Caring for severely ill cancer patients. A comparison of working conditions in hospital-based home care and in hospital.

The goal of the study was to compare working conditions in a hospital with the conditions in a specialized hospital-based home care (HBHC) unit, which aims to replace hospital care for patients in need of institutional car. Staff (doctors included) in a HBHC unit (n = 35) and on three hospital wards (n = 113) participated in the study. All staff members worked regularly with severely ill cancer patients. Question about stress, job satisfaction and working conditions were asked in a self-administered questionnaire. Both groups showed a limited degree of continuous stress and a high degree of job satisfaction. Thus, the overall perception was than the working conditions were good. When significant differences were found, the responses of the HBHC staff were more positive. This included items such as more freedom to make their own decisions (P < 0.001), better co-operation between day and night shifts (P < 0.001), a more reasonable work load (P = 0.0001), fewer problems in communication with patients (P < 0.001), and fewer problems with tension (P < 0.05) and with sleeping (P < 0.05). The findings may be due to several factors: the HBHC staff were older, more often married, had more children, had worked longer in health care and were thus more experienced. Complementary explanations may be continuous education within the HBHC and an organization stimulating the staff's own initiative, but also capable of supporting when necessary.(ABSTRACT TRUNCATED AT 250 WORDS)