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Work-related stress and work ability among Croatian university hospital midwives

To explore sources and levels of stress at work and work ability in Croatian midwives. Midwives are in general subjected to multiple stressors. Psychological distress during long period of time among healthcare professionals has negative effects on the workers' health, work ability and quality of care provided to patients. The work ability is a term describing the workers resources related to physical, mental, and social demands of work. As a measure of work ability in midwifery, the Work Ability Index (WAI) should be considered as a very predictive instrument: midwives with poor WAI score usually leave the current job in the next five years. Settings: university hospitals in Zagreb, Croatia Design: cross-sectional design survey Participants: Three hundred healthcare workers ; 105 qualified midwives and 195 paediatric nurses, were invited to complete the questionnaire. Total response rate was 53% (158/300). Sample comprised 14.7 % of all hospital-based midwives in Zagreb hospitals. Occupational Stress Assessment Questionnaire (OSAQ) for health care workers, and Work Ability Index (WAI) Questionnaire. SPSS for Windows was used for statistical analysis. Descriptive statistics was used. Differences between groups were calculated using an independent samples t-test and Χ 2- test for categorical variables. Analysis of covariance (ANCOVA) was performed to detect differences in WAI between groups of midwives and nurses. Over three quarter of midwives (46/60 or 76.7%) believed their job was stressful and considered the insufficient work resources to be most stressful. More than half midwives marked insufficient number of co-workers, unexpected situations, inadequate income, night work, incurable patients and poor organization of work with high level of stress. The perceived specific stressors differed between workplace groups in the same hospital. Comparisons with the paediatric nurses in the same hospitals were made. Insufficient resources to work with and poor organization of work were more common factor of stress among midwives than paediatric nurses (P<0.05). Midwives and nurses differed significantly with respect to age (P=0.002). Midwives were younger, spent less years of service at the actual work place compared to paediatric nurses (P<0.001). Also midwives had lower education than paediatric nurses (P=0.044). The midwives' mean WAI score was 40.0 (95% CI 38.4-41.4), and paediatric nurses' mean WAI score was 37.5 (95% CI 36.4-38.8) indicating good work ability. After adjusting for age, the difference in WAI score between the groups of workers was not significant. Croatian midwives experienced work-related stress emerging from the feeble organizational factors with high level: insufficient financial recourses to work with, insufficient number of co-workers, poor organization of work, communication with superiors and emotion work. Midwives' work ability in the relation of their job demands was good. Our results confirm that WAI score significantly decreases with age. Implications for practice: Results from our research could be the massage for hospital management to improve organizational factors and resources as well as midwives' education and position in heath care system.

midwifery; stress; work ability; Croatia

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