Evaluating the roles of workload and practice climate in workforce retention across the midwifery career lifespan: A latent profile analysis of early-, mid-, and late-career US midwives

IF 4.4 2区医学 Q1 NURSING Women and Birth Pub Date : 2024-10-26 DOI:10.1016/j.wombi.2024.101833

E. Brie Thumm , Denise Smith , Zach Giano

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Abstract

Problem

Retention of midwives across the career lifespan is essential to address workforce shortages.

Background

While workplace factors are demonstrated to affect job satisfaction and turnover intention, there is little research investigating how workplace factors affect midwives at different career stages. Aim: To examine the effects of workload and practice climate on job satisfaction and turnover intention at different career stages.

Methods

In a secondary analysis, we split a sample of US midwives into early-, mid-, and late-career stages. We used latent profile analysis to create profiles (called “classes”) of workload (volume of women/individuals receiving care and acuity) and practice climate. Job dissatisfaction and turnover intention were compared between classes by career stages.

Findings

Across all career stages, classes with negative practice climates had significantly higher turnover intention and job dissatisfaction, regardless of patient volume or acuity. Among early career midwives, high workload was not associated with high turnover intention or job dissatisfaction in the context of positive practice climates. The highest proportion of mid- career participants were in the class with high turnover intention and job dissatisfaction, while in the early career subsample the largest proportion was in the class with low dissatisfaction and low turnover intention.

Discussion

Across all career stages, the practice climate was the primary driver of turnover intention and job dissatisfaction. Practice climate is particularly important for early-career midwives working in high-volume settings. Mid-career midwives are an under-studied group at risk of leaving the profession.

Conclusion

Efforts to retain the midwifery workforce would benefit from tailoring retention strategies to midwives at different career stages.

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评估工作量和实践氛围在助产士职业生涯中对劳动力保留的作用：对美国早期、中期和晚期助产士的潜在特征分析

背景虽然工作场所因素被证明会影响工作满意度和离职意向，但很少有研究调查工作场所因素如何影响处于不同职业阶段的助产士。目的：研究不同职业阶段的工作量和实践氛围对工作满意度和离职意向的影响。方法在一项二次分析中，我们将美国助产士样本分为早期、中期和晚期职业阶段。我们使用潜特征分析法创建了工作量（接受护理的妇女/个人数量和严重程度）和实践氛围的特征（称为 "类别"）。在所有职业阶段中，无论病人数量或严重程度如何，工作氛围消极的班级的离职意向和工作不满意度都明显较高。在早期职业生涯的助产士中，在积极的工作氛围下，高工作量与高离职意愿或工作不满意度无关。在职业生涯中期的参与者中，高离职意愿和工作不满意度的比例最高，而在职业生涯早期的子样本中，低不满意度和低离职意愿的比例最高。执业环境对在高工作量环境中工作的早期职业助产士尤为重要。结论针对不同职业阶段的助产士量身定制挽留策略将有助于留住助产士队伍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Women and Birth NURSING-OBSTETRICS & GYNECOLOGY

CiteScore

7.20

自引率

13.20%

发文量

371

审稿时长

27 days

期刊介绍： Women and Birth is the official journal of the Australian College of Midwives (ACM). It is a midwifery journal that publishes on all matters that affect women and birth, from pre-conceptual counselling, through pregnancy, birth, and the first six weeks postnatal. All papers accepted will draw from and contribute to the relevant contemporary research, policy and/or theoretical literature. We seek research papers, quality assurances papers (with ethical approval) discussion papers, clinical practice papers, case studies and original literature reviews. Our women-centred focus is inclusive of the family, fetus and newborn, both well and sick, and covers both healthy and complex pregnancies and births. The journal seeks papers that take a woman-centred focus on maternity services, epidemiology, primary health care, reproductive psycho/physiology, midwifery practice, theory, research, education, management and leadership. We also seek relevant papers on maternal mental health and neonatal well-being, natural and complementary therapies, local, national and international policy, management, politics, economics and societal and cultural issues as they affect childbearing women and their families. Topics may include, where appropriate, neonatal care, child and family health, women’s health, related to pregnancy, birth and the postpartum, including lactation. Interprofessional papers relevant to midwifery are welcome. Articles are double blind peer-reviewed, primarily by experts in the field of the submitted work.