Midwifery Job Autonomy in New Zealand: I do it all the time

INTRODUCTION

This research aimed to identify what supports and what hinders job autonomy for midwives in New Zealand.

METHODS

Registered midwives participated in an open-ended, online survey in 2019. Anonymised participants were asked to describe an incident when they felt they were using their professional judgement and/or initiative to make decisions and the resultant actions. The data was analysed thematically.

FINDINGS

The participants identified that autonomy is embedded within midwifery practice in New Zealand. Self-employed midwives who provide continuity of care as Lead Maternity Carers, identified they practice autonomously 'all the time'. The relationship with women and their family, and informed decision making, motivated the midwife to advocate for the woman - regardless of the midwife's work setting. Midwifery expertise, skills, and knowledge were intrinsic to autonomy. Collegial relationships could support or hinder the midwives' autonomy while a negative hospital work culture could hinder job autonomy.

DISCUSSION

Midwives identified that autonomous practice is embedded in their day to day work. It strengthens and is strengthened by their relationships with the woman/whanau and when their body of knowledge is acknowledged by their colleagues. Job autonomy was described when midwifery decisions were challenged by health professionals in hospital settings and these challenges could be viewed as obstructing job autonomy.

CONCLUSION

The high job autonomy that New Zealand midwives enjoy is supported by their expertise, the women and colleagues that understand and respect their scope of practice. When their autonomy is hindered by institutional culture and professional differences provision of woman-centred care can suffer.

Understanding Singaporean medical students' stress and coping

Medical school is intrinsically stressful, and high levels of stress have untoward effects. Although surveys have revealed some sources of stress among medical students, little is known about the qualitative aspects of these stressors and their associated coping behaviours, particularly among medical students in Singapore. Our exploratory pilot study found that relationship issues and examinations were the major sources of stress for medical students. The respondents described multiple context-sensitive coping styles, as well as reported 'avoidance' or 'wishful thinking' coping strategies as ineffective. Their stress-and-coping process suggests the influence of Asian culture and medical school culture. Our findings thus indicate the need for further research, potentially using new methodologies such as the critical incident analysis technique, and thoughtful consideration of culture when implementing programmes in Singapore medical schools to improve the students' stress-and-coping responses.

Improving Job Tenure Outcomes for People with Disabilities

The need for job retention services in rehabilitation is clearly indicated in statistics on unemployment and job loss rates for people with disabilities. In this article, information is provided on a three-part job retention model (the 3M model) containing the constructs of match, maturity, and mastery. The thesis of the article is that individuals with disabilities are more likely to retain employment when rehabilitation counselors provide retention services compatible with the 3Ms. Counselors can help people with disabilities (a) establish the prerequisite job—person match, (b) meet career maturity challenges, and (c) demonstrate mastery of novel workplace problems.

Stress, coping, and work engagement within the -specific job context: comment on Kaiseler, et Al. (2014)

This work discusses the use of tools that make use of context information. Comments are based on a previous study that looked into the relationship between stressors, coping, and work engagement (Kaiseler, Queirós, Passos & Sousa, 2014). A set of propositions are provided for research that will allow the design of contextualized stress interventions in specific job settings.

Emotional versus cognitive rumination: are they differentially affecting long-term psychological health? The impact of stressors and personality in dental students

In the process of recovery from work, rumination is considered as an important mediating variable in the relationship between work demands and psychological health outcomes. Past research differentiated affective rumination from problem-solving pondering. The aim of the present study was to test a moderated mediation model for these two distinct ruminative states and to show how personality (i.e. neuroticism and conscientiousness) can alter the mediating effect. The present study is based on 119 surveys from dental students with a time lag of 6 months. Participants filled out questionnaires assessing specific study-relevant performance demands, rumination and personality and a screening measure for psychological health status. Neuroticism was found to moderate the demand-affective rumination association, but conscientiousness did not moderate the demand-problem-solving pondering association. Moderated mediation analysis revealed that affective rumination mediates the impact of demands on psychological health only for individuals low in neuroticism. Findings are discussed regarding potential interventions for dental students to prevent negative psychological health outcomes due to increased work-related demands in the long term.

Coping with coping strategies: how distributed teams and their members deal with the stress of distance, time zones and culture

The changing world of work is increasing demands on workers through greater need for flexibility in global collaboration. This multiple-case study uses a qualitative research approach to study context-specific job stressors and coping in ten geographically distributed work teams. Results demonstrate the complex and dynamic nature of the stress-coping process and how coping strategies, adapted to manage stress-evoking uncertainty and ambiguity in distributed work, created secondary sources of psychological strain to individuals. The main strategies for managing the uncertainty and ambiguity in the studied teams were extensive emailing, travelling to face-to-face meetings and extending workdays to collaborate simultaneously across time zones. Continuously used, these coping strategies created work overload and strain. Experienced workers, who had good self-management skills, succeeded in coping with these secondary sources of strain by prioritizing and setting clear limits for workload. Less-experienced workers were overloaded and needed more social support from their leaders and teammates. The study proposes that distributed team members rely heavily on individual coping resources, because spatial and temporal distance hinders or even precludes the mobilization of social resources related to emotional, instrumental and informational social support.

What qualitative research has taught us about occupational stress

While many reviews of job stress and the stressor–strain relationship have been conducted, such reviews typically focus exclusively on quantitative data. In the current paper, we review qualitative studies on occupational stress that met two criteria: (1) the studies employed qualitative methods; (2) the stressors, strains and/or coping strategies were grouped into identifiable, higher-order categories. Results indicated that the nature of the stressors experienced varied by (a) occupation, (b) country, (c) seniority and (d) gender. The review further revealed that organizational constraints, work overload and interpersonal conflict were relatively universal stressors. Anger and annoyance were the most frequently reported psychological strains in the United States and the United Kingdom, while Chinese workers exhibited tension and anxiety and Indian workers exhibited acceptance. Coping strategies also varied by gender, occupation and country. Research on gender differences suggested that, compared to men, women tended to report more interpersonal stressors. Differences in the ways in which the two types of methodologies are applied, as well as their relative strengths and weaknesses, underline the value of qualitative approaches to the study of occupational stress, especially when used in conjunction with quantitative methods in mixed-methods studies.

Constructions of work stress and coping in a female- and a male-dominated department

In the present study the nature of stress and coping was investigated and considered as socially constructed. Thirty small group interviews were performed using the Critical Incident Technique in one female- and one male-dominated customer service department of a telecom company. The main themes about stress among both women and men were often expressed as collective phenomena and were connected to the organizational change and downsizing process, problems when carrying out the work and lack of autonomy. However, a striking difference between female and male interviews was found in the way that women to a greater extent expressed lack of autonomy and their working situation was described as strictly regulated. The findings illustrate that a traditional gender difference regarding autonomy could be found when comparing a female- and a male-dominated department even though they were performing the same type of job. Both women and men portrayed coping as a mixture of collective and individual strategies. They often mentioned collective acceptance, resignation and hardening. There is a need for further research about women and men at work, taking into consideration the interpersonal context and the collective nature of stress and coping.