Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P O Box 457, 405 30, Gothenburg, SE, Sweden.
Department of Health and Nursing, School of Health and Welfare, Halmstad University, Halmstad, Sweden.
BMC Health Serv Res. 2022 Apr 2;22(1):436. doi: 10.1186/s12913-022-07852-3.
Midwives report a challenging work environment globally, with high levels of burnout, insufficient work resources and low job satisfaction. The primary objective of this study was to identify factors in the organisational and psychosocial work environment associated with midwives' job satisfaction. A secondary objective was to identify differences in how midwives assess the organisational and psychosocial work environment compared to Swedish benchmarks.
This nation-wide, cross-sectional web survey study analysed midwives' assessment of their organisational and psychosocial work environment using the COPSOQ III instrument. A multivariable, bi-directional, stepwise linear regression was used to identify association with job satisfaction (N = 1747, 99.6% women). A conventional minimal important score difference (MID ± 5 as a noticeable difference with clinical importance) were used to compare midwives' results with Swedish benchmarks.
A multivariable regression model with 13 scales explained the variance in job satisfaction (R = .65). Five scales, possibilities for development, quality of work, role conflict, burnout and recognition, explained most of the variance in midwives' job satisfaction (R = .63) and had β values ranging from .23 to .10. Midwives had adverse MID compared to Swedish benchmarks with higher difference in mean values regarding quantitative demands (8.3), work pace (6.0) emotional demand (20.6), role conflicts (7.9) and burnout (8.3). In addition, lower organisational justice (-6.4), self-rated health (-8.8), influence (-13.2) and recognition at work (-5.8). However, variation and meaning of work showed a beneficial difference in mean values with 7.9 and 13.7 respectively.
Midwives reported high levels of meaningfulness in their work, and meaningfulness was associated with job satisfaction. However, midwives also reported adversely high demands and a lack of influence and recognition at work and in addition, high role conflict and burnout compared to Swedish benchmarks. The lack of organisational resources are modifiable factors that can be taken into account when structural changes are made regarding organisation of care, management and resource allocation. Midwives are necessary to a high quality sexual, reproductive and perinatal health care. Future studies are needed to investigate if job satisfaction can be improved through professional recognition and development, and if this can reduce turnover in midwives.
全球范围内，助产士报告称工作环境具有挑战性，存在高 burnout 率、工作资源不足和低工作满意度等问题。本研究的主要目的是确定与助产士工作满意度相关的组织和心理社会工作环境因素。次要目的是确定助产士对组织和心理社会工作环境的评估与瑞典基准之间的差异。
本全国性、横断面网络调查研究使用 COPSOQ III 工具分析了助产士对其组织和心理社会工作环境的评估。采用多变量、双向、逐步线性回归来确定与工作满意度的关联（N=1747，99.6%为女性）。使用常规最小重要评分差异（MID±5 为具有临床重要性的明显差异）来比较助产士的结果与瑞典基准。
一个包含 13 个量表的多变量回归模型解释了工作满意度的变异性（R²=.65）。5 个量表，即发展可能性、工作质量、角色冲突、倦怠和认可，解释了助产士工作满意度的大部分变异性（R²=.63），β 值范围为.23 至.10。与瑞典基准相比，助产士的 MID 较差，在定量需求（8.3）、工作节奏（6.0）、情绪需求（20.6）、角色冲突（7.9）和倦怠（8.3）方面的平均差异较大。此外，组织公平（-6.4）、自我报告健康（-8.8）、影响力（-13.2）和工作认可（-5.8）也较低。然而，工作的多样性和意义显示出有益的差异，平均值分别为 7.9 和 13.7。
助产士报告称他们的工作具有高度的意义，而意义与工作满意度相关。然而，与瑞典基准相比，助产士还报告称工作需求过高、影响力和认可不足，此外，角色冲突和倦怠程度较高。缺乏组织资源是可以考虑的可改变因素，在进行护理组织、管理和资源分配的结构性变革时可以考虑这些因素。助产士是高质量性、生殖和围产期保健的必要条件。需要进一步研究以确定工作满意度是否可以通过专业认可和发展来提高，以及这是否可以减少助产士的离职率。
