Table 1.
Sample characteristics.
| Studies | Design and Sample | Instrument (Cronbach α) | M (SD) | Main Results | EL | RG | ||
|---|---|---|---|---|---|---|---|---|
| PB | WB | CB | ||||||
| Creedy et al. [32], 2017, Australia | Cross-sectional Convenience sample N = 990 |
CBI (PB = 0.90 WB = 0.88 CB = 0.89) DASS |
55.9 (18.06) | 44.69 (19.23) | 19.32 (19.22) | Depression PB (r = 0.62 *) WB (r = 0.63 *) CB (r = 0.39 *) Anxiety PB (r = 0.51 *) WB (r = 0.53 *) CB (r = 0.31) Stress PB (r = 0.59 *) WB (r = 0.63 *) CB (r = 0.39 *) |
2c | B |
| Dawson et al. [33], 2018, Australia | Cross-sectional Convenience sample N1 = 99 caseload midwives N2 = 402 standard care |
CBI MPQ |
N1 = 39.84 (18.8) N2 = 45.7 (19.6) |
N1 = 36.6 (19.9) N2 = 46.3 (20.2) |
N1 = 17.9 (18.7) N2 = 18.3 (16.8) |
N1 vs. N2 PB: p = 0.007; 95% CI (1.59–10.17) WB: p < 0.001; 95% CI (5.29–14.12) CB: p = 0.82; 95% CI (−3.34–4.23) |
2c | B |
| Dixon et al. [34], 2017, New Zealand | Cross-sectional Convenience sample N1 = 473 caseload midwives N2 = 452 employed N3 = 148 both |
CBI (PB = 0.90 WB = 0.87 CB = 0.88) DASS PEMS PES |
N1 = 52.49 (16.71) N2 = 53.93 (18.42) N3 = 49.17 (16.63) |
N1 = 39.67 (18.21) N2 = 42.81 (19.82) N3 = 37.69 (16.49) |
N1 = 23.85 (20.30) N2 = 22.93 (19.87) N3 = 20.0 (15.72) |
Age N1 (r = −0.15 ***) N2 (r = −0.21 ***) N3 (r = −0.14) Years as midwife N1 (r = −0.16 ***) N2 (r = −0.21 ***) N3 (r = −0.17) Hours worked per week N1 (r = 0.06) N2 (r = 0.14 ***) N3 (r = 0.22 ***) Resource adequacy *** N1 (r = −0.36) N2 (r = −0.46) N3 (r = −0.34) Doctor/midwife relationships *** N1 (r = −0.28) N2 (r = −0.25) N3 (r = −0.18) Management support *** N1 (r = −0.36) N2 (r = −0.43) N3(r = −0.24) Autonomy and empowerment N1 (r = −0.18 ***) N2 (r = −0.25 ***) N3 (r = −0.08) |
2c | B |
| Fenwick et al. [35], 2018a, Australia | Cross-sectional Convenience sample N = 990 |
CBI | - | - | - |
Work area (continuity of care) (95% CI): PB: OR = −0.92 (0.21–0.76) WB: OR = −0.86 (0.22–0.84) ** Having children (95% CI): PB: OR = −0.26 (0.49–1.23) WB: OR = −0.61 (0.34–0.85) CB: OR = −0.96 (0.18–0.82) ** |
2b | B |
| Fenwick et al. [44], 2018b, Australia | Cross-sectional Convenience sample N1 = 214 caseload midwives N2 = 648 standard care |
CBI DASS PEMS |
N1 = 50 N2 = 58.3 |
N1 = 35.7 N2 = 46.4 |
N1 = 8.3 N2 = 16.7 |
Caseload care: PB, WB, CB: Lowest rates versus non-continuity care (r = 0.11, r = 0.17 *, r = 0.11, respectively) |
2c | B |
| Henriksen & Lukasse [41], 2016, Norway | Cross-sectional Random simple N = 598 |
CBI (PB = 0.89 WB = 0.89 CB = 0.90) |
- | - | - |
Married/cohabitant (95% CI): PB: OR = 0.6 (0.3–1.2) WB: OR = 0.5 (0.2–0.9) No children (95% CI): PB: OR = 1.2 (0.5–3.0) WB: OR = 1.3 (0.6–3.1) Experience (<1 year) (95% CI): PB: OR = 1.1 (0.7–2.5) WB: OR = 0.7 (0.3–1.4) |
2c | B |
| Hildingsson et al. [42], 2013, Sweden | Cross-sectional Convenience sample N = 475 |
CBI (PB = 0.87 WB = 0.93 CB = 0.81) |
42.99 (18.10) | 33.85 (14.12) | 30.42 (16.13) |
Conflicts with workmates and managers (95% IC): PB: OR = 2.6 (1.4–5.1) ** CB: OR = 2.7 (1.2–5.7) Lack of staff and resources (95% IC): PB: OR = 2.1 (1.2–3.8) WB: OR = 3.9 (2.0–7.4) * CB: OR = 3.0 (1.6–5.8) * |
2c | B |
| Hunter et al. [43], 2019, UK | Cross-sectional Convenience sample N = 1997 |
CBI (PB = 0.92 WB = 0.88 CB = 0.92) |
65.4 | 56.15 | 25.36 | Less than 10 years’ experience and aged 40 and below, are associated with high levels of burnout | 2c | B |
| Jepsen et al. [39], 2017, Denmark | Cross-sectional Random simple N = 50 |
CBI | 37.6 (16.2) | 35.0 (15.7) | 26.5 (16.4) | Caseload midwifery model care reduces burnout levels in all three subscales | 2c | B |
| Jordan et al. [36], 2013, Australia | Cross-sectional Convenience sample N = 58 |
CBI (PB = 0.90 WB = 0.76 CB = 0.92) |
52.1 (17.60) | 50.9 (14.66) | 23.9 (17.63) | PB and WB correlates with age and being single | 2c | B |
| Kristensen et al. [5], 2005, Denmark | Cross-sectional Convenience sample N = 41 |
CBI (PB = 0.87 WB = 0.87 CB = 0.85) |
44.7 | 43.5 | 38.4 | Midwives have the highest score in the personal burnout and client-burnout dimensions | 2c | B |
| Newton et al. [37], 2014, a,b Australia | Cross-sectional Convenience sample N1 = 21 caseload midwives N2 = 130 standard care |
CBI (PB = 0.87 WB = 0.87 CB = 0.85) MPQ |
N1 = 44.2 (21.2) N2 = 50.1 (17.5) |
N1 = 41.1 (21.6) N2 = 45.1 (18.5) |
N1 = 12.3 (9.6) N2 = 22.4 (18.0) |
Caseload midwives have a higher level of job satisfaction. The positive aspects were: Continuity and relationships with known women, flexibility, autonomy | 2c | B |
| Sidebotham et al. [38], 2015, Australia | Cross-sectional Convenience sample N = 1037 |
CBI DASS |
55.9 (18.05) | 48.44 (17.40) | 25.59 (18.33) | One-third of midwives had moderate-high levels of anxiety and stress | 2c | B |
| Stoll & Gallagher [40], 2018, Canada | Cross-sectional Convenience sample N = 136 |
CBI (PB = 0.90 WB = 0.89 CB = 0.91) DASS QOLS PEMS PES |
60.4 | 46.8 | 28.5 | The stressors found were: Workload and not enough time (64.6%), conflicts with workmates (42.4%), lack of care (39.9%), and difficulties in spontaneous labour support (35.4%) | 2c | B |
a,b Two samples were present; * p < 0.001; ** p < 0.01; *** p < 0.05. Note: CB: Client-related burnout; CBI: Copenhagen Burnout Inventory; CS: Compassion satisfaction; DASS: Depression, Anxiety and Stress Scale; EL: Evidence level; QOLS: Quality of Life; MPQ: Midwifery Process Questionnaire; PB: Personal burnout; PEMS: Perceptions of empowerment in Midwifery Scale; PES: Practice Environment Scale; RG: Recommendation grade; WB: Work-related burnout.