The Impact of Sociodemographic Factors on Job Insecurity Among Obstetric Nurses Under the Low Fertility Background: A...

With the continuous decline in fertility rates in China, the demand for obstetric care services has decreased, posing severe challenges to the occupational security and mental health of obstetric nurses.

The purpose of this study is to explore the effects of demographic sociological variables of obstetrical nurses on sense of security under the background of low fertility rate, identify the key driving factors, and put forward intervention countermeasures based on the empirical results, in order to improve the professional survival status of obstetric nurses and stabilize the obstetric nursing team.

From April to May 2025, 406 obstetric nurses were recruited as the research subjects by using the two-stage sampling method and surveyed using a general information questionnaire and Job Insecurity Scale. Q-Q plots assessed data normality; normally distributed data were expressed as M±SD, with t-tests/ANOVA (SNK-q for pairwise comparisons).Under the premise of controlling the hospital agglomeration effect, the factors influencing the hospital agglomeration effect were analyzed by using the linear mixed effect model.

Obstetric nurses' total job insecurity score was 76.07±22.80, with 69.21% above the median (62.5). Linear mixed-effects model analysis showed significant differences (all P<0.05): secondary hospital nurses had higher job insecurity scores than tertiary hospital ones (β=12.55, 95% CI: 6.66~18.43); contracted nurses scored higher than staffed nurses (β=18.832, 95% CI: 13.254~24.409); those with monthly salary ≤4,000 yuan scored higher than ≥6,001 yuan (β=10.002, 95% CI: 2.891~17.113); nurses with 6-10 years of experience scored higher than ≤5 years (β=7.741, 95% CI: 1.829~13.653); team leaders scored lower than general nurses (β=-9.457, 95% CI: -16.245~-2.669). The model explained 26% of individual and 23% of hospital-level variance in job insecurity scores.

Obstetric nurses in Chongqing have relatively high job insecurity affected by hospital and individual factors. This study provides empirical support for a dual approach of "optimizing hospital environment and precise individual empowerment" to stabilize the team and ensure maternal-infant safety.