The relationship between attitudes to homelessness and perceptions of caring behaviours: a cross-sectional study among women experiencing homelessness, nurses and nursing students

Abstract

Background Women experiencing homelessness have complex and multifaceted healthcare needs and yet they are an underserved population across healthcare services. Nurses are trained to perform an integral role in the provision of equitable healthcare and their attitudes towards homelessness may therefore influence the care that women experiencing homelessness receive. This study aimed to examine correlations between attitudes towards homelessness and caring behaviours, and to test if these correlations differed between the groups of women experiencing homelessness, registered nurses, and nursing students. Methods A cross-sectional design using convenience sampling was used to recruit women experiencing homelessness (n = 37), registered nurses (n = 90), and nursing students (n = 138) in Stockholm, Sweden between August 2019 and December 2020. The participants answered two questionnaires: the Attitudes Toward Homelessness Inventory and the Caring Behaviours Inventory-24. Correlations between ordinal variables were calculated using Spearman’s rank correlation ρ. Tests of equality between two independent correlations were performed using a Z-test applied to Fisher’s z-transformed correlations. An advisory board of women with lived experience of homelessness supported the interpretation of the results. Results Weak, negative correlations were identified between the Attitudes Toward Homelessness Inventory and Caring Behaviours Inventory-24. The Attitudes Toward Homelessness Inventory mean total scores (SD) were 4.1 (0.6), 4.2 (0.6), 4.1 (0.5) points for the women experiencing homelessness, registered nurse, and nursing student groups, respectively, with the corresponding scores for the Caring Behaviours Inventory-24 being 4.1 (1.1), 5.2 (0.5), 4.8 (0.7) points, respectively. Conclusions To promote equitable health for women experiencing homelessness, healthcare providers and nurse educators should consider the role of stigmatising attitudes in relation to caring behaviours.

Health literacy and its association with mental and spiritual well-being among women experiencing homelessness

“…On the other hand, interventions targeting people experiencing homelessness risk segregating specific groups of healthcare users. A targeted approach could also exacerbate unintentional biases in healthcare encounters ( Lawrie et al ., 2020 ) such as shame and stigmatising attitudes towards homelessness, which have been shown to negatively impact the caring behaviours that women experiencing homelessness receive ( Gaber et al ., 2022b ). Thus, research increasingly points to a proportionate universalist approach, which proposes that health promotion interventions should be developed and implemented to ensure that they are as accessible and usable as possible for everyone, but that simultaneously offer tailored approaches to reach and engage with groups that are disproportionately impacted by the effects of poor HL, such as women experiencing homelessness ( Stormacq et al ., 2019 ).…”

“…The present study focuses on women experiencing homelessness and is part of a larger study which, besides women experiencing homelessness, also included registered nurses and nursing students. Further details about this larger study, including power calculations specifying that at least 35 women experiencing homelessness should be recruited, are given in previous publications ( Gaber et al ., 2022a , 2022b ). Notably, the study sample of 46 women included in the present study was larger than the threshold value of 35 women obtained from the power calculations.…”

Strengthening Caring Character Education for Prospective Nurses: An Action Research in Nursing Education

“…This is evident through ongoing discussions surrounding caring behaviour, which remains a prominent and significant topic of interest for both academics and nursing practitioners. These discussions are widely addressed in scientific education and are recurrent themes at various conferences (Figueiredo et al, 2022;Firmansyah et al, 2019;Gaber et al, 2022;Greenfield, 2008). In their study, they focus on how caring behaviour affects service satisfaction.…”