Abstract
Objective
To describe the role of worksite characteristics, job role and abortion stigma in
clinical abortion workers' occupational stress.
Study design
We recruited nurses, medical assistants and counseling staff who provide abortion
care at five hospitals and four freestanding clinics in Massachusetts. Study instruments
assessed individual-level abortion stigma (the perception that others treat abortion
as shameful, dirty and socially taboo) using the Abortion Providers Stigma Scale;
job strain through the Job Content Questionnaire; and emotional burnout through the
Depersonalization, Emotional Exhaustion and Personal Accomplishment subscales of the
Maslach Burnout Inventory. Multivariable linear and logistic regression modeling tested
for associations between job role, worksite type, stigma, job strain and burnout,
accounting for demographic and job characteristics.
Results
Of 205 eligible workers, 136 participated (66%). Forty-one percent were medical assistants,
50% nurses, and 9% counselors. In adjusted models, abortion workers with high stigma
had increased odds of experiencing job strain [adjusted odds ratio (aOR) 3.94, 95%
CI 1.19–13.05]. Compared to working in a freestanding clinic, working in a hospital
was associated with lower odds of experiencing the low personal accomplishment dimension
of burnout (aOR 0.49, 95% CI 0.29–0.84) and lower odds of experiencing the depersonalization
dimension of burnout (aOR 0.05, 95% CI 0.01–0.28). Counselors had higher odds of depersonalization
compared to nurses (aOR 4.56, 95% CI 2.3–9.0).
Conclusion
Hospital-based abortion workers experience lower risk for burnout than comparable
workers in freestanding clinics, accounting for abortion stigma and job characteristics.
Implications
Implementing structured supports to alter workflows or improve coping among workers
in freestanding abortion clinics may help mitigate risk of worker burnout and associated
turnover.
Keywords
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Article info
Publication history
Published online: July 24, 2018
Accepted:
July 11,
2018
Received in revised form:
July 9,
2018
Received:
September 8,
2017
Footnotes
☆Prior presentation: Presented in part as an oral abstract at the National Abortion Federation Annual Scientific Meeting, Montreal, Canada, April 22–25, 2017.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
