Pedersen Maja, Bring Camilla, Brünés Nina, Andersen Ove, Petersen Janne, Jarden Mary
Optimed, Clinical Research Center, Copenhagen University Hospital, Hvidovre, Denmark.
Copenhagen University Hospital, Hvidovre, Denmark.
Health Soc Care Community. 2018 Jul;26(4):538-546. doi: 10.1111/hsc.12550. Epub 2018 Feb 28.
The aim of this study was to explore homeless people's health perspectives and experiences of a 2-week medical respite care programme following acute hospitalisation. There is a high level of health inequality when comparing the health status of homeless people to the general population, including increased mortality and morbidity. Homelessness predisposes an increased risk of infectious disease, cancer and chronic illness, such as diabetes and cardiovascular disease. Moreover, homeless people have a higher frequency of acute hospitalisation than general population estimates. In order to facilitate the transition from hospitalisation back to life on the streets, homeless people who were acutely hospitalised in the Capital Region of Denmark were offered 2 weeks of medical respite care from the day of discharge by a non-governmental organisation. This is a qualitative study with a phenomenological hermeneutical approach based on narrative interviews of 12 homeless people who received medical respite care from 1 March 2016 to 30 September 2016. Data were collected through individual semi-structured interviews and analysed according to Lindseth and Norberg's presentation of Paul Ricoeur's theory of interpretation. The analysis identified four themes: (i) basic needs are of highest priority; (ii) a safe environment provides security and comfort; (ii) social support is just as important as healthcare; and (iv) restitution facilitates reflection. The findings indicated that the medical respite care centre provided a place of rest and restitution following hospitalisation, which made room for self-reflection among the homeless people regarding their past and present life, and also their wishes for a better future. This study also indicates that a medical respite care stay can contribute to the creation of a temporary condition in which the basic needs of the homeless people are met, enabling them to be more hopeful and to think more positively about the future.
本研究的目的是探讨无家可归者对急性住院后为期两周的医疗暂托护理计划的健康看法和体验。将无家可归者的健康状况与普通人群相比，存在高度的健康不平等，包括死亡率和发病率上升。无家可归使感染性疾病、癌症和慢性病（如糖尿病和心血管疾病）的风险增加。此外，无家可归者急性住院的频率高于普通人群的估计。为了促进从住院到街头生活的过渡，丹麦首都地区急性住院的无家可归者从出院之日起由一个非政府组织提供为期两周的医疗暂托护理。这是一项定性研究，采用现象学诠释学方法，基于对2016年3月1日至2016年9月30日期间接受医疗暂托护理的12名无家可归者的叙事访谈。数据通过个体半结构化访谈收集，并根据林德塞思和诺伯格对保罗·利科诠释理论的阐述进行分析。分析确定了四个主题：（i）基本需求最为优先；（ii）安全的环境提供安全感和舒适感；（ii）社会支持与医疗保健同样重要；（iv）恢复有助于反思。研究结果表明，医疗暂托护理中心在住院后提供了一个休息和恢复的场所，为无家可归者留出了思考他们过去和现在生活以及对美好未来愿望的自我反思空间。本研究还表明，医疗暂托护理停留期有助于创造一种临时状态，满足无家可归者的基本需求，使他们更有希望，并对未来更积极地思考。
