Regional Delegation of Pays de la Loire, Médecins du Monde, Nantes, France.
Public Health Department, CHU of Nantes, Nantes Université, Nantes, France.
PLoS One. 2023 Feb 1;18(2):e0280273. doi: 10.1371/journal.pone.0280273. eCollection 2023.
The number of homeless people has been constantly increasing in Europe over recent years, as well as the proportion of women among the homeless population. Pregnancy can increase the risk of becoming homeless and, on the other hand, homelessness has been widely connected to adverse perinatal outcomes. The objective of this study was to describe the overall perceived impact of homelessness on health during pregnancy and the postpartum period, using a qualitative research approach to prioritize women's perspective. One-time semi structured interviews were conducted with 10 pregnant women and 10 women in the postpartum period experiencing homelessness in the metropolitan area of Nantes, as well as with six people from their social surroundings. A thematic analysis was performed to identify major themes and sub-themes. Homelessness was perceived as having an overall negative impact on all aspects of health (physical health, mental health, and social well-being) during pregnancy and the postpartum period. Stress and anxiety, food insecurity, social isolation, physical suffering, deterioration of chronic diseases, and pregnancy complications, were the main perceived consequences of homelessness on health. On the other hand, social support, and the "welcomeness" of healthcare professionals during pregnancy and the postpartum period were identified as capable of palliating those consequences. Finally, basic needs, such as having access to suitable housing, being independent, and being in good health, were identified by participants in the study as their main priorities. The results of this study, as well as those found by previous research, allowed us to identify possible axes in tackling homelessness and its complex consequences on health during pregnancy and the postpartum period. Housing and income assistance interventions, promoting social support and employment, outreach services enhancing collaborative networks among healthcare service providers, and integrating coordinated multidisciplinary approaches in primary care have shown to provide promising solutions to this issue.
近年来，欧洲无家可归者的数量一直在不断增加，无家可归者中的女性比例也在增加。怀孕会增加无家可归的风险，而另一方面，无家可归与不良围产期结局广泛相关。本研究的目的是使用定性研究方法描述怀孕期间和产后期间整体感知到的无家可归对健康的影响，优先考虑女性的观点。在南特大都市区，对 10 名孕妇和 10 名经历过无家可归的产后妇女以及他们的 6 名社会环境中的人进行了一次性半结构化访谈。采用主题分析方法确定主要主题和子主题。无家可归被认为对怀孕期间和产后期间所有健康方面（身体健康、心理健康和社会福利）都有整体的负面影响。压力和焦虑、粮食不安全、社会孤立、身体痛苦、慢性疾病恶化和妊娠并发症是无家可归对健康的主要感知后果。另一方面，怀孕期间和产后期间社会支持以及医疗保健专业人员的“欢迎”被认为能够缓解这些后果。最后，研究参与者认为，获得合适住房、独立和身体健康等基本需求是他们的主要优先事项。本研究的结果以及先前研究的结果，使我们能够确定在解决怀孕期间和产后期间无家可归及其对健康的复杂影响方面的可能切入点。住房和收入援助干预、促进社会支持和就业、扩大服务以增强医疗服务提供者之间的合作网络以及在初级保健中整合协调的多学科方法已被证明是解决这一问题的有希望的方法。
