The Impact of the Workload and Traumatic Stress on the Presenteeism of Midwives: The Mediating Effect of Psychological Detachment

Abstract

Objectives. Midwives are at high risk of presenteeism, which may impact the quality of midwifery and maternal and infant health outcomes. However, no research has been conducted to investigate the relationship between workload, traumatic stress, psychological detachment, and presenteeism among midwives. This study, therefore, aimed at exploring the mediating effects of psychological detachment on workload, traumatic stress, and presenteeism among midwives. Method. A multicenter cross-sectional study was conducted among 547 midwives in Jiangsu Province. Participants completed the National Aeronautics and Space Administration task load index, traumatic stress impact subscale for midwives, psychological detachment scale, and Stanford presenteeism scale and provided sociodemographic information. The mediating effects of psychological detachment were assessed using Mplus. Results. The mean score of midwives’ presenteeism was 17.09 ± 3.56. Presenteeism was positively associated with both workload and traumatic stress (both P < 0.01 ) and negatively associated with psychological detachment ( P < 0.01 ) among midwives. Psychological detachment partially mediated the relationships between (a) workload and presenteeism ( β = 0.005, P < 0.05 ) and (b) traumatic stress and presenteeism ( β = 0.006, P < 0.05 ), with mediating effects of 11.90% and 10.00%, respectively. Conclusions. Presenteeism among midwives is at moderately high levels and requires attention from nursing managers. Psychological detachment is a mediating variable of the relationship between workload, traumatic stress, and presenteeism among midwives. Implications for Nursing Management. This study has implications for decreasing midwives’ presenteeism in practical terms. Specifically, it is crucial that care managers attempt to adjust midwives' work patterns, reduce their workload, and provide organizational support for work-related traumatic stress. Moreover, our findings also indicate that psychological detachment is probably an essential element that is worthy of attention.