Job satisfaction and leaving intentions of midwives: analysis of a multinational cross-sectional survey

Abstract

Job satisfaction and leaving intentions of midwives: analysis of a multinational cross-sectional surveyAim To investigate the relationship between turnover intentions and job satisfaction among hospital midwives from seven countries and to determine how the related variables differ between countries. Background Studies investigating professional turnover and job satisfaction among midwives are limited in scope. Method A cross-sectional descriptive survey was used to investigate the intended turnover and job satisfaction relationship among 1190 hospital midwives in European and Asian countries. Data were collected using a set of questionnaires that included questions regarding the leaving intentions of midwives and the McCloskey/Mueller satisfaction scale. Results Midwives were least satisfied with their extrinsic rewards and professional opportunities and with the balance between family and work. Significant differences were found in all domains of job satisfaction according to midwives' intentions to leave their current workplace in hospital or profession of midwife, and to work abroad. Conclusion There are some general satisfying and dissatisfying elements for the profession of midwife across different countries. Implications for nursing management The results highlight the importance of understanding midwives' leaving intentions and related factors across different countries. To prevent midwife turnover, health-care managers should gain greater insight into the early stage of midwives' turnover intention.Keywords: job satisfaction, midwifery, turnover intention Overview of the literatureThe turnover of health-care workers and related determinants have been of interest to researchers from different disciplines for several decades (Coomber & Barriball 2007, Hasselhorn et al. 2008, Simon et al. 2010, Hayes et al. 2012). Ajzen's (1991) theory of planned behaviour has explained factors that predict actual turnover and describe the relationships between a person's attitudes, intentions and turnover behaviour. Attitudes towards behaviour, subjective norms and perceptions of behavioural control have been identified as predictors (i.e. antecedents) of behavioural intentions (Ajzen 1991). Based on this theory, Coomber and Barriball (2007) argued that the cognitive process of turnover intention (i.e. intent to leave) was an important predictor of actual turnover. According to Takase (2010), turnover intent is often triggered by negative psychological responses to organisational, work-related, employment factors or external (i.e. work-life balance) aspects of a job. The psychological responses evolve into gradual withdrawal cognition and behaviours, and lead to actual turnover (Takase 2010).The psychological component of turnover intention is the starting point of the multi-stage turnover reaction (Takase 2010). Coomber and Barriball (2007) described turnover intention (or intent to leave/stay)

The Five Attributes of a Supportive Midwifery Practice Climate: A Review of the Literature

“…Finally, 29 articles were applied to the analysis. Of those 29 articles, 9 were commentaries, reports, or reviews 16-24 ; 10 applied qualitative methods [25][26][27][28][29][30][31][32][33] ; 7 applied quantitative methods 13,14,[34][35][36][37][38] ; and 3 applied a mixed methodology. [39][40][41][42] Ten specifically addressed CNMs/CMs in the United States, and 19 investigated midwives in high-and middleincome countries outside of the United States (see Tables 2 and 3).…”

“…Midwife‐physician collaboration was more prevalent in the literature than collaboration with other members of the health care team; however, that does not demonstrate its hierarchal importance among practice climate attributes. Empirical studies have demonstrated that different elements of the practice climate had differing degrees of importance in different practice settings . For example, Hampton and Peterson found that physician interaction was significantly related to midwives’ job satisfaction only for midwives working in physician offices or hospitals, but among midwives working at educational institutions, the relationship with nurses was predictive of job satisfaction .…”

“…Empirical studies have demonstrated that different elements of the practice climate had differing degrees of importance in different practice settings. 13,29,38 For example, Hampton and Peterson found that physician interaction was significantly related to midwives' job satisfaction only for midwives working in physician offices or hospitals, but among midwives working at educational institutions, the relationship with nurses was predictive of job satisfaction. 38 Everly found that physicians had a greater impact on midwives' control over their work in a hospital setting as opposed to a birth center.…”

“…25 Based on a consensus of the literature reviewed, 9 traits of an effective and supportive midwifery practice leadership were identified: 1) shares and promotes midwifery values 19,25,26,34 ; 2) builds internal and external relationships 16,25,27 ; 3) transparency and communication 16,19,27,[34][35][36]39 ; 4) provides timely and compassionate feedback 13,16,25,28,35,36,39 ; 5) supports midwives in cases of adversity 28,[34][35][36]39 ; 6) determines performance and quality indicators consistent with midwifery model of care 29,34 ; 7) fosters growth in individual midwives 13,16,25,[34][35][36] ; 8) technical expertise 25,39 ; and 9) supports work-life balance. 13,26,27,30,37 The literature implies that midwives should be led by midwives, although a discussion specifically about this was not identified in the review. This is consistent with the organizational science literature that supports leaders having technical expertise in the area they are leading.…”

The case for developing an online intervention to support midwives in work-related psychological distress

“…Yet the psychological distress that some midwives endure can impair their cognitive function, decision making skills and their ability to provide compassionate, safe and high quality care (Beaumont, Durkin et al 2016, Knezevic, Milosevic et al 2011). The mental wellbeing of midwives can also be directly correlated with high staff turnovers, high staff sickness rates and low productivity rates, as those in distress can disengage from the profession (Brunetto, Xerri et al 2013, Kenworthy, Kirkham 2011, Jarosova, Gurkova et al 2016). This becomes important as the world tries to recruit and retain a high quality midwifery workforce in the face of global shortages (McInnes, Mc Intosh 2012).…”