Fostering Trust With a Young Man Experiencing Homelessness and Advanced Cancer.
Fostering Trust With a Young Man Experiencing Homelessness and Advanced Cancer.
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DOI：
10.1177/08258597211013957
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发表时间：
2022-07
影响因子：
1.7
通讯作者：
Moryl N
中科院分区：
文献类型：
--
作者：
Rosa WE;Andersen LJ;Frierson E;Fulton C;Moryl N
无家可归者 (PEH) 在所有环境中都面临着公平的健康、社会和姑息治疗的无数障碍。布兰登是一名 23 岁的男性，尽管处境困难，但他言谈得体、仪表整洁、彬彬有礼。他小时候受到严重虐待，然后被遗弃，住在多个寄养家庭中，直到 18 岁。由于没有始终如一的成年人关怀，他不出所料地陷入了混乱的生活方式，与不同的母亲生了 3 个孩子，并在纽约市无家可归。他患有新诊断的肾细胞癌，已转移至肺、淋巴结和骨。脊柱和骨盆转移引起瘫痪性躯体疼痛，影响行走和坐立，并阻止布兰登进行对他在街头生存和保管阿片类药物至关重要的日常生活活动。缺乏基本的社会支持和多次被遗弃的历史，使得这个年轻、无家可归、真正孤立的男人的护理计划非常具有挑战性。随着时间的推移，与布兰登合作的住院和门诊跨学科团队成员都赢得了他的信任。一个“安全的地方”打开了治疗关系各方的心扉，并制定了一个患者和姑息治疗团队都可以接受的计划。由于复杂的障碍，临床医生经常面临为 PEH 提供持续、务实的姑息治疗服务的挑战。继续倡导公平和量身定制的服务，确保为 PEH 提供高质量的姑息治疗，对于个人、机构和系统层面来说至关重要，以促进健康公平和有尊严的护理。
Persons experiencing homelessness (PEH) face countless barriers to equitable health, social, and palliative care across all settings. Brandon was a 23-year-old male, well-spoken, groomed, and polite despite difficult circumstances. He was severely abused then abandoned as a child, living in multiple foster homes until 18. With no consistent caring adult figure, he predictably fell into a chaotic lifestyle, had 3 children by different mothers, and became homeless in New York City. He presented with newly diagnosed renal cell carcinomametastatic to lung, lymph nodes, and bone. Spine and pelvic metastases caused paralyzing somatic pain that interfered with walking and sitting and prevented Brandon from performing the activities of daily living essential for his survival on the streets and safekeeping of opioids. Lack of basic social support and a history of multiple abandonments made a care plan for this young, homeless, and truly isolated man very challenging. The inpatient and outpatient interdisciplinary team members partnering with Brandon each earned his trust with time. A “safe place” opened hearts on all sides of the therapeutic relationship and led to a plan that was acceptable for both the patient and the palliative care team. Clinicians are often challenged to provide sustained and pragmatic palliative care services for PEH due to complex barriers. Continued advocacy for equitable and tailored services that ensure high-quality palliative care for PEH is critical at individual, institutional, and system levels to promote health equity and dignified care.
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影响因子：
2.9
作者：
Hudson BF;Shulman C;Low J;Hewett N;Daley J;Davis S;Brophy N;Howard D;Vivat B;Kennedy P;Stone P
通讯作者：
Stone P
影响因子：
1.7
作者：
Dasgupta S;Tie Y;Lemons-Lyn A;Broz D;Buchacz K;Shouse RL
通讯作者：
Shouse RL
DOI：
10.1111/1753-6405.13038
发表时间：
2020-09-21
影响因子：
3.5
作者：
Seastres, Ramon Jose;Hutton, Jennie;Sundararajan, Vijaya
通讯作者：
Sundararajan, Vijaya
影响因子：
8.1
作者：
Tinland A;Loubière S;Boucekine M;Boyer L;Fond G;Girard V;Auquier P
通讯作者：
Auquier P
影响因子：
4.7
作者：
Radbruch L;De Lima L;Knaul F;Wenk R;Ali Z;Bhatnaghar S;Blanchard C;Bruera E;Buitrago R;Burla C;Callaway M;Munyoro EC;Centeno C;Cleary J;Connor S;Davaasuren O;Downing J;Foley K;Goh C;Gomez-Garcia W;Harding R;Khan QT;Larkin P;Leng M;Luyirika E;Marston J;Moine S;Osman H;Pettus K;Puchalski C;Rajagopal MR;Spence D;Spruijt O;Venkateswaran C;Wee B;Woodruff R;Yong J;Pastrana T
通讯作者：
Pastrana T