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荷兰初级保健机构中初任助产士所感知到的工作要求和资源

Perceived job demands and resources of newly qualified midwives working in primary care settings in The Netherlands.

作者信息

Kool Liesbeth, Feijen-de Jong Esther I, Schellevis Francois G, Jaarsma Debbie A D C

机构信息

Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science, Amsterdam Public Health Research Institute, Van de Boechorstraat 7, 1081 BT Amsterdam, The Netherlands; University of Groningen, University Medical Center Groningen, Department of General Practice & Elderly Medicine, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; AVAG (Academy Midwifery Amsterdam and Groningen), Dirk Huizingastraat 3-5, 9713GL Groningen, The Netherlands.

Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science, Amsterdam Public Health Research Institute, Van de Boechorstraat 7, 1081 BT Amsterdam, The Netherlands; NIVEL (Netherlands Institute for Health Services Research), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands.

出版信息

Midwifery. 2019 Feb;69:52-58. doi: 10.1016/j.midw.2018.10.012. Epub 2018 Oct 26.

Abstract

OBJECTIVE

The objective of this study is to identify perceived job demands and job resources of newly qualified midwives (NQMs), working in primary midwifery care during their first years in practice.

DESIGN/SETTING: A qualitative study, with semi-structured group interviews was conducted. Midwives working less than three years in primary midwifery care in the Netherlands were invited to join a focus group interview.

MEASUREMENTS AND FINDINGS

Five focus group interviews were with 31 participants. Interviews were transcribed and analyzed. Data were analyzed thematically by using the different characteristics of the Job Demands Resources model. Working as a locum midwife is demanding for Dutch NQMs, due to a large number of working hours in different practices and a lack of job security. Decision-making and adapting to local guidelines and collaborations demand a high cognitive load. These aspects of the work context negatively impact NQMs' work and private life. Working with clients and working autonomously motivates the newly graduates. Support from colleagues and peers are important job resources, although colleagues are also experienced as a job demand, due to their role as employer. Strictness in boundaries, flexibility and sense of perspective are NQMs' personal resources. On the other hand, NQMs perceived perfectionism and the urge to prove oneself as personal demands.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Dutch NQMs' first years in primary midwifery care are perceived as highly demanding. In primary care, NQMs usually work as locum midwives, self-employed and in different practices. Working in different practices requires not only working with different client populations and autonomous decision-making, but also requires adaptation to different local working arrangements. Building adequate support systems might help NQMs finding a balance between work and private life by having experienced midwives available as mentors. Furthermore, training and coaching of NQMs help them to become aware of their personal resources and demands and to help them strengthen their personal resources. Improving NQMs' working position through secure employments require changes in the organization of maternity care in the Netherlands.

摘要

目的

本研究的目的是确定初出茅庐的助产士(NQMs)在执业头几年从事初级助产护理工作时所感受到的工作需求和工作资源。

设计/背景:进行了一项定性研究,采用半结构化小组访谈。邀请在荷兰从事初级助产护理工作不到三年的助产士参加焦点小组访谈。

测量与结果

对31名参与者进行了五次焦点小组访谈。访谈内容进行了转录和分析。使用工作需求-资源模型的不同特征对数据进行了主题分析。对于荷兰的初出茅庐的助产士来说,担任临时助产士要求很高,因为在不同机构工作时间长且缺乏工作保障。决策以及适应当地指南和合作需要很高的认知负荷。工作环境的这些方面对初出茅庐的助产士工作和私人生活产生负面影响。与客户合作和自主工作激励着应届毕业生。同事和同行的支持是重要的工作资源,不过同事由于其雇主角色,也被视为一种工作需求。在界限、灵活性和洞察力方面的严谨是初出茅庐助产士的个人资源。另一方面,初出茅庐的助产士将完美主义和证明自己的冲动视为个人需求。

关键结论及对实践的启示

荷兰初出茅庐的助产士在初级助产护理工作的头几年被认为要求很高。在初级护理中,初出茅庐的助产士通常担任临时助产士,自主从业且在不同机构工作。在不同机构工作不仅需要与不同的客户群体合作并自主决策,还需要适应不同的当地工作安排。建立适当的支持系统可能有助于初出茅庐的助产士通过有经验的助产士担任导师来平衡工作和私人生活。此外,对初出茅庐的助产士进行培训和指导有助于他们意识到自己的个人资源和需求,并帮助他们强化个人资源。通过稳定就业来改善初出茅庐助产士的工作地位需要荷兰产妇护理组织做出改变。

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