Prevalence of and factors associated with burnout in midwifery: A scoping review

Abstract

INTRODUCTION Midwifery care meets the triple aims of health system improvement, i.e. good health outcomes, high client satisfaction, and low per capita costs. Scaling up access to midwifery care is a global priority yet the growth and sustainability of the profession is threatened by high levels of burnout and attrition. This scoping review provides a comprehensive review of the existing literature on burnout in midwifery, with a focus on prevalence, associated factors and potential solutions. METHODS Four electronic databases were searched to locate relevant literature up to July 2019. A total of 1034 articles were identified and reduced to 27 articles that met inclusion criteria. We summarize sample sizes, settings, study designs, burnout measures, prevalence of burnout, associated factors and potential solutions, and recommendations. RESULTS Prevalence of burnout was highest among Australian, Western Canadian and Senegalese midwives and lowest among Dutch and Norwegian midwives. Midwives working in caseload/continuity models reported significantly lower burnout compared to midwives working in other models. We identified 26 organizational and personal factors that were significantly associated with burnout, such as high workload, exposure to traumatic events, and fewer years in practices. Organizational support to improve work-life balance and emotional well-being, as well as more continuing education to raise awareness about burnout and how to cope with it, emerged as common strategies to prevent and address burnout. CONCLUSIONS Burnout is a serious and complex occupational phenomenon. More qualitative research is needed in this area, to better understand the lived experience of burnout. AFFILIATION

Strategies of nurse-midwives in relation to working conditions in maternity hospitals

“…feeling of belonging and cohesion of these workers, functioning as efficient collective resources to minimize tiredness, stress and overloads resulting from an unworthy occupational context, with precarious ambience, intensification and demand for productivity, which induce isolation destabilization of professional identity, suffering and illness of workers. It is noteworthy that the findings of this study are supported by international research that addresses the working conditions of nursing professionals in different countries, correlating them with suffering, illness and job dissatisfaction (29)(30)(31)(32)(33)38) . In this regard, nurse-midwives and midwives who work in work ambiance with security, necessary resources and good interpersonal relationships, combined with salaries and decent work hours, have higher degrees of job satisfaction, with positive impacts on their health and qualification of obstetric care (29)(30)(31)(32)(33)38,41) .…”

“…Infrastructure is an essential element for hospitals, as environments with spaces, furniture and material resources necessary for healthcare practice, with temperature, sound, lighting, synesthesia and color appropriate to the specificities of care, provide privacy, individuality and comfort; these elements translate into well-being for users and experiences of pleasure for workers (9,(23)(24)(25)(26)(27)(28) . On the other hand, an environment in dissonance with the recommended standards can generate dissatisfaction and weariness of workers in the performance of their work activities, shaping situations of suffering that negatively impact on the humanization, quality and safety of care (2,7,9,(27)(28)(29)(30)(31)(32)(33) .…”

“…Such characteristics attributed to labor are present in health work organization. However, nursing is the staff most affected, because, in addition to frequent accumulation of work relationships due to low wages, its activities include shortage of workers and wear and tear related to the complexity and heterogeneity of occupational activities in the hospital; these activities are configured as an overload for adding a greater load of material and immaterial work (1,(6)(7)(8)(9)(29)(30)38) .…”

“…It is worth mentioning that the world of work's current configuration is potentially harmful to workers' health, since restrictions on investments in human resources and infrastructure add uncertainties, dissatisfactions, occupational stress and suffering. (29)(30)38) . Such issues promote imbalances that are expressed through anguish, frustration, sadness, stress, tachycardia, tension headache, lack of concentration and creativity, depression, low productivity, musculoskeletal pain, tiredness, progressive exhaustion and exhaustion (2,27) .…”

I felt so much conflict instead of joy: An analysis of narratives from pregnant people in British Columbia who declined care recommendations

“…Midwives and physicians who witnessed abusive care felt moral distress and were at increased risk for post-traumatic stress symptoms. (28,29) These negative experiences in turn contribute to burnout, which is linked to attrition of care providers and provision of lower quality care (30). These studies highlight the negative impact of witnessing disrespect and abuse among care providers and the indirect impact on patients, making a strong case for the need to eradicate disrespectful and abusive care provider behaviours through education, professional codes of conducts, hospital policies, collection of accountability metrics, remediation and sanctions.…”