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在外出环境中为无家可归者提供全科医生护理的好处:一项定性研究。

Benefits of GP care in outreach settings for people experiencing homelessness: a qualitative study.

机构信息

Edinburgh Access Practice, Edinburgh.

School of Health in Social Science, University of Edinburgh, Edinburgh.

出版信息

Br J Gen Pract. 2021 Jul 29;71(709):e596-e603. doi: 10.3399/BJGP.2020.0749. Print 2021 Aug.

Abstract

BACKGROUND

Although people experiencing homelessness (PEH) have the worst health outcomes in society, they have a low uptake of primary care services. GP outreach has developed as a way of increasing their access into primary care but little is known about the experience of patients receiving care in this way.

AIM

To explore PEHs' experiences of GP care in community outreach settings in UK; and to seek staff/volunteers' views on the strengths and weaknesses of GP community outreach services.

DESIGN AND SETTING

A multi-method qualitative study with PEH and staff/volunteers working in three different community outreach settings in the UK.

METHOD

Individual semi-structured interviews were carried out with 22 PEH and two focus groups with key staff/volunteers. Data were analysed thematically using framework analysis.

RESULTS

GP outreach services better enabled PEH to access medical care and staff/volunteers valued GP support to promote, and facilitate access to, healthcare services. In particular, the findings illuminate the high value that PEH placed on the organisational environment of the GP outreach service. Valued aspects of GP outreach were identified as comfortable, safe, and engendering a sense of belonging; convenient, opportunistic, and a one-stop shop; and being heard, having more time, and breaking down barriers.

CONCLUSION

The organisational environment is important in enabling PEH to engage with GP services. The physical and organisational environment of the outreach settings were the most important factors; they created a space where professional barriers between the GP and patients were flattened, so facilitating a therapeutic relationship.

摘要

背景

尽管无家可归者(PEH)的健康状况最差,但他们对初级保健服务的利用率却很低。全科医生外展服务的发展是增加他们进入初级保健的途径之一,但人们对以这种方式接受护理的患者的体验知之甚少。

目的

探索英国社区外展环境中无家可归者接受全科医生护理的体验;并寻求工作人员/志愿者对全科医生社区外展服务的优势和劣势的看法。

设计和设置

一项在英国三个不同社区外展点工作的无家可归者和工作人员/志愿者的多方法定性研究。

方法

对 22 名无家可归者进行了个体半结构化访谈,并对关键工作人员/志愿者进行了两次焦点小组讨论。使用框架分析对数据进行主题分析。

结果

全科医生外展服务使无家可归者更好地获得医疗护理,工作人员/志愿者重视全科医生的支持,以促进和便利获得医疗保健服务。特别是,研究结果阐明了无家可归者对全科医生外展服务组织环境的高度重视。确定了全科医生外展的有价值的方面,包括舒适、安全和归属感;便利、机会主义和一站式服务;被倾听、有更多时间和打破障碍。

结论

组织环境对于使无家可归者能够接受全科医生服务很重要。外展点的物理和组织环境是最重要的因素;它们创造了一个空间,使全科医生和患者之间的专业障碍得以消除,从而促进了治疗关系。

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