Nurse‐led mental and physical healthcare for the homeless community: A qualitative evaluation

Abstract

Increased morbidity and mortality rates are prominent issues among homeless individuals. To help reduce these health inequalities, dedicated senior mental and physical health nurses have been deployed to work within and alongside local statutory and voluntary organisations. This qualitative evaluation examined the impact of nurseled homeless healthcare in Warwickshire, United Kingdom. During January and February 2021, online semi-structured interviews were conducted with 17 professionals including the mental and physical homeless health nurses (n = 4), statutory health and local authority professionals (n = 4), and voluntary and community sector professionals (n = 9). Interviews were qualitatively analysed using inductive, reflexive thematic analysis. Data analysis identified three overarching themes related to the meaning, impact and future development of nurse-led homeless healthcare: (1) Nurse-led homeless healthcare and health inequalities, (2) The multi-agency approach of nurse-led homeless healthcare, and (3) Future development of nurse-led homeless healthcare. The findings confirm the benefits of homeless healthcare in reducing health inequalities and promoting a more accessible, flexible and person-centred approach to holistic care. Yet, prevailing organisational and system-level barriers were also identified as currently limiting the capacity, provision and practicalities of delivering nurse-led homeless healthcare. Recommendations were identified with international relevance and included: (i) continued implementation of person-centred healthcare for homeless individuals, (ii) strengthening of organisational collaboration and communication pathways to improve coordinated care, (iii) development of the managerial and structural aspects of provision, (iv) addressing limitations associated with scope and capacity to ensure that delivered healthcare is adequately intensive, (v) increased availability of clinical or therapeutic spaces, and (vi) implementation of long-term plans supported by evaluation and commissioning.

Contraception‐related knowledge, attitude, belief contexts among US women experiencing homelessness: A scoping review

“…However, whether knowledge of where to obtain contraception would result in subsequent contraception acquisition or consistent utilization remains to be seen, similar to findings for a variety of sexual health behaviors among general populations (Pazol et al, 2015) and populations experiencing homelessness (Bagheri Amiri et al, 2018; Verulava et al, 2018). Health care providers and other community organizations can work together to support women experiencing homelessness, as demonstrated in the United Kingdom (Bell et al, 2022) and the United States (Pennington et al, 2010; Weinstein et al, 2013), incorporating strategies to provide easy‐to‐access, factual information on contraception to reduce misconceptions. Future studies can build on contraception knowledge‐ or health literacy‐based interventions to determine linkages between contraception knowledge, sources of information, and behavior.…”

The impact of patient‐centred care on the relationship between access to care and subjective health outcomes amongst people experiencing homelessness: A mediation analysis

“…Commonly cited barriers to healthcare access amongst PEH included structural and interpersonal factors such as inflexible and inconvenient services, stigma, and poor communication (Omerov et al, 2020). Although programs have improved access to care for PEH by removing structural barriers such as providing transportation (Lebrun‐Harris et al, 2013), co‐locating clinics in places frequented by PEH (Bell et al, 2022), and expanding insurance coverage to low‐income adults (Warfield et al, 2016), PEH still report dissatisfaction with the care they receive (Jones et al, 2017; Purkey & MacKenzie, 2019).…”