Abstract:Introduction
Burnout refers to a constellation of feelings of exhaustion, depersonalization, and low sense of personal accomplishment that develops secondary to long‐term occupational stress. Several studies have identified that health care professionals are a high‐risk occupational group for burnout, but knowledge about this syndrome among midwives has not been fully explored. The purpose of this study was to perform a systematic review of the prevalence and levels of burnout among midwives and analyze the re… Show more
“…Most studies measuring burnout among midwives have been conducted in caseload and non-caseload models of care in Australia, Scandinavia, the United Kingdom, Japan, Spain, or Turkey 8 - 10 . However, there are substantial differences in midwifery practice, between and within countries, with respect to the role and responsibilities of midwives, midwifery education, organization, and care models 2 , 23 .…”
INTRODUCTION
Midwifery services are a cornerstone of maternal care, but the mental health of midwives is at risk in many work settings. The aim of this study was to assess burnout and attitudes toward midwifery among midwives in Baden-Württemberg, Germany.
METHODS
A cross-sectional online survey among midwives was conducted from 16 October to 10 December 2017. Burnout was assessed using the Copenhagen Burnout Inventory (CBI).
RESULTS
A total of 602 survey respondents were studied; 48.3%, 38.2%, and 23.3% of midwives reported moderate or high (CBI score ≥50) levels of personal burnout, work-related burnout, and client-related burnout, respectively. Midwives with moderate or high burnout in at least one CBI dimension worked more weekly hours, were more commonly employed, and worked more frequently in the hospital. In turn, midwives with low burnout levels worked fewer weekly hours, more commonly freelance, and more frequently community based (all p<0.001). Moderate or high burnout levels were associated with a reduced likelihood to recommend midwifery as a profession (OR=0.34; 95% CI: 0.23–0.49) and an increased likelihood to intent leaving the profession (OR=3.39; 95% CI: 2.0–5.9) in a multivariable regression adjusting for midwife characteristics and work practices.
CONCLUSIONS
Burnout symptoms were common among midwives. Burnout could be a health risk for midwives and a challenge to the profession by discouraging present and future midwives from practicing midwifery.
“…Most studies measuring burnout among midwives have been conducted in caseload and non-caseload models of care in Australia, Scandinavia, the United Kingdom, Japan, Spain, or Turkey 8 - 10 . However, there are substantial differences in midwifery practice, between and within countries, with respect to the role and responsibilities of midwives, midwifery education, organization, and care models 2 , 23 .…”
INTRODUCTION
Midwifery services are a cornerstone of maternal care, but the mental health of midwives is at risk in many work settings. The aim of this study was to assess burnout and attitudes toward midwifery among midwives in Baden-Württemberg, Germany.
METHODS
A cross-sectional online survey among midwives was conducted from 16 October to 10 December 2017. Burnout was assessed using the Copenhagen Burnout Inventory (CBI).
RESULTS
A total of 602 survey respondents were studied; 48.3%, 38.2%, and 23.3% of midwives reported moderate or high (CBI score ≥50) levels of personal burnout, work-related burnout, and client-related burnout, respectively. Midwives with moderate or high burnout in at least one CBI dimension worked more weekly hours, were more commonly employed, and worked more frequently in the hospital. In turn, midwives with low burnout levels worked fewer weekly hours, more commonly freelance, and more frequently community based (all p<0.001). Moderate or high burnout levels were associated with a reduced likelihood to recommend midwifery as a profession (OR=0.34; 95% CI: 0.23–0.49) and an increased likelihood to intent leaving the profession (OR=3.39; 95% CI: 2.0–5.9) in a multivariable regression adjusting for midwife characteristics and work practices.
CONCLUSIONS
Burnout symptoms were common among midwives. Burnout could be a health risk for midwives and a challenge to the profession by discouraging present and future midwives from practicing midwifery.
“…During this process, midwives also face additional challenges of frustration due to their increased workload and poor communication with the psychiatrist, as well as noncompliance of the mothers due to stigma surrounding mental health and poor hospital conditions. High workload, poor relationships with supervisors, and perceived lack of time to provide high quality care for patients are all risk factors for burnout among midwives worldwide [3]. However, in this study, midwives reported they are satisfied with the current system, and mostly made minor suggestions for improvement, such as integrating a depression screening questionnaire to the antenatal care protocol.…”
Section: Discussionmentioning
confidence: 64%
“…We as midwives do more frequent home visits to ensure her compliance, to make sure she takes her medications at the correct time, to check her improvement and to educate the family members and gain their support. We also visit them along with the psychiatrist when we check her improvement to decide on further treatments.-PHM 3 We talk with the patient as well as with the family members spending a lot of time with them. We advise the family on how to take care of a mother with such a problem.…”
Section: Sometimes They Are Not Attending To Household Work Like Earl...mentioning
confidence: 99%
“…2 Duke Global Health Institute, Duke University, Durham, NC, USA. 3 University of Bergen, Bergen, Vestland, Norway. 4 Faculty of Medicine, University of Ruhuna, Matara, Southern Province, Sri Lanka.…”
Background
Almost all pregnant people in Sri Lanka receive antenatal care by public health midwives. While there is strong infrastructure in Sri Lanka for postpartum mental health care, the current practices within antenatal mental health care have not been externally evaluated. The purpose of this study is to investigate the current clinical guidelines and experiences of how public health midwives diagnose and treat antenatal depression.
Methods
We conducted in-depth interviews with 12 public health midwives from four antenatal clinics in the Bope Poddala division in Galle, Sri Lanka and reviewed and extracted information on antenatal depression from clinical guidelines. Data was collected in Sinhala and translated into English. We used applied thematic analysis and worked closely with our local team to ensure data trustworthiness.
Results
Midwives (n = 12) reported varying degrees of knowledge on antenatal depression and did not have standardized diagnosis patterns. However, they were very consistent in their clinical practices, following guidelines for referral and follow-up of case management, building strong rapport. In their practice, midwives continue to face challenges of lack of human resources and high stigma around mental illness. They suggested that that care could be improved with use of a standardized diagnostic tool, and easier access to specialist care. We found the clinical guideline on the diagnosis and treatment of antenatal depression is lacking key details on symptoms for appropriate diagnosis, but it clearly guides on how to navigate treatment.
Conclusions
Public health midwives are following the clinical guideline to refer pregnant women who need intervention for antenatal depression and follow-up for case management. However, there is a need for more specific and context-relevant guidelines, especially for diagnosis of antenatal depression. Formative research is needed to explore intervention strategies to improve antenatal depression management in Sri Lanka.
“…44 In contrast, excessive workload and an ongoing lack of resources can be expected to increase burnout, which results in high rates of turnover and leaving health professions. [45][46][47] A more flexible workforce could facilitate care practices that reduce risk of transmission such as expansion of telehealth services, early hospital discharge with postpartum home care, and home visits for newborn well checks. Increasing flexibility will require a range of changes in training, employment, practice, and reimbursement.…”
The objective of this study was to describe the system's initial pandemic response from the perspectives of perinatal health workers and to identify opportunities for improved future preparedness. An exploratory survey was designed to identify perinatal practice changes and workforce challenges during the initial weeks of the COVID-19 pandemic. The survey included baseline data collection and weekly surveys. A total of 181 nurses, midwives, and physicians completed the baseline survey; 84% completed at least 1 weekly survey. Multiple practice changes were reported. About half of respondents (50.8%) felt the changes protected patients, but fewer (33.7%) felt the changes protected themselves. Most respondents providing out-ofhospital birth services (91.4%) reported increased requests for transfer to out-of-hospital birth. Reports of shortages of personnel and supplies occurred as early as the week ending March 23 and were reported by at least 10% of respondents through April 27. Shortages were reported by as many as 38.7% (personal protective equipment), 36.8% (supplies), and 18.5% (personnel) of respondents. This
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