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'A question of time and work-situation': a cluster analysis of Swedish midwives' levels of burnout and attitudes towards midwifery continuity of care
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Women's Health, Uppsala University Hospital, Uppsala, Sweden.
Umeå University, Faculty of Medicine, Department of Nursing. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Women's Health, Uppsala University Hospital, Uppsala, Sweden.
2025 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 143, article id 104302Article in journal (Refereed) Published
Abstract [en]

Background: Midwifery continuity of care (MCoC) has been associated with reduced burnout and increased work satisfaction among midwives. Despite these benefits, MCoC is not common in Sweden.

Aim: This study aimed to explore midwives' profiles based on burnout levels and attitudes towards midwifery continuity of care, considering various background and work-related factors.

Methods: A national cross-sectional digital survey was conducted among midwives in Sweden. The questionnaire covered the Copenhagen Burnout Inventory (CBI), attitudes towards MCoC and background variables. Cluster analysis identified a set of profiles, which were then compared by calculating odds ratios and 95 % confidence intervals for various background and work-related factors. Logistic regression examined the factors most associated with each profile.

Findings: A three-cluster solution for the 1,983 midwives surveyed was suggested, labelled as Reserved, Visionary, and Sensitive. Midwives in the Reserved cluster exhibited negative attitudes towards MCoC, through negative scores on both components and negative scores on the CBI. Within the Visionary cluster, midwives showed positive scores on the Relational component of MCoC, but negative scores on the Practical and Organisational component and the CBI. In the Sensitive cluster, midwives exhibited the highest scores on the CBI and negative scores on the Practical and Organisational component of MCoC, with just slightly positive scores on the Relational component. Cluster membership was associated with length of work experience (p<0.001) and work domain (p<0.001).

Conclusion: Based on the CBI and attitudes towards MCoC, three distinct clusters of midwives were identified, with different factors contributing to membership in each cluster. Understanding how midwives relate to MCoC can facilitate the implementation of the model, potentially improving midwives' work-related health.

Place, publisher, year, edition, pages
Elsevier, 2025. Vol. 143, article id 104302
Keywords [en]
Attitudes, Burnout, Cluster analysis, Continuity of care, Midwifery, Work-related
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Occupational Health and Environmental Health Nursing
Identifiers
URN: urn:nbn:se:umu:diva-236127DOI: 10.1016/j.midw.2025.104302ISI: 001424119700001PubMedID: 39914055Scopus ID: 2-s2.0-85216888283OAI: oai:DiVA.org:umu-236127DiVA, id: diva2:1942805
Funder
Region Uppsala, LUL-987136Available from: 2025-03-06 Created: 2025-03-06 Last updated: 2025-03-06Bibliographically approved

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Hildingsson, Ingegerd

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