amp Health Management Jessica Sherman N MScA Health Services Coordinator Welcome Hall Mission Homelessness Homelessness describes the situation of an individual or family without stable permanent appropriate housing or the immediate prospect means and ability of acquiring it ID: 915404
Download Presentation The PPT/PDF document "Homelessness, Chronic Illness" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Homelessness, Chronic Illness & Health Management
Jessica Sherman, N, MSc(A)Health Services CoordinatorWelcome Hall Mission
Slide2Homelessness“Homelessness describes the situation of an individual or family without stable, permanent, appropriate housing, or the immediate prospect, means and ability of acquiring it
. It is the result of systemic or societal barriers, a lack of affordable and appropriate housing, the individual/household’s financial, mental, cognitive, behavioural or physical challenges, and/or racism and discrimination.”(Canadian homelessness research network, 2012)
Chronic disease and homelessness
Up to 85% of population experiencing homelessness reports chronic disease diagnosis
Slide3Perceptions, needs and preferences of self-management support among men experiencing homelessness in Montreal
Graduate Student Researcher Laura Merdsoy, n, MSc(A)
Study Supervisors
Dr
. Sylvie Lambert (Principle Investigator) Assistant Professor, Ingram School
of nursing, McGill
University Jessica Sherman, Health Services coordinator, Welcome Hall Mission
Slide4BackgroundThe Chronic Care Model and Self-Management
The Chronic Care Model (CCM) was developed around 1998 with the goal of mitigating the burden of chronic disease on both individuals and the healthcare system
19/20 studies that included self-management support, patient outcomes improved
(
Bodenheimer
, 2003)
Slide5Study question and design
Question:
What
are the perceptions, needs, and preferences of self-management support among men experiencing homelessness in Montreal?
Design: Qualitative
Setting
:
WHM
Participants
: 18 men experiencing
homelessness,
regardless of disease and time since
diagnosis,
and accessing the WHM emergency shelter services
Data
collection: one semi-structured interview (face-to-face, approx. 1-1.5 hours)
Data
analysis: analysis of transcripts (thematic analysis)
Slide6ResultsPERCEPTIONS OF SELF MANAGEMENT
Most participants perceived chronic disease SM as important Participants expressed confidence to carry out many SM behaviorsParticipants showed creativity and resourcefulness in adapting SM behaviours to the context of homelessness
“I
put all my pills in the Kinder Egg. So, I have it in my pocket, I feel it,
so
every night, [I] take my pills
”
Slide7ResultsSELF-MANAGEMENT SUPPORT NEEDS
Resourcefulness with medical SM, however, emotional SM was identified as particularly challengingEmotions around chronic disease and homelessness were intertwined
Slide8ResultsThree vulnerable groups were identified
Slide9ResultsPREFERENCES FOR SELF-MANAGEMENT SUPPORT
Without consistent HCP
Both
good and bad experiences
Not generally satisfied with chronic disease information received
Used healthcare services only in case of emergencies
Faced barriers
to accessing services
38.4% of participants saw the on-site nurse
With consistent HCP
Overall
positive experiences
Satisfied with chronic disease information received
Regularly
used healthcare services
Appreciate the
ability to “talk about problems and personal things”
Slide10ResultsPreferences for self-management support
Barriers includedExpiration of health insuranceNegative past experiences
Prejudice and stigma
“They [doctors] size you up and they're like... this guy is a street guy… And if he's a street guy than he's here for drugs... they basically blow off everything you say.”
Slide11Results
Preferences for self-management supportParticipants supported the idea of peer-support SMS interventions
Unlike
HCPs, peers have “been through all of it.”
Opportunity to share lived experience and
expertise
“…it's good to have people to talk to… even if you
knew
people were just
around…it
just made you feel, sort of, better.”
Slide12DiscussionParticipants do have confidence to adapt self management behaviours
And they have done so independentlyMain needs for SM support is for development of social support and emotional coping skillsPrimary preference is for SM support to be provided through HCPPreference for consistent HCPParticipants identified a secondary preference for peer support
Peer-led
element crucial to Stanford Chronic Disease Self-management Program – the “gold standard” of SMS
Slide13Thank you