Midwives’ occupational wellbeing and its determinants. A cross-sectional study among newly qualified and experienced Dutch midwives | 85 differences could be that Dutch NQMs are able to begin practice with a competence level that is already high.43 The novice level in other occupations might explain lower levels of work engagement.12 Another explanation could be a lack of job or personal resources, according to the JD-R model;13 in our findings, a lack of support from colleagues and an imbalance in work and rest times were associated with lower odds of high work engagement. The results of our study reveal that personal resources – hope, resilience, optimism and self-efficacy – were positively associated with high work engagement and negatively associated with burnout symptoms. These findings are consistent with previous findings on wellbeing in other occupations.44 Although personal characteristics were measured in studies on midwives’ occupational wellbeing, personal resources are a relatively new addition to these studies.13 The importance of conserving and optimising personal resources as part of midwives’ wellbeing were supported by this study. Our findings added specific knowledge about the importance of personal resources for NQMs. In our previous qualitative studies, Dutch NQMs mentioned openness, flexibility and setting boundaries as important personal resources in their work in midwifery practice 28,29 Dutch NQMs mentioned different personal demands as hampering their work. In line with these outcomes, our study suggests that all four personal resources are strong determinants of high work engagement. Strengths & limitations A first strength of this study is that, to our knowledge, this study is unique in that it explores both burnout symptoms and work engagement among midwives and uses the JD-R model as its theoretical framework. The JD-R model, which incorporates both positive and negative wellbeing, provides us with a comprehensive view of occupational wellbeing.16 Midwives seem similar to other healthcare professionals: highly engaged in their work and therefore willing to deal with job demands because of their involvement with clients. If burnout symptoms alone are investigated, it is not possible to show a process of declining engagement. A second strength of this study is the use of validated scales in the questionnaire to increase reliability. A third strength is the generalisability to the population of community-based midwives. In this study, we had a larger number of community-based midwives (81%) than in the Dutch population of midwives as a whole (72%). Our study population included a quarter of the population of Dutch midwives who were currently practising, with comparable percentages on background variables, except for work setting. Our findings are less generalisable for hospital-based
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