28 | Chapter 2 International research shows a gap in knowledge about the specific work and personal characteristics of NQMs.1 Also, as stated earlier, Dutch primary NQMs’ working circumstances differ from NQMs in other countries. Therefore, the aim of this study is to identify perceived job demands, job resources and personal resources by NQMs working in primary midwifery care during their first years in practice. METHOD A qualitative descriptive design was used for this study. Data were collected through focus group interviews with NQMs. For reporting this study, we used the COREQ checklist.18 The Job Demands-Resources (JD-R) model19 was used as a theoretical framework (figure 1) to identify the specific work-related demands and resources in primary midwifery care. The JD-R model was developed in the early nineties of the twentieth century,19 and has been widely used for different (healthcare) professions, which allowed us to compare our results with other professions and occupations.20 The JD-R model describes the relationships between job and personal characteristics as two intertwined processes: 1) the motivational process, leading to work-engagement and 2) the stress process, leading to exhaustion and burnout. The JD-R model is based on the assumption that, although work characteristics differ for various occupations and professions, they can be modelled in two categories: job demands and job resources. Contrary to other models, the JD-R model permits the incorporation of many possible working conditions, depending on the specific working context.20 In addition to work characteristics (job demands and job resources), personal resources were integrated in this model.21,22 In this study we only used elements of the JD-R model, to identify job demands, job resources and personal resources that are relevant for NQMs. We did not use the other components of the JDR model (exhaustion and work engagement) in this study. Job demands are aspects of the job requiring effort and are associated with mental or physical costs, for example work overload, heavy lifting or job insecurity. Job resources help the professional achieve job goals or reduce job demands, such as feedback, job control or social support. Personal resources help employees in achieving goals, such as resilience, optimism, flexibility and self-confidence.20 Participants were NQMs, less than three years after graduation and working in primary midwifery care in the Netherlands. Participants were recruited from course participant lists from continuous professional development (CPD) courses, organized by all four midwifery academies in the Netherlands and from alumni of cohort 2016 of the midwifery academy Groningen. From the participant lists, which included year of
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