Health care restructuring, work environment, and health of nurses.

BACKGROUND: In the last 15 years, the health care system has undergone significant restructuring. The study's objective was to examine the psychosocial work environment and the health of nurses after major restructuring in comparison with two reference populations. METHODS: This cross-sectional study involved 2,006 nurses from 16 health centers. A questionnaire measured current work characteristics: psychological demands, decision latitude, and social support at work from Karasek's Job Content Questionnaire, organizational changes, and health effects. Prevalence ratios and binomial regression were used to examine the associations between current work characteristics, changes and psychological distress (PSI). RESULTS: There was a considerable increase in the prevalence of PSI and of adverse psychosocial work factors in comparison to the prevalence reported by a comparable group of nurses in 1994. These adverse factors were also more prevalent among nurses than among Québec working women and they were independently associated with psychological distress. CONCLUSION: Workplace interventions should be based on elements identified by many nurses as being problematic.

Production and reproduction: the issues involved in reconciling work and pregnancy.

Quebec legislation in occupational health contains a measure that gives pregnant workers the right to demand healthy and safe work conditions so that they can continue working while they are pregnant. About one-third of pregnant workers exercise this right every year. Nonetheless, even though the legislation's goal is to favor continued employment, more than 75 percent of the female workers who are eligible for protective reassignment are, in fact, not reassigned to other work stations or tasks, and instead must stop working. The results presented here stem from research intended to improve our understanding of the difficulties that arise in the workplace when the organization of work has to be reconciled with pregnancy. In telling us their experiences, the 51 pregnant workers we interviewed gave us their definition of "reconciliation." They did this by identifying the elements and areas of their occupational and family responsibilities that hindered or favored this reconciliation. They thus brought to light the predominant role that social relationships play in these situations. The comments of the women we met shed light on work conditions and organizations whose characteristics, once identified, suggest some of the changes needed to make this reconciliation possible.