Changes in the Work and Motivation of Staff Delivering Home Care Services in Finland


  • Ritva Laamanen Ph.D.,

  • Ulla Broms M.Sc.,

  • Anja Häppölä M.Sc.,

  • Mats Brommels M.D., Ph.D.,

  • Ritva Laamanen is a Lecturer in Health Services Research, Ulla Broms is a Research Associate, Anja Häppölä is a Research Associate, and Mats Brommels is a Professor of Health Services Management in the Department of Public Health, University of Helsinki, Finland.

Address correspondence to Ritva Laamanen, Department of Public Health, PO Box 41, 00014 University of Helsinki, Finland.


This article describes how the policy to emphasize noninstitutional care is reflected in home care service strategies and work characteristics as well as the work motivation of home care staff in Finland. The data were gathered through a questionnaire answered by 312 employees in home care services and 22 social welfare and primary health care administrators. The methods of analysis used were cross-tabulations, one-way analysis of variance, and regression analysis. According to the results, institutional care had been reduced too fast and home care services had not been developed sufficiently. Most of the staff reported that their work had changed considerably. Although their work had become more interesting and more independent, over one third of the employees felt that the pressure of work had become unbearable and their responsibility was too heavy. The views of the home care staff differed from those of the administrators regarding the change strategies that had been carried out. The majority of the staff were moderately or highly motivated. Thirty-four percent of the variance of work motivation was explained mainly by work characteristics. More attention should be paid to the development of home care services before institutional care is reduced. Training the staff and informing them about the planned reform should not be neglected.