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Using qualitative data and quantitative measures of psychological distress, this research examines attitudes towards psychotropic drug use among 14 home care recipients and their caregivers. It relates these attitudes to the type of family support provided and the women's level of mental health (both self-reported and attributed to the aged drug user by the caregiver). Four categorical themes--"it's a habit", "it's useful and under control", "it keeps her under control", and "what drug use?"--describe the types of attitudes of caregivers towards psychotropic drug use by the elderly women they care for. These themes are associated with the level of congruence between self-reported and caregiver-ascribed scores of mental health. The results, although exploratory, indicate that a large divergence between self-reported and caregiver-ascribed scores of psychological distress was associated with caregivers' attitudes of indifference or resignation towards drug use. The drug is perceived as necessary not only by the user but also by the overworked caregiver, who sees it as a way of lightening her burden. From a clinical perspective, our findings indicate that the influence of caregivers needs to be taken into account in any effort to reduce or stop chronic psychotropic drug use by elderly users.

Looking at the case of occasional part-time nurses, this study highlights the difficulties in balancing work and family that are inherent in nonstandard jobs. Eight focus groups were held, involving 48 nurses in 4 regions of Quebec. Analysis of the data collected reveals that nurses "on call" are particularly affected by overwork and experience great difficulty in balancing their work and family obligations. The participants proposed a variety of solutions, such as establishing day care centres adapted to the needs of nurses on call and instituting a timetable grid for occasional part-time nurses so that they can plan their work hours.

This article presents the results of an exploratory study funded by the Social Sciences and Humanities Research Council of Canada. The objectives of this research were to explore (a) the perception by elderly women caregivers of the shift to ambulatory care; (b) their use of coping behaviours in the face of this major change within the health care system; and (c) their perceptions of health care services. In a theoretical framework of stress and coping, and using standardized questionnaires and open-ended questions, 40 home interviews were initially conducted with elderly women, each of whom was caring for her spouse after his discharge from hospital. Additional data were collected through focus groups. Quantitative and qualitative analyses revealed that elderly women caregivers perceive ambulatory care in a positive manner and as a change involving challenges only when they feel in control of the health care situation and when the care does not necessitate specialized abilities. When the care to be provided is complex and requires continued involvement and specific competence on the caregiver's part, the situation results in insecurity for elderly women. Caregivers use cognitive coping strategies to deal with their problems and are not inclined to use formal services in their social support network. Participants in this study wished to be better informed about the health care system in general ("how the system works") so that they could acquire a sense of predictability. Other expectations of elderly women caregivers concerned the importance of continuity in health services delivery, better preparation for the transition from hospital to home and availability of psychological support for themselves. These results suggest a critical analysis of the present paradigm guiding health care services, in which family caregivers are considered as resources or coworkers instead of coclients.