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Context: Family caregivers are now considered an at-risk population in Canada. As hospital stays have been gradually reduced, family caregivers of the elderly are burdened with complex responsibilities. This change in care delivery was implemented with little consideration for services offered to this specific population., Intervention and Discussion: The purpose of this study was to explore the perceptions of four groups of stakeholders towards services as determinants of health: family caregivers, professionals, community organizations and health care administrators. Focus groups (FG) were conducted (n=11 with 49 participants), followed by semi-structured interviews with key informants (n=29), in urban and rural areas. Results of content analysis were categorized according to the Donabedian model. Congruent perceptions between groups pinpointed the following: A limited accessibility of services, a lack of flexibility and coordination of services, a disregard for health promotion of caregivers and a lack of preventive services. Transportation problems and geographical distance to access services were specific to rural area., Conclusion: Results provide evidence-based data for public health. They suggest insights for the development of preventive interventions and services for this increasing at-risk population of family caregivers in Canada.

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.