探索在 COVID-19 大流行期间改变对初级卫生保健服务支持的体验以及对无家可归者护理质量和安全的影响：一项定性混合方法研究方案。
Exploring the experiences of changes to support access to primary health care services and the impact on the quality and safety of care for homeless people during the COVID-19 pandemic: a study protocol for a qualitative mixed methods approach.
机构信息
NIHR Greater Manchester Patient Safety Translational Research Centre, 6th Floor Williamson Building, Oxford Road, Manchester, M13 9PL, Centre for Primary Care, The University of Manchester, Manchester, UK.
Groundswell, London, UK.
出版信息
Int J Equity Health. 2021 Jan 10;20(1):29. doi: 10.1186/s12939-020-01364-4.
BACKGROUND
Despite high level of health care need amongst people experiencing homelessness, poor access is a major concern. This is sometimes due to organisational and bureaucratic barriers, but also because they often feel stigmatised and treated badly when they do seek health care. The COVID-19 pandemic and the required social distancing measures have caused unprecedented disruption and change for the organisation of primary care, particularly for people experiencing homelessness. Against this backdrop there are many questions to address regarding whether the recent changes required to deliver services to people experiencing homelessness in the context of COVID-19 will help to address or compound problems in accessing care and inequalities in health outcomes.
METHODS
An action led and participatory research methodology will be employed to address the study objectives. Interviews with people experiencing homelessness were will be conducted by a researcher with lived experience of homelessness. Researchers with lived experience are able to engage with vulnerable communities in an empathetic, non-judgemental way as their shared experience promotes a sense of trust and integrity, which in turn encourages participation in research and may help people speak more openly about their experience. The experiences of health professionals and stakeholders delivering and facilitating care for people experiencing homelessness during the pandemic will also be explored.
DISCUSSION
It is important to explore whether recent changes to the delivery of primary care in response to the COVID-19 pandemic compromise the safety of people experiencing homelessness and exacerbate health inequalities. This could have implications for how primary healthcare is delivered to those experiencing homelessness not only for the duration of the pandemic but in the future.
背景
尽管无家可归者的医疗需求水平很高，但他们往往难以获得医疗服务，这是一个主要问题。这有时是由于组织和官僚障碍造成的，但也因为他们在寻求医疗保健时常常感到受到歧视和虐待。COVID-19 大流行和必要的社交距离措施对初级保健的组织造成了前所未有的破坏和变化，特别是对无家可归者而言。在这种背景下，人们有许多问题需要解决，即在 COVID-19 背景下为无家可归者提供服务所必需的最近的变化是否有助于解决或加剧获得护理方面的问题，以及健康结果方面的不平等问题。
方法
将采用行动主导和参与式研究方法来实现研究目标。将由一位具有无家可归经历的研究人员对无家可归者进行访谈。具有无家可归经历的研究人员能够以富有同情心和非评判性的方式与弱势社区接触，因为他们的共同经历促进了信任和诚信感，从而鼓励他们参与研究，并且可能帮助人们更公开地谈论自己的经历。还将探讨在大流行期间为无家可归者提供和促进护理的卫生专业人员和利益相关者的经验。
讨论
重要的是要探讨 COVID-19 大流行期间为响应 COVID-19 大流行而对初级保健的提供所做的最近的改变是否会危及无家可归者的安全并加剧健康不平等。这可能对不仅在大流行期间而且在未来为无家可归者提供初级保健产生影响。
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