| Objective:To investigate and analyze the status of empathy fatigue among midwives at different levels of hospitals in the east,middle and west regions of China,and to further identify the risk factors among the influencing factors,in order to understand the degree,characteristics and regularity of empathy fatigue among midwives,and to provide theoretical basis and basis for targeted interventions to reduce the incidence of empathy fatigue among midwives,strengthen the construction of midwifery personnel and ensure the safety of mother and child.Methods:This study adopts the method of combining quantitative and qualitative research.Quantitative studies:From June 2018 to May 2019,three public hospitals in the east,middle and western regions of China were selected by random drawing of lots in 31 provinces,municipalities directly under the Central Government and autonomous regions of the three economic regions,and each of the four provinces in the east,middle and western regions,12 provinces,to facilitate the selection of 52 hospitals of different levels,and 489 midwives were selected by convenience sampling method according to the inclusion exclusion criteria.Cross-sectional survey was conducted by general information questionnaire,compassion fatigue scale and social support assessment scale.SPSS 22.0 software was used for data cleaning,statistical description and analysis,and x 2 was used for description and statistics of general data(demographic data,working environment data),scores of various scales,hospital distribution,etc The test and nonparametric test were used to compare the degree of compassion fatigue of midwives with different demographic data and different working environments.Considering the hierarchical structure of data(hospital and individual),the mlwi 2.30 software package was used to match the two levels of logistic with individual level 1 and hospital level 2 Model,the influence factors of midwife's compassion fatigue were analyzed by multi-level statistical model,and the difference was statistically significant(P<0.05).Qualitative research:the objective sampling method was used to select the midwives from the 12 provinces and cities in the quantitative research from the secondary,tertiary comprehensive and specialized hospitals with mild or above compassion fatigue.The data were collected through the field research method and interview method,and the midwives were selected as the research object according to the maximum variation strategy.The traditional content analysis method was used to analyze the data,code,classify and extract the main data Question,so cycle until saturated.Result:1.Quantitative research results(1)A total of 489 questionnaires were collected,477 of which were valid,with an effective recovery rate of 97.8%.The scores of compassion fatigue were:compassion satisfaction(31.64± 6.47),job burnout(27.87 ± 5.01),secondary traumatic stress(26.21± 5.70),and social support(37.93 ± 6.44).82.6%of midwives were moderate or above;(2)The results of single factor analysis showed that age,marital status,hospital level,children's situation,traumatic delivery,region,hospital level,work treatment,work load,working atmosphere and social support had an effect on the degree of compassion fatigue of midwives(P<0.05);(3)The results showed that the variance of level 2 was 0.926(P<0.05),which indicated that there was aggregation of compassion fatigue at the hospital level,and the hierarchical structure could not be ignored.The multilevel model should be used to analyze the multilevel model logistic The results of regression analysis showed that hospital level,children's situation,area,working atmosphere,number of traumatic delivery events,sleep quality and social support had influence on the level of compassion fatigue(P<0.05).2.Qualitative research resultsA total of 34 midwives were interviewed,and 210000 transcripts were transcribed.Based on the analysis of the interview data,the influencing factors of midwives'compassion fatigue were extracted.There were seven themes:(1)the negative emotional experience of overworked experience;(2)the imperfect social support system;(3)the high level of psychological flexibility;(4)the traumatic events of delivery;(5)the heavy physical and mental load;(6)the poor cultural environment;(7))Work and family are difficult to reconcile.Conclusion:The incidence and severity of compassion fatigue is high in midwives,and compassion fatigue is affected by a variety of factors.Among them,social support organizations support midwives in different regions,between hospital levels,between departments,and the public has a cognition of midwives.Misunderstandings,the number and degree of trauma of labor trauma,unreasonable organization to actively deal with labor trauma,and difficulty in coordinating family and work are risk factors.Qualitative research explains quantitative research;Heavy physical and mental loads,and a low level of mental resilience all have an effect on compassion fatigue of midwives.Qualitative research supplements quantitative research and improves the influencing factors of compassion fatigue of midwives,further proving the advantages of combining sexual research with quantitative research. |
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