Yale Program in Addiction, Yale School of Medicine, New Haven, CT, USA.
VA Connecticut Healthcare System, West Haven, CT, USA.
Qual Health Res. 2022 Dec;32(14):2118-2125. doi: 10.1177/10497323221135795. Epub 2022 Nov 10.
The experiences of care of people with lived experience of homelessness are rarely embraced to change care delivery. We conducted qualitative group and one-on-one interviews utilizing experience group methodology with 27 people with lived experience of homelessness currently housed in one permanent housing community in central Texas. We analyzed data using an inductive thematic approach to identify shared obstacles and barriers to receiving health care. We then analyzed findings with the capability, comfort, and calm value framework to identify health outcomes that matter most to study participants. Poor access to care, discontinuities in care, distrust in providers, and confusing terminology were identified as the biggest barriers to health. The overwhelming majority of experiences reflected poor health outcomes of , the outcome of a health care experience that adds ease to one's life rather than logistical and administrative chaos. We propose three practical approaches to achieve calm for this population as follows: systems-level embracement of compassionate care, integration of relationship-based care navigation into all levels of care, and building efficient transportation into care design. We conclude that designing health care that works in the lives of people with lived experience of homelessness is critical to address the gaps in care that fuel the health disparity these individuals face compared to people without this lived experience.
很少有人从有过无家可归经历的人的护理体验中吸取经验来改变护理服务。我们在德克萨斯州中部的一个永久性住房社区中,对 27 名目前有住房的有过无家可归经历的人进行了定性小组和一对一访谈,利用体验小组方法进行了研究。我们使用归纳主题分析方法对数据进行了分析,以确定接受医疗保健服务方面的共同障碍和障碍。然后,我们使用能力、舒适和冷静价值框架来分析调查参与者最关心的健康结果。调查结果表明,获得医疗服务的机会有限、护理服务不连续、对提供者的不信任以及术语混乱是健康的最大障碍。绝大多数人的经历都反映出他们的健康状况不佳,这是医疗服务体验的结果,这种体验给他们的生活带来了便利,而不是后勤和行政上的混乱。我们提出了实现这一人群平静的三种实用方法,如下所示:在系统层面上接受富有同情心的护理、将基于关系的护理导航整合到各个护理层面、以及将高效的交通融入护理设计中。我们的结论是,设计适合有过无家可归经历的人的医疗保健服务对于解决这些人与没有这种经历的人相比面临的护理差距至关重要。