98 | Chapter 5 QEEW 2.0 (Questionnaire on the Experience and Evaluation of Work),19 the Psychological Capital Questionnaire (PCQ),20 and the General Self-Efficacy Scale (GSE).21 Dependent variables in this study were burnout symptoms and work engagement. Independent variables were sociodemographic characteristics, task demands, resources at work, and personal resources. Study population Midwives in the Netherlands who work in community care were included. In textbox 1 we have provided background information regarding the way community midwives work in the Netherlands. Midwives working only in an hospital, or education or research were excluded. Background information regarding the way community midwives work in the Netherlands. The professional education of midwives in the Netherlands consists of a four-year direct entry Bachelor of Science programme and gives access to registration in the so-called BIG-register of individual health care professionals of the Health Ministry, allowing license to practice.22 According to the regulations of the Ministry of Education, the educational program entails 240 European Credits Transfer System (ECTS) on which 100 ECTS spend on placements (60 ECTS in community care settings). One ECTS stands for 25-30 hours workload. 23 According to the national figures, 72% of the midwives work in a community-based setting, and 28% of the midwives work in a hospital-based setting.1 A large proportion of midwives in the community work in independent practices, either as owners or as locums. Only a minority (4%) are employed at an independent practice.1 Each midwifery practice offers 24/7 care. The default independent practice is set at 105 full care units. This means that a midwife takes care of the prenatal, natal and postnatal care of approximately 107 women annually.24 Community midwives are self-employed, which means they can decide how many clients to take on and how much time to spend with each client. This also means that the number of working hours is not restricted, as is the number of days off. Practice assistants can help the midwife with administrative and organizational tasks. Community midwives take care of women experiencing normal pregnancies and births and in postpartum periods. Women are referred to a hospital if risks of adverse foetal or maternal outcomes are high or if complications arise during pregnancy or childbirth. In the hospital, obstetricians, nurses and hospital midwives take over care.25
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