Isik U. Zeytinoglu

Job stress and job dissatisfaction of home care workers in the context of health care restructuring.

Changes in the social organization of home care work due to health care restructuring have affected the job stress and job dissatisfaction of home care workers. This article reports the results of a survey of 892 employees from three nonprofit home care agencies in a medium-sized city in Ontario, Canada. Survey results are complemented by data from 16 focus groups with 99 employees. For the purposes of this study, home care workers include both office workers (managers, supervisors, coordinators, office support staff, and case managers) and visiting workers (nurses, therapists, and visiting homemakers). Focus group participants indicated that health care restructuring has resulted in organizational change, budget cuts, heavier workloads, job insecurity, loss of organizational support, loss of peer support, and loss of time to provide emotional laboring, or the “caring” aspects of home care work. Analyses of survey data show that organizational change, fear of job loss, heavy workloads, and lack of organizational and peer support lead to increased job stress and decreased levels of job satisfaction.

Nursing Generations in the Contemporary Workplace

Preserving a viable workforce is contingent upon recruiting and retaining more young people and persuading older workers to remain with the organization. The success of these efforts may depend on offering appropriate incentives to workers in different age cohorts. Although only limited research has been carried out on the topic, findings have consistently shown that the workforce consists of generational groups with different attributes and priorities. This mixed-methodology study uses survey and focus group results to explore some of the differences among age cohorts of nurses in three Canadian hospitals. The research revealed significant differences in career commitment; affective, normative, and continuity commitment to the organization; job satisfaction; stress and emotional exhaustion; depersonalization; personal accomplishment; and propensity to leave the hospital. This article concludes with recommendations for policies that address the needs of nurses of different ages.

Perceived Participation in Decision-Making in a University Setting: The Impact of Gender

This analysis of responses to a 1988 survey of full-time faculty at a medium-sized university in central Canada indicates that women were less likely than men to perceive themselves as participating in university decision-making, even with controls for other relevant variables. Academic rank, visible or ethnic minority status, and membership in networks were also influential. No significant effect was found for the possession of a Ph.D., the amount of teaching experience, the possession of tenure, having a mentor, or the proportion of women in the divisions faculty.

Market-Modelled Home Care in Ontario: Deteriorating Working Conditions and Dwindling Community Capacity

The closure of a non-profit, unionized home support agency in Hamilton in 2002 offers an illuminating case study of the local impacts of Ontarios contractual approach to home care. A survey of the 317 support workers who were laid off revealed that only 38 percent stayed in the home-care sector; most were absorbed by for-profit, non-unionized agencies where their employment conditions deteriorated. These findings are at odds with the long-established connection between quality of home-care employment and quality of home-care service. They have implications for developing criteria for dispersing public funds in mixed economies of community care, and for conceptualizing the capacity-building responsibilities of governments in their coordination.

Occupational Health Issues Among Employees of Home Care Agencies

The purpose of this paper is to explore occupational health issues among employees of home care agencies. Results of a survey of 892 office and visiting employees of three not-for-profit home care agencies and focus group discussions show that employees of home care agencies experience high levels of stress, tiredness and exhaustion. This work-related stress is most acutely felt by those in managerial occupations, nurses and therapists. When compared to findings from the Canadian National Population Health Survey, employees of home care agencies are found to be significantly more likely than all working women to suffer from allergies, asthma, arthritis or rheumatism, back problems, high blood pressure, migraine headaches, and work-related injuries in the past year. Many employees of home care agencies suffer pain or discomfort in several body locations. Visiting employees of home care agencies suffer from sprains or strains, dislocations, fractures, and bruises as a result of lifting or moving clients, bending or straining, accidental falls, repetitive motion injuries, and motor vehicle accidents. Home care office staff suffer from repetitive strain injuries and respiratory illness. Implications for policy and research are discussed.

Market-Modelled Home Care: Impact on Job Satisfaction and Propensity to Leave

Responding to increasing health-care costs, deficit financing and the aging of the population, many OECD nations are exploring new cost-efficient health-care models. One such model, designed to manage the homebased health-care system through the application of quasi-market principles has been adopted by the province of Ontario. Findings from a case study of 835 Ontario home-care workers indicate that a market-modelled approach to health-care restructuring may be leading to decreased levels of job satisfaction and a greater propensity to leave among workers in the home-care sector.

Achieving Flexibility through Insecurity: A Comparison of Work Environments in Fixed-term and Permanent Jobs in Finland and Canada

In this comparative study of Finland and Canada, we use representative data to examine work environments in fixed-term and permanent jobs. Results are similar for all workers regardless of whether they are employed on fixed-term or permanent contracts. All workers feel their working hours are inflexible, but feel they have control over the tasks they perform and they have low risk of accident. The only difference is in the feelings of job insecurity: fixed-term workers, in both Finland and Canada, feel more insecure than those in permanent jobs. Our findings indicate that the global trends in flexibility and insecurity permeate all workers.

The nuanced nature of work quality: Evidence from rural Newfoundland and Ireland

This article explores the relationship between job and work quality and argues that while it is important to examine job quality, to understand workers’ experiences fully, the focus should be on the broader concept of work quality, which places the job against its wider socio-economic context. Based on the experiences of 88 rural workers gathered via interviews in Newfoundland and Ireland, it appears that the same or similar jobs can be regarded very differently depending upon the context in which they are embedded, as people at different locations and/or stages of life have an individual set of aspirations, expectations and life experiences. The study found that the factors that affect work quality are moulded by broader aspects of life – family, friends, community, lifestyle and past experiences – that shape an individual.

Working in the margins : Women's experiences of stress and occupational health problems in part-time and casual retail jobs

ABSTRACT Women workers dominate the labor market of part-time and casual jobs in Canada and other industrialized countries, particularly in the retail trade and consumer services sector. However, research into the occupational health consequences of part-time and casual jobs for this large group of women workers is still in its early stages. Emerging evidence suggests that part-time and casual jobs contribute to stress and result in health problems for women. To learn about the impact of part-time and casual jobs on womens experiences of stress and their resulting physical and emotional health, we conducted interviews and focus groups with occupational health and safety union representatives and female workers in retail and consumer services. Results show that stress is a major occupational health problem for these women, due to the working conditions in part-time and casual jobs, the psychosocial work environment, and the gendered work environment in the retail trade and consumer services. Stress from part-time and casual jobs results in repetitive strain injuries, migraine headaches, and feelings of low self-esteem, low motivation, and job dissatisfaction for women. The disconcerting implication of our research is that part-time and casual employment comes at a cost for some women.

Task shifting in the provision of home and social care in Ontario, Canada: implications for quality of care

Growing healthcare costs have caused home-care providers to look for more efficient use of healthcare resources. Task shifting is suggested as a strategy to reduce the costs of delivering home-care services. Task shifting refers to the delegation or transfer of tasks from regulated healthcare professionals to home-care workers (HCWs). The purpose of this paper is to explore the impacts of task shifting on the quality of care provided to older adults from the perspectives of home healthcare workers. This qualitative study was completed in collaboration with a large home and community care organisation in Ontario, Canada, in 2010-2011. Using a purposive sampling strategy, semi-structured telephone interviews were conducted with 46 home healthcare workers including HCWs, home-care worker supervisors, nurses and therapists. Study participants reported that the most common skills transferred or delegated to HCWs were transfers, simple wound care, exercises, catheterisation, colostomies, compression stockings, G-tube feeding and continence care. A thematic analysis of the data revealed mixed opinions on the impacts of task shifting on the quality of care. HCWs and their supervisors, more often than nurses and therapists, felt that task shifting improved the quality of care through the provision of more consistent care; the development of trust-based relationships with clients; and because task shifting reduced the number of care providers entering the clients home. Nurses followed by therapists, as well as some supervisors and HCWs, expressed concerns that task shifting might compromise the quality of care because HCWs lacked the knowledge, training and education necessary for more complex tasks, and that scheduling problems might leave clients with inconsistent care once tasks are delegated or transferred. Policy implications for regulating bodies, employers, unions and educators are discussed.