Turnover Intention and Associated Factors Among Night-Shift Midwives in China: A Cross-Sectional Study

Midwives play a crucial role in maternal and neonatal health. However, there is a growing global shortage of midwives, and the high turnover rate is a key contributing factor. The research focusing on the turnover intention of night-shift midwives is limited in China.

This cross-sectional study was conducted from January to December 2023 across 493 public hospitals in mainland China, with 1588 night-shift midwives participating. A self-designed questionnaire collected sociodemographic information and night-shift work-related characteristics. Turnover intention was measured using the Turnover Intention Scale, and sleep quality was assessed using the Pittsburgh Sleep Quality Index. Multiple linear regression analysis was conducted to identify factors influencing turnover intention.

A proportion of 49.7% (n = 789) of night-shift midwives reported turnover intentions. Lower turnover intention was associated with being married, having better health status, good sleep quality, and ≥ 15 years of work experience. Higher satisfaction with shift scheduling and overall work were also associated with lower turnover intention. Conversely, completing additional work during rest time after night shifts and experiencing job burnout were associated with higher turnover intentions.

High turnover intention among night-shift midwives represents a significant challenge for maternal health services in China. Hospital administrators may consider prioritizing shift scheduling systems, regularly monitoring job burnout and satisfaction levels, and implementing targeted interventions to reduce turnover and ensure workforce sustainability.