Previous Health Care Experiences' Influence on Health Care Perceptions Among Residents of Six Homeless Shelters in Seattle, Washington, July-October 2021.

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES Journal of Patient-Centered Research and Reviews Pub Date : 2023-07-18 eCollection Date: 2023-01-01 DOI:10.17294/2330-0698.2012
Ashley A Meehan, Sarah N Cox, Nicholas B Thuo, Julia H Rogers, Amy C Link, Miguel A Martinez, Natalie K Lo, Brian J Manns, Melissa A Rolfes, Eric J Chow, Helen Y Chu, Emily Mosites, Morhaf Al Achkar
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Abstract

Purpose: The study purpose was to learn and describe 1) where homeless shelter residents receive health care, 2) what contributes to positive or negative health care experiences among shelter residents, and 3) shelter resident perceptions toward health care.

Methods: Semi-structured interviews (SSIs) utilizing purposive sampling and focus group discussions (FGDs) utilizing convenience sampling were conducted at 6 homeless shelters in Seattle-King County, Washington, during July-October 2021. All residents (age ≥18) were eligible to participate. SSIs were conducted with 25 residents, and 8 FGDs were held. Thematic analysis was conducted using Dedoose.

Results: Participants received health care in settings ranging from no regular care to primary care providers. Four elements emerged as contributing positively and negatively to health care experiences: 1) ability to access health care financially, physically, and technologically; 2) clarity of communication from providers and staff about appointment logistics, diagnoses, and treatment options; 3) ease of securing timely follow-up services; and 4) respect versus stigma and discrimination from providers and staff. Participants who felt positively toward health care found low- or no-cost care to be widely available and encouraged others to seek care. However, some participants described health care in the United States as greedy, classist, discriminatory, and untrustworthy. Participants reported delaying care and self-medicating in anticipation of discrimination.

Conclusions: Findings demonstrate that while people experiencing homelessness can have positive experiences with health care, many have faced negative interactions with health systems. Improving the patient experience for those experiencing homelessness can increase engagement and improve health outcomes.

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2021 年 7 月至 10 月华盛顿州西雅图市六家无家可归者收容所的居民以前的医疗经历对医疗观念的影响。
目的:该研究旨在了解和描述 1) 无家可归者收容所居民在哪里接受医疗保健服务;2) 是什么因素导致收容所居民获得积极或消极的医疗保健体验;3) 收容所居民对医疗保健的看法:方法:2021 年 7 月至 10 月期间,在华盛顿州西雅图-金县的 6 家无家可归者收容所进行了有目的抽样的半结构式访谈(SSI)和方便抽样的焦点小组讨论(FGD)。所有居民(年龄≥18 岁)均有资格参与。与 25 名居民进行了 SSI,并举行了 8 次 FGD。使用 Dedoose 进行了专题分析:结果:参加者接受医疗保健的环境从没有定期医疗保健到初级医疗保健提供者不等。有四个因素对医疗保健体验有积极和消极的影响:1) 在经济、身体和技术方面获得医疗服务的能力;2) 医疗服务提供者和工作人员对预约流程、诊断和治疗方案的清晰沟通;3) 获得及时后续服务的难易程度;以及 4) 医疗服务提供者和工作人员的尊重与羞辱和歧视。对医疗保健持积极态度的参与者认为,低成本或无成本的医疗保健服务非常普遍,并 鼓励其他人寻求医疗保健服务。然而,一些参与者认为美国的医疗保健服务是贪婪的、阶级歧视的、不值得信赖的。参与者称,由于担心受到歧视,他们推迟了就医时间并自行用药:研究结果表明,虽然无家可归者可以在医疗保健方面获得积极的体验,但许多人也面临着与医疗系统的负面互动。改善无家可归者的就医体验可以提高他们的参与度并改善健康状况。
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来源期刊
Journal of Patient-Centered Research and Reviews
Journal of Patient-Centered Research and Reviews HEALTH CARE SCIENCES & SERVICES-
自引率
5.90%
发文量
35
审稿时长
20 weeks
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