Illness narratives of people who are homeless

Håkanson, Cecilia; Öhlén, Joakim

doi:10.3402/qhw.v11.32924

Cited by 21 publications

(16 citation statements)

References 47 publications

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“…Challenges to accessing healthcare include navigating complicated healthcare systems, 10 managing unstable housing situations, balancing competing priorities (such as food, shelter and addictions) 11 and previous negative experiences with healthcare services and professionals. 12 …”

Section: Introductionmentioning

confidence: 99%

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End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care

et al. 2017

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Background:Being homeless or vulnerably housed is associated with death at a young age, frequently related to medical problems complicated by drug or alcohol dependence. Homeless people experience high symptom burden at the end of life, yet palliative care service use is limited.Aim:To explore the views and experiences of current and formerly homeless people, frontline homelessness staff (from hostels, day centres and outreach teams) and health- and social-care providers, regarding challenges to supporting homeless people with advanced ill health, and to make suggestions for improving care.Design:Thematic analysis of data collected using focus groups and interviews.Participants:Single homeless people (n = 28), formerly homeless people (n = 10), health- and social-care providers (n = 48), hostel staff (n = 30) and outreach staff (n = 10).Results:This research documents growing concern that many homeless people are dying in unsupported, unacceptable situations. It highlights the complexities of identifying who is palliative and lack of appropriate places of care for people who are homeless with high support needs, particularly in combination with substance misuse issues.Conclusion:Due to the lack of alternatives, homeless people with advanced ill health often remain in hostels. Conflict between the recovery-focused nature of many services and the realities of health and illness for often young homeless people result in a lack of person-centred care. Greater multidisciplinary working, extended in-reach into hostels from health and social services and training for all professional groups along with more access to appropriate supported accommodation are required to improve care for homeless people with advanced ill health.

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Section: Introductionmentioning

confidence: 99%

“…Sobriety is often a requirement for engaging in health- and social-care assessments. 12 , 13 In practical terms, these factors render many services inaccessible to this population.…”

Section: Introductionmentioning

confidence: 99%

End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care

et al. 2017

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“…language barriers or sensory, learning or age related disability) [8,9] or as a consequence of perceived [10] or actual stigma enacted (e.g. labelling of some homeless patients as 'difficult' leading to barriers in accessing care) [3,11].…”

Section: Introductionmentioning

confidence: 99%

Patient safety in marginalised groups: a narrative scoping review

Cheraghi-Sohi

Panagioti

Daker‐White

et al. 2020

Int J Equity Health

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Background: Marginalised groups ('populations outside of mainstream society') experience severe health inequities, as well as increased risk of experiencing patient safety incidents. To date however no review exists to identify, map and analyse the literature in this area in order to understand 1) which marginalised groups have been studied in terms of patient safety research, 2) what the particular patient safety issues are for such groups and 3) what contributes to or is associated with these safety issues arising.Methods: Scoping review. Systematic searches were performed across six electronic databases in September 2019. The time frame for searches of the respective databases was from the year 2000 until present day.Results: The searches yielded 3346 articles, and 67 articles were included. Patient safety issues were identified for fourteen different marginalised patient groups across all studies, with 69% (n = 46) of the studies focused on four patient groups: ethnic minority groups, frail elderly populations, care home residents and low socio-economic status. Twelve separate patient safety issues were classified. Just over half of the studies focused on three issues represented in the patient safety literature, and in order of frequency were: medication safety, adverse outcomes and near misses. In total, 157 individual contributing or associated factors were identified and mapped to one of seven different factor types from the Framework of Contributory Factors Influencing Clinical Practice within the London Protocol. Patient safety issues were mostly multifactorial in origin including patient factors, health provider factors and health care system factors.Conclusions: This review highlights that marginalised patient groups are vulnerable to experiencing a variety patient safety issues and points to a number of gaps. The findings indicate the need for further research to understand the intersectional nature of marginalisation and the multi-dimensional nature of patient safety issues, for groups that have been under-researched, including those with mental health problems, communication and cognitive impairments. Such understanding provides a basis for working collaboratively to co-design training, services and/or interventions designed to remove or at the very least minimise these increased risks.Trial registration: Not applicable for a scoping review.

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“…Lester and Bradley found negative attitudes in British primary care physicians towards homeless persons (24). Håkanson und Öhlén concluded from the narratives of homeless persons that physicians need to be aware of the special needs of sick homeless people in order to be able to treat them appropriately (25).…”

Section: Standard Outpatient Carementioning

confidence: 99%