助产士离职意向的工作和健康相关决定因素：瑞典全国横断面和前瞻性队列研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-01-07 DOI:10.1016/j.midw.2025.104283

Gunnel Hensing , Anna Dencker , Ing-Marie Carlsson , Malin Hansson

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引用次数: 0

摘要

背景：助产士对于实现关于性健康和生殖健康的可持续发展目标至关重要。然而，助产士短缺挑战着全球医疗保健组织。目的是分析独立变量之间的横向和前瞻性关联：“发展的可能性”；“工作质量”；“角色冲突”;“识别”;“自我评估的健康状况”和“倦怠”以及因变量：“打算离开目前的职位”和“打算放弃助产”方法：2020年，对瑞典的助产士进行了全国范围的网络调查（n = 5076），这些助产士被列为助产士组织工会的成员。这项研究在2023年重复进行（n = 4398名助产士）。进行了横断面（n = 3696）和前瞻性（n = 531/406）单变量和多变量logistic回归。结果：我们发现，报告发展可能性、工作质量和认可的受访者有意离职的概率较低，而报告角色冲突和倦怠的受访者有意离职的概率较高。在第一个前瞻性分析（n = 531）中，我们发现在基线时报告良好的工作质量和认可与在随访时报告离职意向的较低概率相关，而基线时的倦怠与在随访时报告离职意向的较高概率相关。在第二次前瞻性分析（n = 406）中，我们排除了在基线时报告有意离职的受访者，发现只有基线时的工作质量才能预测在随访时离职的低概率。对于第二个因变量，退出助产的意向，我们发现发展和认可的可能性与较低的退出概率相关，而倦怠与较高的退出概率相关。在第一个前瞻性分析中，我们发现基线时的认知与较低的辞职概率相关，而基线时的倦怠与较高的辞职概率相关。当排除那些在基线时报告有意退出助产的人时，我们发现认知和自评健康与随访时报告有意退出的较低概率相关。结论：工作质量、认可度和健康状况是留住助产士的重要因素。作为一个对卫生保健非常重要的专业团体的一个不起眼但相关的愿望，认可脱颖而出。

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Work and health-related determinants of midwives' intention to leave: Nationwide cross-sectional and prospective cohort studies in sweden

Background

Midwives are essential for achieving the Sustainable Development Goal on sexual and reproductive health. However, midwifery shortage challenge healthcare organisations globally. The aim was to analyse cross-sectional and prospective associations between independent variables: ‘possibilities of development’; ‘quality of work’; ‘role conflict’; ‘recognition’; ‘self-rated health’ and ‘burnout’ and dependent variables: ‘intention to leave current position’ and ‘intention to quit midwifery’.

Methods

In 2020 a nation-wide web-survey was distributed to midwives in Sweden (n = 5076) listed as members in unions that organise midwives. This was repeated in 2023 (n = 4398 midwives). Cross-sectional (n = 3696) and prospective (n = 531/406) uni- and multivariable logistic regressions were performed.

Results

We found a lower probability of intention to leave current position in respondents who reported possibilities for development, quality of work and recognition while those reporting role conflicts and burnout had a higher probability of intention to leave current position. In the first prospective analysis (n = 531) we found that reporting good quality of work and recognition at baseline were associated with a lower probability of reporting intention to leave current position at follow-up while burnout at baseline was associated with a higher probability of reporting intention to leave current position at follow-up. In the second prospective analysis (n = 406) we excluded respondents who reported intention to leave current position at baseline and found that only quality of work at baseline predicted a low probability of intention to leave at follow-up. For the second dependent variable, intention to quit midwifery, we found that possibilities for development and recognition was associated with a lower probability to quit while burnout was associated with a higher probability. In the first prospective analysis, we found that recognition at baseline was associated with a lower probability to quit while burnout at baseline was associated with a higher probability. When excluding those who reported intention to quit midwifery at baseline, we found that recognition and self-rated health was associated with a lower probability to report intention to quit at follow-up.

Conclusion

Quality of work, recognition and health appeared to be important for retention among midwives. Recognition stands out as a humble but relevant wish from a professional group of great importance for health care.

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.