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)
To effectively promote health-related quality of life in vulnerable older people, medication adherence and health literacy of patients should be assessed, and patient-centred intervention strategies that consider their individual differences should be developed.
The Champion's Health Belief Model Scale (CHBMS) is a reliable and valid instrument developed for American women to measure beliefs about breast cancer and breast self-examination. The purpose of this study is to translate the CHBMS into Korean and to validate the scale among Korean women. The CHBMS was translated using a back-translation technique. A convenience sample of 264 women was recruited from a continuing education center, a community health center, and a university in 3 South Korean cities. The participants were asked to complete the translated Korean version of the CHBMS questionnaire. The data obtained were analyzed using a principal component analysis with varimax rotation for construct validity. Loading criterion was set at .45. Cronbach's alpha was computed for the reliability of the scale.From the analysis, two items from the Benefits domain and four items from the Motivation domain were deleted from the original scale. Thus, the final Korean version of the CHBMS (CHBMS-K) consisted of 36 items that were clustered to 6 subscales: susceptibility (5 items), seriousness (7 items), benefits (4 items), barriers (6 items), confidence (11 items), and motivation (3 items). Cronbach's alpha reliability coefficients for the 6 subscales ranged from .92 to .72. The CHBMS-K was found to be reliable and valid in scale for use with Korean women. It can be used in planning and testing interventions to improve breast self-examination beliefs and practice.
The objective of our study was to examine the effect of lifetime lactation on breast cancer risk among premenopausal women. The data were from a prospective cohort study with a follow-up period of 6 years in Korea (1995Korea ( -2000 Although the protective effect of lactation on breast cancer has been discussed among researchers for more than 20 years, no study ever found a detrimental effect of breastfeeding on risk of breast cancer. For example, an inverse association between lifetime lactation and breast cancer risk among premenopausal women has been found in some case-control studies, 1-8 whereas other studies show no association. 9 -13 It is noteworthy that studies from the countries in which the prevalence of prolonged lactation is high, such as China 6,7 and Japan, 13,14 have consistently shown an association between lactation and a reduced risk of breast cancer. On the contrary, studies of Western populations, in which the duration of lactation is relatively short, have provided inconsistent results regarding the relation between breastfeeding and the risk of breast cancer. 10,11,15,16 These findings from case-control studies are also evident in cohort studies: Six cohort studies [17][18][19][20][21][22] to date have attempted to clarify the association between lifetime lactation and a reduced risk of breast cancer. Neither the first cohort study for premenopausal women in Norway 17 nor 2 studies from the Nurses' Health Study for U.S. women 18,19 showed the protective effect of lactation on breast cancer risk. However, the most recent nested casecontrol studies for an Iceland cohort 20 and a Connecticut cohort 21 reported a negative association between breastfeeding and breast cancer risk in both pre-and postmenopausal women. In particular, a significant reduction in breast cancer risk was observed among the women who had breastfed for more than 36 months in a Shanghai Textile Workers' cohort study, although a significant reduction in risk was not observed in women who had breastfed for fewer than 36 months. 22 Despite the several previous researches that uncovered the relationships between various aspects of lactation and breast cancer risk, gaps and inconsistencies remain. Given the finding that lactation is a potentially modifiable risk factor for breast cancer, which is a disease with great public health concerns for women of all ages and races, rigorous investigations are warranted to clarify the inconsistent conclusions from previous studies of lactation and breast cancer.Our study is the seventh reported cohort study to examine prospectively the relation between lactation and breast cancer. Our study used data gathering from 110,604 premenopausal Korean women to clarify the potential beneficial effect of lactation on the risk of breast cancer among premenopausal parous women. MATERIAL AND METHODSThe Korea Medical Insurance Corporation (KMIC) is the largest Korean insurance group that provides health insurance to government employees, teachers and their family members. Of the entire Korean populat...
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