Experiences of Adult Men Who Are Homeless Accessing Care: A Qualitative Study

Abstract

Introduction: Homeless individuals experience increased rates of chronic physical and mental health conditions. They also experience difficulty accessing care and poor health outcomes compounded by social and economic factors, such as housing insecurity, unemployment, and limited social support. The purpose of this study was to describe the perceptions of homeless individuals related to their health and experiences accessing care. Method: Qualitative descriptive methods and content analysis were used to gather, analyze, and interpret the data and identify themes. Results: Three themes were identified: men who are homeless experience bias throughout their health care and interpersonal relationships, the best care is person-centered and considers patients’ priorities, and care coordination resources are inadequate. Discussion: The housing needs of homeless individuals are best contextualized by their health and social needs. In addition, their priorities must be taken into consideration to develop culturally congruent services that are appropriate and effective care for this population.

A scoping review examining patient experience and what matters to people experiencing homelessness when seeking healthcare

“…Twelve studies did not define a specific health service context and instead reported information on general patient experiences engaging with any area of health services. The tools utilised across the studies included interviews (n = 20), focus groups [29,31,[33][34][35][36] (n = 7), surveys [32,[37][38][39][40][41][42][43] (n = 8), and qualitative ranking exercise [44] (n = 1) to facilitate exploration of patient experience. The qualitative ranking exercise asked PEH and experts to prioritise 16 aspects of PHC.…”

“…to care, the availability and flexibility of services, and geographic and financial accessibility. The most common patient experiences reported within this domain were timeliness of treatment [31,[33][34][35][36]59], flexibility and convenience of services [45,46,51,56] (especially those offering co-located [46,[53][54][55] or drop-in services [34,45,53,56,59]), the physical and organisational environment [46], and the location of services [33,34,[53][54][55].…”

“…Person-centred care incorporates the diverse experiences of individuals and their specific needs and priorities. Repeatedly, participants valued services that recognised the complexities relating to homelessness and which tailored services to meet their needs [33,34,52,53]. PEH greatly appreciated the social capital gained from health services, in particular positive social interaction, shared norms and decreased feelings of isolation [30,46,53].…”

“…Safety for PEH was most often discussed in relation to the physical environment of health services [46,53], discharge practices [28,31,53] and rapport with healthcare personnel [30,54,59]. However, cases of physical assault by security personnel [36], mechanical restraint [31], and stigma from health professionals had a negative impact on their willingness to access services [33,45,52]. While accountability was considered an important characteristic [44], in only one paper did PEH expressed concerns that health services were not accountable [29].…”

Centering the narrative experiences of homeless individuals: a call to action

“…I read with interest the article by Henderson et al in the March 2022 issue of the Journal of Transcultural Nursing (Henderson et al, 2022). I commend the authors for their careful study of the perceptions of homeless individuals regarding their health and their experiences in seeking health care.…”