Kohler Stefan, Bärnighausen Till, Eichenauer Jutta, Scheichenbauer Christel, Paul Nicolas
Heidelberger Institut für Global Health, Universität Heidelberg, Heidelberg.
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin.
Gesundheitswesen. 2023 May;85(5):e5-e15. doi: 10.1055/a-1851-9619. Epub 2022 Oct 20.
A shortage of midwives has been the subject of discussion in Germany in recent years. In this study, we asked midwives in Baden-Wuerttemberg about their health and professional satisfaction.
In collaboration with the Baden-Wuerttemberg Midwives Association, an online midwives survey was conducted from October 16 to December 10, 2017. Using a visual analog scale (0-100 points), the WHO-5 questionnaire (0-100 points) and the Copenhagen Burnout Inventory (0-100 points), data on health, well-being and burnout were collected. Job satisfaction was assessed on a 7-point Likert scale. Seven hundred and twenty-two midwives participated in the survey. For this study, 545 to 608 data sets were analyzed.
Of the studied midwives, 78.1% rated their health as good or very good (≥60 points). No statistically significant difference was observed between freelance midwives, employed midwives, and midwives who worked in both occupation forms (P=0.12). Midwives who were exclusively (15.0%) or partially (12.6%) employed were more likely to have very low well-being (≤25 points) than freelance midwives (7.3%; P=0.023). In addition, midwives who were exclusively (41.5%) or partially (39.4%) employed were more likely to have a moderate or high risk of burnout (≥50 points) than freelance midwives (20.6%; P<0.001). A lower health rating, lower well-being or higher burnout risk were associated with higher professional dissatisfaction in one or more domains. In multivariable analyses, higher burnout risk in particular was associated with higher job dissatisfaction in various domains.
A large proportion of midwives in our study showed symptoms of depression and/or burnout. On average, the health status of midwives seems to be above the health status of women from the general population in Germany, but the well-being of midwives below. We recommend further investigation of how the stress of midwives can be reduced in the course of advancing midwifery and obstetric care structures.
近年来，助产士短缺一直是德国讨论的话题。在本研究中，我们询问了巴登-符腾堡州助产士的健康状况和职业满意度。
2017年10月16日至12月10日，与巴登-符腾堡州助产士协会合作开展了一项在线助产士调查。使用视觉模拟量表（0 - 100分）、世界卫生组织-5问卷（0 - 100分）和哥本哈根倦怠量表（0 - 100分）收集健康、幸福感和倦怠方面的数据。工作满意度采用7点李克特量表进行评估。722名助产士参与了调查。本研究分析了545至608个数据集。
在参与研究的助产士中，78.1%将自己的健康状况评为良好或非常好（≥60分）。自由职业助产士、受雇助产士以及从事两种职业形式的助产士之间未观察到统计学上的显著差异（P = 0.12）。与自由职业助产士（7.3%）相比，专职（15.0%）或兼职（12.6%）受雇的助产士幸福感极低（≤25分）的可能性更高（P = 0.023）。此外，与自由职业助产士（20.6%）相比，专职（41.5%）或兼职（39.4%）受雇的助产士出现中度或高度倦怠风险（≥50分）的可能性更高（P < 0.001）。较低的健康评分、较低的幸福感或较高的倦怠风险与一个或多个领域的较高职业不满相关。在多变量分析中，尤其较高的倦怠风险与各个领域较高的工作不满相关。
我们研究中的很大一部分助产士表现出抑郁和/或倦怠症状。总体而言，助产士的健康状况似乎高于德国普通女性的健康状况，但幸福感低于普通女性。我们建议进一步研究如何在推进助产和产科护理结构的过程中减轻助产士的压力。
