Abstract
Hospital midwives and neonatal intensive care (NICU) nurses frequently encounter work-related stressors and are therefore vulnerable to developing mental health problems, such as secondary traumatic stress, burnout, anxiety, and depression. However, so far, the exact nature of these work-related stressors (traumatic vs. non-traumatic stressors) has not been investigated. This concurrent triangulation mixed methods cross-sectional study aimed to compare mental health symptoms in hospital midwives and NICU nurses, and to identify and compare work-related traumatic and non-traumatic stressors for both professional groups. 122 midwives and 91 NICU nurses of two Swiss university hospitals completed quantitative measures (Secondary Traumatic Stress Scale, STSS; Hospital Anxiety and Depression Scale, HADS; Maslach Burnout Inventory, MBI) and one qualitative question in an online survey. When controlling for socio-demographic variables, NICU nurses had a higher STSS total score and higher STSS subscales scores and less HADS anxiety subscale scores than hospital midwives. Work-related stressors were classified into five themes: “Working environment,” “Nursing/midwifery care,” “Dealing with death and dying,” “Case management” and “Others.” Forty-six (46.3%) percent of these were classified as traumatic work-related stressors. NICU nurses reported more traumatic stressors in their working environment but no other differences between professional groups regarding the total number of work-related traumatic vs. non-traumatic stressors were found. Measures, such as teaching strategies to amend the subjective appraisal of the traumatic stressors or providing time to recover in-between frequently occurring work-related traumatic stressors might not only improve the mental health of professionals but also decrease sick leave and improve the quality of patient care.
Highlights
Work-related psychosocial stress is one of the most concerning issues of occupational health in industrialized countries [1]
The present study focuses on staff working with the perinatal population in a hospital environment: midwives working in a maternity department and nurses working in a neonatal intensive care unit (NICU)
We propose that work-related stressors, which hospital midwives and NICU nurses frequently encounter, can be classified into traumatic stressors, defined by direct or indirect exposure to death, threatened death, actual or threatened serious injury, actual or threatened sexual violence [18,19,20] and nontraumatic stressors, such as the lack of regular shifts, a heavy workload, and limited resources
Summary
Work-related psychosocial stress is one of the most concerning issues of occupational health in industrialized countries [1]. Stress, experienced by approximately 45% of working Europeans, is seen as the second most important threat posed by the working environment (after musculoskeletal problems), and costs approximately 25 billion euros per year [2]. As a result, reducing the burden of work-related mental health problems and psychiatric sickness absence is a key priority for the World Health Organization [3]. Patient-care professionals are more vulnerable than other professionals to develop mental health difficulties [4]. Their mental health problems are linked to high quantitative, emotional, sensorial and cognitive demands at work, a high rhythm of work, and a demand for hiding emotions [4]
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