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Invest. educ. enferm ; 37(2): [E03], 15-06-2019. Figure 1
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1007258


Abstract Objective. To understand the family experience regarding the trajectory of crack users for the street situation. Method. Qualitative study using the systemic approach as the theoretical referential and the narrative as methodological referential. We conducted interviews with eleven family members of crack users with street situation experience cared for at a community mental health service. We analyzed the interviews using the inductive content analysis technique. Results. The family members understood the trajectory of the crack users for the street situation from two perspectives. One before the street situation process, for which they described a problematic childhood, the presence of stressor traumas/ events, vulnerabilities in the family environment, and their family members' encounter with the drug world. Moreover, another posterior to the street situation, for which they narrated the perception of alterations in the users, the discovery of crack use, the deepening of the individuals' relationship with the streets, and the adoption of coping strategies. Conclusion. It was made evident that the family adopts an explicative model for the behavior of drug use and contact with the streets based on the life history of the crack user family member.

Resumen Objetivo. Comprender la trayectoria de usuarios de crack en situación de calle desde la perspectiva de los familiares. Métodos. Estudio cualitativo, realizado en un servicio público de salud mental, que utiliza el abordaje sistémico como referencial teórico y la narrativa como referencial metodológico. Se realizó una entrevista en profundidad con cuestión orientadora junto a 11 familiares, y la técnica de análisis de contenido para la exploración de las narrativas. Resultados. Los familiares comprendieron la trayectoria para la situación de calle a partir de dos perspectivas principales: el pasado, donde narraron eventos de la infancia / adolescencia de los usuarios, y el presente, donde contaron específicamente sobre la ocurrencia de la situación de calle. Discusión: Los eventos que justifican el uso de drogas son percibidos como momentos de fragilización, a partir del entendimiento de que el usuario era un "niño-problema". Conclusión. Se evidenció que la creencia familiar puede funcionar como los ajustes para cuidar y mantener la unión y la homeostasis familiar.

Resumo Objetivo. Compreender a experiência familiar sobre a trajetória de usuários de crack para a situação de rua. Método. Estudo qualitativo utilizando a abordagem sistêmica como referencial teórico e a narrativa como referencial metodológico. Foram realizadas entrevistas com 11 familiares de usuários de crack com vivência de situação de rua e atendidos em um serviço de saúde mental comunitário. As entrevistas foram analisadas por meio da técnica de análise de conteúdo indutivo. Resultados. Os familiares compreenderam a trajetória dos usuários de crack para a situação de rua a partir de duas perspectivas. Uma anterior ao processo da situação de rua, onde descreveram uma infância problemática, presença de traumas/eventos estressores, vulnerabilidades no ambiente familiar e o encontro dos seus familiares com o universo das drogas. E uma posterior, onde narraram sobre a percepção de alterações nos usuários, a descoberta do uso de crack, o aprofundamento da relação dos indivíduos com as ruas e a adoção de estratégias de enfrentamento. Conclusão. Evidenciou-se que a família adota um modelo explicativo para o comportamento de uso de droga e contato com a rua baseado na história de vida do familiar usuário de crack.

Humanos , Pessoas em Situação de Rua , Cocaína Crack , Serviços Comunitários de Saúde Mental , Relações Familiares
Soins ; 64(836): 45-48, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-31208583


Maternity professionals are sometimes required to provide care to migrant women in precarious circumstances. Decisions regarding the future and the social and medical support provided to these mothers and their babies must be made quickly and be efficient and effective, despite having to contend with a lack of resources. A qualitative study focused on professionals' emotional reactions in these contexts combining pregnancy, vulnerability, migration and perinatal care. It enabled an original research protocol to be established favouring professionals' reflexivity.

Pessoal de Saúde/psicologia , Pessoas em Situação de Rua , Serviços de Saúde Materna , Migrantes , Emoções , Feminino , Humanos , Gravidez , Pesquisa Qualitativa
BMC Public Health ; 19(1): 789, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31221113


BACKGROUND: Socially disadvantaged groups, such as drug users, sex workers and homeless individuals, are labelled as "hard-to-reach" (HTR) in public health and medical research. HIV disproportionately impacts these populations, but data on how the HTR status could affect antiretroviral therapy (ART) adherence among HIV-positive people are limited and have not been previously synthesized in a systematic manner. We performed a meta-analysis to explore the association between HTR status and optimal antiretroviral therapy adherence in the HIV-infected population to provide evidence and recommendations regarding ART adherence improvement and HIV infection control and prevention among HTR people. METHODS: The PubMed, EMBASE, and Cochrance Library databases and the bibliographies of relevant studies were systematically searched up to December 2018. Full-text studies published in English were included, and no geographic or race restrictions were applied. Studies that quantitatively assessed the association between HTR status and optimal ART adherence among HIV-infected populations with a status of homelessness, sex work, or drug use were eligible for inclusion. We estimated the pooled odds ratios (ORs) of HTR characteristics related to ART adherence from each eligible study using a random effects model. The sensitivity, heterogeneity and publication bias were assessed. RESULTS: Our search identified 593 articles, of which 29 studies were eligible and included in this meta-analysis. The studies were carried out between 1993 and 2017 and reported between 1999 and 2018. The results showed that HTR status resulted in a 45% reduction in the odds of achieving optimal ART adherence compared to odds in the general population (OR = 0.55, 95% confidential intervals (CIs) 0.49-0.62), and this significant inverse association was consistently found regardless of study design, exposure measurement, adherence cut-off points, etc. Subgroup analyses revealed that the HTRs tend to be suboptimal adhering during a longer observational period. CONCLUSIONS: HIV treatment adherence is extremely negatively affected by HTR status. It is crucial to develop appropriate interventions to improve ART adherence and health outcomes among HTR people who are HIV-infected.

Fármacos Anti-HIV/uso terapêutico , Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/tratamento farmacológico , Pessoas em Situação de Rua/estatística & dados numéricos , Adesão à Medicação/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Humanos , Estudos Observacionais como Assunto
BMC Public Health ; 19(Suppl 4): 548, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196020


BACKGROUND: The presence of homelessness in Malaysia is not a new issue. The existence of homeless population is growing, along with the development of this country. With the increasing number of homelessness, the range of issues, such as health services financier among them, has surfaced. However, there was limited study conducted on this subject. The main objective of this study was thus, to identify the financier of health services among the homelessness in Kuala Lumpur and factors associated with it. METHODS: In this cross-sectional study, we include 196 homeless people aged above 18 years, Malaysian who were able to communicate with interviewers, and respondents who were not aggressive. These respondents were transits at Pusat Transit Gelandangan Kuala Lumpur and Anjung Singgah Kuala Lumpur and were available during interview sessions. They were selected via simple random sampling and were interviewed via face to face guided interviews using a validated structured questionnaire. Data were analysed descriptively, as well as using bivariate and multivariate analysis to explore the associated factors. RESULTS: The study showed that 57.7% homeless utilized the health services with only 37.8% assessed government health services. Only 42.5% of the respondents use their own money and 46.9% received aids to finance their health. Major influencing factors that influence homeless people to use their own money for health services were education level, income and disability, with adjusted OR (95% CI) of 3.15 (1.07-9.25), 0.08 (0.029-3.07) and 0.05 (0.003-0.88) while p value was 0.037, < 0.001 and 0.041 respectively. The influencing factors for receiving aid for health services were income and those who took drugs with adjusted OR (95% CI) of 6.50 (2.30-18.39), and 0.33 (0.11-0.95) while p value was < 0.001 and 0.041 respectively. CONCLUSION: There is low healthcare services utilization and affordability among homelessness. All parties should play a role in ensuring that homeless people are not left behind in the health care accessibility in Malaysia.

Acesso aos Serviços de Saúde/economia , Serviços de Saúde/economia , Financiamento da Assistência à Saúde , Pessoas em Situação de Rua/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto Jovem
Community Dent Health ; 36(2): 137-142, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31070874


OBJECTIVE: A qualitative exploration of the barriers and facilitators for people experiencing homelessness achieving good oral health. PARTICIPANTS: Adults using two homeless centres in Leeds. METHODS: Focus group discussions were convened with homeless people using support services. Both an inductive and deductive approach to data analysis was taken. Themes were identified and then a framework applied to analysis using Nvivo software. RESULTS: Three focus group discussions with 16 participants were conducted with people experiencing homelessness. The barriers identified were insufficient information on local dental services, negative attitudes of oral health professionals, low priority of dental care, anxiety and cost of dental treatments. Facilitators included single dental appointments, accessible dental locations and being treated with respect. CONCLUSIONS: Despite the barriers that prevent people experiencing homelessness from maintaining and improving their oral health, the participants were aware that they needed oral healthcare and requested that dental services were made available to them and were accessible in line with their socioeconomic status and needs.

Acesso aos Serviços de Saúde , Pessoas em Situação de Rua , Saúde Bucal , Adulto , Assistência Odontológica , Grupos Focais , Humanos
JAMA ; 321(20): 1977, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31135853
BMC Public Health ; 19(1): 635, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31126265


BACKGROUND: Up to 80% of the adult homeless population use tobacco, and smoking cessation programs could offer an important opportunity to address preventable mortality and morbidity for this population. This population faces serious challenges to smoking cessation, including the impact of the social environment. METHODS: Forty participants (11 female; 29 male) from an ongoing smoking cessation randomized clinical trial conducted at 2 urban homeless shelters in the Upper Midwest were invited to take part in semi-structured interviews in 2016-2017. An interviewer used a semi-structured interview guide asking participants to describe their experience of how the social environment impacted their attempt to quit smoking. RESULTS: Participants described feeling pressure to smoke and drink in and around shelters, and that this pressure had led some to start smoking or resume smoking, along with making it very challenging to quit. Participants described being motivated to quit, and seeing smoking cessation as positively impacting the time and focus they felt they had for finding housing. However many felt more interested in reducing their smoking, rather than quitting. CONCLUSIONS: Addressing smoking cessation for people experiencing homelessness is both an important public health opportunity, and a challenge. There is a need to consider cessation in the context of the social and environmental factors impacting smokers who are experiencing homelessness. In particular, there is a need to address the collective value placed on smoking in social interactions. Despite these challenges, there are high levels of motivation and interest in addressing smoking. TRIAL REGISTRATION: NCT01932996 . Date of registration 30th August 2013. Prospectively registered.

Pessoas em Situação de Rua/psicologia , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Meio Social , Estresse Psicológico/psicologia , Adulto , Idoso , Feminino , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Fumantes/estatística & dados numéricos , Fumar/epidemiologia , Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , População Urbana
An. psicol ; 35(2): 175-180, mayo 2019. graf
Artigo em Espanhol | IBECS | ID: ibc-181686


Objetivos: Analizar la incidencia de diferentes variables en el padecimiento de reiterados episodios en la situación sin hogar. Método: El trabajo se realizó a partir de los datos obtenidos de una muestra representativa de las personas en situación sin hogar en Madrid (España) (n=188). Resultados: El padecimiento de una enfermedad grave o crónica ejerce un efecto en la "puerta giratoria" a la situación sin hogar mediado por una percepción subjetiva muy negativa de la propia salud que, a su vez, se encuentra mediada por el padecimiento de alguna discapacidad. El consumo excesivo de alcohol ejerce un efecto en la "puerta giratoria" a la situación sin hogar mediado por el acceso a tratamiento por problemas derivados de dicho consumo. Padecer una enfermedad grave o crónica correlaciona con tener o haber tenido problemas derivados de un consumo excesivo de alcohol. El padecimiento de múltiples sucesos vitales estresantes ejerce un efecto directo en la "puerta giratoria" a la situación sin hogar. Conclusiones: Para prevenir la "puerta giratoria" a la situación sin hogar hay que eliminar las barreras que dificultan el acceso a los recursos normalizados de salud a las personas en exclusión social, a la vez que implementar programas continuados de apoyo para las personas sin hogar o en riesgo que incluyan prioritariamente cuestiones de salud

Objectives: To analyse the impact of different variables on repeated episodes of homelessness. Method: The study was conducted based on data obtained from a representative sample of homeless people in Madrid (Spain) (n=188). Results: Suffering from a serious or chronic illness has an effect on the revolving door to homelessness, which is mediated by a highly negative subjective perception of the individual's own health, which is in turn mediated by suffering from a disability. Excessive alcohol consumption has an effect on the revolving door to homelessness, mediated by access to treatment for problems caused by alcohol consumption. Suffering from a serious or chronic illness correlates with having problems caused by excessive alcohol consumption. Experiencing multiple stressful life events has a direct effect on the revolving door to homelessness. Conclusions: To prevent the revolving door to homelessness, it is necessary to remove the barriers that hinder access to normal health resources which are experienced by people suffering from social exclusion, while implementing on going support programmes for homeless people or those at risk of homelessness, which primarily deal with health issues

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pessoas em Situação de Rua/psicologia , Alcoolismo/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Mentais/epidemiologia , Pessoas em Situação de Rua/estatística & dados numéricos , Pacientes Desistentes do Tratamento/psicologia , Problemas Sociais/psicologia , Acesso aos Serviços de Saúde/tendências
BMC Public Health ; 19(1): 445, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035978


BACKGROUND: Problem gambling (PG) is a serious public health concern that disproportionately affects people experiencing poverty, homelessness, and multimorbidity including mental health and substance use concerns. Little research has focused on self-help and self-management in gambling recovery, despite evidence that a substantial number of people do not seek formal treatment. This study explored the literature on PG self-management strategies. Self-management was defined as the capacity to manage symptoms, the intervention, health consequences and altered lifestyle that accompanies a chronic health concern. METHODS: We searched 10 databases to identity interdisciplinary articles from the social sciences, allied health professions, nursing and psychology, between 2000 and June 28, 2017. We reviewed records for eligibility and extracted data from relevant articles. Studies were included in the review if they examined PG self-management strategies used by adults (18+) in at least a subset of the sample, and in which PG was confirmed using a validated diagnostic or screening tool. RESULTS: We conducted a scoping review of studies from 2000 to 2017, identifying 31 articles that met the criteria for full text review from a search strategy that yielded 2662 potential articles. The majority of studies examined self-exclusion (39%), followed by use of workbooks (35%), and money or time limiting strategies (17%). The remaining 8% focused on cognitive, behavioural and coping strategies, stress management, and mindfulness. CONCLUSIONS: Given that a minority of people with gambling concerns seek treatment, that stigma is an enormous barrier to care, and that PG services are scarce and most do not address multimorbidity, it is important to examine the personal self-management of gambling as an alternative to formalized treatment.

Jogo de Azar/terapia , Autogestão/métodos , Adaptação Psicológica , Jogo de Azar/psicologia , Comportamentos Relacionados com a Saúde , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Atenção Plena/métodos , Autogestão/psicologia
MMWR Morb Mortal Wkly Rep ; 68(15): 344-349, 2019 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-30998671


Although diagnoses of human immunodeficiency virus (HIV) infection among persons who inject drugs in the United States are declining, an HIV outbreak among such persons in rural Indiana demonstrated that population's vulnerability to HIV infection (1). In August 2018, Public Health-Seattle and King County (PHSKC) identified a cluster of cases of HIV infection among persons living homeless, most of whom injected drugs. Investigation identified 14 related cases diagnosed from February to mid-November 2018 among women who inject drugs and men who have sex with women (MSW) who inject drugs and their sex partners. All 14 persons were living homeless in an approximately 3-square-mile area and were part of a cluster of 23 cases diagnosed since 2008. Twenty-seven cases of HIV infection were diagnosed among women and MSW who inject drugs in King County during January 1-November 15, 2018, a 286% increase over the seven cases diagnosed in 2017. PHSKC has alerted medical and social service providers and the public about the outbreak, expanded HIV testing among persons who inject drugs or who are living homeless, and is working to increase the availability of clinical and prevention services in the geographic area of the outbreak. This outbreak highlights the vulnerability of persons who inject drugs, particularly those who also are living homeless, to outbreaks of HIV infection, even in areas with high levels of viral suppression and large syringe services programs (SSPs).

Surtos de Doenças , Infecções por HIV/epidemiologia , Heterossexualidade/estatística & dados numéricos , Pessoas em Situação de Rua/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Washington/epidemiologia , Adulto Jovem
Arq. bras. psicol. (Rio J. 2003) ; 71(1): 112-127, jan.-abr. 2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1007502


Este texto pretende problematizar as práticas clínicas com moradores de rua, em uma proposta que se afasta da clínica tradicional. Para tal, utiliza a teoria da Análise Institucional como interlocutora para abarcar o campo de forças do instituído e do instituinte, que emerge através dos analisadores, efeitos que sustentam essa relação antagonista. Os analisadores encontrados foram: (1) Inserção do plantão psicológico na instituição: demandas e tensões; (2) Dificuldades, bloqueios e entraves vividos nos plantões psicológicos e (3) Espaço clínico como encontro com a alteridade. Concluímos que há uma insuficiência dos modelos tradicionais de Psicologia no contato com outros arranjos clínicos, o que convoca a emergência de outra clínica, instituinte e potente

This article intends to problematize clinical practices with homeless people, in a proposal that departs from the traditional clinic. For this, it uses the theory of Institutional Analysis as interlocutor to encompass the field of forces of the instituted and the instituent, which emerges through the analyzers, effects that sustain this antagonistic relationship. The analyzers that were found include: (1) Insertion of the psychological duty in the institution: demands and tensions; (2) Difficulties and obstacles experienced in psychological duties; and (3) Clinical space as encounter with otherness. We conclude that there is an insufficiency of the traditional models of Psychology in the contact with other clinical arrangements, which justifies the emergence of another clinic, instituent and potential

Este artículo pretende problematizar las prácticas clínicas con los moradores de la calle, en una propuesta que se aparta de la clínica tradicional. Para ello utiliza la teoría del Análisis Institucional como interlocutora para abarcar el campo de fuerzas del instituido y del instituyente, que emerge a través de los analizadores, efectos que sostienen esa relación antagonista. Los analizadores fueron: (1) Inserción el cambio psicológico en la institución: demandas y tensiones; (2) Dificultades, bloqueos y obstáculos vividos en los plantones psicológicos y (3) Espacio clínico como encuentro con la alteridad. Concluimos que hay una insuficiencia de los modelos tradicionales de Psicología en el contacto con otros arreglos clínicos, lo que convoca la emergencia de otra clínica, instituyente y potente

Humanos , Psicologia Clínica , Pessoas em Situação de Rua/psicologia , Acolhimento
Matern Child Health J ; 23(6): 811-820, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31006084


Objectives Research on adverse childhood experiences (ACEs) has provided a valuable framework for understanding associations between childhood maltreatment and family dysfunction and later poor health outcomes. However, increasing research suggests the number and types of childhood adversities measured warrants further examination. This study examines ACE exposure among adults who experienced homelessness in childhood, another type of childhood adversity. Methods This cross-sectional, descriptive study used the 2016 South Carolina (SC) Behavioral Risk Factor Surveillance System (BRFSS) survey and additional ACE modules to examine ACE exposure among SC adults and childhood homelessness. Standard descriptive statistics were calculated for each variable. Bivariate analysis compared types and number of ACEs by childhood homeless status. All analyses used survey sampling weights that accounted for the BRFSS sampling strategy. Results Data from 7490 respondents were weighted for analyses. Among the 215 respondents who reported homelessness in childhood, 68.1% reported experiencing four or more ACEs. In contrast, only 16.3% of respondents who reported no homelessness in childhood reported experiencing four or more ACEs. The percent of respondents was significantly higher for each of 11 ACEs among those who reported childhood homelessness, compared to those who did not. Conclusions for Practice Adults who reported homelessness in childhood also reported significantly greater exposure to higher numbers and types of ACEs than adults reporting no childhood homelessness. Study findings can be important in informing additional indicators important to the assessment of ACEs and to program developers or organizations that provide housing assistance to at-risk families and children.

Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Experiências Adversas da Infância/estatística & dados numéricos , Maus-Tratos Infantis/estatística & dados numéricos , Violência Doméstica/estatística & dados numéricos , Pessoas em Situação de Rua , Acontecimentos que Mudam a Vida , Transtornos Mentais/psicologia , Adolescente , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Criança , Maus-Tratos Infantis/psicologia , Estudos Transversais , Violência Doméstica/psicologia , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , Pessoa de Meia-Idade , Problemas Sociais , South Carolina/epidemiologia , Inquéritos e Questionários , Adulto Jovem
Nutrients ; 11(4)2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30939796


Although nutritional problems are a major concern for the homeless, their vitamin D status has not yet been widely evaluated. This study was a retrospective chart review conducted at a single academic, urban public hospital's emergency department (ED). Patients whose serum 25-hydroxyvitamin D [25(OH)D] levels had been checked in the ED from July 2014 to June 2015 were reviewed and enrolled. For a healthy settled civilian control, 2011 and 2012 data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES) were used. A total of 179 patients were enrolled. Vitamin D deficiency was observed in 133 patients (73.7%). The vitamin D deficiency group showed a lower hemoglobin level than that of non-vitamin D deficiency group (p = 0.02). Winter visits were more common among the deficiency group (p = 0.048). Rhabdomyolysis was observed only in the deficiency homeless group (p = 0.03). When using age and sex as covariates of propensity score matching 25(OH)D levels were lower in the homeless than in the healthy control (15.7 ± 7.4 ng/mL vs. 18.2 ± 5.5 ng/mL, p < 0.001). Moreover, when the controls were limited to residents of the same city, the serum 25(OH)D level also was lower in the homeless than in the control (15.7 ± 7.4 ng/mL vs. 17.1 ± 5.4 ng/mL, p = 0.03). In summary, vitamin D deficiency was common and more frequent among homeless patients.

Serviço Hospitalar de Emergência , Pessoas em Situação de Rua , Deficiência de Vitamina D/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , República da Coreia/epidemiologia , Estudos Retrospectivos
Br J Community Nurs ; 24(4): 165-172, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30969851


This literature review aimed to answer the focus question: are district nurses well placed to provide equitable end of life care (EOL) for homeless individuals? It focused on 10 primary research studies, from which two themes emerged and subsequently formed the basis of the discussion: (1) the difficulty in predicting disease trajectory in people who are homeless and (2) the gaps in existing systems. The main findings from these themes were a lack of education on the recognition of the dying and a general lack of knowledge of the complex challenges faced by and health needs of homeless people, which cause stigma from both the general public and health professionals towards these marginalised individuals. Further, there is certainly a lack of suitable places to deliver palliative and EOL care for people who are homeless. Available services are inflexible and have no tolerance for substance misuse, which creates an access barrier for homeless people in need of EOL care.

Enfermagem em Saúde Comunitária/organização & administração , Pessoas em Situação de Rua , Padrões de Prática em Enfermagem , Assistência Terminal , Humanos , Medicina Estatal , Reino Unido