Midwives’ occupational wellbeing and its determinants. A cross-sectional study among newly qualified and experienced Dutch midwives | 83 Variety 1.04(1.02, 1.07) 1.05(1.03, 1.06) 1.04(1.03, 1.06) Work and rest times 0.97(0.94, 0.99) 0.99(0.98, 1.00) 0.99(0.97, 1.00) PERSONAL RESOURCES Hope 8.27(3.34, 20.5) 4.03(2.73, 5.96) 4.46(3.14, 6.33) Optimism 2.17(1.14, 4.14) 2.40(1.65, 3.50) 2.14(1.56, 2.93) Resilience 4.84(2.46, 9.52) 2.24(1.61, 3.11) 2.45(1.84, 3.26) Self-efficacy 1.13(1.04, 1.24) 1.19(1.12, 1.26) 1.16(1.10, 1.21) CI=confidence interval, OR=odds ratio, , Significant: P<.05 , *= reference group DISCUSSION In this study, we assessed the occupational wellbeing of Dutch midwives as reflected in burnout symptoms and work engagement. Burnout symptoms were shown by seven percent of the respondents. The individual indicators showed even higher percentages among the respondents: 19 percent had high scores on exhaustion and 10 percent had high scores on cynicism. There were no differences in the frequency of burnout symptoms between NQMs and EMs. All measured job demands were significantly and positively associated with burnout symptoms. Almost 40 percent of Dutch midwives reported high work engagement; NQMs showed the highest percentage (49%), compared with 35 percent for EMs. A lower level of experience was significantly associated with high work engagement. Determinants of high work engagement were age below 40, education at Master’s and PhD level, selfemployment and working in a rural environment. Job resources associated with high work engagement were career opportunities, the availability of learning resources and feedback, a high degree of autonomy and variety in work activities. All personal resources – hope, resilience, optimism and self-efficacy – were associated with high work engagement and lowering the odds of burnout symptoms. The results for burnout symptoms among Dutch midwives differed from international outcomes. About seven percent of our respondents reported burnout symptoms: a combination of high exhaustion and high cynicism. Internationally, 20-60 percent of midwives display burnout symptoms.4 There are three possible explanations for these differences. Firstly, the choice the UBOS-C versus that of the CBI (Copenhagen Burnout Inventory) in the WHELM studies.4 The CBI measures three different subscales of burnout: work, personal and client burnout.4 Among Swedish midwives, for example, 40 percent scored high in the personal burnout subscale, while work burnout and client burnout were around 15 percent.40 Our study only measured work-related burnout symptoms. The differences In personal burnout symptoms might explain our relatively low burnout figures. Secondly, our sample may differ from the norm group for the UBOS-C. The norm
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