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hostel 支持工作人员在英国与无家可归者一起导航医疗保健的经验:一项定性研究。

Hostel support workers' experiences navigating healthcare alongside people experiencing homelessness: a qualitative study in the UK.

机构信息

Imperial College London, London, UK

GKT School of Medical Education, King's College London, London, UK.

出版信息

BMJ Open. 2024 Sep 23;14(9):e085949. doi: 10.1136/bmjopen-2024-085949.

Abstract

OBJECTIVES

This study aimed to explore how hostel support workers (HSWs) experience navigating healthcare alongside people experiencing homelessness (PEH). PEH experience poor health outcomes, increased mortality and face many barriers when accessing healthcare. HSWs have a dynamic and holistic role, working with PEH to navigate access to health and social care, whilst facilitating independence. HSWs have been described as important in addressing barriers to access and linking healthcare and PEH. However, HSWs' experiences navigating this role across sectors remains underexplored.

DESIGN

In this qualitative study, semistructured interviews were conducted, and phenomenological thematic analysis was performed.

SETTING

Interviews were conducted with participants from 13 hostels across four UK counties.

PARTICIPANTS

17 HSWs were interviewed, with experience in their role ranging from 3 months to over 10 years.

RESULTS

Three themes were identified.HSWs feeling stigmatised by healthcare staff (HCS), including power inequalities between HSWs and HCS, and the impact of stigma against PEH in healthcare on HSWs.Working across sectors, including both collaborative and disconnected experiences.In-reach and its role in linking PEH and healthcare. This included the contrasting subthemes of in-reach as an effective link versus in-reach being an impractical and unsustainable solution.

CONCLUSIONS

Cross-sector collaboration has been recognised as an effective way to increase healthcare access and improve outcomes for Inclusion Health Groups, including PEH. This has been further highlighted by the formation of Integrated Care Systems, which strive to bring sectors together to tackle inequalities in outcomes, experience and access. Collaborative relationships between sectors, that is, hostels and healthcare, are vital for increasing healthcare access for PEH. We explored the experiences of HSWs navigating healthcare access for this marginalised population. Recognising and understanding these experiences are the first steps in building collaborative cross-sector relationships to improve healthcare accessibility, experiences and outcomes for PEH.

摘要

目的

本研究旨在探讨宿舍支持工作人员(HSWs)在与无家可归者(PEH)一起寻求医疗保健时的体验。PEH 的健康状况较差,死亡率较高,在获得医疗保健方面面临许多障碍。HSWs 的角色具有动态性和整体性,与 PEH 合作,在获得卫生和社会保健的同时促进独立性。HSWs 被描述为在解决获取障碍和将医疗保健与 PEH 联系起来方面非常重要。然而,HSWs 在跨部门中担任这一角色的经验仍未得到充分探索。

设计

在这项定性研究中,进行了半结构化访谈,并进行了现象学主题分析。

设置

在英国四个县的 13 家宿舍中对参与者进行了访谈。

参与者

对 17 名 HSW 进行了访谈,他们在该职位上的工作经验从 3 个月到 10 年以上不等。

结果

确定了三个主题。HSWs 感到被医疗保健人员(HCS)歧视,包括 HSWs 和 HCS 之间的权力不平等,以及医疗保健中对 PEH 的污名化对 HSWs 的影响。跨部门工作,包括协作和不协作的经验。内部联系及其在联系 PEH 和医疗保健方面的作用。这包括内部联系作为有效联系与内部联系作为不切实际和不可持续的解决方案的对比子主题。

结论

跨部门合作已被公认为增加医疗保健机会和改善包括无家可归者在内的包容性健康群体的结果的有效途径。这一点进一步得到了综合保健系统的形成的强调,该系统努力将各个部门联合起来,解决结果、经验和机会方面的不平等。部门之间的协作关系,即宿舍和医疗保健,对于增加无家可归者的医疗保健机会至关重要。我们探讨了 HSWs 为这一边缘化群体寻求医疗保健的经验。认识和理解这些经验是建立跨部门协作关系以改善无家可归者的医疗保健可及性、体验和结果的第一步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0723/11418567/a996ad7418b2/bmjopen-14-9-g001.jpg

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