Denton Margaret, Zeytinoglu Isik Urla, Davies Sharon, Lian Jason
McMaster Centre for Gerontological Studies, McMaster University, Hamilton, Ontario, Canada.
Int J Health Serv. 2002;32(2):327-57. doi: 10.2190/VYN8-6NKY-RKUM-L0XW.
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.
医疗保健结构调整导致家庭护理工作社会组织的变化，影响了家庭护理工作者的工作压力和工作满意度。本文报告了对加拿大安大略省一个中等城市的三家非营利性家庭护理机构的892名员工进行调查的结果。调查结果得到了来自16个焦点小组、99名员工的数据补充。在本研究中，家庭护理工作者包括办公室工作人员（经理、主管、协调员、办公室支持人员和个案经理）和上门服务人员（护士、治疗师和上门家政服务人员）。焦点小组参与者表示，医疗保健结构调整导致了组织变革、预算削减、工作量增加、工作不安全、组织支持丧失、同伴支持丧失以及提供情感劳动（即家庭护理工作的“关怀”方面）的时间减少。对调查数据的分析表明，组织变革、对失业的恐惧、繁重的工作量以及缺乏组织和同伴支持会导致工作压力增加和工作满意度下降。
