Mental Workload and Burnout Among Midwives at Primary Healthcare Centers in Muna and West Muna Districts

Nurmitasari; Hernah Riana; Jumiyati; Julian Jingsung; Nindy Elliana Benly

doi:10.30994/jceh.v9i2.814

Authors

Nurmitasari Department of Midwifery, INKEIS Menara Bunda, Kolaka, Indonesia
Hernah Riana Department of Midwifery, INKEIS Menara Bunda, Kolaka, Indonesia
Jumiyati Department of Midwifery, INKEIS Menara Bunda, Kolaka, Indonesia
Julian Jingsung Department of Midwifery, STIKES Pelita Ibu, Kendari, Indonesia
Nindy Elliana Benly Department of Midwifery, Politeknik Paramata Raha, Raha, Indonesia

DOI:

https://doi.org/10.30994/jceh.v9i2.814

Keywords:

Burnout Syndrome, MBI-HSS, Mental Workload, Midwives, NASA-TLX, Primary Healthcare Center

Abstract

Midwives at primary healthcare centers face substantial cognitive and organizational demands that may contribute to burnout; evidence from Muna and West Muna Districts is limited. Objective: To examine the association between mental workload and burnout and to assess demographic factors associated with burnout among midwives at primary healthcare centers. A quantitative analytic cross-sectional study was conducted among 100 actively practicing midwives selected by total sampling from ten primary healthcare centers in Muna and West Muna Districts (March–May 2026). Mental workload was assessed using a context-adapted NASA-TLX (Cronbach’s α = 0.87), and burnout using a context-adapted MBI-HSS (α = 0.89). Spearman correlation and simple and multiple linear regression were performed. Mental workload averaged 20.32 ± 2.84; according to the study’s categorical thresholds, 31% of midwives had high mental workload, 38% moderate, and 31% low workload. Burnout averaged 21.99 ± 3.82, with 27% classified as high burnout, 29% moderate, and 44% low. Mental workload was strongly associated with burnout (r = 0.897, p < 0.001; R² = 0.805) and remained the strongest predictor in the adjusted model (B = 1.242, p < 0.001). Permanent employment status was associated with lower burnout (B = −1.084, p = 0.002). Higher mental workload was strongly associated with greater burnout. Public Health Center-level interventions should prioritize workload redistribution, administrative support, staffing review, and structured burnout prevention.

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References

Alemu, S. S., Hajure, M., Agago, M. T., Hussein, F., Gesisa, H. I., Teferi, S. M., Yohanes, D., & Wedajo, L. F. (2024). Prevalence of burnout and associated factors among midwives, 2023: Institution-based cross-sectional study. Frontiers in Public Health, 12, 1422915. https://doi.org/10.3389/fpubh.2024.1422915

Amiri, S., Mahmood, N., Mustafa, H., Javaid, S. F., & Khan, M. A. (2024). Occupational Risk Factors for Burnout Syndrome Among Healthcare Professionals: A Global Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 21(12), 1583. https://doi.org/10.3390/ijerph21121583

Daneshvar, E., & Otterbach, S. (2025). Workplace stressors and burnout among healthcare professionals: Insights from the pandemic and implications for future public health crises. Scientific Reports, 15(1), 42015. https://doi.org/10.1038/s41598-025-21540-2

Dari, I. W., Suratmi, S., & Qowi, N. H. (2025). Hubungan Quality of Nursing Work Life Dengan Burnout Syndrome Pada Perawat di RSUD Dr. Soegiri Lamongan. Journal of Nursing Invention, 6(2), 127–135. https://doi.org/10.33859/jni.v6i2.863

Faizah, N., Muhardi, M., & Suwarsi, S. (2023). Analisis pengukuran beban kerja fisik dan mental perawat menggunakan Index of Physical Workload dan NASA-Task Load Index. 7(2). https://jurnal.stie-aas.ac.id/index.php/jie/article/view/8950

Girleanu, I. (2024). To determine the effects of burnout and compassion fatigue on registered nurses’ ability to deliver patient care. Practice Nursing, 35(10), 346–357. https://doi.org/10.12968/pnur.2023.0030

Hart, S. G., & Staveland, L. E. (1988). Development of NASA-TLX (Task Load Index): Results of Empirical and Theoretical Research. In Advances in Psychology (Vol. 52, pp. 139–183). Elsevier. https://doi.org/10.1016/S0166-4115(08)62386-9

Islamiyah, H. S., Febriyana, N., & Dwi Jayanti, R. (2023). FACTORS RELATED TO BURNOUT INCIDENCE IN MIDWIVES DURING THE COVID-19 PANDEMIC. Indonesian Midwifery and Health Sciences Journal, 7(2), 142–152. https://doi.org/10.20473/imhsj.v7i2.2023.142-152

Jeniawaty, S., Mairo, Q. K. N., & Ginarsih, Y. (2020). Analysis Midwife Workload with Nasa-TLX Method. Medico-Legal Update, 20(2). https://doi.org/10.37506/mlu.v20i2.1195

Kurniawati, F., Fikaris, M. F., Eryani, I. S., Rohendi, A., & Wahyudi, B. (2023). THE EFFECT OF WORKLOAD, BURNOUT, AND WORK MOTIVATION ON NURSE PERFORMANCE. Jurnal Aplikasi Manajemen, 21(4), 915–927. https://doi.org/10.21776/ub.jam.2023.021.04.05

Li, J., Shu, W., Miao, Q., Wang, Y., Wang, X., Yang, L., Li, P., & Xin, S. (2025). The relationship between compassion fatigue and psychological resilience among Chinese midwives: A cross-sectional study. BMC Nursing, 24(1), 802. https://doi.org/10.1186/s12912-025-03326-z

Li, L. Z., Yang, P., Singer, S. J., Pfeffer, J., Mathur, M. B., & Shanafelt, T. (2024). Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systematic Review and Meta-Analysis. JAMA Network Open, 7(11), e2443059. https://doi.org/10.1001/jamanetworkopen.2024.43059

Mardhiyah, A., Azis, U., Sanusi, M., Wijaya, F., & Aman, A. (2026). GAMBARAN TINGKAT BURNOUT PADA TENAGA KESEHATAN DI RUANG RAWAT INAP RUMAH SAKIT: LITERATUR REVIEW. PREPOTIF : JURNAL KESEHATAN MASYARAKAT, 10(1), 2184–2196. https://doi.org/10.31004/prepotif.v10i1.57747

Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99–113. https://doi.org/10.1002/job.4030020205

Matthews, R. P., Newton, M. S., Hyde, R. L., Shafiei, T., Llewelyn, F., & Forster, D. A. (2024). I love my job. But it’s physically, mentally, and emotionally draining”: A cross-sectional survey exploring midwives’ intentions of leaving the profession in Melbourne, Australia. BMC Health Services Research, 24(1), 1471. https://doi.org/10.1186/s12913-024-11863-7

Mohd Balwi, M. K., Yee, D. W., Thukiman, K., & Haziqah, A. (2021). The Relationship Between Workload and Burnout Among The Medical Staff In Hospital. Sains Humanika, 13(2–2). https://doi.org/10.11113/sh.v13n2-2.1891

Noviani, D., Haryeti, P., & Astuti, A. P. K. (2024). HUBUNGAN BEBAN KERJA DENGAN BURNOUT PERAWAT DI UNIT GAWAT DARURAT PUBLIC HEALTH CENTER WILAYAH KERJA SUMEDANG UTARA. JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG, 16(1), 317–325. https://doi.org/10.34011/juriskesbdg.v16i1.2552

Paul, N., Limprecht-Heusner, M., Eichenauer, J., Scheichenbauer, C., Bärnighausen, T., & Kohler, S. (2022). Burnout among midwives and attitudes toward midwifery: A cross-sectional study from Baden-Württemberg, Germany. European Journal of Midwifery, 6(July), 1–12. https://doi.org/10.18332/ejm/150582

Pradidta, E., Fauzan, R., Saputra, P., & Karsim, K. (2025). Pengaruh Konflik Peran Ganda dan Beban Kerja Berlebihan Terhadap Kelelahan dengan Stres Kerja Sebagai Variabel Mediasi di Public Health Center. Jurnal Multidisiplin West Science, 4(06), 743–758. https://doi.org/10.58812/jmws.v4i06.2291

Suleiman-Martos, N., Albendín-García, L., Gómez-Urquiza, J. L., Vargas-Román, K., Ramirez-Baena, L., Ortega-Campos, E., & De La Fuente-Solana, E. I. (2020). Prevalence and Predictors of Burnout in Midwives: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 17(2), 641. https://doi.org/10.3390/ijerph17020641

Syahputra, F., Razi, T. K., Amelia, K. R., & Afriani, N. (2024). HUBUNGAN MASA KERJA, BEBAN KERJA DAN STATUS KEPEGAWAIAN TERHADAP KINERJA BIDAN DALAM MELAKSANAKAN PROGRAM MANAJEMEN TERPADU BALITA SAKIT (MTBS) DI PUBLIC HEALTH CENTER INDRAJAYA DAN DELIMA KABUPATEN PIDIE. Future Academia : The Journal of Multidisciplinary Research on Scientific and Advanced, 2(1), 20–31. https://doi.org/10.61579/future.v2i1.57

Taureng, H., Azmi, I. S. M. M., Oo, S. S., & Aung, M. M. T. (2024). Occupational stress and burnout among midwives: Challenges and consequences for maternal and child health care in Makassar Indonesia. Science Midwifery, 12(5), 1763–1768. https://doi.org/10.35335/midwifery.v12i5.1774

UNFPA. (2021). Maternal Mental Health Guidelines for Healthcare Providers.

Utama, I. A., Asnawi; Hasnur, Hanifah. (2025). HUBUNGAN BEBAN KERJA MENTAL DAN BEBAN KERJA FISIK TERHADAP PATIENT SAFETY PADA PERAWAT DAN BIDAN DI UPTD PUBLIC HEALTH CENTER AEK HABIL KOTA SIBOLGA TAHUN 2024. Jurnal Kesehatan Tambusai, (Vol. 6 No. 1 (2025): MARET 2025), 3975–3986.

Yuniar, D. (2025). Analisis Beban Kerja dan Burnout Bidan terhadap Implementasi Keselamatan Maternal-Neonatal di Kota Balikpapan. Jurnal Dunia Kesmas, 14(4).