This article presents one of the first studies to specifically analyse dimensions of stress among Australian veterinarians and the validity of its related questionnaire. Australia occupies an important component of the world veterinary demographic. By 2002 for example, the relative number of veterinary practitioners in this country was higher than for the United States (US), United Kingdom (UK) and Canada . The most common causes of extreme stress among them was shown to be long working hours per day, not having enough holidays per year, not having enough rest breaks per day, the attitude of customers, lack of recognition from the public and not having enough time per patient. Such findings are consistent with some previous research conducted among veterinarians in the Asia-Pacific region. In Australia for example , the main stressors relating to working conditions were time-related, including long working hours and having insufficient recreation time. In New Zealand , total hours worked were shown to be a main cause of stress. In one German study , the probability of intense psychosocial stress was shown to increase as the number of work hours increased. In another investigation from the same country , correlations were also demonstrated between a high number of working hours and subsequent stress.
Prospects for future promotion, the attitude of superiors and the pressure to over-service or to over-prescribe were the least likely to have caused stress among our Australian veterinarians when the data was analysed as a group. This was somewhat of an interesting finding because quality of leadership and collaboration with co-workers has been previously demonstrated as a stress correlate in other occupations . In the current study however, having insufficient time per patient and the pressure to over-service or over-prescribe were shown to be significant sources of stress for veterinarians in small animal practice. Although the practitioner-client relationship is a very important component of modern veterinary practice, this topic appears to have been rarely studied. What is known is that clients may generate significant negative emotion among veterinarians [13, 14]. In a previous Australian study for example , clients who did not pay their accounts were a source of chronic irritation and stress for the veterinary practitioner. In New Zealand, client expectations were shown to be an important stressor, especially for females . Personal relationships are also known to affect this particular working group, with difficulties achieving a work-life balance having been previously demonstrated among veterinarians . Stress relating to the work-home interface has also been demonstrated among physicians , a comparable occupational group to veterinarians in many ways.
Three main correlates of stress during the current study included age, gender and practice type. Relationships between stress and age have been previously documented in a variety of studies. In Germany for example , veterinarians aged 35-54 years were more likely to experience stress than their older counterparts. Similarly in New Zealand , younger veterinarians experienced more stress from personal relationships, while family needs were shown to be a particular stressor for those aged between 35 and 54. Interestingly, another Australian study  did not record any age-related correlations. In our current investigation, gender was shown to be a strong correlate for almost all aspects of stress. This is again, similar to the aforementioned New Zealand study , where females were significantly more stressed than males regarding hours worked, employer/colleague expectations, client expectations, communication with clients, resources, support from senior staff, professional support and unexpected outcomes. In Germany, female veterinarians engaged in high-risk alcohol consumption more often than their male counterparts, although the latter were more likely to binge drink . In an Australian study of workers who euthanize animals , females reported higher mean levels of stress when compared to their male counterparts.
Another key finding in the current study was evidence of a relationship between stress and working in small animal practice, particularly regarding not having enough time per patient and the pressure to over-service or over-prescribe. Interestingly, an investigation of New Zealand veterinarians  also documented a stress relationship with practice type, albeit in a slightly different manner. Veterinarians working in large or mixed animal practice were more concerned with after hours work than those in small animal practice, while the responsibility for animals' lives was more of a concern for the latter . In Germany, stress was more common among practice owners and veterinarians working in clinical practice than those working elsewhere . It is reasonable to hypothesise that small practice owners or sole operators may be less inclined, or even able, to take sick leave when they feel stressed. Research among their medical counterparts has already shown, for example, that physicians are known to experience a variety of psychosocial stressors , and yet, seldom take sick leave and tend to make less use of primary health care services . Workplace health promotion programs may be useful in this regard, particularly considering that reduced work ability is known to be associated with health and work ability .
For these reasons, learning to cope with stress remains a critical area of professional practice. While the current study and others have clearly demonstrated that job stress and mental pressure do affect veterinarians [11, 12], various anti-stress skills now exist which may help workplace stress to be dealt with in appropriate ways . Support from partners, family and co-workers is always important, and encouragingly, levels of professional support appear to be increasing. A previous study of Australian veterinarians over the past 5 decades, for example, demonstrated that the average recent graduate has had progressively more opportunities for support from other veterinarians . While certain stress-coping skills can be acquired from books or learnt through counselling, they still need to be practiced to enable integration into everyday life . Some research conducted in non-veterinarians has suggested that short duration Stress Management Training (SMT) may be useful in reducing some aspects of stress, anxiety and self-perceived depression . Such strategies may also be useful in the veterinary profession.
Although the current study has clearly demonstrated the presence of stress in Australian veterinary practice, it is also important to keep our findings in perspective. Despite the potential for a wide array occupational hazards, many find that a career in veterinary science is very rewarding . A longitudinal study of veterinarians by Heath  found that after 10 years in practice most participants felt that their career had lived up to expectations and was a great source of satisfaction. Our current study has shown that despite some veterinarians experiencing extreme stress in certain areas, the actual proportion was relatively low, and it is reasonable to hypothesise that their overall levels of stress were not excessive, similar to a previous Australian study . On the other hand, a longitudinal investigation from this country reported that almost three-quarters of veterinarians either agreed or strongly agreed that their veterinary work caused them a significant amount of stress . Either way, the results clearly suggest that stress represents an important issue for Australian veterinarians.
While certain limitations were inherent in the current study, including the reliability of self-reported health measures, our investigation nevertheless provides a detailed analysis of stress dimensions among a large cohort of Australian veterinarians, for what appears to be the first time. Although we achieved a relatively high response rate of 64% using standard methods for postal surveys , a mixed-mode methodology such as that described by Wilkins and colleagues  may have afforded a higher return rate. All of these measures may be useful for future researchers of veterinarians' health to consider.