The Effect of Stress Management on Occupational Stress and Satisfaction among Midwives in Obstetrics and Gynecology Hospital Wards in Iran

Effectiveness of interventions on occupational stress, health and well-being, performance, and job satisfaction for midwives: A systematic mixed methods review

BACKGROUND

Work-related stress is high in midwifery with negative implications for midwives' health and performance. This systematic review therefore examined which stress management interventions (SMIs) are most effective at reducing occupational stress and improving midwives' health and well-being, performance, and job satisfaction.

METHODS

A systematic review included studies if they were: investigating midwives or student midwives; examining an individual- or organisation-level intervention; reporting the intervention effects on at least one outcome (e.g., job performance); peer-reviewed; and published in English. Methodological quality was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was conducted and data were presented by SMI level (i.e., individual vs. organisation) and modality type (e.g., mindfulness, care model). Sum codes were used to compare the effects of individual- and organisation-level SMIs on outcomes.

FINDINGS

From 2605 studies identified, 30 were eligible (18 individual- and 12 organisation-level SMIs). Eight studies were deemed low quality. While individual- and organisation-level SMIs were equally effective in improving job satisfaction and performance, there was a trend for organisation-level SMIs more effectively reducing work stress and improving health and well-being. Specific individual- (i.e., mindfulness, simulation training) and organisation-level (i.e., reflective groups, midwifery care models) SMIs were most beneficial.

CONCLUSION

It is recommended that health practitioners and policy makers implement interventions that target both individual- and organisation-levels to optimally support midwives' work stress, health, well-being, and performance. Notwithstanding these findings and implications, some studies had poor methodological quality; thus, future research should better follow intervention reporting guidelines.

Experiences of newly qualified midwives during their transition to practice: a systematic review of qualitative research

Objective

To summarize and evaluate the experiences and expectations of newly qualified midwives (NQMs) during their transition from school to clinical practice. One of the main objectives was to provide references for the development of midwifery professional teaching and provide a basis for hospital administrators and instructors of midwifery to develop guidelines and strategies.

Methods

A systemic review of qualitative research using meta-aggregation was conducted. We collected studies from 12 databases between inception and February 2023. All qualitative studies published in English and Chinese that reported on the experiences of NQMs during their transition to practice were included. Two independent reviewers assessed the study quality and the credibility of study findings by using the JBI Qualitative Assessment and Review Instrument. The process of searching followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations.

Results

A total of 14 studies were included, and 84 findings were extracted. The results were grouped into 8 new categories and synthesized into 3 main themes: multi-dimensional challenges, physical and emotional responses, and demands and expectations. The included studies were identified to be of good quality and the results of the methodological quality appraisal were all B grade or higher.

Conclusion

The transition period is a critical career development for NQMs. However, they faced various stress during the period, which had a negative impact on their physical and mental health. Therefore, it's important to deeply understand their challenges and needs. And effective management strategies should be implemented, such as in-depth cooperation between hospitals and schools, improvement of the clinical transition support system, enhancement of continuing education, and standardization of the management system. This may be beneficial to improve the quality of clinical midwifery and maintain the stability and sustainable development of the midwifery team.

The effectiveness of adapted group mindfulness-based stress management program on perceived stress and emotion regulation in midwives: a randomized clinical trial

Background

Midwives' stress can have negative consequences on their emotional state, burnout, and poor quality of midwifery care. This study aimed to determine the effectiveness of an adapted mindfulness-based stress management program on perceived stress and the emotional regulation of midwives.

Methods

The study was a parallel randomized clinical trial on the midwives working in general hospitals of Zanjan, Iran. In this study, 121 midwives registered to participate based on the census sampling method were screened using a cut point of ≥ 28 in the Perceived Stress Scale (PSS). From the initial sample, 42 subjects had inclusion criteria assigned to two groups of control (n = 21) and intervention (n = 21) using online random allocation. The intervention group received an 8-week adapted mindfulness-based stress management program. This program emanates from the Kabat-Zinn's MBSR program, which has been adjusted according to the Iranian culture. The ANCOVA and repeated measure analysis of variance test were used to compare groups over time.

Results

The results showed that the group intervention effectively affected perceived stress (P = 0.001) and difficulty in emotion regulation during the post-intervention period (P = 0.001). Moreover, the interventions were effective in emotion regulation (P = 0.003), but it was not effective on perceived stress (P = 0.125) at the 3-month follow-up.

Conclusions

This adapted mindfulness-based program successfully reduced stress and increased emotion regulation strategies in midwives; however, the long-term outcomes of this treatment program need further consideration.

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

OBJECTIVES

to understand the working conditions and strategies adopted by nurse-midwives in maternity hospitals.

METHODS

a qualitative, descriptive, exploratory study with 20 nurse-midwives from public maternity hospitals in the city of Rio de Janeiro. Data were collected from June to September 2018 through semi-structured interviews, submitted to thematic content analysis and discussed in the light of the psychodynamics of work.

RESULTS

working conditions are inadequate due to poor infrastructure and resource deficit. Therefore, they develop defensive strategies to mitigate suffering, avoid destabilization of professional identity and minimize losses on care, through material purchase, lunch hour abdication, task reorganization and break implementation.

FINAL CONSIDERATIONS

the strategies adopted hide work precariousness and suggest alienation of workers, evidencing the need to foster political awareness of this collective to promote concrete transformations in their work reality.

Midwives perceptions: Birth unit environment and the implementation of best intrapartum care practices

PROBLEM

Midwives related avoidable factors causing maternal morbidity and mortality rates continue to occur despite the existing intrapartum care-related evidence-based practice guidelines and continuing staff development initiatives.

RESEARCH QUESTION

What are your perceptions regarding a birth unit environment that supports the implementation of best intrapartum care practices.

OBJECTIVE

To explore and describe midwives' perceptions about the birth environment that supports the implementation of best intrapartum care practices.

METHOD

A qualitative design that is explorative, descriptive, and contextual in nature using a descriptive phenomenology approach.

SETTING

A public hospital birth unit in the Gauteng Province in South Africa.

POPULATION AND SAMPLE

The population comprised of 56 permanently employed female registered midwives. A purposive sampling method was used to select 26 participants who met the selection criteria, these participants were willing to participate in the study and to sign the consent form. Data collection process involved three focus group interviews using semi-structured interviews. A qualitative data analysis method was used to analyse data. Trustworthiness was ensured and ethical considerations were adhered to.

FINDINGS

Three main themes emerged namely, interpersonal skills, improved staff development, and adequate resources.

DISCUSSION

Conducive birth environment is crucial to childbirth outcomes. Midwives' constant introspection is essential in fulfilling their obligation to render competent and ethical intrapartum care.

CONCLUSION

Midwives identified perceived birth environment barriers affecting their implementation of best intrapartum care practices. Adoption of a comprehensive approach to address the birth unit environment-related factors is suggested to support midwives in their endeavour to provide the best care to women during childbirth.

Effectiveness of stress inoculation training on occupational stress of midwives in healthcare centers of Zahedan in Health Transformation Plan in 2017

INTRODUCTION

Occupational stress is a main problem of healthcare workers, which significantly affects their professional and personal performance. The aim of this study was to determine the impact of a stress immunization program on occupational stress of midwives working in health centers.

MATERIALS AND METHODS

In this quasi-experimental study, 80 midwives working in health centers of Zahedan (2017) were divided into test and control groups based on random allocation. The intervention involved a stress immunization program consisting of two workshops (each lasting 4 h) in two consecutive weeks, which was implemented for the intervention group. As data collection tool, Health and Safety Executive Occupational Stress Questionnaire was completed in three steps before, immediately after, and 1 month after the intervention. Data were analyzed using descriptive and analytical statistics, independent t-test, and repeated measures ANOVA.

RESULTS

The findings showed that mean stress score in the intervention group was increased from 79.5 ± 9.7 before intervention to 104.5 ± 17.3 immediately after it, which was increased to 110.5 ± 18.3 1 month after intervention (P < 0.001). In the control group, mean stress score was decreased immediately after as well as 1 month after the intervention, which was statistically significant after the intervention and 1 month after it (P > 0.023).

CONCLUSION

The stress immunization program is an inexpensive and effective way to reduce the stress of midwives; therefore, it is suggested to be used to effectively handle occupational stress among midwives and to improve their quality of care.