Rae Bernadette Emma, Rees Sharon
London South Bank University, UK.
J Adv Nurs. 2015 Sep;71(9):2096-107. doi: 10.1111/jan.12675. Epub 2015 Apr 27.
To understand the perspective of the homeless about their healthcare encounters and how their experiences of receiving healthcare influence their health-seeking behaviour.
A phenomenological study was undertaken because of the increasing levels of homelessness in the United Kingdom. Most of the current literature is American or Canadian.
An interpretive phenomenological inquiry.
An opportunistic sample of fourteen single homeless adults was recruited from one male hostel and one non-residential day centre. Data collection was done in 2013. Semi-structured audio-recorded interviews were conducted one-to-one. Colaizzi's method for data analysis was used.
Three major themes were identified. Expressed Health Need, Healthcare Experiences and Attitudes to health care. Health problems are recognized by the homeless but the need for intervention is not always prioritised. Obstacles in access to health care in the UK are both perceived (attitudes towards the homeless; previous bad experience) and actual (difficulty in registering with a general practitioner, difficulty travelling to services, being forced to move to new area). Some homeless people feel that they are treated with prejudice and receive substandard care. Positive healthcare experiences were also reported.
Positive and negative healthcare encounters can profoundly affect the homeless.
Address apparent inconsistency of care; promote greater interdisciplinary communication and referrals to homeless services from prisons and hospitals; increase the availability of intermediate services; reduce obligation of homeless to move area; research experiences of homeless families.
了解无家可归者对其医疗保健遭遇的看法，以及他们接受医疗保健的经历如何影响其寻求医疗行为。
由于英国无家可归者数量不断增加，开展了一项现象学研究。目前的大多数文献来自美国或加拿大。
一项诠释现象学探究。
从一家男性旅社和一个非住宿日间中心招募了14名单身无家可归成年人的机会样本。数据收集于2013年进行。一对一进行半结构化录音访谈。采用科莱齐的数据分析方法。
确定了三个主要主题。表达的健康需求、医疗保健经历和对医疗保健的态度。无家可归者认识到健康问题，但干预需求并非总是被优先考虑。英国在获得医疗保健方面的障碍既有感知到的（对无家可归者的态度；以前的糟糕经历），也有实际存在的（难以在全科医生处注册、前往医疗机构困难、被迫搬到新地区）。一些无家可归者觉得他们受到了歧视，得到的是不合格的护理。也有积极的医疗保健经历的报告。
积极和消极的医疗保健遭遇会对无家可归者产生深远影响。
解决明显的护理不一致问题；促进更多的跨学科交流以及从监狱和医院转介到无家可归者服务机构；增加中间服务的可及性；减少无家可归者搬迁地区的义务；研究无家可归家庭的经历。
