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兽医群体健康管理——瑞典奶牛兽医的经验和看法。

Veterinary herd health management-Experiences and perceptions among Swedish dairy cattle veterinarians.

机构信息

Department of Clinical Sciences, Swedish University of Agricultural Sciences, P.O. Box 7054, SE-750 07 Uppsala, Sweden.

District Veterinary Organization, Swedish Board of Agriculture, Norra Vägen 9, SE-543 35 Tibro, Sweden.

出版信息

J Dairy Sci. 2022 Aug;105(8):6820-6832. doi: 10.3168/jds.2021-21184. Epub 2022 Jun 7.

DOI:10.3168/jds.2021-21184
PMID:35688734
Abstract

Cattle veterinarians have long been encouraged to take on a role as proactive health consultants. However, the process so far has been slow in Sweden and elsewhere, and only a rather small proportion of cattle work conducted by veterinarians involves veterinary herd health management (VHHM). The aims of this exploratory study were to explore Swedish cattle veterinarians' interpretation of VHHM services and to understand the factors that might affect the extent to which cattle veterinarians perform VHHM. Six focus group discussions with cattle veterinarians complemented with 5 individual telephone interviews with clinic managers were conducted in 2020. In total, 33 cattle veterinarians participated, all employed by the largest employer of Swedish cattle veterinarians: Distriktsveterinärerna (Swedish Board of Agriculture). Participants were chosen from 6 geographical regions with the aim to present variations in gender, age, country of education, proportion of dairy cattle work at the clinic, experience in the veterinary profession, and experience in work with dairy herds and in VHHM. The focus group discussions and interviews were recorded and these recordings were transcribed and analyzed thematically. Participants interpreted VHHM as work associated with the process of advising and included both ad hoc advising and more strategic forms of services. Prebooked visits per se were not seen as VHHM. We identified 4 different themes among the factors affecting the extent of VHHM services: (1) farmer trust and demand; (2) veterinary competence; (3) time available for VHHM; and (4) the individual veterinarian's commitment and motivation. To gain farmers' trust and to create a demand for VHHM services, the results of VHHM work and the veterinarian's competence were deemed central by the participants. The veterinarians' skills in communication and relation building were considered especially important. Some farmers were perceived as having little interest in, or lacking deeper knowledge about, VHHM services. The promotion of VHHM services was mentioned as an important factor to increase farmer demand. Participants described VHHM as work demanding high skills and continuous capacity development. Veterinarians' personal commitment and motivation were also described as important for the extent to which VHHM services were performed. This was in turn affected by the psychosocial work environment (e.g., workload, interest and recognition from farmers and managers, and acceptance, priority, and support by colleagues and managers). Clinic managers had a central role in the extent to which VHHM services are offered by an individual veterinarian due to their responsibility for staff scheduling, which highly affects the conditions for capacity development, intercollegiate networking, and cooperation. Lack of time was a major barrier for VHHM. On-call duty time and subsequent compensatory leave affected the total time available, and participants described time conflicts between VHHM and emergency services; moreover, it was perceived as challenging to find sufficient time for capacity development in several different species for veterinarians working in mixed practice. The slow development toward more proactive approaches for cattle veterinarians can be explained by the numerous different factors that together constrain the veterinarian to the traditional role of diagnosing and treating sick animals.

摘要

长期以来,兽医们一直被鼓励扮演积极主动的健康顾问角色。然而,在瑞典和其他地方,这一进程一直较为缓慢,兽医开展的牛群健康管理(VHHM)工作中,只有相当小的一部分涉及到 VHHM。本探索性研究旨在探讨瑞典奶牛兽医对 VHHM 服务的解释,并了解可能影响兽医开展 VHHM 服务程度的因素。2020 年,我们进行了六次奶牛兽医焦点小组讨论,并对六名诊所经理进行了五次单独的电话访谈。共有 33 名奶牛兽医参加了此次研究,他们均受雇于瑞典最大的奶牛兽医雇主:Distriktsveterinärerna(瑞典农业委员会)。参与者来自六个地理区域,目的是展示不同的性别、年龄、教育背景、诊所奶牛工作比例、兽医职业经验、以及在奶牛群和 VHHM 方面的工作经验。对焦点小组讨论和访谈进行了录音,并对这些录音进行了转录和主题分析。参与者将 VHHM 解释为与咨询过程相关的工作,包括临时咨询和更具战略性的服务形式。兽医们本身并不认为预约访问是 VHHM。我们在影响 VHHM 服务范围的因素中确定了 4 个不同的主题:(1)农民的信任和需求;(2)兽医能力;(3)开展 VHHM 服务的可用时间;(4)兽医的个人承诺和积极性。为了获得农民的信任并创造对 VHHM 服务的需求,参与者认为 VHHM 工作的结果和兽医的能力是至关重要的。兽医在沟通和关系建立方面的技能被认为尤为重要。一些农民被认为对 VHHM 服务几乎没有兴趣或缺乏更深入的了解。提高农民的需求被认为是促进 VHHM 服务的一个重要因素。参与者将 VHHM 描述为需要高技能和持续能力发展的工作。兽医的个人承诺和积极性也被描述为开展 VHHM 服务的重要因素,这反过来又受到心理社会工作环境的影响(例如,工作量、来自农民和管理者的兴趣和认可、同事和管理者的接受、优先级和支持)。由于负责员工排班,诊所经理在兽医提供 VHHM 服务的程度上起着核心作用,这极大地影响了能力发展、校际联网和合作的条件。缺乏时间是 VHHM 的一个主要障碍。值班时间和随后的补休时间影响了可用的总时间,参与者描述了 VHHM 和紧急服务之间的时间冲突;此外,对于在混合实践中工作的兽医来说,他们认为在多种不同物种中找到足够的时间进行能力发展是具有挑战性的。奶牛兽医向更积极主动的方法发展缓慢,可以用许多不同的因素来解释,这些因素共同限制了兽医传统的诊断和治疗患病动物的角色。

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