With the improvement of living standards and upgrade of health concept, people are having increasingly higher demands for disease treatment and services. They require not only effective disease treatment, but also high-quality care services. “Healthy China 2030” also emphasizes on improving the level and quality of health care services and establish a health care quality management system with Chinese characteristics . Reasonable allocation of human resources is a guarantee for effective nursing. In recent years, the obstetrics are especially short-handed in terms of nursing resources. According to the Statistical Bulletin of China’s Health Development in 2020, the coverage rate of nurses and/or midwives per 1,000 population in China is merely 3.34. In1992, China launched “Baby-friendly Initiative”, which started from “promoting breast feeding and establishing baby-friendly hospitals”. As hospitals began to provide rooming-in [3–4], the nurses’ job has changed from attending to the pregnant and parturient women to mother-infant care guidance and health education for the family with the puerperae and the newborn at the center, resulting in high work load for the nurses in obstetrics. Moreover, during Covid 19 pandemic, in order to minimize the flow of people, only one fixed accompanying relative (usually the husband) is allowed in the obstetric ward. Inexperienced in breast feeding and newborn caring, these new parents are often overreacted to the newborn’s normal cry, and resort to the nurses for help, thus interrupting their work flow and bringing burden to the care services. Therefore, the MIC helpers become an integral part of in-hospital services to solve the problem of insufficient healthcare resources, guarantee high-quality mother-infant care, and control the cost of nursing human resources.
As a kind of nursing assistants, the MIC helpers are those who provide care services for the pregnant, the parturient, and the infant in their daily life . Mainly engaged in auxiliary nursing, they are not professional healthcare workers in medical institutions . Their workplaces can be hospitals, mother-infant service agencies (postpartum care centers), and the homes of the puerperae. The MIC helpers discussed in this article are mainly responsible for the care of the puerperae in hospital during 2 to 5 days after parturition, and their job covers attending to the puerperae, assistance in infant feeding and daily care for the newborn, etc. They are hired by the puerperae voluntarily according to the needs. Currently, the MIC helpers in the hospitals are usually dispatched by the mother-infant service agencies and managed by both after the hospitals sign agreement with the agencies. The advent of this occupation marks a refined division of labor and individualization of social demands. Researches in recent years have shown that scientific care can effectively promote the maternal and infants’ physical health, and that the nursing intervention from the MIC helpers during puerperium is closely related to the health of the puerperae and the newborn [7, 8]. With the assistance of the MIC helpers, the working pressure of obstetric nurses, especially of the night shift nurses, is substantially reduced . The MIC helpers are gradually gaining scale for their indispensable role in the overall obstetric care service chain.
In China, however, there are quite a few deficiencies in human resource management, system construction, and service delivery of the MIC helpers, most of whom are re-employed middle-aged laid-off women in rural and urban areas. Such problems as uneven quality, high job mobility, and unstable team are quite concerning. To further implement the spirits and requirements of “Notice on Strengthening the Training and Standardized Management of Medical Caregivers” by National Health Commission in 2019 and other relevant documents , and to better stabilize and develop the team, this article hopes to focus on the inner needs of the MIC helpers to have an in-depth understanding of their working concept and values.
Emerging from psychology, human resource management and organizational behavior, psychological contract is a crucial part in scientific management. It refers to the individual employee’s perception and belief system of the responsibilities and obligations between employees and employers, and it is about psychological expectations and commitment in the subjective sense . The two-dimension structure theory of psychological contract has been widely applied . One is transactional dimension consisting of specific, short-term, and tangible mutual obligations with the two parties focusing on instant exchange of immediate interests. The other is relational dimension composed of extensive, long-term, and open mutual obligations, which is not only based on the exchange of economic elements, but also on the future career development, learning and self-improvement as well as the exchange of social feelings. Based on the Chinese cultural background, Chinese scholar Li Yuan  believes obligations in interpersonal communication and interpersonal environment are of great importance for Chinese employees. Therefore, he has put forward with three-dimension psychological contract, i.e., normal obligations, interpersonal obligations, and developmental obligations. Normal obligations emphasize on the explicit, concrete, and fundamental mutual obligations of employees and employers. Interpersonal obligations focus on the two parties’ social connections and mutual trust and respect. Developmental obligations highlight that both employers and employees take responsibility in career success and career development of each other. Psychological contract theory has been widely applied in the human resource management of various industries. An Irish scholar , after his survey of doctors, found that there was a positive relationship between psychological contract and job satisfaction. Australian scholar John Rodwell  conducted a research on 113 allied health professionals and found that psychological contract breach had negative effects on the employees’ emotions and commitments. In China, some scholars have already surveyed the psychological contract of medical care workers  and care helpers in elderly care institutions [17, 18]; nevertheless, there has been rare research on the psychological contract of the obstetric MIC helpers in hospitals. Given that occupational wellbeing is a subjective feeling of happiness in the workplace, it can be used to measure the employees’ positive feelings towards their work and cognitive evaluation . Good occupational wellbeing is a prerequisite for a stable working team. Hence, this study aims to investigate the condition of the MIC helpers’ psychological contract and occupational wellbeing, explore their influencing factors, and analyze their relationship in order to provide some references for standardized management of the MIC helpers.