinson in 1992, is used to describe the negative consequences of working in a caregiving occupation, specifically, caring for those who are experiencing trauma and suffering, coupled with empathy and a strong desire to help (Figley, 1995).

Burnout occurs as a result of severe, prolonged stress at work and is described by Maslach and Jackson (1981) as having three components: emotional exhaustion from chronic stress; cynicism and detachment from the job; and feelings of incompetency and a lack of achievement resulting in a lack of personal performance or accomplishment. Generally, work-related stressors which lead to burnout are related to organisational management including factors such as role ambiguity, excessive workload, staff inequity and social factors (Sardiwalla et al, 2007). Those working in care-giving occupations, including animal-related occupations, are susceptible to burnout due to the emotional intensity of working with those who are in distress and traumatised (Sardiwalla et al, 2007).

Current research describes the relationship between compassion fatigue and burnout as overlapping (Figley, 2003; Alkema et al, 2008; Potter et al, 2010); burnout is one negative component of compassion fatigue. It is important to recognise that compassion fatigue and burnout are distinct concepts whereby one (burnout), describes a general reaction to work-related environmental stress that can be experienced by employees in any occupational field and the other (compassion fatigue), relates directly to the relationship an employee has with the work that is being undertaken.

Compassion satisfaction refers to the positive aspect of working as a care-giver. It refers to the emotional rewards or gratification received through empathy and compassion felt by those who care for the suffering and traumatised (Stamm, 2010). While there is limited literature focusing on compassion fatigue, there is even less that focuses on compassion satisfaction. This is true in human healthcare and even more so in animal healthcare. Only one single study was identified which looked at veterinarian satisfaction (Shaw et al, 2012). However, this study measured veterinarian satisfaction specific to interactions during companion animal visits and the veterinarian-client-patient interaction, and while positive interactions within this triangular relationship certainly contribute to personal satisfaction and mental wellbeing, it does not take into account the many other external factors which may positively influence overall job satisfaction (Shaw et al, 2012).

When people are faced with frequent physical and emotional challenges over a long period of time they may become fixated on the negative aspects of life and, if left unabated this can lead to mental health disorders such as anxiety and distress. It is therefore important to investigate the concept of compassion satisfaction in order to understand its apparent counterbalancing protective mechanism against compassion fatigue.

This study aims to investigate the incidence of compassion satisfaction and compassion fatigue (burnout and secondary traumatic stress) in those working in animal-related occupations using the Professional Quality of Life (ProQoL) Scale (Stamm, 2010).

Methods

Participants

Participants were recruited opportunistically at animal-related conferences (n=4) or in-house seminars (n=3) where the aims of the study were specified. Respondents were advised that return of the completed survey was interpreted as informed consent to participate. Participation was on a voluntary, self-selection basis, and the ProQoL surveys were disseminated, completed and returned to the researcher on the same day. All surveys handed out were returned, thus the return rate was considered to be 100% (n=233 respondents). Four of the returned surveys were incomplete and therefore were not included in the analysis and report of results. The adjusted return rate was 98% (n = 229). Those participants included in the analysis were employed in various occupations (see Table 1), drawn from a range of animal-related workplaces: emergency veterinary practices n=17, animal research technicians n=32; shelter workers n=40; veterinary practices n=140.


Table 1. Demographic characteristics
Table 1. Demographic characteristics
Characteristics Frequency %
Group Emergency practices 17 7.4
Animal research technicians 32 14.0
Shelter workers 40 17.5
Veterinary practices 140 61.1
Gender Female 195 85.2
Male 34 14.8
Age (in years) 18–25 46 20.1
26–35 97 42.4
36–45 46 20.1
46–55 30 13.1
>50 10 4.4
Occupation Veterinarian 69 30.1
Veterinary nurse 67 29.3
Animal research technician 23 10.0
Practice manager/supervisor 36 15.7
Receptionist 8 3.5
Animal foster 11 4.8
Student 5 2.2
Others 10 4.4
Number of years in industry <1 15 6.6
1–5 86 37.6
6–10 77 33.6
11–15 18 7.9
16–20 17 7.4
>20 16 7.0

This study was approved by the University of Queensland Human Research Ethics Committee (2012000819).

Measures

The ProQoL Scale is a self-report survey and is the most commonly used measure of positive (compassion satisfaction — CS) and negative (compassion fatigue — CF) effects on people who are working with extremely stressful events. Compassion satisfaction is about the pleasure derived from work well done. Compassion fatigue is partitioned into two sections: burnout (BO), measured by exhaustion, frustration, anger and depression; and secondary traumatic stress (STS) which is about work-related secondary exposure to extreme or traumatic stressful events. The negative effects of secondary traumatic stress include fear, sleep difficulties, intrusive images or avoiding reminders of traumatic experiences. There is good construct validity of the Pro-QoL which has been utilised in more than 200 publications (Stamm, 2010). Reliability estimates for the three subscales have been reported as 0.87 for the compassion satisfaction scale; 0.72 for the burnout scale; and 0.80 for the compassion fatigue scale (Braun and Clarke, 2006). The three scales of the ProQoL (CS, BO and STS) measure separate constructs, although compassion fatigue has shared variance with burnout (5%, r=-0.14; co-σ=2%; n=1187) and secondary traumatic stress (2%, r=-0.23; co-σ=5%; n=1187). Burnout and secondary traumatic stress have demonstrated a shared variance of 34% in previous analyses, likely reflecting the distress that is common to both conditions (Stamm, 2010).

Completion of the ProQoL involves selecting response choices on a 0 (never) to 5 (very often) Likert scale. Scoring of the ProQoL initially involves reversing items 1 (I am happy), 4 (I feel connected to others), 15 (I have beliefs that sustain me), 17 (I am the person I always wanted to be) and 29 (I am a very caring person), then summing the items for each scale and converting the raw score into a t-score. Each scale therefore has a mean of 50 (SD 10). Higher scores on the compassion satisfaction scale represent greater satisfaction while higher scores on both burnout and secondary traumatic stress represent greater risk of burnout and higher secondary traumatic stress.

Stamm (2010) makes the point that the ProQoL is not a diagnostic tool but rather a screening instrument that can be useful in raising awareness of issues which may need to be addressed. That is, the ProQoL provides a snapshot of an individual's or organisational balance of positive and negative experience related to the work being undertaken. Any definitive conclusions are best drawn when the tool is used over time and trends are identified (Potter et al, 2010).

For the purposes of this study respondents were also asked to provide the following demographic data: workplace type; gender; age; occupation; and number of years in the industry.

Statistical analysis

Descriptive analyses of demographic characteristics of participants were conducted, followed by exploration of the range of scores (raw scores and t-scores) and frequency of cut-off scores according to levels of distress (low, average, high). Descriptive scores on the three scales by gender, age group, number of years in the industry and occupation category were conducted. Cross tabulation and Chi Square analysis (χ2) tests were conducted between t-scores on each of the three scales and gender, age, number of years in the industry and occupation categories. Chi Square analysis and the t-statistic were used to assess differences in scores as this enables clearer understanding of frequencies reported through the ProQoL and whether contingencies exist between the demographic variables.

Results

Most of the survey respondents (~61%) were employed in veterinary practice (either veterinarians or veterinary nurses/technicians) and 85% of all respondents were female. 42% of participants were between 26 and 35 years of age, and 71% had been working in animal-related occupations between 1 and 10 years (seeTable 1).

Table 2 displays the summary statistics (raw scores and t-scores) on the three scales of the ProQoL. The range of scores was widest on the two scales which measured the negative aspects; burnout (range 25.1–82.3) and secondary traumatic stress (range 28.7–81.25).

Table 2.

Summary Statistics on the three scales of the ProQoL

N Minimum Maximum Mean Std. Deviation
CS 229 23 50 39.2 5.9
BO 229 10 44 24.8 5.9
STS 229 12 43 24.6 5.9
CS t score 229 22.8 68.18 50.0 10.0
BO t score 229 25.1 82.30 50.0 10.0
STS t score 229 28.7 81.25 50.0 10.0

(CS: compassion satisfaction, BO: Burnout, STS: secondary traumatic stress)

Table 3 illustrates the frequency of cut-off scale t-scores for the 229 participants in this study. While most participants scored in the mean or top quartile on the compassion satisfaction scale, demonstrating professional fulfilment, about a quarter reported a score which indicated that they were deriving less satisfaction from their work. Low burnout was reported by 78% of participants; however 21% of participants had a score which indicated that they were at higher risk of burnout. Low or average symptoms of secondary traumatic stress was reported by 74% of participants; however, 25.8% were at risk of secondary traumatic stress.

Table 3.

Frequency of low, average and high t-scores on the three subscales of the ProQoL for the 229 participants

Compassion satisfaction Burn out Secondary traumatic stress
t-scores Frequency % Frequency % Frequency %
Low 59 25.8 54 23.6 63 27.5
Average 109 47.6 126 55.0 107 46.7
High 61 26.6 49 21.4 59 25.8

Compassion satisfaction

As shown in Table 4, findings were statistically significant for the relationship between compassion satisfaction and age (χ2=7.96, p=0.02); where older workers reported more compassion satisfaction. Further, the relationship between compassion satisfaction and number of years in the industry was also statistically significant (χ2=9.51, p=0.05); where those who had been employed in the industry for between 6 and 15 years were more likely to report average or lower levels of compassion satisfaction. Occupation was also an important factor, with veterinarians and animal research technicians reporting significantly lower compassion satisfaction scores (χ2=31.78, p<0.001). There were no statistically significant differences by gender. Those categorised as ‘Others’ (which includes receptionists, volunteers and foster carers) had the greatest percentage of high scores for compassion satisfaction (50%), while veterinarians revealed the greatest percentage of low scores (43.5%).

Table 4.

CS: t-scores by gender, age, number of years in industry and occupation categories

CS:t-scores
Low % Average % High %
Gender Female 25.6 49.2 25.1 χ2=1.87, p=0.39
Male 26.5 38.2 35.3
Age 18-35 23.8 54.5 21.7 χ2=7.96, p=0.02
≥ 36 29.1 36.0 34.9
Number of years in industry 229 25.1 82.30 50.0 χ2=9.51, p=0.05
1-5yrs 17.8 54.5 27.7
6-15yrs 31.6 46.3 22.1
>15yrs 33.3 30.3 36.4
Occupation Veterinarian 43.5 36.2 20.3 χ2=31.78, p < 0.001
Veterinary nurse 16.4 64.2 19.4
Animal research technician 34.8 43.5 21.7
Practice manager/supervisor 16.7 50.0 33.3
Others* 11.8 38.2 50.0

*

Includes receptionist, students, animal fosterers and other non-professional volunteers

Burnout

Analyses of the relationship between burnout and time spent in the industry indicated that those who had been employed 6–15 years reported significantly higher scores indicative of a greater risk of burnout (χ2=11.98, p=0.02) as shown in Table 5. There were no statistically significant differences by gender, age, or occupation. However, veterinarians revealed the greatest percentage of high scores for burnout (34.8%) while ‘Others’ reported the greatest percentage of low scores (29.4%).

Table 5.

BO: t-scores by gender, age, number of years in industry and occupation categories

BO-t scores
Low % Average % High %
Gender Female 21.5 55.9 22.6 χ2=3.34, p=0.19
Male 35.3 50.0 14.7
Age 18–35 21.0 60.1 18.9 χ2=4.03, p=0.13
≥ 36 27.9 46.5 25.6
Number of years in industry 1–5yrs 26.7 59.4 13.9 χ2=11.98, p=0.02
6–15yrs 15.8 55.8 28.4
>15yrs 36.4 39.4 24.2
Occupation Veterinarian 20.3 44.9 34.8 χ2=12.40, p=0.13
Veterinary nurse 25.4 59.7 14.9
Animal research technician 26.1 60.9 13.0
Practice manager/supervisor 19.4 58.3 22.2
Others* 29.4 58.8 11.8

*

Includes receptionist, students, animal fosterers and other non-professional volunteers

Secondary traumatic stress

In contrast, analyses demonstrated that gender was more influential on the reporting of secondary traumatic stress (χ2=7.10, p=0.03) with women being significantly more likely than men to report high scores (Table 6). No other variables reached statistical significance in this analysis of secondary traumatic stress. However, veterinarians also revealed the largest percentage of high scores for secondary traumatic stress (31.9%), closely followed by ‘Others’ (29.4%) and practice managers/supervisors (27.8%). Interestingly, animal research technicians had the lowest percentage of high-risk secondary traumatic stress scores (8.7%).

Table 6.

STS: t-scores by gender, age, number of years in industry and occupation categories

STS-t score
Low % Average % High %
Gender Female 24.6 47.2 28.2 χ2=7.10, p=0.03
Male 44.1 44.1 11.8
Age 18-35 26.6 51.0 22.4 χ2=3.34, p=0.20
≥ 36 29.1 39.5 31.4
Number of years in industry 229 28.7 48.5 22.8 χ2=4.53, p=0.34
1-5yrs 22.1 48.4 29.5
6-15yrs 39.4 36.4 24.2
Occupation Veterinarian 21.7 46.4 31.9 χ2=11.67, p=0.17
Veterinary Nurse 23.9 53.7 22.4
Animal Technician 52.2 39.1 8.7
Practice Manager/supervisor 27.8 44.4 27.8
Others* 29.4 41.2 29.4

*

Includes receptionist, students, animal fosterers and other non-professional volunteers

Discussion

The findings of this study indicate that compassion satisfaction is lowest among veterinary surgeons and animal research technicians. However, occupation was not a significant factor in the risk of burnout or secondary traumatic stress. These findings are congruent with those of Rohlf and Bennett (2005) where occupational context was reported as not being associated with different levels of stress symptoms, in particular, euthanasia-related stress (Rohlf and Bennett, 2005). The negative aspects of professional quality of life — burnout and secondary traumatic stress — showed contrasting patterns, with significant differences apparent in those who had been working longer in the industry associated with greater risk of burnout and women facing a greater risk of secondary traumatic stress than men.

It is possible to assume that with the pressures of workload and perhaps specifically, patient load, there would be little time for veterinarians to engage in the nurturing behaviour (e.g. petting, grooming, and providing fundamental comfort care) that may contribute to compassion satisfaction. Veterinarians are moving from patient to patient, providing diagnosis, prognosis and treatment plans, these activities are essential to veterinary care. However, the intimate interactions of implementing medical treatment and the associated care, nursing and nurturing are carried out by the veterinary nurses. A veterinarian's ability to gain compassion satisfaction is perhaps hindered by their inability to engage with their patients at this level. Similarly, the low levels of compassion satisfaction among animal research technicians may be attributed to their involvement in the processes of research which can induce disease, discomfort, anxiety or pain. These conditions require the animals to be cared for and nursed with the ultimate outcome being euthanasia, a situation which is described by Arluke (1994) as ‘the caring–killing paradox’: where employees care for the animals which they ultimate have to kill. This is a painful process that often evokes complex emotional states (Rohlf and Bennett, 2005).

Contrastingly, compassion satisfaction was reported to be higher for those categorised as ‘Others’. As mentioned above, this is likely due to the types of interaction with animals. That is, veterinary nurses, foster carers and volunteers for instance are very tactile and nurturing in their interactions with the animals under their care. Cleaning, feeding, changing bedding; providing not only medical nursing and rehabilitation but the loving, caring, bonding type behaviours which are ‘feel good’ undertakings. Engaging in positive interactions and behaviours which create feelings of satisfaction helps to balance the negative effects of caring for the acutely ill or traumatised patients (Arluke, 1994). For an individual or organisation, high scores on compassion satisfaction are a reflection of engagement with the work being done (Stamm, 2010). This indicates the importance of being proactive in both self-care and team-care in at-risk occupations; by facilitating and fostering policies and procedures that promote positive interactions and downtime which are focused on building compassion satisfaction.

This research showed that those who had been in an animal-related occupation for more than 15 years reported the most satisfaction. Stamm (2010) states that while it is tempting to presume those with more experience do better, it is likely that those with greater exposure and low resiliency left the field, while those who remained were differentially resilient. Furthermore, the current analyses indicate a possible link between compassion satisfaction and burnout for those who had been employed in animal-related occupations for between 6–15 years. That is, they reported higher scores indicative of a greater risk of burnout and were more likely to report average or lower scores for compassion satisfaction.

Hooper et al (2010) stated that human healthcare workers (nurses) are struggling to meet the demands for improved patient satisfaction and outcomes with demands for greater efficiency at a time when patients expect improved service. It can be seen that this point is also true for those working in animal-related occupations where resources are often limited and workload is high. Being intrinsically woven in high responsibility/low control environments further adds to the pressures of animal healthcare workers (Hooper et al, 2010).

Maslach and Jackson (1981) described burnout as a syndrome of emotional exhaustion and cynicism that occurs frequently among individuals who do ‘people-work’. The symptoms of burnout — depleted emotional resources, development of cynical feelings and attitudes and, markedly increased negative self-evaluation (Maslach and Jackson, 1981) — are evident throughout the ever increasing literature on this topic. Through this study, and the greater work in which this research sits (Scotney et al, 2017), burnout can be expected as a frequent occurrence in those people who do ‘animal-work’ (Scotney et al, 2017). Burnout involves a prolonged response to stressors in the workplace (Scotney, 2017) and is a cumulative syndrome which can have a negative impact on employee longevity (Potter, 2010). It is therefore unsurprising that the results of the analyses in this study demonstrate the significant relationship between burnout and length of time in animal-related occupations (specifically those employed for between 6–15 years). However, in contrast those who are employed for greater than 15 years' experience higher levels of compassion satisfaction which is congruent with the concept of ‘survivors’; those who are better able to cope with the stressors of animal-related work or have greater resiliency. Perhaps this is best explained by Figley and Roop in their book Compassion fatigue in the Animal-Care Community (2006). Figley and Roop explained that there are five phases of transition for a new helper (animal care-giver); Phase One is The Dream developed often in childhood and sustained through education until employment. Phase Two is The Start — employment, ready to make a difference and make the world a better place for animals, enthusiasm overflows. Phase Three is Losing Our Breath — realising the journey is long and arduous, enthusiasm dampens and feelings of anger, frustration and perhaps hopelessness filter in. Phase Four is Seeking Rhythm — recognising a need to set a steady pace in order to sustain sanity, health and energy. This is the phase that sees employees either take steps to move forward or ‘check out’ and leave the profession. And finally, Phase Five is Finding Rhythm — finding the pace, the niche, the rhythm — a stride that is sustainable and provides a sense of relief. This system of understanding fits with the findings of this study where those employed for between 6–15 years are perhaps in Phases Three and Four; losing breath and leaving the industry or looking for rhythm and surviving the journey. It is surmised that the direction taken at the crossroads of Phase Three and Phase Four would be influenced by an individual's own characteristics including level of compassion satisfaction and resilience (Maslach, 2003).

Where previously classified as an anxiety disorder, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (American Psychiatric Association, 2013) now defines post-traumatic stress disorder (PTSD) as a trauma and/or stress-related disorder precipitated by a traumatic event or exposure to a traumatic event. It is characterised by symptoms of re-experiencing the trauma, avoidance and numbing, negative cognitions and mood, and arousal. (Figley and Roop, 2006). This study revealed that women are at greater risk of secondary traumatic stress than men. It is difficult to surmise why this might be the case. However, one hypothesis could be that more women are acutely affected by trauma experienced by animals than men. A study conducted by Tolin and Foa (2006) entailed a review of literature spanning 25 years of research investigating the sex differences in vulnerability to PTSD: men and women were found to experience different forms of post traumatic events (PTEs) and even when the type of PTE was controlled for, measureable sex differences in prevalence and severity remained (Tolin and Foa, 2006). However, Tolin and Foa (2006) concluded that much more research needed to be done before any conclusions could be reached regarding how sex acts as a vulnerability or resilience factor.

As veterinarians are often charged with ultimate responsibility for the lives of animals in their care, it is easy to see how constant interactions with traumatised patients and distressed clients can become fuel for secondary traumatic stress. However, while veterinarians showed the greatest risk of burnout (80% of respondents reporting moderate to high levels) and secondary traumatic stress (77% of respondents reporting moderate to high levels), these did not reach statistical significance. Similarly, veterinary nurses were also identified as an at-risk group for burnout (75% of respondents reporting moderate to high levels) and secondary traumatic stress (75% of respondents reporting moderate to high levels), but again these did not reach statistical significance. The interesting difference between these two occupations is that 84% of veterinary nurses reported moderate to high levels of compassion satisfaction whereas veterinarians' reported the lowest levels (43.5%).

Given the unique environment of biomedical research, it is curious that animal research technicians were not shown to be an at-risk group for secondary traumatic stress. This finding may relate to the fact that these technicians are, more often than not, educated and informed about the procedures, methods and expected outcomes of the work that they do. However, this contradicts the work of Rohlf and Bennett (2005) who indicated that people who look after animals and, as part of their occupation, are required to euthanase them should be regarded as an at-risk population for post traumatic stress. Furthermore, as quoted in Rohlf and Bennett (2005), MacNair (2005) explains that there are people, who in other contexts, experience post traumatic stress as a result of actively participating in traumatic events, these people are said to have perpetration-induced traumatic stress (PITS). For example, armed forces veterans who have killed people in warfare (MacNair, 2005), and, police officers who have shot criminals in the line of duty (Loo, 1986).

In interpreting the results of combination scores, those reporting high compassion satisfaction with low to moderate burnout and secondary traumatic stress are thought to be in the most positive situation. This combination indicates a greater balance between the positive and negative aspects of animal-related occupations. Findings from this study suggest that those employees under the ‘Others’ category are more likely to experience this combination. It is conceivable that this finding may be related to the satisfaction and healing effects of fostering and volunteering. That is, those who engage in foster care and volunteering are perhaps sustained by the satisfaction gained from the specific nurturing work they do every day and the tangible difference they can see in each animal they work with. The ‘happy endings’ outweigh the sad. It is however, important to note here that those categorised as ‘Others’ may be unpaid for the work that they do (with the exception of receptionists). Hamilton and Taylor (2012) report that it is not necessarily a straightforward desire to care for other species that motivates people to work with animals nor is it solely motivated by financial reward. Often rewards reach into more symbolic and ethical domains of value creation (Hamilton and Taylor, 2012). This point is perhaps a significant factor in the results for this category and warrants further investigation.

Contrastingly, those reporting high secondary traumatic stress and high burnout with low compassion satisfaction are considered to be in the most distressing situation. This combination describes an employee who is not only physically and emotionally exhausted but is experiencing traumatic events both in ‘real time’ and as recurring flashbacks (typically symptomatic of PTSD). A deficit of any form of satisfaction and a propensity to judge themselves harshly would add to the severity of this combination. While not reaching statistical significance, it was evident from the results reported in this study that those working as veterinarians were most at risk of experiencing this combination. This is not entirely surprising given the consistent reports of traumatic events/situations, time constraints and high patient load as described in Scotney et al, 2017. This result may contribute some explanation as to the growing rate of suicide in veterinarians (Jones-Fairnie et al, 2008; Bartram and Baldwin, 2010; Platt et al, 2010). As previously stated, there appears little time for veterinarians to engage in the ‘feel good’ behaviours and interactions which promote workplace satisfaction. Perhaps compounding this is a lack of downtime to reflect, digest, re-set. That is, heal from hectic and/or traumatic shifts before having to return again.

According to Stamm (2010), those who score high on burnout, in any combination with the other scales, are at risk as individuals and may also put their organisation in high-risk situations as physical and mental exhaustion can create a myriad of health and safety concerns when reflexes and response times are compromised. Veterinarians, veterinary nurses, animal research technicians and practice managers/supervisors all report moderate to high scores on burnout (74–80%). Approximately, 20–25% of each of these occupations reported a low score on burnout. Primarily associated with high workloads and poor workplace procedures or polices, burnout manifests as feelings of inefficiency, and a loss of purpose and direction. Often people suffering burnout feel as though nothing they do makes a difference and they are likely to be disengaged with their patients (Stamm, 2010), clients or animals under their care.

Animal research technicians were least likely to experience secondary traumatic stress with moderate to low scores for 91% of the surveyed population. However, with moderate to high scores for burnout and low to moderate scores for compassion satisfaction, this occupational category is classified as an at-risk group.

Previous studies conducted in the human healthcare sector (Hooper et al, 2010; Stamm, 2010; Ray et al, 2013) revealed mean scores for compassion satisfaction of approximately 37. Thus, the mean for compassion satisfaction in those working in animal-related occupations is similar to that experienced by oncology nurses, emergency, nephrology and medical-surgical intensive care unit nurses and, those working as mental healthcare professionals. The mean burnout score of 24.8 is higher than that reported in the studies by Stamm (1999) and Potter et al (2010). The mean secondary traumatic stress score of 24.6 is much higher in this study where the average compassion fatigue scores for Stamm (1999) and Potter et al (2010) were 13 and 15.2 respectively. This demonstrates that the risk for secondary traumatic stress is perhaps considerably higher for those working in animal-related occupations than it is for those working in human health care.

This study shows that there is a need for effective consideration at both an organisational and individual level in the development of strategies, and the development of tools and resources available to support employees within animal-related work environments. Research which implements and investigates the effects of these structured prevention and intervention programmes is a priority.

Conclusion

This study aimed to investigate the prevalence of compassion satisfaction and compassion fatigue (burnout and secondary traumatic stress) in those working in animal-related occupations. While most of the surveyed population scored in the mean or top quartile on the compassion satisfaction scale, all of the occupational categories reported experiencing the negative aspects of caring: burnout and secondary traumatic stress. The prevalence of compassion fatigue demonstrated in these results should be a major concern in animal-related occupations. Longitudinal studies which examine the attributes and characteristics of those who remain in the industry for greater than 15 years need to be conducted in order to further understand how individual mental and emotional constructs might have an impact on occupational success and longevity in animal-related occupations. This information would provide a beneficial, contextualised resource to inform resilience training programmes and preventative strategies specifically targeted towards those working in animal-related occupations, thus, providing access to resources aimed at ensuring mental wellbeing and a positive work/life balance for all employees.

This study has demonstrated the need to address concerns relating to the mental wellbeing of those employed in animal-related occupations. However, the limitations of using only the ProQoL Scale may have hindered the ability to provide a more holistic picture of occupational stress and compassion fatigue. Further qualitative research should be conducted that includes other validated self-assessment tools such as the Depression, Anxiety and Stress (DAS) Scale and the Jobs Resources-Demands Scale in conjunction with exploration of the Challenge-Hindrance theoretical framework. Additionally, elicitation of the more subjective, contextualised and often highly emotive perspectives of employees across various animal-related occupations would provide a deeper understanding of the nuances in particular animal-related settings.

KEY POINTS

  • Mental stress is understood to be the foremost causative factor of work-related mental disorders in Australia, with exposure to a traumatic event and work pressure being the most commonly reported mechanisms.
  • The Professional Quality of Life scale (ProQoL) is a self-report survey and is the most commonly used measure of positive (compassion satisfaction – CS) and negative (compassion fatigue – CF) effects on people who are working with extremely stressful events.
  • The results of this study indicate that compassion satisfaction is lowest among veterinary surgeons and animal research technicians. However, occupation was not a significant factor in the risk of burnout or secondary traumatic stress.
  • Compassion satisfaction was reported to be higher for those categorised as ‘Others’. That is, veterinary nurses, foster carers and volunteers who engage in very tactile and nurturing interactions with the animals under their care. These positive interactions and behaviours create feelings of satisfaction which help to balance the negative effects of caring for the acutely ill or traumatised patients.
  • Those who report high compassion satisfaction with low to moderate burnout and secondary traumatic stress are thought to be in the most positive situation. While those reporting high secondary traumatic stress and high burnout with low compassion satisfaction are considered to be in the most distressing situation.
  • There is a demonstrated need to address concerns relating to the mental wellbeing of those employed in animal-related occupations. Access to resources and training programmes aimed at ensuring wellbeing and a positive work/life balance for all employees should be a priority.

Keep up to date with The Veterinary Nurse!

Sign up to The Veterinary Nurse's regular newsletters and keep up-to-date with the very latest clinical research and CPD we publish each month.