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.

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Les divers projets de réforme du système de santé au Canada depuis les années 1990 ont profondément modifié les milieux de travail et les attitudes des travailleurs dans le domaine de la santé. Dans cet article, nous examinons les liens entre, d'une part, la détérioration de l'environnement de travail externe, la lourdeur des charges de travail et la satisfaction du personnel infirmier à l'égard du travail, et, d'autre part, les intentions des travailleurs face à un changement possible d'emploi. Les données étudiées proviennent d'une enquête réalisée en 2002 et à laquelle ont répondu 1 396 infirmières et infirmiers de trois hôpitaux d'enseignement du sud de l'Ontario. Nous avons d'abord analysé les données globalement ; ensuite, nous avons étudié de façon séparée celles qui concernent le personnel à plein temps, à temps partiel et occasionnel.

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.