ABSTRACT
Hospital-based nurses who have not practiced in home health care may find it difficult to anticipate patients' needs during the transition from hospital to home. This column focuses on increasing competency in preparing patients for home health services.
Subject(s)
Continuity of Patient Care , Home Care Services , Patient Care Planning , Patient Discharge , Patient Education as Topic , Aged , Audiovisual Aids , Humans , Manuals as Topic , United StatesABSTRACT
This ethnographic study was conducted to determine what homeless people experience during the transition from street life into community housing. Data were gathered through participant observation at a program designed to secure housing and support services for homeless people upon discharge from a psychiatric hospital. Sixty homeless, mentally ill adults were followed from hospital discharge through their first 2 years in community housing. Homeless people interact with health care providers across a cultural divide produced by vast differences in their lived experiences. This cultural distance limits access to the services that these individuals require to achieve residential stability.
Subject(s)
Health Services Needs and Demand/organization & administration , Ill-Housed Persons/psychology , Mentally Ill Persons/psychology , Patient Discharge , Public Housing , Adaptation, Psychological , Adult , Aftercare , Anthropology, Cultural , Attitude to Health/ethnology , Case Management , Community Health Nursing , Community Mental Health Services , Cultural Diversity , Empathy , Female , Health Transition , Ill-Housed Persons/education , Humans , Longitudinal Studies , Male , Nurse's Role , Nursing Methodology Research , Social SupportABSTRACT
Nurses play a critical role in helping homeless patients make the transition from revolving door hospitalizations or emergency department visits to ongoing care through an outpatient clinic. This column focuses on increasing competency in the care of homeless patients. The next column will focus on a different type of transition-preparing hospitalized patients for discharge and referral to home health care.
Subject(s)
Clinical Competence , Ill-Housed Persons/psychology , Nurse's Role/psychology , Cooperative Behavior , Empathy , Health Services Needs and Demand , Humans , Nurse-Patient Relations , Patient Advocacy , Patient Discharge , Patient Participation , Practice Guidelines as Topic , Referral and Consultation , Total Quality Management/organization & administration , TrustABSTRACT
This qualitative longitudinal study documents the experiences of 60 people who are homeless and mentally ill from their state mental hospital discharge through their first two years in community housing. The study explores the personal, cultural, and environmental contexts of life for adults who are homeless and mentally ill and examines the interaction between an individual's needs and community resources. The research identifies forces that perpetuate homelessness and traces the struggles that people who are homeless and mentally ill encounter during the transition from the streets to stable housing. The findings describe a culturally based pattern of mutual avoidance between homeless mentally ill clients and caregivers, which limits delivery of services to the population. Recommendations include development of alternative systems of care delivery, expansion of educational experiences with underserved populations, and increased funding for service or research with people who are homeless and mentally ill.
