INTRODUCTION
1.1 Background of the
Study
The midwife may practice in any setting including the
home, the community, and hospital or in any other maternity service. In all
settings, the midwife remains responsible and accountable for the care she
provides. The midwife works in partnership with women on her own professional
responsibility, to give women the necessary support, care and advice during
pregnancy, labour and the postpartum period up to six weeks, to facilitate
births and to provide care for the newborns. The midwife understands, promotes
and facilitates the physiological processes of pregnancy and childbirth,
identifies complications that may arise in mother and baby, accesses
appropriate medical assistance and implements emergency measures as necessary.
When women require referral, midwives provide midwifery care in collaboration
with other health professionals. Midwives have an important role in health and
wellness promotion and education for the woman, her family and the community.
Midwifery practice involves informing and preparing the woman and her family
for pregnancy, birth, breastfeeding and parenthood and includes certain aspect
of women’s health, family planning and infant’s well-being (Health Practitioners
Competence Assurance Act, HPCAA 2003, America).
The attitude of midwives and the work environment are
known to affect each other mutually. Positive interaction contributes to both
the individual’s health and the success of the institution (Tekarslan, Sencan,
Kilinc & Bayal 2004). These midwives demonstrate common or personal
attitudes towards their profession, managers and institutions which varies
according to the interaction experienced in the work place (Bayal, 2005).
Attitude is the predisposition or potential behavioural interaction to respond
in a favourable or unfavourable way to any concrete – abstract, animate –
inanimate objects in the environment, which shaped over time in relation to the
upbringing of the individual and lifelong experiences (Erem, 2004; Tekarslam et al., 2004). In addition, it could
prompt the individuals to distinguish themselves from others; however, it might
change or gain strength or completely disappear in time, while it cannot be
observed directly, it can be interpreted from the individuals statements and
behaviours (Schermerhorn, Hunt & Osborn, 2005; Simsek, Akgemci & Celik,
2004). The attitude of employees towards a profession manifest itself in the
way they respond to work related factors. Given the relationship between the
individual’s attitude and behaviours towards an object, many authors have
expressed that identifying the attitudes of employees towards their profession
would provide significant data for managers in predicting employees job
satisfaction, performances and productivity (Hulm & Judge, 2003).
Negative attitude have been found in a significance
number of midwifery populations since the 1960s and 1970s and although the
proportion of midwives with pessimistic attitudes appeared to lessen throughout
later decades, negative attitudes still exist today (Waston & Devellis, 2005).
Although researchers such as Howard and Chung claim that the attitude appeared
to have improved since the 1970s, negative attitude identified in numerous
studies throughout the 1980s and 1990s suggest that attitude may not have
actually changed all that much from those found decades ago. In institutions
providing human services in healthcare industry, characterization of midwives
and nurses’ attitudes towards their profession is essential for both other individuals
employed towards their profession is essential for both other individuals
employed in the same organization and patients receiving healthcare from these
institutions as midwives and nurses are the members of the healthcare team who
spend the most time and thereafter, the most familiar with patients.
However, studies have so far demonstrated that midwives
exhibit negative attitude towards their profession such as frequently
complaining about the difficulties of the professionals and working conditions,
finding the profession very stressful, practicing unwilling, seriously
considering to leave the profession, and showing a tendency to absenteeism and
job dissatisfaction (Konver, Brewer, Wu, Cheng & Suzuki, 2006). Most of the
midwives in Nigeria are
employed in public hospital, which account for the majority of the hospital in Nigeria
1.2 Statement of
Problem
The attitude of many midwives towards pregnant women
and those in labour is poor by study report. In the course of their
professional duty as midwives, they act inappropriately to the women in labour.
Such attitude raises the question of what the duties of the midwives are to a
woman in labour. Sometimes, one wonders if they have any knowledge of the
literal meaning of their profession or even what their profession entails. The
situation becomes worse if the woman in labour is an HIV – positive patients.
Their attitudes range from that of neglect to abandonment such that one
questions the professional training they had and knowledge about the mode of
transmission of HIV and the skill to prevent it. The Nigerian health system as
a whole has been plagued by problems of service quality, including unfriendly
staff attitudes to patients, inadequate skills, decaying infrastructures,
chronic shortages of essential drugs and the well – known “out - of – stock
syndrome”. It was observed in the course of clinical experience that midwives
spend less than one minute to interact and answer questions from the patients.
Interaction with patients also revealed lack of satisfaction with the care they
received because they were not involved in the decisions concerning their care.
The patients complained of the midwives becoming too busy to attend to them
even when they were in pain, anxious or fretful. In view of all these, does it
imply that the midwives have negative attitude towards their patient or are
there certain factors that influence the practice of midwifery. These questions
can only be answered at the end of this study.
1.3 Purpose/Aim of
the Study
The purpose/aim of this study was to determine factors
influencing work attitude of midwives in the maternity unit, General Hospital
Calabar, Cross River State ,
Nigeria
1.4 Specific Objectives
of the Study
The specific objectives of this study were to:
(i)
Determine the
influence of educational level on midwives attitude and practice in the
maternity unit.
(ii)
Ascertain whether
professional experience influence the attitude and practice of midwives in
maternity unit, General Hospital Calabar.
(iii)
Determine the
relationship between age of midwives and attitude and practice in maternity
section, General Hospital Calabar.
(iv)
Ascertain the
influence of marital status on attitude and practice of midwives attending to
women in the maternity unit.
1.5 Research Questions
(i)
What is the
influence of educational level on attitude and practice of midwives in the
maternity unit?
(ii)
What is the
relationship between level of professional experience and attitude and practice
of midwives in the maternity unit, General
Hospital
(iii)
What is the
relationship between age and attitude and practice of midwives in the maternity
section, General Hospital
(iv)
What is the
influence of professional ranks on attitude and practice of midwives attending
to women in the maternity?
Research Hypothesis
H1:
There is no significant relationship between the educational level on attitude
and practice of midwives in maternity unit.
H2:
There is no significant relationship between the ages and attitude of midwives
in maternity unit.
1.6 Scope of the Study
This study was limited to the midwives working in the
maternity unit of General
Hospital
1.7 Significance of the
Study
The Profession: If factors responsible for midwives negative
attitudes and practice are discovered, necessary intervention will be planned
to address these problems and it may enhance professional practice related to
midwifery. If such factors are addressed, the image of this profession may be
enhanced.
The Patients: This study may also facilitate recovery of the
patients because of interpersonal relationship between the midwives and the
women. It would encourage the women to freely communicate their feelings and
problems without hesitation thereby meeting their psychological needs. It would
also strengthen the relationship between midwives and the women which can lead
to the provision of holistic care. This study may bring about valuing and
respecting the women as a unique individual who possess their own meanings,
experience and attitude. If intervention is implemented the patient will
benefit in terms of satisfaction with the care provided.
The Midwives: It may help in identification of factors respectively
needed in areas of attitude so that if necessary intervention could be planned
and implemented to address negative attitude.
The Hospital
Management: This study may enhance
the image of the hospital and the organizational goals of the hospital will be
achieved. It would encourage more women to seek for their health care services.
The Researchers: Finally, the outcome of this study may also serves as
a source of information for future researchers and equips the researcher with
additional knowledge about the attitude and practice of midwives in the
maternity unit.
1.8 Limitations of the
Study
The main problem encountered in this study was
difficulty in getting all the accessible used for the study due to their tight
duty schedule shift.
Operational
Definition of Terms
Attitude: Refers to
the ways midwives react to a situation emotionally, express themselves
physically or verbally to the patients that may be positive or negative.
Midwives: Persons who have been admitted to a midwifery
educational programme, who has successfully completed the prescribed course of
studies and has acquired the required qualification to be registered and/or
legally licensed to practice midwifery.
Work: Refers to providing advice, care and support for women,
their partners and families before, during and after childbirth including
counselling, health promotion and education.
Factors: Age, marital status, professional experience and
educational level.
Age: Refers to the number of years that the midwives has
lived or existed.
Marital status: Refers to whether midwives are married or not married.
Professional
Experience: Refers to duration/years
of midwives have been working in the maternity section.
Educational Level: Refers to the level and type of training the midwives
have undergone.
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