Intentions to leave and actual turnover of community midwives in the Netherlands. A mixed method study exploring the reasons why | 101 Participants were recruited through Facebook pages for midwives, through the website of the Royal Dutch Organisation of Midwives, through snowball sampling, and through the researchers' networks. Potential participants were able to send an email to receive additional information about the study. They were invited for an interview after they agreed to participate. Eligible participants were community midwives who had stopped working in the midwifery profession within the past five years. We assumed that they would remember clearly what it was like to quit their jobs. Data collection took place in March 2021 and April 2021. Prior to the interviews, a topic list was developed by two researchers. The topics were derived from the document analysis of the open-ended survey questions, a literature study, and the JD-R model. This topic list was tested twice on midwives who were not included in the target population. As a result, the order of topics was adjusted. The interviews were conducted by two researchers, respectively a researcher and a master student/midwife. All interviews were discussed by the entire research team, which allowed us to reflect on the possible influence that the researchers had on the interview process. Depending on the participant's preference, the interview could take place online or on-site. Online interviews were held via digital platforms (Microsoft Teams or Zoom). After 15 interviews, we did not derive new information. However, we decided to carry on with the five interviews which were already planned. All interviews were recorded (by audio and video) and notes were taken. After approximately three interviews, the findings were discussed among the researchers and the topic list was then adjusted slightly. After each interview, a summary was written. All interviews were conducted in Dutch and transcribed verbatim. The transcripts and summaries were member-checked by each participant. No adjustments were needed. Analysis We analysed the transcripts of the interviews by moving from inductive coding to a framework analysis. This included the following steps: 1. We developed a coding scheme; 2. The open codes were placed into categories by two researchers; 3. The applied JDR model by Schaufeli et al.27 was used to order the developed categories. We then conducted a second analysis using a narrative analysis. In each transcript, we looked for the turning points that led to the decision to leave work as a practicing midwife. These turning points were collected in a separate document per participant so that we could properly examine whether there was a potential accumulation of reasons for the participant.26 MaXQDA, version 2020.4 was used to analyse this data.
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