Article ID: JJAM-2024-0065
Purpose
Midwives' proactive and active involvement benefits expectant and postpartum mothers and promotes task shifting and sharing, which was initiated due to the physician work style reform. However, despite the expectation that hospitals would be settings where midwives can work proactively, no demonstrated increase in the number of in-hospital midwives has been observed. One of the suggested reasons for this is anxiety regarding responsibilities, such as midwifery diagnosis and midwifery. This study conducted a review of previous research and examined the factors influencing midwives' mission in terms of their professional duties. This study aimed to determine midwives' needs to be able to work independently against the background of continuing task shifting and sharing. Two hypotheses were proposed: high generalized self-efficacy positively influences an expanding sense of mission and influences the expanding sense of mission through the quality of experience.
Methods
A mediation analysis was conducted with the expanding sense of mission scale as the dependent variable, the generalized self-efficacy scale as the independent variable, and the quality of nurses' occupational experience scale as the mediating variable. Of the 100 facilities randomly selected from 2082 delivery facilities across Japan, 35 facilities and 605 midwives who provided consent were included in the study. A total of 184 responses (30.4% response rate) were obtained, and 176 valid responses (95.7% valid response rate) were included in the analysis. The research for this study was conducted from April to July 2024.
Results
The mean age of the participants was 38.1 (SD 10.6) years, the mean years of clinical experience was 14.3 (SD 9.8) years, and the mean years of midwifery experience was 12.9 (SD 9.5) years. The mediation analysis results indicated that generalized self-efficacy had a direct effect on the expanding sense of mission and an indirect effect on the quality of nurses' occupational experiences. These results supported both of the study's hypotheses.
Conclusion
The results suggest that to enhance midwives' expanding sense of mission, they must follow a reflective process in which they self-evaluate their experiences or evaluate them with facilitators, and recognize and verbalize their challenges. Although using an expanding sense of mission as a variable, as it was in this study, is a new theory, the reliability of the scale indicated by Cronbach's α coefficient and the support for the study's two hypotheses has suggested that the theory contributed to the demonstration of the reproducibility of the value of an expanding sense of mission.
