Klinisyen Veteriner Hekimlerin Yaşam Doyumları Üzerine Bir Çalışma

Çalışmada, klinisyen veteriner hekimlerin yaşam doyum düzeyleri ve bunu etkileyen faktörler araştırıldı.

Bu amaçla, Türkiye'nin Orta ve Doğu Anadolu bölgelerinde bulunan 14 ilde klinisyenlik yapan 129 veteriner hekim üzerinde anket uygulandı.

Klinisyenlerin yaşam doyumu konusunda bir tatminsizlikleri olduğu saptandı. Katılımcıların yaklaşık yüzde 5'inin açlık sınırının, yüzde 77'sinin ise yoksulluk sınırının altında gelire sahip oldukları bulundu. Aile yönlendirmesiyle ve bilinçsizce veteriner fakültesini seçimin yaşam doyumu konusunda tatminsizliğe yol açtığı saptandı.

Sonuç olarak, Türkiye'deki klinisyen veteriner hekimliğinde önemli bir darboğaza girildiği; yaşanan darboğazın öncelikle, planlama olmaksızın açılan fakültelerin ve mezun sayılarındaki artışın yarattığı enflasyondan kaynaklandığı ve bu türden sorunların, özellikle Türkiye gibi ekonomisi çok güçlü olmayan ülkelerde daha ciddi sonuçlar doğurduğu söylenebilir. Bunlara ek olarak, yaşanan sorunların global bir boyut kazanma potansiyelinin olduğu da ileri sürülebilir.

* The results of this study were presented in 6th International Veterinary Medicine Students Scientific Research Congress.

This study evaluates factors that affect life satisfaction levels of veterinary practitioners.

The survey conducted on 129 veterinarians working in 14 provinces in Central and Eastern Anatolia regions of Turkey.

It was determined that these veterinarians are unsatisfied with their life. It was found that about 5 per cent and 77 per cent of these veterinarians have income under hunger and poverty levels, respectively. The main reason for a low satisfaction level was because of choosing the veterinary schools under family influences unconsciously without having enough information on what they are getting into.

As a result, opening of veterinary schools without planning resulting in high number of veterinary graduates cause significant difficulties for veterinary practitioners in Turkey. Such problems become more severe in countries like Turkey that do not have a powerful economy. In addition, it can be said that such problems have a tendency to become global as well.

Giriş

The practice of veterinary medicine is one of the oldest scientific skills developed by humans [1]. Veterinarians, one of the most important occupations, have been demanded in parallel to the change and development of societies with respect to their duties and responsibilities [2]. Even though practice of veterinary medicine in Turkey had a rapid development period with the first scientific veterinary school opened in the first half of the 19th century (1842), encountered a number of significant problems starting from 1980s [3]. Especially negative aspects of reorganization of the Ministry of Agriculture in 1984–85 as faulty organizational, occupational, educational and training policies caused the the current dilemma. Currently veterinary profession has become a less preferred occupation compared to the pre 1980 period, after which the goverment ceased hiring veterinarians [4]. Consequently, veterinary medicine has become a profession that had lost its sociological status with highly unsatisfied members for their job and occupation. These negative aspects observed especially for the veterinarians working in supermarkets and animal production plants are also valid for practitioners working privately [2].

The aim of this study is to examine the factors that affect life satisfaction level of practitioners working in the central and eastern Anatolian regions in Turkey.

This study was carried out among practitioners in 14 provinces (Diyarbakır, Siirt, Mardin, Ardahan, Elazığ, Kayseri, Niğde, Şırnak, Erzurum, Batman, Kars, Malatya, Sivas, and Nevşehir), its lie between 37:25N–40:25N latitudes and 34:40E–43:05E longitudes (Figure 1).

Since the survey included only one veterinarian from each of Şırnak, Siirt, Mardin and Batman provinces, these four provinces were assessed in the same group due to the similarities between them. The technique described by Krejcie and Morgan [5] was used in the selection of the samples. Within the frame of this technique, 129 practitioners out of 220 working in this area were determined as the sample size for this study.

A questionnaire was developed to determine the attitudes about life satisfaction of the participants. The questionnaire was composed of three sections. Four items of independent variables as work duration, age, gender and income about demographic information were asked to all participants in the first section. In the second section of the survey there were closed end questions related to their sociologic status perceptions, satisfaction levels as well as the situation of the country and the reasons for selecting veterinary schools. The second section also included life satisfaction set with Likert scale including six judgments [6]. Items were scored from 5 for “strongly agree” through 1 for “strongly disagree” with “neutral” in the middle of the scale scored as 3 [7]. When comparisons were made between groups for set of life satisfaction, a score of <3 was classified as disagreement and interpreted as unsatisfactory. A score of ≥3 was interpreted as satisfactory. The survey was pre-tested by ten practitioners.

The survey was administered to 129 practitioners who agreed to take a part in the study between June 2003 and February 2004 and data were collected by written questionnaire.

SPSS Version 11.0 for Windows was used for all statistical analyses. Frequencies were used for demographic analyses. A mean rating was calculated for attitudes about set of life satisfaction. P values were calculated for the parametric tests among groups. Independent Student-t test was used to measure differences between gender groups. A variance analysis was used in order to determine the differences between the age, work duration and income groups. Following these analyses, Duncan test was applied for the group comparisons of the significant parameters. In comparisons between incoming level and level of life satisfaction, p values were calculated for Pearson correlations [8]. P values <0.05 were considered significant.

The effects of work duration, age, gender, and income on the attitude about life satisfaction in all groups were determined by means of Linear Regression Modelling [9].

Y_ijkl = µ + a_i + b_j + c_k+ d_l + e_ijkl
Y_ijkl = the ijklth
µ = population mean
a_i = i the effects of gender (i= 1, 2)
b_j = j the effects of age (l= 1, 2, 3, 4)
c_k = k the effects of work duration (j= 1, 2, 3, 4, 5)
d_l = l the effects of level of incoming (m= 1, 2, 3, … 8)
e_ijkl = the error term (0, σ2e)

Bulgular

The demographic values of the independent variables such as work duration, age, gender, and income were determined in the study (Table 1).

Life satisfaction: The scores obtained for each item composing set of life satisfaction and the mean value calculated for set of life satisfaction indicated that all the groups showed life satisfaction attitude (Table 1). Analysis of the replies given by the subjects revealed that 54.3% (n=70) of the sample group are satisfied with their life (mean score: 3≥). According to demographic groups it was observed that the veterinarians having been between 31-40, over 51 years of age, having been working in clinics for 11-20 years and having annual income of over USD 17.500 are more satisfied with their life compared to other demographic groups. No differences in terms of gender, experience, age and, income level were observed for the set of life satisfaction (Table 1).

A positive correlation was found between income level and life satisfaction (r=0.194; p=0.029). The rate of independent variables in explaining the differences in life satisfaction levels was 36 per cent (R²=0.36).

Perception of sociological status: While 68.5 per cent of the participants considered themselves as middle class, 25.2 per cent considered themselves as high class. It was observed that high classes were more satisfied with their life. The participants considering themselves as high and middle class scored differently than those of as low class (p=0.014) (Table 2).

The status of veterinary medicine in the country: The participants answered as “very good” and “good” rated 14.1 per cent among participants and were more satisfied with their life compared to those of as “rather bad” and “bad” (p=0.045) (Table 2).

Professional satisfaction: The participants considering themselves as satisfied with their occupation were 57.8 per cent along with a positive attitude in their life. On the contrary, those considering veterinary medicine as an unsatisfactory occupation were less satisfied with their life (Table 2).

The relation between the reasons for choosing veterinary school and life satisfaction: The factors that affect the decision of the subjects in choosing veterinary schools are shown in Table 3. The aspect of the veterinary occupation was the most effective factor to be interested in whereas the family influence was the least effective one. When the effect of choosing veterinary medicine on life satisfaction is examined, it is observed that the subjects who entered veterinary schools by considering scope, reputability and income level of the occupation are more satisfied with their life. On the contrary, the subjects who chose veterinary medicine under the family influence or unconsciously are less satisfied with their life (Table 3).

Tartışma

The reason that female participants and small animal practitioners were represented with a relatively low proportion was that total number of females and small animal practitioners were less in these regions. These might have caused a bias in favor of the male participants and large animal practitioners in the current study. The clinics included in the sample group were restricted to those in the Central and Eastern Anatolia regions due to transportation problems. It could be said that these types of restrictions occurred in this study may have resulted in weakness to represent all practitioners all over Turkey.

About half of the participants were not satisfied with their life based on the evaluation of general life satisfaction set which is compatible with the results of study conducted on veterinarians in different sectors by Özen and Ateş [2]. A study conducted by the State Institute of Statistics on Turkish citizens [10] revealed that more than half of the participants were not satisfied with their life which is similar to the life satisfaction level of Turkish veterinarians.

It was observed that the veterinarians having been between 31-40, over 51 years of age, having clinical experince of 11-20 years and having annual income of over USD 17.500 are more satisfied with their life according to the demographic variables. Even though no attitude differences were observed in terms of gender, males scored life satisfaction set higher than females. Older and more experienced veterinarians displayed more positive attitude on life satisfaction compared to other demographic groups based on age and work duration variables even though no statistically significant differences were observed for their replies. The studies conducted on professional satisfaction and job satisfaction of Turkish physicians [11,12] have shown that older and more experienced physicians have more positive attitude on life satisfaction compared to younger and less experienced physicians. Again, Özen and Ateş [2] reported that age and experience are the factors that increase job satisfaction. Similarly, positive effect of experience has been reported on income in the USA and UK veterinarians [13,14,15]. Results of age, experience and life satisfaction relations in our study support the above literatures.

Generally, life satisfaction is accepted as a degree that an individual achieves his objectives and that increases with high achievements [16]. Even though it is difficult to explain professional satisfaction in a monist approach by relating it to a single reason as pointed out by Başaran [17], it is accepted that job satisfaction is the most important element in life satisfaction since it has a crucial part in life of an individual [16]. Ünal et al. [12] reported that there was a relation between job satisfaction and life satisfaction whereas Musal et al. [11] reported that one of the most important factors that has effect on job satisfaction was income level. The results of our study showed that increases of income affect the life satisfaction positively and the veterinarians earned more than USD 17.500 annually are more satisfied with their life. It could be said that our results support Ünal et al. [12] and Musal et al. [11].

According to Davis [18] job satisfaction is the pleasure or displeasure of people related to their jobs. Positive attitude towards job is equivalent to job satisfaction whereas negative attitude means dissatisfaction [19]. In addition, according to Taner [20] satisfaction of an individual with his job affects his enjoying his profession and that the value he gives to his profession positively; whereas according to Bingöl [21] dissatisfaction with job affects the approach towards the profession and other aspects of life negatively. In addition to these findings, Kemerlioğlu [22] reported that professions are regarded as a main indicator for determining social classes and professional position which is parallel to the satisfaction of an individual. Likewise, in our study, it was observed that the subjects who regarded veterinary medicine as an dissatisfactory profession (42.2%) felt themselves in medium or lower sociologic classes (74.8%) and who think that status of veterinary medicine in Turkey is “bad” or “quite bad” (85.9%), displayed a negative attitude in terms of dissatisfaction towards life in general. Depending on this data, it can be said that dissatisfaction with life may be related to job satisfaction and such dissatisfaction may have significant negative effects on the point of view about the veterinary profession in general.

Based on our results, 95 per cent of veterinary practitioners earn less than USD 20,000 annually. Hunger and poverty levels were reported to be USD 4,700 and USD 15,000, respectively by the Confederation of Turkish Trade Unions for minimum living conditions of a family for four members [23]. Considering this, 5 per cent and 77 per cent of the participants are under hunger and poverty levels, respectively. Özen and Ateş [2] reported similar results that 20 per cent of veterinarians are under hunger and per cent 87 under poverty levels.

It has been reported that average starting income in the last six years (1998-2003) for the veterinarians working in large animal clinics is about USD 45,000 in the USA [24,25,26,27,28,29] and 24,000-36,000 in the UK annually [15]. It has also been reported that 10 per cent of the veterinarians in the USA has the lowest income with USD 38,000 [30]. Experienced Turkish practitioners even with the highest level of income earn less than the veterinarians just started working in the USA and UK. These show a significant gap between income levels of the veterinarians in Turkey and in the USA and UK, and could be considered as an evidence of negative situation of veterinarians in Turkey. It should be pointed out that this negative trend is not only peculiar to Turkey. According to the results of “Managing Your Economic Future in Veterinary Medicine Symposium” held in April 1996 in the USA, it was reported that the veterinarians who are the member of JAVMA do not have expected average economic levels [31]. It has also been reported that even though average income level of members of other professions that can be compared to veterinarians like physicians and surgeons has increased within the last decades, income level of veterinarians has not increased and moreover the veterinarians started to feel ashamed of their profession due to low starting income [32].

In addition, AVMA former chairman Dr. Sherbyn W. Ostrich [33] stated ongoing erosion in veterinary medicine with potential negative effects on life quality. In this context, it can be said that the status of the veterinarians has a global dimension depending on macro-economic structure of the relevant country.

When the relation between reasons for selecting veterinary medicine and general life satisfaction taken into consideration, it could be said that the preferred factors like income level, reputability and scope of the profession in selecting veterinary schools had positive effects compared to the selections made under family influence unconsciously on life satisfaction. The percent of the participants who stated that their decision was not influenced by their families or having been unconscious was only about 50 per cent and this shows that the problems start at the very beginning of entrance to veterinary schools. In addition to these factors, decreased interest in the veterinary schools both in Turkey [4] and the USA [34] may show the relation between life satisfaction and selecting veterinary medicine as a profession. Thus, it can be said that there is mutual interaction between the reasons for preferring veterinary schools and factors like job and life satisfaction.

In addition to these, it can be said that one of the factors that affects future of veterinary medicine and life satisfaction of veterinarians is the number of schools and graduates. It has been reported that 2000 veterinarians graduated from 27 veterinary schools in the USA, encountered serious problems after graduation and most of whom were employed in small animal clinics and continuation of this situation may be a serious threat for future of the profession due to the rapid increase in the number of veterinarians [34,35].

Even though currently the UK is not affected, the numbers of veterinary graduates have been increasing since 1980s and this might be thought to cause employment problems in the future [36]. Compared to 52 veterinary schools in the EU excluding its last 10 member [37], it can be said that these concerns related to the increase of the number of veterinary schools and graduates are more evident in Turkey with 19 veterinary schools and might cause serious problems in the future.

As a result, opening of veterinary schools without planning resulting in high number of veterinary graduates cause significant difficulties for veterinary practitioners in Turkey. Such problems become more severe in countries like Turkey that do not have a powerful economy. In addition, it can be said that such problems have a tendency to become global as well.

Acknowledgments
We thank Ender İleri and Hüseyin Gözün DVM, Sanovel Drug Inc., and Erkan Uygur DVM, Yöntem Medikal Inc.

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