Responding to COVID-19 While Serving Veterans Experiencing Homelessness: The Pandemic Experiences of Healthcare and Housing Providers.
Responding to COVID-19 While Serving Veterans Experiencing Homelessness: The Pandemic Experiences of Healthcare and Housing Providers.
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DOI：
10.1177/21501319221112585
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发表时间：
2022-01
影响因子：
3.6
通讯作者：
Dobalian, Aram
中科院分区：
文献类型：
--
作者：
Gin, June L.;Balut, Michelle D.;Alenkin, Nikola R.;Dobalian, Aram
关键词：
美国退伍军人事务部 (VA) 分别通过补助金和每日津贴 (GPD) 计划和无家可归患者联合护理团队 (HPACT) 为无家可归的退伍军人提供过渡性住房和医疗保健。在 SARS-CoV-2 大流行开始时，GPD 组织和 HPACT 诊所面临着成为重要提供者的挑战，其任务是确保其护理下的退伍军人的福祉。通过对美国各地的 13 家提供者（代表 2 个 HPACT 计划的 6 名 HPACT 医疗保健提供者和 7 名 GPD 工作人员）进行半结构化访谈，本研究探讨了他们从大流行开始到 2021 年访谈日期期间在确保退伍军人安全和提供持续护理任务方面的经验。 GPD 和 HPACT 提供商均报告称，在大流行开始时，员工对 COVID-19 感染的安全担忧有所加剧，但几个月后，随着安全调整融入到他们的日常工作中，这种担忧已降至较低且稳定的水平。然而，持续存在的挑战包括退伍军人之间的隔离和心理健康挑战、远程医疗作为护理提供途径的固有局限性、由于工作量增加和频繁变化导致提供者沮丧和倦怠，以及为退伍军人进入 GPD 住房进行测试的后勤工作。加强 GPD 组织的大流行病防备规划、为个人防护装备 (PPE) 提供资金、提供促进退伍军人远程医疗访问的技术以及防止提供者精疲力竭的战略，对于在这场大流行期间维持无家可归者提供者的能力和增强应对下一次公共卫生紧急情况的准备能力至关重要。
The U.S. Department of Veterans Affairs (VA) provides essential care through transitional housing and healthcare for Veterans experiencing homelessness through the Grant and Per Diem (GPD) program and the Homeless Patient Aligned Care Team (HPACT), respectively. At the onset of the SARS-CoV-2 pandemic, GPD organizations and HPACT clinics faced the challenge of being essential providers tasked with ensuring the well-being of Veterans under their care. Through semi-structured interviews with 13 providers (6 HPACT health care providers representing 2 HPACT programs, and 7 GPD staff members) across the U.S., this study explored their experiences navigating the tasks of keeping Veterans safe and providing ongoing care from the start of the pandemic up to the 2021 interview dates. Both GPD and HPACT providers reported amplified safety concerns about COVID-19 infection among staff at the start of the pandemic, which diminished to a lower, stable level after a few months as adaptations made for safety became embedded in their routines. However, ongoing challenges included isolation and mental health challenges among Veterans, inherent limitations of telehealth as a care delivery avenue, provider frustration and burnout due to increased workload and frequent change, and the logistics of administering testing for Veterans to enter GPD housing. Enhanced pandemic preparedness planning for GPD organizations, funding for personal protective equipment (PPE) and providing technology to facilitate Veterans’ telehealth access, and strategies for preventing provider burnout are critical to both sustaining homeless providers’ capabilities during this pandemic and enhancing readiness to respond to the next public health emergency.
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