Using a Staff Survey to Customize Burnout and Compassion Fatigue Mitigation Recommendations in a Lab Animal Facility

Abstract

Working with research animals exposes employees to emotionally demanding work and moral stressors. The emotional impact of animal research is similar to that of working with human patients, and is similarly associated with burnout (BNO) or compassion fatigue (CF), which can lead to psychosomatic symptoms, pervasive states of stress, workplace conflict, and at its most extreme, suicidal ideation. One remedy for such feelings is increasing the satisfaction one feels from performing one's job well, known as compassion satisfaction (Csat). To address these occupational health concerns in an academic research setting, the Ohio State University's Lab Animal Resources (ULAR) study team reviewed existing preventative programing both internal and external to the university. Subsequently, a survey was distributed to all staff members to assess the following factors: employee awareness of free resources already available to them, association between staff demographics and the experience of BNO and/or CF, and the employee's own mitigation recommendations. Respondents were mostly female, in 20 to 49 age range, with 0 to 4 y in the field. Of those responding, 81.6% specified that they had experienced BNO and CF alone, together, or in combination with CSat. Factors statistically associated (P < 0.05) with BNO and CF were age, number of years in the field, and number of animals euthanized per year. A relative risk analysis was also used to identify protective factors. Only the age of respondents appeared to be a protective factor— the 50+ age group had 88.57% (RR = 0.1143) reduction in risk for experiencing BNO and/or CF. Participant suggestions indicated that employees would like improvements to the work environment, more novel work experiences, and more positive feedback from department leadership. The social ecological model, a public health model for program interventions, was used as a framework for the development of recommendations to mitigate BNO and CF while increasing CSat. The recommendations were customized for ULAR employees based on the survey findings.

Stress is a normal and familiar emotional state that all of us have experienced. Less familiar are the emotional conditions of burnout (BNO) and compassion fatigue (CF). BNO refers to the emotional exhaustion that results from chronic or severe stress, whereas CF refers to the strain that results from exposure to the trauma of others. Both have the potential to cause significant mental distress and are frequently associated with those who work in caregiving fields, such as veterinary medicine. These jobs require high levels of empathy and involve frequent exposures to moral stressors (ethical dilemmas).¹⁶ BNO and CF can decrease the quality of animal care and increase worker turnover and sick leave while fostering low morale.¹⁵ However, unlike BNO, CF not only effects one's work life but also affects the core of an individual's personality, shifting his/her view and interaction with the world in a negative way.⁹ The impact of CF can negatively influence a person's emotional stability, spiritual beliefs, and personal relationships.⁷

Although BNO and CF are not medical diagnoses, they have been linked with other mental health disorders such as depression, anxiety, and posttraumatic stress disorder.²⁸ In severe cases, CF has even been linked to suicide.¹⁶ In fact, veterinary surgeons were found to be 4 times as likely to have suicidal thoughts when compared with the general public.⁵ A Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report estimated that 1 in 10 veterinarians was suffering from serious psychologic distress while 1 in 6 has experienced suicidal ideation.²⁰ A major contributor to the high suicide rates seen in veterinary professionals is believed to be work-related stressors, especially those surrounding the euthanasia of animals.⁵ In addition, Belinda Platt's systematic review of suicidal behavior in veterinary surgeons found that being female and under the age of 35 were also risk factors for both BNO and CF.²⁴

CF and BNO are of additional concern in lab animal settings because animal caregivers and researchers are expected to euthanize and induce disease in animals, often animals with whom they have established emotional bonds.¹⁴ Further complicating the matter is the public controversy over such research activities. A lab animal worker's social group may include individuals who have negative connotations associated with the use of animals for research,¹⁴ thus fostering feelings of shame and guilt about the work, and subsequently limiting the ability to feel social support or to make social connections outside of the workplace. In addition, lab animal workers may feel uncomfortable discussing moral stress with their coworkers and supervisors, fearing it may lead to marginalization.⁴ These factors lead to the breakdown of social support and connections, both of which are key to the healthy management of stress and thus prevention of BNO and CF.²⁶ Due to these negative job aspects, the veterinary specialty of Laboratory Animal Medicine has deemed psychosocial distress as an occupational health hazard.¹⁰

An important intervention for decreasing the severity of BNO and CF are programs that aim to train employees on how to increase their feelings of compassion satisfaction (CSat)²⁵ CSat is the happiness one gains and the satisfaction one feels from performing one's job well.²⁹ One approach to increasing CSat is by implementing an employee wellness program. Enacted by one's place of work, these types of programs aim to provide quality of life improvements by promoting participation in activities that reduce BNO and CF. When executed correctly, employee wellness programs can benefit both the employer and the employee. A meta-analysis of 50 wellness programs reported that employees participating in such programs could expect improvements in stress, weight, and heart health.¹⁷ Recognizing the value of such initiatives, large academic institutions have begun to offer a variety of wellness programs to its employees. At The Ohio State University (OSU), available programs include Your Plan for Health (which provides employees with free yearly biometric screenings),³⁰ the Employee Assistance Program (EAP),where employees can obtain free mental health services,³² and the Wellness Innovator Program, which is used to train employees on how to bring wellness to the workplace.³¹ Outside of OSU, programs include the Accelerated Recovery Program (ARP) for Compassion Fatigue¹³ which is used in the field of traumatology, Wellness in the Workplace Toolkit² by the American Veterinary Medical Association, and a variety of animal shelter support programs as reviewed by K. Anderson,³ SG. Rogelberg,²⁶ and B. Gammie.¹² Although valuable resources as a whole, these programs do not specifically address the unique stressors associated with animal research.

ALN, now Laboratory Equipment, worked toward addressing this by surveying more than 600 lab animal professionals about compassion fatigue in 2015. Respondents reported that job rotation, appropriately staffed teams, leadership discussion of staff's value, and encouragement for staff to speak about difficult times would all be helpful for preventing BNO and CF.¹⁸ Other lab animal professional organizations like AALAS have also highlighted this issue by providing online continuing education on the topic.¹ In addition, a recent review in JAALAS helped to define BNO and CF in a lab animal setting.²¹

Active programs specific to mitigating animal research-related stressors are limited. However, during the time of this study, 2 large academic research institutions began promoting their approach to addressing this need; The University of Washington's Dare2Care,²² and The University of Michigan's Compassion Fatigue: Education and Engagement in Animal Research.⁶ These programs are designed to foster an understanding of CF and provide employees with the skills and resources needed to cope with the emotional challenges associated with the care and use of laboratory animals.

Most of the active lab animal programs target multiple levels of the social-ecological model.¹⁹ This model is used in public health programming and recognizes that wellness changes at the individual level are important, but not always possible due to an individual's social environment.¹⁹ According to this model, a program aiming to improve wellness outcomes needs to have interventions aimed at not only the individual's attitudes, knowledge, and skills, but also at the other 4 levels of individual's social environment; the interpersonal, institutional, community, and public policy levels. The interpersonal level includes workgroup networks, the institutional level consists of organizations and their rules for operations, the community level involves the relationship among organizations, and the public policy level addresses local, state, and national laws in addition to accreditation rules.

A review of the literature and existing lab animal worker programs at other academic institutes yielded many approaches to mitigating BNO and CF among employees. To date outcome assessments for these types of programs have not been published. To build a program customized to the needs of ULAR employees, more information about employee awareness of the existing university resources was needed, as well as an assessment of the prevalence of BNO and CF among employees and identification of potential risk factors in the lab animal setting, such as frequent performance of euthanasia, and specifically to ULAR. A survey was designed to gather this information and to serve as a baseline for future comparisons to assess the impact of various interventions. This forum also allowed the staff to provide suggestions for amendments and additions to the mitigation program.

Materials and Methods

Study Population.

The population of interest consisted of university laboratory animal resources (ULAR) employees. ULAR is comprised of approximately 90 employees which facilitate the humane care and use of animals in biomedical research and teaching at OSU within an AAALAC accredited animal care program. The centralized program promotes the responsible use of animals for the benefit of society and oversees compliance with federal regulations and guidelines related to animal use. Veterinary services including training, preventive medicine, and surgical support. Clinical care is provided by 30% of employees, while direct animal care (facility oversight and husbandry) within the dedicated animal vivaria are provided by approximately 60% of employees. The remaining 10% of employees provide no direct animal care, performing cage wash and other support or administrative services.

ULAR maintains over 70,000 sq ft. of dedicated animal housing.²³ The majority of animals housed are rodents (with an average daily cage census of 18,000 cages), but additional species include dogs, cats, pigs, nonhuman primates, guinea pigs, zebra fish, and rabbits. Rodents at OSU are used for internationally recognized research programs in cancer and cancer genetics, cardiovascular and lung disease, and high-field imaging. In addition, signature programs and multidisciplinary approaches include comparative and translational oncology, infectious disease, and neuromusculoskeletal science. The type of interactions that employees have with research animals, specifically the performance of euthanasia, depends on the job duties. Specific job titles were not requested in the survey to protect the participant's identity as only a small number of individuals may work with certain species. However, job titles within ULAR and their interactions with euthanasia are provided in Figure 1.

Figure 1.

Euthanasia frequency of ULAR staff based on job title and corresponding obligations. Clinical vets listed under both frequent and rare as some clinical vets have more euthanasia responsibilities than others. Frequent euthanasia occurs daily when rare euthanasia occurs monthly or less.

All study procedures were approved by OSU's Institutional Review Board (IRB). Informed consent was obtained from all subjects, measures were put in place to protect the identity of all subjects, and no coercion was used to solicit the participants.

Inhouse Survey.

A survey was distributed to all ULAR staff members, excluding the study team members, through Qualtrics online survey software (2018 Qualtrics, Seattle, WA).

The survey consisted of 25 questions, comprised of open and closed-ended questions, and required approximately 10 to 15 min to complete. It was sent to all 90 ULAR staff members, excluding those involved with creating the study, and 70 responded. Of the 70 that participated, their response rate to each invidual question varied as they were able to skip questions they did not feel comfortable answering. Open-ended questions had an average of 27 responses and were formatted as display boxes for participants to fill in. Closed-ended questions had an average of 65 responses and were formatted as drop-down boxes, multiple-choice, side-by-side matrices, and scale questions. An incentive of a 3, $5.00 dollar coffee gift cards were raffled off to the 70 participants. A visual representation of the information collected via the survey can be found in Figure 2.

Figure 2.

Visual representation of the survey question categories with the number of questions in parentheses.

Prior to the distribution of the survey, a department-wide mandatory meeting was used to communicate the goals of the study and request participation. Follow up reminder emails were sent 2 wk and 2 d before the survey closed to encourage participation.

Measures.

Our measures of interest were gender; age; years worked with research animals; species worked with; euthanasia frequency; workplace discussion of BNO, CF, and CSat; awareness of resources already available to ULAR staff; and whether the individual had ever personally experienced BNO, CF, or CSat.

BNO, CF, and CSat experiences were measured by first asking if participants were familiar with the meaning of these terms. Definitions were then provided, and participants were asked if they ever personally experienced them. If yes was selected, they were prompted to specify which ones. Participants could select all that applied. Because “select all” was used for the BNO, CF, and CSat measurement, responses were grouped into a “negative experience” group and “positive experience” group for data analysis. The negative experience group (40 participants) contained individuals that reported experiencing BNO and/or CF. Some individuals in this group also reported experiencing CSat. The positive experience group (9 participants) contained the individuals that only selected experiencing CSat and was too small to analyze further. Those that selected experiencing “none” (9 participants) or “unsure” (6 participants) of the experiences were excluded from the analysis.

Data Analysis.

Descriptive statistics, Fisher exact test, and relative risk were used to analyze the survey responses. Responses were exported from Qualtrics online survey software (2018 Qualtrics, Seattle, WA) to Microsoft Excel (Microsoft 2018, Redman, WA) for cleaning prior to importing into SAS JMP statistical software (JMP Pro Version 12, Cary, NC) and MEDCALC statistical software (MEDCALC, Ostend, Belgium).

Fisher exact test was performed to determine any significant associations between a negative experience (any combination of BNO, CF, and CSat) with gender, age, years worked in the field, and the frequency euthanasia was performed. If a significant association was present, then a relative risk analysis was calculated to determine any protective factors with the association.

Results

Survey Results.

Of the 90 employees contacted, 70 completed the survey with a 78% response rate. Because it was not mandatory to answer each question, the n is listed within the tables/figures.

The majority of the participants were female (80%), primarily in the 20 to 29 (28%), 30 to 39 (27%), and 40 to 49 (27%) age range, with 19% older than age 50. Just over half of the staff had been in the field for less than 10 y; 0 to 4 y (38%) and 5 to 9 (17%). The majority of participants reported working with rodents (92%), while 26% to 33% reported working with pigs, dogs, rabbits, and nonhuman primates. Most participants (61%) selected that they euthanized a range of 1 to 49 animals per year. A small minority of participants (9.8%) reported euthanizing more than 100 animals per year. The full demographic breakdown is available in Table 1.

Table 1.

Participant demographics obtained from staff survey. *For species worked with, participants were able to select all that applied, so total counts exceed the n and 100%.

Gender (n = 64)	Percent
Male	20.31%
Female	79.69%
Age range (n = 64)
20–29	28.12%
30–39	26.56%
40–49	26.56%
50–59	15.62%
60+	3.12%
Years worked with research animals (n = 65)
0–4	38.46%
5–9	16.92%
10–14	21.54%
15–19	7.69%
20–24	4.61%
25–29	6.15%
30+	4.61%
Species worked with at time of survey (n = 65)*
Other (facilities, former caretaker, multiple, grass rats, guinea pigs, ferrets, cotton rats, hamsters, poultry, reptiles, birds, and chinchillas)	16.92%
Aquatic	13.85%
Sheep	20.00%
Cats	21.54%
Nonhuman primates	26.15%
Rabbits	29.23%
Dogs	32.31%
Pigs	33.85%
Rodents	92.31%
Number of animals euthanized per year (n = 51)
None	15.69%
1–49	60.78%
50–99	13.73%
100+	9.80%

When asked if the conditions BNO, CF, and CSat had been discussed at their place of work, respondents indicated that CF was discussed most frequently (36%), followed by BNO (34%) and CSat (30%) (Figure 3 A). Overall, 77% (49) of respondents indicated that they had experienced BNO, CF, or CSat (Figure 3 B). Of the 49 respondents who reported “yes” to personally experiencing BNO, CF, or CSat, 81.6% reported experiencing BNO and CF either solely, in combination with each other, or in combination with CSat (negative experience) (Figure 3 C). Only 18% reported experiencing Csat (positive experience) without any feelings CF or BNO (negative experience).

Figure 3.

Participant responses to survey questions dealing with workplace discussions and personal experiences with burnout (BNO), compassion fatigue (CF), and compassion satisfaction (CSat). Respondents selected all that applied, so total counts may be larger than the number of respondents.

Participant knowledge of the resources currently available to them varied based on the type of resource. Most of the respondents indicated that they were aware of the Employee Assistance Program (EAP) (Table 2). Despite this high awareness, less than half felt that OSU's EAP would be effective at helping them deal with BNO or CF (Table 2). Relatively few (23%) were aware that the departments had wellness innovators to provide resource guidance related to wellness concerns including BNO and CF (Table 2).

Table 2.

Frequency distribution for respondent resource awareness [Employee Assistance Program (EAP) and Wellness Innovators], respondent reporting on perceived effectiveness of EAP for assisting with burnout and compassion fatigue, and respondent awareness of their assigned wellness innovator. Responses were obtained from the staff survey. *Indicates that “unsure” was not a reportable option for this question.

	Yes	%	No	%	Unsure	%
Are you aware of EAP? (n = 63)	49	77.78	14	22.22	*	*
Do you believe EAP would effective? (n = 45)	20	44.44	4	8.89	21	46.67
Are you aware of the wellness innovator program? (n = 63)	30	47.62	33	52.38	*	*
Are you aware of your wellness innovator? (n = 45)	7	23.33	23	76.67	*	*

Demographically, those who reported experiencing BNO and CF at the highest rate had been in the field for 0 to 4 y (78.26%) (Table 3). A similar pattern of self-reported burnout and compassion fatigue was also observed in the 30 to 39-y-old age range (87.5%) (Table 3). BNO and CF rates were much lower (10%) for participants in the 50 and older age range (Table 3).

Table 3.

Factors (categorical data) associated with experiencing burnout (BNO) and/or compassion fatigue (CF). P values from Fisher exact test are also displayed with the significant values bolded.

Variable	n	Experienced BNO and/or CF freq (%)	Experienced CSAT only or nothing at all freq (%)	P value
Gender
Male	9	5 (27.78)	4 (10.26)	0.1236
Female	48	35 (72.22)	13 (27.02)
Age
20–29	17	14 (82.35)	3 (17.65)	0.0002
30–39	16	14 (87.50)	2 (12.50)
30–39	16	14 (87.50)	2 (12.50)
40–49	14	10 (71.43)	4 (28.57)
50+	10	1 (10.00)	9 (90.00)
Years worked with research animals
0–4	23	18 (78.26)	5 (21.74)	0.0002
5–9	8	6 (75.00)	2 (25.00)
10–14	14	10 (71.43)	4 (28.57)
15–19	4	3 (66.67)	1 (33.33)
20–24	2	1 (50.00)	1 (50.00)
25–29	4	1 (25.00)	3 (75.00)
30+	3	1 (33.33)	2 (66.67)
Number of animals euthanized per year
None	8	5 (62.50)	3 (37.50)	0.0120
1–49	31	23 (74.19)	8 (25.81)
50–99	7	4 (57.14)	3 (42.86)
100+	5	5 (100.0)	0 (00.00)

Fisher's Exact Test Results.

Categorical data for the presence of BNO and CF was analyzed through the use of a Fisher exact test to identify significant associations between select demographics and experiencing negative feelings. Of the 4 associations tested, 3 were determined to be statistically significant (P ≤ 0.05). The results of the Fisher exact test analysis suggest that the likelihood of experiencing any combination of BNO and/or CF is associated with age (n = 57, P = 0.0000), number of years in the field (n = 58, P = 0.0002), and number of animals euthanized per year (n = 51, P = 0.0119) (Table 3). An association was not identified with gender.

Relative Risk Results.

Analysis of the relative risk (RR) was performed to identify any protective and/or damaging risk factors. The only protective factor found was age (Table 4). When compared with the age group with the highest incidence of BNO and/CF (30 to 39 y olds) the participants 50 and older had not only the lowest incidence of BNO and/or CF, but had an 89% (RR = 0.1143) reduction in risk for experiencing BNO and/or CF. No other significant risk reductions were found. No damaging risk factors were found.

Table 4.

Relative risk (RR) findings for burnout (BNO) and/or compassion fatigue (CF) with associated categorical variables. Comparison groups varied by highest incidence of BNO and CF to lower exposure. Significant values are bolded.

Exposure group	RR	95% CI	P value
Age group, in years, compared with 30–39 group (highest incidence of BNO and/or CF)
20–29	0.9412	0.7059–1.254	0.6795
40–49	0.8163	0.5585–1.1932	0.2946
50+	0.1143	0.0176–0.7405	0.0229
Years worked in the field compared with 0–4 y (lowest exposure)
5–9	0.9583	0.6084–1.5096	0.8543
10–14	0.9127	0.6148–1.3550	0.6505
20–24	0.9583	0.5231–1.7557	0.8904
25–30	0.6389	0.1571–2.5975	0.5313
30+	0.3194	0.0577–1.7680	0.1911
Number of animals euthanized per year compared with 0 animals euthanized per year (lowest exposure)
1–49	1.1871	0.6676–2.1107	1.00
50–99	0.9143	0.3961–2.1104	0.8337
100+	1.60	0.9354–2.7368	0.861

Participant Provided Suggestions.

Of the 70 participants who took the survey, 35 (50%) provided suggestions as to how ULAR could best ameliorate BNO and CF. Responses were coded by first reading all the suggestions, then grouping the responses that contained the same word choice. Common word groupings were trust, open discussion, free expression, more resources for help, job rotation, interaction with others, ULAR's impact on research, an increase in staff appreciation, and more leadership support. These word groupings were then organized into 3 improvement themes: the work environment, new work experiences, and positive feedback (Figure 4).

Figure 4.

Of the 70 participants who took the survey, 35 provided their own recommendations for alleviating burnout and compassion fatigue. Recommendations were categorized by theme with frequency counts in parentheses. Respondents could provide more than one suggestions, so total counts exceed 35.

Discussion

Based on survey results, we identified that ULAR staff is mostly female, in the 20 to 49 age range, and that the largest percentage of employees were in the first 4 y of their lab animal career. This is valuable information as research has found that being female and having limited professional experience are both risk factors for developing BNO and CF.²⁴ Our analysis found no association between gender and experiencing BNO and CF. However, associations were detected with age and length of time in the field. In the RR analysis, only age maintained its statistical significance. The finding indicated that participants 50 and older had an 89% (RR = 0.1143) reduction in risk for experiencing BNO and/or CF when compared with those in the 30 to 39-y-old age group (the group with the highest incidence of BNO and/or CF). Similarly, other research has found that veterinarians over the age of 35 tend to report less psychologic distress from work.²⁴ This relationship may be attributed to the idea that those who had difficulty with the stress associated with the job opted to leave the field while they were younger. Alternatively, individuals 50 and older may be more resilient to workplace stress.

The discordance between Fisher exact test and RR findings could indicate that there are no significant associations and that all staff, regarlesss of their demographic, could be at similar risk. This possibility is supported by a veterinary technician survey which found that all staff members were at risk no matter their demographics or job duty.⁸ The discordance could also be a function of our population size, which was small even though we sampled our entire relevant population with nearly 80% responding. For this reason, the descriptive data and trends are likely representative of the actual population regardless of statistical power. A holistic approach to identifying at-risk staff for BNO and CF could be to include a screening during yearly occupational health evaluations. This method is being pursued by The University of Washington²² and is recommended by the Laboratory Animal Medicine textbook.¹⁰ ULAR management now know that younger staff and newer employees report higher levels of BNO and CF than do their more experienced coworkers. Incorporating awareness of BNO and CF as part of orientation and onboarding and to check in regularly with new staff to review the use of available support services could be a prudent intervention for management.

Respondents reported lower yearly levels of performing euthanasia than had been expected by the study team, likely because the Principal Investigators and their associate research staff perform the majority of experimental manipulations, including euthanasia. However, those who work for ULAR often experience such activities indirectly as they provide husbandry tasks, administer non-study related clinical treatments, or participate in protocol reviews.

Despite the unexpectedly low performance of euthanasia, 82% of ULAR staff nonetheless reported BNO and CF alone or in combination with compassion satisfaction. Only 18% reported experiencing only compassion satisfaction without any BNO or CF. Euthanasia is considered a major stressor in an animal caregiving job,²⁴ but perhaps the amount of distress experienced by an individual is not exclusively dependent on the frequency at which the individual performs euthanasia. Simply witnessing euthanasia, which can occur frequently and in high numbers, perhaps without knowing when it may occur, can all contribute to euthanasia stress.

Alternatively, work experiences that are not related to euthanasia, such as witnessing the negative effects of disease induction during cage changes or daily checks could also contribute to BNO and CF. Even though the disease induction is approved by the IACUC, repeated exposure to animals in poor health could be a component of CF and BNO unique to lab animal research.¹⁴ Apart from work, life issues could also contribute to the development of CF or BNO (for example, employees who are dealing with high levels of familial stress or have unresolved problems with depression, anxiety, or past traumas). Lastly, the monotony of their daily work tasks or their disconnection from the positive outcomes of the research, could also contribute. These questions could be investigated in future surveys.

With regard to OSU-provided mitigation programs, an awareness of the Employee Assistance Program (EAP) was reported by 78% of respondents, yet, 47% were unsure if EAP would be helpful for addressing BNO and CF issues. This important finding supports the value of this type of survey in establishing and evaluating a mitigation program. Simply having an EAP with free mental health counseling is insufficient if the employees do not willing use it when needed. Given the nature of the work stressors in animal research and the negative attitudes of many people, employees may anticipate a negative reaction from a counselor. One solution to this would be to identify specific counselors to be available to the ULAR staff and who are familiar with the realities and benefits of research and the typical job duties of employees prior to any meetings. Providing opportunities to introduce these designated counselors to the employees (for example, at a department meeting or by providing continuing education on CF) may also increase the likelihood that employees will reach out for support when needed.

In addition to OSU's EAP, ULAR had designated Wellness Innovators within the unit at the time the survey was distributed. More than half of the respondents (52%) reported that they had not heard of the wellness innovator program. Of the 48% who had heard of the program, only 23% knew which ULAR staff members filled those roles. Wellness Innovators are an approach recommended by the American Veterinary Medical Association.² ULAR will explore additional ways to use them to raise awareness among the staff.

Some of the staff provided recommendations in this survey were similar to those found in the Laboratory Equipment survey Preventing Compassion Fatigue in the Vivarium¹⁷ and to interventions being implemented at other research universities.^5,22 This similarity supports their importance and potential benefit to lab animal professionals, and suggests thay they should be included in the BNO and CF mitigation programs. The suggestions included open discussion of workplace issues like finances and feeling overworked, as well as issues with BNO and CF, increased variety to their daily routines, increased social interactions at work, and positive feedback from leadership that emphasizes the importance of their jobs. In addition, when implementing the program, ULAR should highlight which parts were in response to suggestions from the staff. This alone could boost morale because staff would know that their concerns were heard and valued.

Our study had several limitations that might have affected the results. Most notably, the small population size, 70 respondents, made statistical analysis difficult and required the regrouping of some data. We addressed this challenge by consulting with a professional biostatistician to ensure that regroupings were handled appropriately. Furthermore, we had a high overall response rate to our survey (77.78%) indicating that our sample was largely representative of the entire ULAR population (n = 90) and increases confidence in the descriptive results and trends. Some respondents (ranging from 5 to 40 depending on the individual question) did not answer all of the survey questions, which may have introduced a nonresponse bias for those particular questions. Furthermore, not all staff members have job responsibilities that include euthanasia or direct animal work (for example, administrative staff). This may have influenced the amount of self-reported BNO, CF, and CSat. Lastly, using a survey for data collection introduces concerns with voluntary response bias, social desirability response bias, and recall bias. We attempted to reduce the impact of these by ensuring anonymity, keeping the survey short, and offering an incentive for participation.

Moving forward, we believe that the ULAR department assessment survey should be repeated annually to assess the ongoing impact of BNO and CF mitigation efforts. We also believe that the surveyed be expanded to include non-ULAR staff members (research staff, PI's, and IACUC members) as they can also be at risk for BNO and CF. This population was not included in the current study because our initial focus was ULAR staff. Expanding the study population would help to expand the scope of CF and BNO mitigation efforts to include individuals associated with a variety of departments and colleges across campus. By adding additional questions and making slight modifications to current ULAR specific questions, future surveying could be easily performed. Additional questions should include the participant's job title or category and an open-ended request intended to specifically inquire about job tasks that potentially contribute to BNO or CF. This would allow the evaluators to better associate risk factors to each specific job title. While including job titles could reduce anonymity, the risk would be significantly reduced as the population surveyed would be much larger than the ULAR population alone. Further possible additions include questions about sources of CSat, as it is important to preventing CF, and about the personal impact of various implemented components of the mitigation plan.

The study team summarized mitigation program recommendations and provided those to leadership within ULAR for assessment and an open discussion of the practicality of implementation (Figure 5). To date, ULAR has begun to use a department of Wellness Innovators to implement some of the recommendations. However, addressing higher levels of the social ecological model still needs to be accomplished. Currently, innovators lead wellness activities on a weekly basis during break time. Activities have included aerobic exercise, yoga, and meditation. The Wellness Innovators have also brought health coaching sessions to monthly continuing education meetings that covered the topics of BNO and CF, meal planning, and breathing exercises to reduce stress at work. Issues with BNO and CF will likely never be fully eradicated from an animal research facility but a workplace program that includes all staff members in its development has the potential to help staff cope with the negative components of a caregiving career in a constructive manner. By sharing the findings of this study with other animal research institutions, we hope to affect an even larger group of professionals that want to help their staff with these very real concerns.

Figure 5.

Study team recommendations based on study findings. Star clip art indicates from where the finding was obtained. Recommendations are grouped based on where they fit into the Social Ecological Model. Program interventions were aimed at the individual's attitudes, knowledge, and skills, workplace networks, institution's rules for operations, organizations with the institution's community and aimed at lab animal accrediting bodies.