
One in six married women in Korea experiences career interruptions due to life cycle events like marriage, child-care, and childbirth, according to a 2022 Statistics Korea survey1). These interruptions typically occur in life cycle events such as childbirth, childcare, and marriage, which occur in the late 20s to early 40s, a crucial period for economic activity, and are known to negatively impact female workers’ long-term career management2-4).
Recognizing this challenge, the government actively implements specific systems and policies to prevent career disruptions and support female workers’ employment secu-rity and participation in economic activities5). Representative policies in this regard include maternity protection and work-family balance assistance, established under the Labor Standards Act6) and the Equal Employment Oppor-tunity and Work-family Balance Support Act (Gender Emp-loyment Equality Act)7).
The maternity protection policy provides pre- and post- natal leave and reduced working hours during pregnancy, while the work-family balance assistance policy offers pare-ntal leave, reduced working hours during childhood, and family leave8). Research suggests that these policies posi-tively impact female workers’ job satisfaction, commitment, personal development, and work-family balance9-11).
Despite these benefits, underutilization remains a concern, with many women opting to leave their jobs instead. Orga-nizational cultures that discourage policy use and lack of su-pport for finding substitutes are often cited as key reasons12).
Globally, a staggering 80% of dental hygienists experience career interruptions due to childcare responsibilities13). In Korea, many married female dental hygienists in their 30s and 40s have similarly faced at least one career disruption due to marriage, childbirth, or childcare14,15). Yet, these expe-rienced professionals possess valuable knowledge, expertise, and skills honed through years of practice. Their career interruptions related to maternity and parenthood can have significant consequences: wasted professional resources, increased recruitment and training costs, and a potential decline in care quality, ultimately impacting the population’s oral health16-18). Notably, Korea’s active dental hygienist workforce sits at 49.3%, decreasing annually, and the labor shortage is intensifying19). Considering that life-cycle events like childbirth and child-rearing are primary reasons for dental hygienists leaving the field, finding effective solutions to help them maintain work-family balance and job continuity is crucial to addressing the workforce gap20). However, a lack of research specifically examining the utilization of maternity protection and work-family support policies by dental hygienists hinders our understanding of the true extent of career disruptions within dental hygienists.
This study aimed to assess, via a survey, dental hygi-enists’ awareness and utilization of maternity protection and work-family balance policies in hospitals and clinics, generating baseline data for policy improvements and a better working environment for dental hygienists.
This study, approved by the Institutional Review Board of Gangneung-Wonju National University (IRB No. GWNUIRB-2022-4), sought to gauge dental hygienists’ perspectives on maternity protection and work-family ba-lance assistance policies. We conducted a survey targeting those working in dental hospitals and clinics.
The participants were dental hygienists from dental cli-nics. We used G*power 3.1.9.7 to calculate the needle sample size, aiming for 90% power, a 0.05 significance level, and an effect size of 0.30. This yielded a required minimum of 172 participants. Anticipating a 15% dropout rate, we recruited 200 individuals. The survey was distri-buted only to dental hygienists on an online community forum after informing them of the study’s purpose. Parti-cipants were required to provide consent by checking the “I agree to participate” box within the online questionnaire. Of the 200 collected samples, 22 did not meet the selection criteria, leaving 178 valid responses for data analysis.
The questionnaire was developed by extracting ques-tions from three existing surveys: a work-family balance study conducted by the Ministry of Employment and Labor and the Korea Women’s Policy Research Institute12), Kim and Kim’s21) research on improving Korea’s maternity protection systems, and An and Han’s22) analysis of nurses’ utilization of maternity protection systems. The questionnaire comprised 48 questions covering various sections and was developed using the Google forms platform.
Demographic information consisted of six questions that assessed age, clinical experience, marital status, childbirth history, number of children, and work type. Three further questions gathered information about the dental clinic, including location, type, and employee count.
The maternity protection and work-family support sys-tem awareness consisted of 36 questions that explored awareness of five systems: pre- and post-natal leave, mate-rnity work-hour reduction, parental leave, childcare work- hour reduction, and family leave. This section also investi-gated the ease of policy utilization within the clinic, per-sonal experience using them, and any unfair treatment faced afterward.
Awareness of government-support programs consisted of two questions that gauged familiarity with government benefits for workers and businesses using relevant pro-grams. These benefits include pre- and post-natal leave, parental leave, childcare work-hour reduction, employer benefits, and childcare substitute worker subsidies. Identi-fying dental hygienists’ awareness of these programs gui-ded their inclusion in the survey.
Regarding the improvement plan, one open-ended question asked for suggestions on revitalizing maternity and work- family support systems. Additionally, respondents could freely provide further feedback beyond the proposed acti-vation measures.
After cleaning the data in SPSS version 25 (SPSS Inc., Chicago, IL, USA), we conducted a cross-tabulation ana-lysis to examine how participant awareness of the policies, the government-supported system, its clinic-level usefulness, and personal usage experience varied across diverse gene-ral characteristics. Frequency analyses revealed the most common reasons why participants had not used these policies, as well as their suggestions for revitalizing them.
Table 1 shows the results of awareness regarding mate-rnity protection and work-family balance assistance policies. Over 60% of dental hygienists were aware of pre- and post-natal leave (67.8%), reduced working hours during pregnancy (66.7%), and parental leave (69.5%). However, awareness of reduced working hours during childhood and family leave was significantly lower at 48.6% and 30.5%, respectively. Regarding general characteristics, awareness was highest among those with two or more children, and participants with more years of clinical experience tended to be more aware of the policies (p<0.001).
Awareness of Maternity and Work-family Balance Assistance Policies by General Characteristics
Variable | Pre- and post-natal leave | p |
Reduction of working hours during pregnancy | p |
Parental leave | p |
Reduction of working hours during childhood | p |
Family leave | p |
|||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
I know | Don’t know | I know | Don’t know | I know | Don’t know | I know | Don’t know | I know | Don’t know | ||||||
Total | 120 (67.8) | 57 (32.2) | 118 (66.7) | 59 (33.3) | 123 (69.5) | 54 (30.5) | 86 (48.6) | 91 (51.4) | 54 (30.5) | 123 (69.5) | |||||
Age | |||||||||||||||
20∼29 years old | 24 (42.1) | 33 (57.9) | <0.001 | 22 (38.6) | 35 (61.4) | <0.001 | 29 (50.9) | 28 (49.1) | <0.001 | 17 (29.8) | 40 (70.2) | 0.002 | 8 (14.0) | 49 (86.0) | 0.003 |
30∼39 years old | 72 (79.1) | 19 (20.9) | 72 (79.1) | 19 (20.9) | 70 (76.9) | 21 (23.1) | 51 (56.0) | 40 (44.0) | 33 (36.3) | 58 (63.7) | |||||
40 years of age or older | 24 (82.8) | 5 (17.2) | 24 (82.8) | 5 (17.2) | 24 (82.8) | 5 (17.2) | 18 (62.1) | 11 (37.9) | 13 (44.8) | 16 (55.2) | |||||
Marital status | |||||||||||||||
Married | 80 (88.9) | 10 (11.1) | <0.001 | 81 (90.0) | 9 (10.0) | <0.001 | 77 (85.6) | 13 (14.4) | <0.001 | 62 (68.9) | 28 (31.1) | <0.001 | 40 (44.4) | 50 (55.6) | <0.001 |
Unmarried | 40 (46.0) | 47 (54.0) | 37 (42.5) | 50 (57.5) | 46 (52.9) | 41 (47.1) | 24 (27.6) | 63 (72.4) | 14 (16.1) | 73 (83.9) | |||||
Number of children | |||||||||||||||
No children | 60 (52.2) | 55 (47.8) | <0.001 | 60 (52.2) | 55 (47.8) | <0.001 | 67 (58.3) | 48 (41.7) | <0.001 | 39 (33.9) | 76 (66.1) | <0.001 | 22 (19.1) | 93 (80.9) | <0.001 |
One | 36 (94.7) | 2 (5.3) | 36 (94.7) | 2 (5.3) | 33 (86.8) | 5 (13.2) | 27 (71.1) | 11 (28.9) | 18 (47.4) | 20 (52.6) | |||||
Two or more | 24 (100.0) | 0 (0.0) | 22 (91.7) | 2 (8.3) | 23 (95.8) | 1 (4.2) | 20 (83.3) | 4 (16.7) | 14 (58.3) | 10 (41.7) | |||||
Clinical experience | |||||||||||||||
Less than 5 years | 16 (34.0) | 31 (66.0) | <0.001 | 17 (36.2) | 30 (63.8) | <0.001 | 23 (48.9) | 24 (51.1) | <0.001 | 13 (27.7) | 34 (72.3) | <0.001 | 6 (12.8) | 41 (87.2) | <0.001 |
Less than 5∼10 years | 43 (69.4) | 19 (30.6) | 41 (66.1) | 21 (33.9) | 42 (67.7) | 20 (32.3) | 26 (41.9) | 36 (58.1) | 15 (24.2) | 47 (75.8) | |||||
10 years or more | 61 (89.7) | 7 (10.3) | 60 (88.2) | 8 (11.8) | 58 (85.3) | 10 (14.7) | 47 (69.1) | 21 (30.9) | 33 (48.5) | 35 (51.5) | |||||
Shift types | |||||||||||||||
Full-time | 104 (66.2) | 53 (33.8) | 0.111 | 102 (65.0) | 55 (35.0) | 0.102 | 106 (67.5) | 51 (32.5) | 0.161 | 73 (46.5) | 84 (53.5) | 0.029 | 46 (29.3) | 111 (70.7) | 0.416 |
Part-time | 10 (100.0) | 0 (0.0) | 10 (100.0) | 0 (0.0) | 10 (100.0) | 0 (0.0) | 9 (90.0) | 1 (10.0) | 4 (40.0) | 6 (60.0) | |||||
Part-time jobs | 5 (55.6) | 4 (44.4) | 5 (55.6) | 4 (44.4) | 6 (66.7) | 3 (33.3) | 3 (33.3) | 6 (66.7) | 3 (33.3) | 6 (66.7) | |||||
Other (short) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | |||||
Dentistry type | |||||||||||||||
Dental clinic | 96 (64.9) | 52 (35.1) | 0.184 | 94 (63.5) | 54 (36.5) | 0.205 | 97 (65.5) | 51 (34.5) | 0.042 | 64 (43.2) | 84 (56.8) | 0.015 | 38 (25.7) | 110 (74.3) | 0.014 |
Dental hospital | 11 (78.6) | 3 (21.4) | 12 (85.7) | 2 (14.3) | 11 (78.6) | 3 (21.4) | 11 (78.6) | 3 (21.4) | 8 (57.1) | 6 (42.9) | |||||
General hospital | 7 (100.0) | 0 (0.0) | 5 (71.4) | 2 (28.6) | 7 (100.0) | 0 (0.0) | 5 (71.4) | 2 (28.6) | 3 (42.9) | 4 (57.1) | |||||
University dental hospital | 6 (75.0) | 2 (25.0) | 7 (87.5) | 1 (12.5) | 8 (100.0) | 0 (0.0) | 6 (75.0) | 2 (25.0) | 5 (62.5) | 3 (37.5) |
Values are presented as n (%).
*The analysis was performed using a chi-square test.
Table 2 presents the survey results on dental hygienists’ awareness of government support programs related to maternity protection and work-family balance assistance policies. For employee support systems, 58.2% were aware of pre- and post-natal leave benefits, and 63.3% knew about parental leave benefits. However, only 49.2% recog-nized the reduced working hours benefit during childhood. Interestingly, awareness of employee programs increased with age, with married dental hygienists were more infor-med than single ones (p<0.001). Additionally, having more children and clinical experience was significantly associated with greater knowledge of government-sponsored programs (p<0.001).
Awareness of Government Support Programs for Maternity Protection and Work-Life Balance Assistance Policies
Variable | Support for employees | Support for employers | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pre- and post-natal leave benefits | p |
Parental leave benefits | p |
Reduction of working hours during childhood benefits | p |
Subsidy system for parental leave | p |
Subsidy system for substitute labor | p |
|||||||
I know | Don’t know | I know | Don’t know | I know | Don’t know | I know | Don’t know | I know | Don’t know | |||||||
Total | 103 (58.2) | 74 (41.8) | 112 (63.3) | 65 (36.7) | 87 (49.2) | 90 (50.8) | 78 (44.1) | 99 (55.9) | 74 (41.8) | 103 (58.2) | ||||||
Age | ||||||||||||||||
20∼29 years old | 17 (29.8) | 40 (70.2) | <0.001 | 25 (43.9) | 32 (56.1) | <0.001 | 16 (28.1) | 41 (71.9) | <0.001 | 13 (22.8) | 44 (77.2) | <0.001 | 11 (19.3) | 46 (80.7) | <0.001 | |
30∼39 years old | 65 (71.4) | 26 (28.6) | 65 (71.4) | 26 (28.6) | 51 (56.0) | 40 (44.0) | 48 (52.7) | 43 (47.3) | 47 (51.6) | 44 (48.4) | ||||||
40 years of age or older | 21 (72.4) | 8 (27.6) | 22 (75.9) | 7 (24.1) | 20 (69.0) | 9 (31.0) | 17 (58.6) | 12 (41.4) | 16 (55.2) | 13 (44.8) | ||||||
Marital status | ||||||||||||||||
Married | 77 (85.6) | 13 (14.4) | <0.001 | 76 (84.4) | 14 (15.6) | <0.001 | 66 (73.3) | 24 (26.7) | <0.001 | 60 (66.7) | 30 (33.3) | <0.001 | 59 (65.6) | 31 (34.4) | <0.001 | |
Unmarried | 26 (29.9) | 61 (70.1) | 36 (41.4) | 51 (58.6) | 21 (24.1) | 66 (75.9) | 18 (20.7) | 69 (79.3) | 15 (17.2) | 72 (82.8) | ||||||
Number of children | ||||||||||||||||
No children | 45 (39.1) | 70 (60.9) | <0.001 | 54 (47.0) | 61 (53.0) | <0.001 | 35 (30.4) | 80 (69.6) | <0.001 | 29 (25.2) | 86 (74.8) | <0.001 | 25 (21.7) | 90 (78.3) | <0.001 | |
One | 35 (92.1) | 3 (7.9) | 35 (92.1) | 3 (7.9) | 32 (84.2) | 6 (15.8) | 31 (81.6) | 7 (18.4) | 30 (78.9) | 8 (21.1) | ||||||
Two or more | 23 (95.8) | 1 (4.2) | 23 (95.8) | 1 (4.2) | 20 (83.3) | 4 (16.7) | 18 (75.0) | 6 (25.0) | 19 (79.2) | 5 (20.8) | ||||||
Clinical experience | ||||||||||||||||
Less than 5 years | 15 (31.9) | 32 (68.1) | <0.001 | 21 (44.7) | 26 (55.3) | <0.001 | 12 (25.5) | 35 (74.5) | <0.001 | 12 (25.5) | 35 (74.5) | <0.001 | 10 (21.3) | 37 (78.7) | <0.001 | |
Less than 5∼10 years | 31 (50.0) | 31 (50.0) | 33 (53.2) | 29 (46.8) | 25 (40.3) | 37 (59.7) | 21 (33.9) | 41 (66.1) | 19 (30.6) | 43 (69.4) | ||||||
10 years or more | 57 (83.8) | 11 (6.2) | 58 (85.3) | 10 (14.7) | 50 (73.5) | 18 (26.5) | 45 (66.2) | 23 (33.8) | 45 (66.2) | 23 (33.8) | ||||||
Shift types | ||||||||||||||||
Full-time | 89 (56.7) | 68 (43.3) | 0.416 | 98 (62.4) | 59 (37.6) | 0.166 | 75 (47.8) | 82 (52.2) | 0.396 | 65 (41.4) | 92 (58.6) | 0.073 | 61 (38.9) | 96 (61.1) | 0.047 | |
Part-time | 8 (80.0) | 2 (20.0) | 9 (90.0) | 1 (10.0) | 7 (70.0) | 3 (30.0) | 8 (80.0) | 2 (20.0) | 8 (80.0) | 2 (20.0) | ||||||
Part-time jobs | 5 (55.6) | 4 (44.4) | 4 (44.4) | 5 (55.6) | 4 (44.4) | 5 (55.6) | 4 (44.4) | 5 (55.6) | 4 (44.4) | 5 (55.6) | ||||||
Other (short) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | ||||||
Dentistry type | ||||||||||||||||
Dental clinic | 81 (54.7) | 67 (45.3) | 0.208 | 87 (58.8) | 61 (41.2) | 0.032 | 68 (45.9) | 80 (54.1) | 0.278 | 60 (40.5) | 88 (59.5) | 0.064 | 57 (38.5) | 91 (61.5) | 0.104 | |
Dental hospital | 11 (78.6) | 3 (21.4) | 11 (78.6) | 3 (21.4) | 9 (64.3) | 5 (35.7) | 10 (71.4) | 4 (28.6) | 9 (64.3) | 5 (35.7) | ||||||
General hospital | 5 (71.4) | 2 (28.6) | 7 (100.0) | 0 (0.0) | 5 (71.4) | 2 (28.6) | 5 (71.4) | 2 (28.6) | 5 (71.4) | 2 (28.6) | ||||||
University dental hospital | 6 (75.0) | 2 (25.0) | 7 (87.5) | 1 (12.5) | 5 (62.5) | 3 (37.5) | 3 (37.5) | 5 (62.5) | 3 (37.5) | 5 (62.5) |
Values are presented as n (%).
*The analysis was performed using a chi-square test.
Regarding support systems for employers, a substantial gap in awareness remained. Specifically, 55.9% of dental hygie-nists were unaware of the parental leave subsidy, and 58.2% did not recognize the subsidy for substitute labor during child-birth and childcare. Notably, younger age and less clinical experience were significantly associated with lower aware-ness of these government support programs (p<0.001).
While over half of dental hygienists (50.3%) reported freely utilizing pre-and post-natal leave within their clinics (Table 3), accessing specific measures proved more chal-lenging. Freedom declined sharply for reduced working hours during pregnancy (64.4%), parental leave (59.3%), childcare work hour reduction (68.9%), and family leave (75.7%). Notably, the type of clinic made a significant difference in policy accessibility. Dental hygienists in dental hospitals, general hospitals, and university dental hospital enjoyed greater ease of use compared to those in dental clinics (p<0.05). Interestingly, access to reduced working hours during childhood did not vary significantly by dentistry type (p=0.071).
Usability of Access to in-Dental Clinic Maternity Protection and Work-life Balance Assistance Policies
Variable | Pre- and post-natal leave | p |
Reduction of working hours during pregnancy | p |
Parental Leave | p |
Reduction of working hours during childhood | p |
Family leave | p |
|||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Free to use | Unavailable | Free to use | Unavailable | Free to use | Unavailable | Free to use | Unavailable | Free to use | Unavailable | ||||||
Total | 89 (50.3) | 88 (49.7) | 63 (35.6) | 114 (64.4) | 72 (40.7) | 105 (59.3) | 55 (31.1) | 122 (68.9) | 43 (24.3) | 134 (75.7) | |||||
Age | |||||||||||||||
20∼29 years old | 33 (57.9) | 24 (42.1) | 0.370 | 25 (43.9) | 32 (56.1) | 0.067 | 26 (45.6) | 31 (54.4) | 0.653 | 22 (38.6) | 35 (61.4) | 0.125 | 20 (35.1) | 37 (64.9) | 0.033 |
30∼39 years old | 42 (46.2) | 49 (53.8) | 25 (27.5) | 66 (72.5) | 35 (38.5) | 56 (61.5) | 22 (24.2) | 69 (75.8) | 15 (16.5) | 76 (83.5) | |||||
40 years of age or older | 14 (48.3) | 15 (51.7) | 13 (44.8) | 16 (55.2) | 11 (37.9) | 18 (62.1) | 11 (37.9) | 18 (62.1) | 8 (27.6) | 21 (72.4) | |||||
Marital status | |||||||||||||||
Married | 49 (54.4) | 41 (45.6) | 0.260 | 31 (34.4) | 59 (65.6) | 0.745 | 39 (43.3) | 51 (56.7) | 0.465 | 28 (31.1) | 62 (68.9) | 0.991 | 20 (22.2) | 70 (77.8) | 0.513 |
Unmarried | 40 (46.0) | 47 (54.0) | 32 (36.8) | 55 (63.2) | 33 (37.9) | 54 (62.1) | 27 (31.0) | 60 (69.0) | 23 (26.4) | 64 (73.6) | |||||
Number of children | |||||||||||||||
No children | 51 (44.3) | 64 (55.7) | 0.023 | 39 (33.9) | 76 (66.1) | 0.758 | 42 (36.5) | 73 (63.5) | 0.138 | 33 (28.7) | 82 (71.3) | 0.244 | 28 (24.3) | 87 (75.7) | 0.411 |
One | 20 (52.6) | 18 (47.4) | 1436.8) | 24 (63.2) | 16 (42.1) | 22 (57.9) | 11 (28.9) | 27 (71.1) | 7 (18.4) | 31 (81.6) | |||||
Two or more | 18 (75.0) | 6 (25.0) | 10 (41.7) | 14 (58.3) | 14 (58.3) | 10 (41.7) | 11 (45.8) | 13 (54.2) | 8 (33.3) | 16 (66.7) | |||||
Clinical experience | |||||||||||||||
Less than 5 years | 25 (53.2) | 22 (46.3) | 0.778 | 21 (44.7) | 26 (55.3) | 0.106 | 21 (44.7) | 26 (55.3) | 0.785 | 16 (34.0) | 31 (66.0) | 0.867 | 17 (36.2) | 30 (63.8) | 0.085 |
Less than 5∼10 years | 29 (46.8) | 33 (53.2) | 16 (25.8) | 46 (74.2) | 25 (40.3) | 37 (59.7) | 19 (30.6) | 43 (69.4) | 12 (19.4) | 50 (80.6) | |||||
10 years or more | 35 (51.5) | 33 (48.5) | 26 (38.2) | 42 (61.8) | 26 (38.2) | 42 (61.8) | 20 (29.4) | 48 (70.6) | 14 (20.6) | 54 (79.4) | |||||
Shift types | |||||||||||||||
Full-time | 81 (51.6) | 76 (48.4) | 0.466 | 59 (37.6) | 98 (62.4) | 0.131 | 67 (42.7) | 90 (57.3) | 0.190 | 49 (31.2) | 108 (68.8) | 0.466 | 40 (25.5) | 117 (74.5) | 0.666 |
Part-time | 4 (40.0) | 6 (60.0) | 1 (10.0) | 9 (90.0) | 2 (20.0) | 8 (80.0) | 3 (30.0) | 7 (70.0) | 1 (10.0) | 9 (90.0) | |||||
Part-time jobs | 3 (33.3) | 6 (66.7) | 2 (22.2) | 7 (77.8) | 2 (22.2) | 7 (77.8) | 2 (22.2) | 7 (77.8) | 2 (22.2) | 7 (77.8) | |||||
Other (short) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 0 (0.0) | 1 (100.0) | |||||
Dentistry type | |||||||||||||||
Dental clinic | 67 (45.3) | 81 (54.7) | 0.015 | 47 (31.8) | 101 (68.2) | 0.019 | 50 (33.8) | 98 (66.2) | <0.001 | 40 (27.0) | 108 (73.0) | 0.071 | 27 (18.2) | 121 (81.8) | <0.001 |
Dental hospital | 9 (64.3) | 5 (35.7) | 7 (50.0) | 7 (50.0) | 9 (64.3) | 5 (35.7) | 7 (50.0) | 7 (50.0) | 6 (42.9) | 8 (57.1) | |||||
General hospital | 6 (85.7) | 1 (14.3) | 6 (85.7) | 1 (14.3) | 6 (85.7) | 1 (14.3) | 4 (57.1) | 3 (42.9) | 4 (57.1) | 3 (42.9) | |||||
University dental hospital | 7 (87.5) | 1 (12.5) | 3 (37.5) | 5 (62.5) | 7 (87.5) | 1 (12.5) | 4 (50.0) | 4 (50.0) | 6 (75.0) | 2 (25.0) |
Values are presented as n (%).
*The analysis was performed using a chi-square test.
Table 4 reveals insights into policy utilization among those who had given birth. Notably, 27.7% availed of pre- and post-natal leave, and 16.9% utilized reduced working hours during pregnancy. Additionally, clinical experience played a significant role. Dental hygienists with more years of experience were more likely to have used pre- and post-natal leave, reduced pregnancy working hours, pare-ntal leave, and reduced childcare work hours (p<0.001). However, family leave utilization remained unaffected by clinical experience (p=0.734). Table 5 further details reasons for not utilizing policies that either restricted access or discouraged usage. Notably, some opted for annual or monthly leave instead of policy benefits.
Experience Using the Maternity Protection and Work-life Balance Assistance Policies
Variables | Pre- and post-natal leave experience | p |
Reduction of working hours during pregnancy experience | p |
Parental leave experience | p |
Reduction of working hours during childhood experience | p |
Family leave experience | p |
|||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Never given birth | Yes | No | Never given birth | Yes | No | Never given birth | Yes | No | Never given birth | Yes | No | Yes | No | ||||||
Total | 115 (65.0) | 49 (27.7) | 13 (7.3) | 115 (65.0) | 30 (16.9) | 32 (18.1) | 115 (65.0) | 47 (26.6) | 15 (8.5) | 115 (65.0) | 28 (15.8) | 34 (19.2) | 15 (8.5) | 162 (91.5) | |||||
Age | |||||||||||||||||||
20∼29 years old | 55 (96.5) | 2 (3.5) | 0 (0.0) | <0.001 | 55 (96.5) | 2 (3.5) | 0 (0.0) | <0.001 | 55 (96.5) | 2 (3.5) | 0 (0.0) | <0.001 | 55 (96.5) | 1 (1.8) | 1 (1.8) | <0.001 | 3 (5.3) | 54 (94.7) | 0.451 |
30∼39 years old | 47 (50.6) | 36 (39.6) | 8 (8.8) | 47 (51.6) | 21 (23.1) | 23 (25.3) | 47 (51.6) | 36 (39.6) | 8 (8.8) | 47 (51.6) | 20 (22.0) | 24 (26.4) | 10 (11.0) | 81 (89.0) | |||||
40 years of age or older | 13 (44.8) | 11 (37.9) | 5 (17.2) | 13 (44.8) | 7 (24.1) | 9 (31.0) | 13 (44.8) | 9 (31.0) | 7 (24.1) | 13 (44.8) | 7 (24.1) | 9 (31.0) | 2 (6.9) | 27 (93.1) | |||||
Marital status | |||||||||||||||||||
Married | 29 (32.2) | 48 (53.3) | 13 (14.4) | <0.001 | 29 (32.2) | 29 (32.2) | 32 (35.6) | <0.001 | 29 (32.2) | 46 (51.1) | 15 (16.7) | <0.001 | 29 (32.2) | 28 (31.1) | 33 (36.7) | <0.001 | 11 (12.2) | 79 (87.8) | 0.069 |
Unmarried | 86 (98.9) | 1 (1.1) | 0 (0.0) | 86 (98.9) | 1 (1.1) | 0 (0.0) | 86 (98.9) | 1 (1.1) | 0 (0.0) | 86 (98.9) | 0 (0.0) | 1 (1.1) | 4 (4.6) | 83 (95.4) | |||||
Number of children | |||||||||||||||||||
No children | 115 (65.0) | 0 (0.0) | 0 (0.0) | <0.001 | 115 (65.0) | 0 (0.0) | 0 (0.0) | <0.001 | 115 (65.0) | 0 (0.0) | 0 (0.0) | <0.001 | 115 (65.0) | 0 (0.0) | 0 (0.0) | <0.001 | 5 (4.3) | 110 (95.7) | 0.020 |
One | 0 (0.0) | 29 (76.3) | 9 (23.7) | 0 (0.0) | 16 (42.1) | 22 (57.9) | 0 (0.0) | 28 (73.7) | 10 (26.3) | 0 (0.0) | 14 (36.8) | 24 (63.2) | 7 (18.4) | 31 (81.6) | |||||
Two or more | 0 (0.0) | 20 (83.3) | 4 (16.7) | 0 (0.0) | 14 (58.3) | 10 (41.7) | 0 (0.0) | 19 (79.2) | 5 (20.8) | 0 (0.0) | 14 (58.3) | 10 (41.7) | 3 (12.5) | 21 (87.5) | |||||
Clinical experience | |||||||||||||||||||
Less than 5 years | 45 (95.7) | 1 (2.1) | 1 (2.1) | <0.001 | 46 (95.7) | 1 (2.1) | 1 (2.1) | <0.001 | 45 (95.7) | 1 (2.1) | 1 (2.1) | <0.001 | 45 (95.7) | 0 (0.0) | 2 (4.3) | <0.001 | 4 (8.5) | 43 (91.5) | 0.734 |
Less than 5∼10 years | 47 (75.8) | 10 (16.1) | 5 (8.1) | 47 (75.8) | 7 (11.3) | 8 (12.9) | 47 (75.8) | 10 (16.1) | 5 (8.1) | 47 (75.8) | 7 (11.3) | 8 (12.9) | 4 (6.5) | 58 (93.5) | |||||
10 years or more | 23 (33.8) | 38 (55.9) | 7 (10.3) | 23 (33.8) | 22 (32.4) | 23 (33.8) | 23 (33.8) | 36 (52.9) | 9 (13.2) | 23 (33.8) | 21 (30.9) | 24 (35.3) | 7 (10.3) | 61 (89.7) | |||||
Shift types | |||||||||||||||||||
Full-time | 104 (66.2) | 44 (28.0) | 9 (5.7) | 0.052 | 104 (66.2) | 27 (17.2) | 26 (16.6) | 0.168 | 104 (66.2) | 42 (26.8) | 11 (7.0) | 0.005 | 104 (66.2) | 24 (15.3) | 29 (18.5) | 0.099 | 15 (9.6) | 142 (90.4) | 0.554 |
Part-time | 4 (40.0) | 3 (30.0) | 3 (30.0) | 4 (40.0) | 2 (20.0) | 4 (40.0) | 4 (40.0) | 3 (30.0) | 3 (30.0) | 4 (40.0) | 4 (40.0) | 2 (20.0) | 0 (0.0) | 10 (100.0) | |||||
Part-time jobs | 7 (77.8) | 1 (11.1) | 1 (11.1) | 7 (77.8) | 1 (11.1) | 1 (11.1) | 7 (77.8) | 2 (22.2) | 0 (0.0) | 7 (778) | 0 (0.0) | 2 (22.2) | 0 (0.0) | 9 (100.0) | |||||
Other (short) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 0 (0.0) | 1 (100.0) | 0 (0.0) | 0 (0.0) | 1 (100.0) | |||||||
Dentistry type | |||||||||||||||||||
Dental clinic | 98 (66.2) | 37 (25.0) | 13 (8.8) | 0.519 | 98 (66.2) | 22 (14.9) | 28 (18.9) | 0.492 | 98 (66.2) | 37 (25.0) | 13 (8.8) | 0.888 | 98 (66.2) | 23 (15.5) | 27 (18.2) | 0.979 | 8 (5.4) | 140 (94.6) | <0.001 |
Dental hospital | 8 (57.1) | 6 (425.9) | 0 (0.0) | 8 (57.1) | 5 (35.7) | 1 (7.1) | 8 (57.1) | 5 (35.7) | 1 (7.1) | 8 (57.1) | 3 (21.4) | 3 (21.4) | 4 (28.6) | 10 (71.4) | |||||
General hospital | 4 (57.1) | 3 (42.9) | 0 (0.0) | 4 (57.1) | 1 (14.3) | 2 (28.6) | 4 (57.1) | 3 (42.9) | 0 (0.0) | 4 (57.1) | 1 (14.3) | 2 (28.6) | 0 (0.0) | 7 (100.0) | |||||
University dental hospital | 5 (62.5) | 3 (37.5) | 0 (0.0) | 5 (62.5) | 2 (25.0) | 1 (12.5) | 5 (62.5) | 2 (25.0) | 1 (12.5) | 5 (62.5) | 1 (12.5) | 2 (25.0) | 3 (37.5) | 5 (62.5) |
Values are presented as n (%).
*The analysis was performed using a chi-square test.
Reasons for not Utilizing the Maternity Protection and Work-life Balance Assistance Policies
Variable | Pre- and post-natal leave | Reduction of working hours during pregnancy | Parental leave | Reduction of working hours during childhood | Family leave |
---|---|---|---|---|---|
Reasons for not utilizing |
|||||
Company policy/practice is not to provide | 9 (69.2) | 13 (40.6) | 0 (0.0) | 16 (47.1) | 43 (26.5) |
By using annual |or monthly leave | 1 (7.7) | 3 (9.4) | 1 (0.6) | 4 (11.8) | 39 (24.1) |
By using sick leave | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 6 (3.7) |
Coping with unpaid leave | 1 (7.7) | 2 (6.3) | 1 (0.6) | 1 (2.9) | 20 (12.3) |
I don’t know the policy | 0 (0.0) | 4 (12.5) | 0 (0.0) | 4 (11.8) | 46 (28.4) |
I don’t know how to apply for the program | 0 (0.0) | 2 (6.3) | 0 (0.0) | 1 (2.9) | 34 (21.0) |
Organizational cultures that prevent you from using the | 5 (38.5) | 16 (50.0) | 9 (5.1) | 16 (47.1) | 31 (19.1) |
Due to penalties for use (resignation, termination, discrimination, etc.) | 1 (7.7) | 4 (12.5) | 1 (0.6) | 6 (17.6) | 13 (8.0) |
The analysis was performed by frequency analysis.
aReasons were treated as multiple responses.
When a dental hygienist utilizes pre- or post-natal leave in their clinics, several methods are employed to manage their absence: 30.5% distribute the workload among exi-sting staff, 23.2% hire temporary contractual substitutes, and 21.5% recruit new full-time staff. During parental leave absences, 33.9% rely on workload sharing, followed by 27.1% hiring new full-time staff, and 26.3% opting for temporary substitutes.
A concerning 28.8% of respondents reported experi-encing unfair treatment after utilizing maternity protection or work-family support systems. This manifested in vari-ous ways: 20.0% faced discrimination from colleagues, 15.0% were pressured to resign, 10.0% were unjustifiably dismissed, and another 10.0% received pay cuts as disci-plinary measures. Additional comments revealed experiences like department transfers, discouragement from using the system, and withheld employer-paid salaries.
Table 6 highlights desired measures to improve the situation. The most popular suggestion (68.4%) was man-datory implementation of maternity and family support programs across all workplaces. This was followed by calls for expanded support for substitute workers (48.6%), stren-gthened education and government promotion of the pro-grams (42.4%), and a shift towards flexible work systems, such as time-selective systems (40.1%).
How to Promote Maternity Protection and Work-life Balance Assistance Policies
Variable | n (%) |
---|---|
Implement mandatory maternity protection and work-life balance policies in all workplaces | 121 (68.4) |
Increase education and outreach about government assistance | 75 (42.4) |
Simplify the application process | 50 (28.2) |
Expanded support policies for replacement workers | 86 (48.6) |
Ease the burden by enabling flexible work arrangements | 71 (40.1) |
Establish state-led workforce employment training centers to support training programs for retirees due to childbirth and childcare | 36 (20.2) |
The analysis was performed by frequency analysis.
Reasons were treated as multiple responses.
This study aimed to understand dental hygienists’ awa-reness, usability, and experiences with maternity protection and work-life balance assistance policies in dental hos-pitals, ultimately aiding in future improvements to their working environment.
General characteristics significantly influenced aware-ness. Participants with more children were more interested in these systems compared to those with none. Addi-tionally, higher age, marital status, and clinical experience correlated with increased awareness of both the policies and government support options for employees and emp-loyers taking maternity or paternity leave. These findings are consistent with Im et al.’s study23) study, indicating that the stress of parenting alongside an increased number of children drives a greater need for work-life balance support from government systems. Similarly, previous studies sug-gest female workers caring for children or families are more likely to be aware of such policies due to their heig-htened need for maternity protection and work-life bala-nce policies24).
However, the relevance of these policies extends beyond specific life stages, potentially impacting individuals throug-hout their child-reading and family roles. Therefore, it is crucial to explore strategies ensuring accurate understan-ding and use of work-life balance programs for workers, regardless of age, marital status, or childbearing experi-ence25). Collaborative efforts between the government and dental hygienist associations are key. Developing and distributing manuals on work-life balance policies speci-fically tailored for dental clinics could be valuable. Like-wise, strengthening outreach through text messaging and social media platforms—informing workers and employers of their rights, obligations, and available government support—can prevent underutilization due to a lack of awareness.
The study revealed a disparity in how readily dental hygienists could utilize these policies depending on their workplace. Those working in general hospitals or univer-sity hospitals enjoyed greater freedom compared to those in dental clinics. This disparity likely stems from the hos-pital environment, where established systems and anti- discriminatory measures facilitate smoother policy usage22). Yu’s26) research supports this, demonstrating that health-care organizations with active welfare systems and family- friendly policies significantly improve employees’ work- life balance, and boost organizational commitment. To mini-mize turnover and career interruptions among female emplo-yees, Yu26) further advises healthcare organizations to tailor support strategies to employee needs and consider factors like employee characteristics, and organizational size.
Likewise, Cho’s27) findings show a 30% reduction in career interruptions for female employees in workplaces with acce-ssible maternity or paternity leave policies. This confirms the crucial role policy usability plays in career continuity.
Therefore, to prevent career disruptions and establish a more supportive environment for dental hygienists, expa-nsion of social support is crucial. This ensures policies are readily available not just in general hospitals and uni-versity dental hospitals, but also within dental clinics. Additionally, active policy improvement measures are necessary. By strengthening implementation management and oversight under the Labor Standards Act and the Gender Employment Equality Act, we can effectively address career interruptions stemming from pregnancy and child-birth among dental hygienists.
Only 27.7% of dental hygienists utilized pre- or post- natal leave, and 26.6% took parental leave, highlighting limited policy uptake. Even lower were experiences with reduced working hours during pregnancy (16.9%) and childhood (15.8%). These findings are consistent with those of Moon et al.,17) who reported a 26.9% dental hygienist maternity leave utilization rate.
Organizational culture is a key culprit behind this low usage. Many companies lack established systems, actively discourage policy usage, or harbor internal discrimination. Additionally, a common practice of redistributing workload without hiring substitutes often burdens leave-takers and fosters pressure4). Negative attitudes from colleagues and supervisors further exacerbate the issue, requiring efforts to dismantle such negativity.
While government incentives exist to encourage employers to hire replacements during leave periods, their complex application process and practical problems, like finding suitable candidates, hinder effectiveness. To remedy this, system improvements are crucial. Streamlining the pro-cess, increasing accessibility, and simplifying benefit acqui-sition for employers are key steps.
One promising solution lies in the recently launched Substitute Labour Bank System, where pre-vetted workers are readily available to fill staffing gaps in the civil ser-vice28). Adapting this model, a dental hygienist manpower bank could be established under the leadership of relevant associations. This bank would aim to secure and manage dental human hygienist resources, allowing for flexible allocation to address staffing needs during leave periods. Such a system could prioritize previously career-interrupted hygienists, leveraging their experience and adaptability to benefit both clinicians and workers. This, in turn, could create a virtuous cycle that fosters professional development and career continuity for dental hygienists29).
While maternity protection and work-family balance policies exist, unfair treatment of dental hygienists who utilize them remains a troubling reality. Discrimination, forced resignations, unfair dismissals, and pay cuts are among the reported abuses, despite clear legal protections provided by the International Labor Organization’s labor guidelines30) and the Korean Labor Standards Act6). Em-ployers are legally prohibited from treating workers unfairly because of pregnancy, childbirth, and leave. Nevertheless, the fact that unfair treatment of leave still occurs shows that dental hygienists work without the protection of the law.
The government should strengthen its monitoring of workplaces to ensure compliance with labor laws and provide efficient channels for reporting and resolving unfair treatment. Dental hygienist associations can play a crucial role by establishing reporting systems and offering legal aid or mediation services.
Recommendations from the study participants offer further direction. Implementing mandatory policies across all workplaces, coupled with enhanced education and pro-motion of government support programs, could create a more supportive environment. Additionally, expanding support for substitute workers and promoting flexible work arrangements, such as part-time work options, can ease the burden of filling temporary vacancies.
Moving forward, a collaborative effort between the gover-nment, the Korean Dental Hygienists Association, and the Korean Dental Association is vital. By actively imple-menting the measures proposed in this study, we can ensure that dental hygienists can access and utilize maternity protection and work-family balance policies effectively.
While this study provides valuable insights into factors influencing dental hygienists’ career breaks, it’s important to acknowledge its limitations. The sample size may not fully represent the entire population, and relying solely on questionnaires limited our ability to explore the nuances of policy utilization on an individual level. Nevertheless, this research holds significance as it lays the groundwork for future improvements in dental hygienists’ working envir-onment. By shedding light on key variables like policy awareness, accessibility, and actual usage, this study offers foundational data to inform further interventions.
While dental hygienists in this study demonstrated awa-reness of maternity protection and work-life balance poli-cies, utilizing them freely proved challenging. Restrictive clinic policies, peer pressure, and a lack of substitutes emerged as significant barriers. The government, dentists, and dental hygienist associations must join forces to esta-blish and implement robust social support systems. Only through such collective action can we create a supportive environment where dental hygienists can thrive both pro-fessionally and personally.
None.
Conflict of Interest
No potential conflict of interest relevant to this article was reported.
Ethical Approval
This study was approved by the institutional review board of Gangneung-Wonju National University (IRB No. GWNUIRB-2022-4).
Author contributions
Conceptualization: Soo-Myoung Bae, Bo-Mi Shin, and Seon-Hui Kwak. Data acquisition: Seon-Hui Kwak and Soo- Myoung Bae. Formal analysis: Soo-Myoung Bae, Bo-Mi Shin, and Seon-Hui Kwak. Supervision: Soo-Myoung Bae and Bo-Mi Shin. Writing-original draft: Seon-Hui Kwak. Writing-review & editing: Soo-Myoung Bae, Bo-Mi Shin, and Seon-Hui Kwak.
Funding
None.
Data availability
Raw data is provided at the request of the corresponding author for reasonable reason.
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