University of Manitoba, Winnipeg, Manitoba, Canada.
The American University of Paris, Paris, France.
Qual Health Res. 2020 Jul;30(8):1183-1195. doi: 10.1177/1049732319862532. Epub 2019 Jul 25.
Discourse in popular media, public policy, and academic literature contends that people who are homeless frequently make inappropriate use of hospital emergency department (ED) services. Although researchers have investigated the ED experiences of people who are homeless, no previous studies have examined how this population understands the role of the ED in their health care and in their day-to-day lives. In the present study, 16 individuals participated in semistructured interviews regarding their ED experiences, and narrative analysis was applied to their responses. Within the context of narratives of disempowerment and discrimination, participants viewed the ED in differing ways, but they generally interpreted it as a public, accessible space where they could exert agency. ED narratives were also paradoxical, depicting it as a fixed place for transient care, or a place where they were isolated yet felt a sense of belonging. Implications for policy and practice are discussed.
大众媒体、公共政策和学术文献中的讨论认为，无家可归者经常不当使用医院急诊部（ED）的服务。尽管研究人员已经调查了无家可归者的 ED 经历，但以前没有研究过这一人群如何理解 ED 在他们的医疗保健和日常生活中的作用。在本研究中，16 名参与者参加了关于他们 ED 经历的半结构化访谈，对他们的回答进行了叙事分析。在权力丧失和歧视的叙述背景下，参与者以不同的方式看待 ED，但他们普遍将其解释为一个公共、可及的空间，在那里他们可以发挥作用。ED 的叙述也存在矛盾，将其描述为一个用于短暂护理的固定场所，或者是一个他们感到孤立但又有归属感的地方。讨论了对政策和实践的影响。
