Barriers and bridges to care: voices of homeless female adolescent youth in Seattle, Washington, USA
Barriers and bridges to care: voices of homeless female adolescent youth in Seattle, Washington, USA
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DOI：
10.1046/j.1365-2648.2002.02067.x
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发表时间：
2002-01-01
影响因子：
3.8
通讯作者：
Panke, A
中科院分区：
文献类型：
--
作者：
Ensign, J;Panke, A
的目标。本研究的目的是在以诊所为基础的无家可归的青春期妇女样本中，对寻求生殖健康的行为、咨询的来源和获得护理的问题进行评估。青少年妇女是美国无家可归人口中最脆弱和医疗服务不足的亚群体之一。很少邀请无家可归的青年参加旨在改善他们获得适当保健的机会的研究。此外，他们所生活的文化和无家可归的个人经历往往没有得到解决。研究方法。该研究是描述性的，采用焦点小组和个人访谈的方式，对20名年龄在14-23岁之间的女性青年进行了有目的的抽样。这些妇女说，即使她们无家可归，她们也会向包括母亲在内的其他妇女寻求健康建议。他们报告说，他们首先尝试了自我保健干预措施，当自我保健措施不再奏效时，他们就去了诊所。他们指出，获得保健服务的主要障碍是缺乏保险、对同意的混淆、运输问题、（来自提供者）对自己的自我认识缺乏尊重，以及提供者的判断主义。利用文化能力的概念，研究结果为如何改善这些妇女的沟通和保健服务提供了见解。卫生保健提供者需要认识和欣赏无家可归青年的生活方式、信仰和适应态度，而不是给他们贴上“离经叛道”的标签。所有与无家可归青年打交道或代表他们工作的人员都必须接受有关无家可归青年健康的一般知识的充分培训，并了解文化在他们寻求健康行为中所起的作用。
Aim. The purpose of this study was to conduct an assessment of reproductive health-seeking behaviours, sources of advice, and access to care issues among a sample of clinic-based homeless adolescent women.Background. Adolescent women are among the most vulnerable and medically underserved subgroups within the homeless population in the United States. Homeless youth are rarely invited to participate in research aimed at improving their access to appropriate health care. Also, the culture in which they live and the personal experience of being homeless are often not addressed.Study method. The research was descriptive, using focus groups and individual interviews with a purposeful sample of 20 female youth, aged 14-23 years.Findings. The women said that they seek health advice from other women, including their mothers even while they are homeless. They reported first trying self-care interventions, and going to clinics when self-care actions no longer worked. They stated that the main barriers to health care were lack of insurance, confusion over consent, transportation problems, lack of respect (from providers) for their own self-knowledge, and judgementalism from providers.Conclusion. Using the concept of cultural competency, the results provide insights into how to improve communication and health care services for these women.Recommendations. Health care providers need to recognize and appreciate the lifestyle, beliefs, and adaptive attitudes of homeless youth, rather than labelling them as 'deviant'. All personnel who interact with and on behalf of homeless youth must be adequately trained in general knowledge regarding the health of homeless youth as well as in an understanding of the role that culture plays in their health-seeking behaviours.