Ann Webb Wendy, Mitchell Theresa, Nyatanga Brian, Snelling Paul
Institute of Health and Society, St John's Campus, University of Worcester, Worcester, England.
Nurs Stand. 2018 Feb 28;32(27):53-63. doi: 10.7748/ns.2018.e11070.
Homelessness is a complex and multidimensional issue often involving a combination of personal vulnerability, the limitations of social housing, and inadequacies in welfare support. Providing palliative and end-of-life care to people experiencing homelessness is challenging, both to individuals receiving care and nurses aiming to meet their complex needs. This article discusses what is understood by the concept of 'homelessness' and examines the barriers to accessing effective healthcare for people who are homeless and have life-limiting conditions. The authors review the research into end of life care for people experiencing homelessness and identify areas for further investigation, notably the lack of evidence regarding the end of life care priorities of these individuals. There is a focus on the availability of healthcare services for people who are homeless at the end of life, as well as the factors that should be considered if evidence-based healthcare services for this group of people are to be improved in the future.
无家可归是一个复杂且多层面的问题,通常涉及个人脆弱性、社会住房的局限性以及福利支持的不足等多种因素。为无家可归者提供姑息治疗和临终关怀,对接受护理的个人以及旨在满足其复杂需求的护士来说都具有挑战性。本文讨论了“无家可归”概念的内涵,并审视了无家可归且患有危及生命疾病的人群在获得有效医疗保健方面的障碍。作者回顾了针对无家可归者临终关怀的研究,并确定了需要进一步调查的领域,特别是缺乏关于这些人临终关怀优先事项的证据。重点关注了为临终无家可归者提供医疗保健服务的情况,以及未来若要改善针对这一群体的循证医疗服务应考虑的因素。