BackgroundThe impact of working conditions on the health and well-being of workers of large enterprises has been widely described. This influence has not been studied as extensively in very small and medium-sized enterprises mainly due to methodological difficulties. Smaller organisations nevertheless constitute a reality that needs to be better understood.MethodologyThe aim of this article is to better understand the working conditions of entrepreneurs in small and medium-sized enterprises, to describe the impact of these conditions on their health and well-being, and to learn how their work affects their private lives.This is why a study was conducted in 2015–2016 on a selected sample of entrepreneurs in the Brussels-Capital Region (n = 140). The survey form included questions pertaining to the work environment, motivations underlying the choice of activities, robustness of the business, work-home interference, work-related stress, work satisfaction, self-reported health indicators, and socio-demographic status. The results were compared with those from another survey on workers in small shops conducted between 2012 and 2015 within the same Region (n = 104).ResultsThe number of entrepreneurs who participated in the survey added up to 140, with an even distribution between men and women. Two results are highlighted. The first concerns the difficulties faced by entrepreneurs working with a small team (1 to 4 employees): they are more stressed, report having heavy workloads, describe their health more negatively, consume more sedatives, and claim to suffer from loneliness more often than those working with larger teams or alone. Comparatively, in the study on shopkeepers, business owners working alone found themselves in a worse situation regarding their health and well-being.The second finding involves the difficulties entrepreneurs face when it comes to combining work and family life, and for which gender inequalities were noted. This phenomenon remains insufficiently explored amongst small business owners.ConclusionIn spite of the difficulties encountered at work, commitment to their chosen profession remains strong amongst entrepreneurs. Our results enable us underscore the aspects of entrepreneurial activity that should be taken into account whilst setting up support mechanisms or promoting entrepreneurship, especially amongst and for women.

No abstract

Background National and international strategies have increasingly promoted chronic patient participation at different levels of the health care system, building the image of an ‘active’ chronic patient engaged for example in his/her daily self-care and within associations dealing with service delivery and/or policy advocacy. Drawing upon examples of the fight against diabetes and HIV/AIDS in Mali, this article explores the factors that influence the engagement of patient associations at policy level. We focus on the openness of the institutionalised political system, and explore the role that public authorities, caregivers and donors give to diabetes and HIV/AIDS patients. Methods Data was collected between 2008 and 2014 in Bamako in the framework of a qualitative research. Thirty-eight actors fighting against diabetes were interviewed, as well as 17 representatives of donors. For HIV/AIDS, 27 actors were interviewed. In both cases, non-participant observation was carried out and documentary sources were collected. Based on theory of public and collective action, a historical and cognitive approach was adopted. Data analysis followed an inductive and iterative method. Results Partnerships between public authorities and diabetes patient associations have been intermittent over time and remained rather informal. In the case of people living with HIV/AIDS, the partnership between their associations and public authorities has steadily grown and was progressively institutionalised. Three political factors explain this difference: focus and extent of the commitment of public authorities, existing policy-making processes, and how the law frames patients’ roles. Moreover, opportunities for patient participation depend on the nature and extent of the support provided by international donors. Finally, the cognitive dimension is also at stake, notably in relation to the way the two diseases and patients have been perceived by public authorities, caregivers, and donors. Conclusions Chronic patients are intermittent partners for policy-makers. Despite the image of chronic active patients conveyed by national and international public health strategies, patient participation is not straightforward. Rather, political, economic, and cognitive factors underpin the presence of political opportunities that enable patient participation. Chronicity of the disease appears to play an ambiguous role in the shaping of these factors. Electronic supplementary material The online version of this article (10.1186/s12889-019-7453-2) contains supplementary material, which is available to authorized users.

No abstract

Innovative programs that emerge in response to the rapidly changing care needs of older adults provide an opportunity to study the transformations in working and employment conditions within the homecare sector. This study seeks to understand how innovations introduced in the homecare sector have affected the well-being of homecare workers providing non-medical domestic support to older adults who wish to age in place. Our study is based on a participatory approach involving homecare workers exposed to two innovations in Wallonia (Belgium) that relate to flexible working hours, worker training, and technological equipment. We conducted a literature review, six semi-structured individual interviews with managers, and eight workshops based on the 'Group Analysis Method' involving 9 to 12 homecare workers. The results revealed that the innovations deteriorated working conditions, intensified occupational psychosocial risk factors, and impacted work-life balance. This gave rise to tensions that ultimately had a negative impact on the well-being of workers and on the quality of their care relationship with older adults/caregivers, while also weakening the viability of the services. The workers proposed some avenues to improve and regulate these tensions.