Abstract
This study seeks to clarify the current situation and associated factors regarding Work Engagement (WE) among midwives working in advanced care facilities, which bear the brunt of care for high-risk pregnancies, as well as the contribution of WE to quality of care. A self-administered questionnaire survey was conducted in 2016 with the participation of 503 midwives working in 36 general perinatal maternal and child medical centers and with 125 nurses working at a university hospital selected for analysis as a comparison group. The survey used the Utrecht Work Engagement Scale and the Brief Job Stress Questionnaire, subjecting all results to multiple regression analysis to adjust the sample size. Results revealed that WE among midwives was not found to be significantly different from that among nurses. WE among midwives was found to be positively associated with the “presence of a role model” and “doctor support”. In addition, WE as well as “career opportunities” and the “presence of a role model” were associated with quality of care (adjusted R2 =0.137, P < 0.05). From the study, WE among midwives working at advanced perinatal care facilities was not found to be different from that among nurses working at university hospitals. Among factors contributing to higher WE, the presence of a role model and relationships of trust with physicians were found to be those that represented the occupational characteristics of midwifery. Key words: Midwife, work engagement, job stress, role model, quality of care.
Highlights
In recent years, perinatal care in Japan has undergone marked changes that have included the concentration and prioritization of delivery facilities due to the declining birth rate and a shortage of obstetricians, as well as an increased number of high-risk deliveries resulting from advances in perinatal medicine
From among 104 general perinatal centers in Japan, we focused on midwives working in 36 hospitals that consented to participate in the survey
Work Engagement (WE) among midwives working in general perinatal centers in Japan was not significantly different from that among nurses working at the university hospital in Japan; meaningful work was perceived as an opportunity for personal growth and did not escalate into conflict or stress
Summary
Perinatal care in Japan has undergone marked changes that have included the concentration and prioritization of delivery facilities due to the declining birth rate and a shortage of obstetricians, as well as an increased number of high-risk deliveries resulting from advances in perinatal medicine. Midwives are responsible for caring for independent low-risk mothers and children, and striving to ensure a safe and comfortable delivery, while being called upon to provide life-saving and intensive care to high-risk mothers and children, including the psychological, social, and ethical aspects entailed by the care that goes along with this. Midwifery advanced perinatal care have less than five years of experience (Saitō et al, 2011). This demonstrates the high turnover rate among midwives and the reality that care is for the most part provided by midwives with little experience, and so it is easy to imagine the stress felt by midwives working in these situations
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