Exploring Quality of Primary Care for Patients Who Experience Homelessness and the Clinicians Who Serve Them: What Are Their Aspirations?
Exploring Quality of Primary Care for Patients Who Experience Homelessness and the Clinicians Who Serve Them: What Are Their Aspirations?
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DOI：
10.1177/1049732319895252
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发表时间：
2020-01-02
影响因子：
3.2
通讯作者：
Kertesz, Stefan G.
中科院分区：
文献类型：
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作者：
Varley, Allyson L.;Montgomery, Ann Elizabeth;Kertesz, Stefan G.
为了开发和评估以患者为中心、高质量、以无家可归者为重点的初级保健的有效模式，我们的团队探索了初级保健的关键领域，这些领域可能对患者很重要。我们在医学研究所(IOM)的两份报告中确定了我们的概念框架，这两份报告定义了初级保健的组成部分和保健质量。使用从这个框架产生的问题，我们对36名有过去一年初级保健参与的无家可归者和24名在初级保健环境中为无家可归者有经验的患者提供服务的卫生保健专业人员(临床医生和研究人员)进行了半结构化访谈。模板分析揭示了对该人群很重要的因素。这些包括耻辱，尊重，以及患者对疼痛和成瘾的医疗决策的控制的观点。对于无家可归的患者，研究结果表明，高质量的初级保健对患者和专业人员可能有不同的意义，服务应该量身定做，以满足无家可归者的特定需求。
To develop and evaluate an effective model of patient-centered, high-quality, homeless-focused primary care, our team explored key domains of primary care that may be important to patients. We anchored our conceptual framework in two reports from the Institute of Medicine (IOM) that defined components of primary care and quality of care. Using questions developed from this framework, we conducted semistructured interviews with 36 homeless-experienced individuals with past-year primary care engagement and 24 health care professionals (clinicians and researchers) who serve homeless-experienced patients in the primary care setting. Template analysis revealed factors important to this population. These included stigma, respect, and perspectives on patient control of medical decision-making in regard to both pain and addiction. For patients experiencing homelessness, the results suggest that quality primary care may have different meanings for patients and professionals, and that services should be tailored to meet homeless-specific needs.