Barreras y facilitadores en el acceso y la utilización de los centros de atención primaria para las personas en situación de sinhogarismo

IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Atencion Primaria Pub Date : 2024-04-27 DOI:10.1016/j.aprim.2024.102949
María Sánchez Hidalgo, Maria Sol Andrés, Josepa Canadell Rusiñol, Laura Paloma Fürstenheim Milerud, Estela Gómez Palomar, Marta Moya Tena
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引用次数: 0

Abstract

Objective

To identify barriers and facilitators for the access and use of primary care centers for people experiencing homelessness.

Design

Qualitative study, phenomenological theoretical-methodological approach. Between May 19 and July 27, 2023.

Location

Besòs Primary Health Care Center and Gregal social dining (Besòs and Maresme neighborhood, Barcelona).

Participants

People experiencing homelessness attending the Gregal social dining and professionals from the Besòs Primary Health Care Center.

Method

Theoretical purposive sampling. Individual and group interviews and open non-participant observation. Thematic content analysis, triangulation by independent analysis of three members of the research team and triangulation of methods. Discourse saturation was achieved through variability of discourse and techniques.

Results

Eleven individual interviews, three group interviews and two observations. Different barriers and facilitators were identified. These were classified into five categories: (1) concept and identification of people experiencing homelessness; (2) personal factors of people experiencing homelessness; (3) behaviors and attitudes of professionals; (4) structural factors related to health system regulation, anf (5) internal organizational factors of primary health care centers.

Conclusions

People experiencing homelessness face multiple barriers to access primary health care, although there are also facilitators such as trusting relationships and multidisciplinary and intersectoral work that can be enhanced from primary health care centers to contribute to health equity.

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无家可归者获得和使用初级保健设施的障碍和便利因素
目标确定无家可归者进入和使用初级保健中心的障碍和促进因素。设计定性研究,采用现象学理论方法。时间:2023 年 5 月 19 日至 7 月 27 日。地点:Besòs 初级医疗保健中心和 Gregal 社会餐厅(巴塞罗那 Besòs 和 Maresme 社区)。参与者:参加 Gregal 社会餐厅的无家可归者和 Besòs 初级医疗保健中心的专业人员。个人和小组访谈以及开放式非参与者观察。主题内容分析、研究小组三名成员的独立分析和方法三角测量。通过话语和技术的多变性实现了话语饱和。确定了不同的障碍和促进因素。这些障碍和促进因素被分为五类:(1)无家可归者的概念和身份;(2)无家可归者的个人因素;(3)专业人员的行为和态度;(4)与卫生系统监管有关的结构性因素;(5)初级卫生保健中心的内部组织因素。结论无家可归者在获得初级卫生保健服务方面面临多重障碍,但也有一些促进因素,如信任关系、多学科和跨部门工作,这些都可以从初级卫生保健中心得到加强,从而促进健康公平。
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来源期刊
Atencion Primaria
Atencion Primaria 医学-医学:内科
CiteScore
2.90
自引率
8.00%
发文量
156
审稿时长
33 days
期刊介绍: Atención Primaria es una revista que publica trabajos de investigación relativos al ámbito de la atención primaria de salud. Desde el punto de vista conceptual, Atención Primaria asume el nuevo modelo de atención primaria de salud, orientado no sólo a la curación de la enfermedad, sino también a su prevención y a la promoción de la salud, tanto en el plano individual como en el de la familia y la comunidad. En estos nuevos aspectos que definen el modelo de atención primaria de salud es en los que se centran los trabajos de investigación que publica Atención Primaria, la primera revista de originales española creada para recoger y difundir la producción científica realizada desde los centros de atención primaria de salud sobre cuestiones como protocolización de la asistencia, programas de prevención, seguimiento y control de pacientes crónicos, organización y gestión de la asistencia primaria, entre otros.
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