Documents Denton, Margaret 4 results

"This article examines associations between home care workers' health, and non-standard hours and insecurity. Health refers to symptoms of stress and musculoskeletal disorders (MSDs), non-standard hours refer to part-time and casual hours, and insecurity refers to job and employability insecurity. Data come from our 2002 survey of 532 home care workers (nurses, therapists and personal support workers) in a medium-sized city in Ontario, Canada. Path analysis regression results for the conceptual model show that (1) part-time and casual hours and job insecurity are positively and significantly associated with symptoms of stress, (2) the associations between part-time and casual hours and MSDs are mediated by symptoms of stress, and (3) job and employability insecurity are directly associated with MSDs. Results provide evidence that non-standard hours and insecurity must be addressed in order to improve home care workers' health. We show the detrimental effects of non-standard hours and insecurity on workers' health, and the results have implications for employers, human resource managers, trade unionists and government policy-makers."

"This paper explores aspects of the social production of health by focussing on the ways in which levels of health are shaped by structures of social inequality and behaviors or ‘lifestyles'. We address two questions: What is the relative importance of the social, structural and behavioral determinants of health? And, are there gender differences in the determinants of health? These questions are explored using multiple regression analyses of data from the 1994 Canadian National Population Health Survey. Two measures of health are used: subjective health status and the Health Utilities Index (a measure of functional health status). By structural determinants we refer to age, family structure, main activity, education, occupation, income and social support. Behavioral determinants include lifestyle factors related to smoking, drinking, weight and physical activity. Findings indicate that the structures of social inequality are the most important determinants of health acting both independently and through their influence on the behavioral determinants of health. There are very real differences in the factors that predict women's and men's health. For women, social structural factors appear to play a more important role in determining health. Being in the highest income category, working full-time and caring for a family and having social support are more important predictors of good health for women than men. Smoking and alcohol consumption are more important determinants of health status for men than women, while body weight and being physically inactive are more important for women than men. Our findings suggest the value of models which include a wide range of structural and behavioral variables and affirm the importance of looking more closely at gender differences in the determinants of health."

"Health sector reform of the 1990s affected most health care workers in Ontario and in other provinces. As a result of organizational changes, many workers experienced work intensification. This paper examines the associations between work intensification, stress and job satisfaction focusing on nurses in three teaching hospitals in Ontario. Data come from our 2002 survey of 949 nurses who worked in their employing hospital since the early 1990s when the health sector reform era began. Results show that nurses feel their work has intensified since the health sector reform of the 1990s, and work intensification contributed to increased stress and decreased job satisfaction. Results provide empirical support to the literature which suggests that work intensification has an adverse effect on workers' health and well-being, and work attitudes."

"EN :
Demand for home and community care services has continuously increased in Canada and elsewhere in the last few decades due to aging of the population and healthcare policy changes shaped by budgetary limitations. As a result, home and community care organizations are having trouble hiring adequate numbers of healthcare workers to meet the escalating demand, the result being increased workload on these workers. Another stream of literature has shown that care recipients and their family members, frustrated with the limited ability of healthcare workers to provide adequate care because of increased workload, might resort to violence and harassment. Bringing these two streams of literature together, we examined the relationships among three variables : workload ; workplace violence and harassment ; and well-being of personal support workers (PSWs).

Using structural equation modeling, we analyzed a 2015 Ontario-wide survey of 1,347 PSWs employed in the home and community care sector. The results indicate that workload is negatively associated with extrinsic and intrinsic job satisfaction, and this relationship is mediated by violence and harassment and by stress. Specifically, workload is positively associated with violence and harassment at work, which in turn is positively associated with stress, which in turn is negatively associated with extrinsic and intrinsic job satisfaction.

Our study contributes to the literature by examining the impact of a work environment factor, workload, on the well-being of PSWs. This approach makes it possible to expand the current literature's focus on psychological processes at the individual level to a more contextual approach. Furthermore, the results have important implications for home and community care organizations as well as for the healthcare sector in general. The well-being of PSWs is critical to retaining them and to ensuring the quality of care they provide their clients. Thus, their workload should be lowered to a more manageable level to help minimize the violence and harassment they experience.


FR :
Avec le vieillissement de la population et l'évolution des politiques de santé en raison de contraintes budgétaires, le Canada connait depuis quelques décennies, tout comme d'autre pays, une augmentation continue de la demande de services de soins à domicile et en milieu communautaire. Ainsi, les fournisseurs de ces services ont du mal à embaucher suffisamment de personnel de santé pour répondre à la demande croissante, ce qui augmenterait la charge de travail qui pèse sur ces travailleurs. Un autre courant de littérature montre que certains bénéficiaires de soins, ainsi que les membres de leur famille, frustrés par la capacité limitée du personnel de santé à fournir des soins adéquats en raison de la charge de travail accrue, risquent de recourir à la violence ou au harcèlement. En réunissant ces deux courants de littérature, nous nous sommes penchés sur les relations entre trois variables, soit la charge de travail, la violence et le harcèlement au travail et le bien-être des préposés aux bénéficiaires (PAB).

En utilisant la modélisation par équation structurale, nous avons analysé les données provenant d'une enquête ontarienne menée en 2015 sur 1347 PAB ouvrant dans le secteur des soins à domicile et en milieu communautaire. D'abord, les résultats indiquent que la charge de travail est négativement associée autant à la satisfaction intrinsèque au travail qu'à la satisfaction extrinsèque au travail ; cette relation est influencée par la violence et le harcèlement, ainsi que par le stress. Plus particulièrement, la charge de travail est positivement associée à la violence et au harcèlement sur le lieu de travail, qui sont à leur tour positivement associés au stress, qui est à son tour négativement associé autant à la satisfaction intrinsèque au travail qu'à la satisfaction extrinsèque au travail.

La présente étude contribue à la littérature par une analyse de l'impact d'un facteur du milieu de travail, soit la charge de travail, sur le bien-être des PAB. Cette approche permet d'élargir la portée de la littérature, qui est actuellement centrée sur les processus psychologiques de l'individu, pour tenir davantage compte du contexte. De plus, les résultats ont des implications importantes autant pour les fournisseurs de soins à domicile et en milieu communautaire que pour le secteur de santé en général. Le bien-être des PAB est essentiel pour les retenir et pour garantir la qualité des soins fournis. Ainsi, pour aider à minimiser la violence et le harcèlement qu'ils subissent, la charge de travail devrait être réduite à un niveau plus facile à gérer."