Hansford Lorraine, Thomas Felicity, Wyatt Katrina
Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, UK.
Wellcome Centre for Cultures and Environments of Health, University of Exeter, Queen's Drive, Exeter, EX4 4QH, UK.
Palliat Care Soc Pract. 2022 Jul 7;16:26323524221110248. doi: 10.1177/26323524221110248. eCollection 2022.
Access to affordable, appropriate housing is one of the key social determinants of health, affecting well-being across the lifecourse. However, beyond a recognition that housing quality is linked to place of death, little is known about the ways in which housing status impacts social, emotional, and practical aspects of dying and bereavement.
The Checking Out project is a qualitative study aiming to explore the ways in which socio-economic status impacts people's experiences of, and attitudes towards, death, dying, and bereavement in the United Kingdom. Qualitative interviews were carried out with 14 bereaved individuals with experience of poverty at end of life or in bereavement, and 15 professionals supporting individuals in low-income communities. Interviews were conducted via phone/video call, and data include experiences of end of life and bereavement both before and during the pandemic. Transcripts were examined using thematic analysis.
Housing emerged as an important factor affecting people's experiences, with 7 of the 14 bereaved individuals and all except 1 of the professionals discussing housing-related issues. Participants described ways in which unsuitable housing and housing insecurity impacted practical aspects of dying but also emotional and social well-being at end of life. Housing-related issues affected both patients and their families, though families found it difficult to air these concerns when their relative was dying.
The paper demonstrates how trusted professionals are able to advocate or address the issues faced by bereaved individuals and suggests implications for policy and practice. A greater awareness of the potential impact of housing status across public services, including healthcare practitioners, welfare support, and housing providers, could better support patients and practitioners to address these issues proactively. Housing providers and policy-makers should be included as key partners in collaborative public health approaches to palliative care.
获得负担得起的合适住房是健康的关键社会决定因素之一，影响着整个生命历程中的幸福感。然而，除了认识到住房质量与死亡地点有关外，对于住房状况如何影响死亡和丧亲之痛的社会、情感和实际方面，人们知之甚少。
“结账”项目是一项定性研究，旨在探讨社会经济地位如何影响英国人们对死亡、临终和丧亲之痛的体验及态度。对14名在生命末期或丧亲期间有贫困经历的丧亲者以及15名在低收入社区为个人提供支持的专业人员进行了定性访谈。访谈通过电话/视频通话进行，数据包括大流行之前和期间的临终和丧亲经历。使用主题分析法对访谈记录进行了检查。
住房成为影响人们体验的一个重要因素，14名丧亲者中有7名以及除1名之外的所有专业人员都讨论了与住房相关的问题。参与者描述了不合适的住房和住房不安全如何影响临终的实际方面，以及生命末期的情感和社会幸福感。与住房相关的问题影响了患者及其家人，尽管家人发现当他们的亲人临终时很难表达这些担忧。
本文展示了值得信赖的专业人员如何能够倡导或解决丧亲者面临的问题，并提出了对政策和实践的启示。提高包括医疗从业者、福利支持人员和住房提供者在内的公共服务部门对住房状况潜在影响的认识，可以更好地支持患者和从业者积极解决这些问题。住房提供者和政策制定者应作为姑息治疗协作公共卫生方法的关键合作伙伴被纳入其中。
