Family perspectives on provider conversations about housing needs for children with medical complexity

IF 1.8 4区医学 Q2 PEDIATRICS Child Care Health and Development Pub Date : 2024-03-26 DOI:10.1111/cch.13253

Brandon M. Smith, Pamela K. Donohue, Rebecca R. Seltzer

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Abstract

Background

Children with medical complexity (CMC) have unique, and often unmet, housing needs that place them at risk for housing insecurity and poor health outcomes. Yet, little is known about how families with CMC discuss their housing needs with healthcare providers. We sought to understand: (1) how housing is currently discussed between CMC caregivers and healthcare providers, and (2) how CMC caregivers want such conversations to occur.

Methods

From August to November 2020, we conducted semi-structured interviews with parents/guardians of CMC (<26 years old) in Maryland as part of a larger study to understand their housing experience. Four questions on communication with providers about housing were developed a priori and included in this analysis. Qualitative content analysis was applied to interview transcripts.

Results

Among 31 completed interviews, most participants were female (90%), lived in single-family homes (68%) and were from a mix of neighbourhood types (urban 19%, suburban 58%, rural 22%). Their children ranged in age from 6 months to 22 years, had a mix of insurance types (public 65%, private 29%, both 6%) and nearly all required medical equipment or technology. Four themes emerged: (1) Current housing conversations are rare and superficial, (2) Ideal housing conversations would result in thoughtful care plans and concrete supports, (3) Frequency and initiation of housing conversations are best tailored to family preferences and (4) Value of housing conversations are limited by lack of provider knowledge and time.

Conclusions

Conversations about housing needs for CMC happen in limited ways with healthcare providers, despite a desire on the part of their caregivers. Such conversations can give meaningful insights into the family's specific housing challenges, allowing providers to appropriately tailor care plans and referrals. Future work is needed to capture provider perspectives, design CMC-specific housing screeners and develop interdisciplinary referral strategies.

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从家庭角度看医疗服务提供者就病情复杂儿童的住房需求进行的谈话。

背景：有复杂病症（CMC）的儿童有独特的住房需求，而且往往得不到满足，这使他们面临住房无保障和健康状况不良的风险。然而，人们对有复杂病症儿童的家庭如何与医疗服务提供者讨论他们的住房需求知之甚少。我们试图了解：（1）目前 CMC 护理者与医疗服务提供者之间是如何讨论住房问题的；（2）CMC 护理者希望如何进行此类对话：从 2020 年 8 月到 11 月，我们对 CMC 的父母/监护人进行了半结构化访谈（结果：在 31 个完成的访谈中，大多数参与者都是女性：在 31 个完成的访谈中，大多数参与者为女性（90%），居住在单户住宅中（68%），来自不同类型的社区（城市 19%、郊区 58%、农村 22%）。他们的孩子年龄从 6 个月到 22 岁不等，保险类型各异（公共保险 65%，私人保险 29%，两者都有 6%），几乎所有孩子都需要医疗设备或技术。我们发现了四个主题：（1）目前的住房问题对话很少且肤浅；（2）理想的住房问题对话将产生周到的护理计划和具体的支持；（3）住房问题对话的频率和启动最好根据家庭的偏好进行调整；（4）住房问题对话的价值因缺乏医疗服务提供者的知识和时间而受到限制：结论：尽管 CMC 的照护者希望与医疗服务提供者就 CMC 的住房需求进行对话，但对话的方式很有限。这种对话可以让医疗服务提供者深入了解家庭在住房方面所面临的具体挑战，从而为他们量身定制适当的护理计划和转介方案。今后的工作需要捕捉医疗服务提供者的观点，设计针对 CMC 的住房筛选器，并制定跨学科转介策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child Care Health and Development 医学-小儿科

CiteScore

3.40

自引率

5.30%

发文量

136

审稿时长

4-8 weeks

期刊介绍： Child: care, health and development is an international, peer-reviewed journal which publishes papers dealing with all aspects of the health and development of children and young people. We aim to attract quantitative and qualitative research papers relevant to people from all disciplines working in child health. We welcome studies which examine the effects of social and environmental factors on health and development as well as those dealing with clinical issues, the organization of services and health policy. We particularly encourage the submission of studies related to those who are disadvantaged by physical, developmental, emotional and social problems. The journal also aims to collate important research findings and to provide a forum for discussion of global child health issues.