2023-09-28 14:46:10 +00:00
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abstract: 'Background People who use drugs and are structurally vulnerable (e.g.,
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experiencing unstable and/or lack of housing) frequently access acute
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care. However, acute care systems and providers may not be able to
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effectively address social needs during hospitalization. Our objectives
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were to: 1) explore social service providers'' perspectives on addressing
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social needs for this patient population; and 2) identify what possible
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strategies social service providers suggest for improving patient care.
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Methods We completed 18 semi-structured interviews with social service
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providers (e.g., social workers, transition coordinators, peer support
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workers) at a large, urban acute care hospital in Western Canada between
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August 8, 2018 and January 24, 2019. Interviews explored staff
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experiences providing social services to structurally vulnerable
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patients who use drugs, as well as continuity between hospital and
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community social services. We conducted latent content analysis and
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organized our findings in relation to the socioecological model. Results
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Tensions emerged on how participants viewed patient-level barriers to
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addressing social needs. Some providers blamed poor outcomes on
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perceived patient deficits, while others emphasized structural factors
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that impede patients'' ability to secure social services. Within the
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hospital, some participants felt that acute care was not an appropriate
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location to address social needs, but most felt that hospitalization
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affords a unique opportunity to build relationships with structurally
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vulnerable patients. Participants described how a lack of housing and
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financial supports for people who use drugs in the community limited
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successful social service provision in acute care. They identified
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potential policy solutions, such as establishing housing supports that
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concurrently address medical, income, and substance use needs.
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Conclusions Broad policy changes are required to improve care for
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structurally vulnerable patients who use drugs, including: 1) ending
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acute care''s ambivalence towards social services; 2) addressing
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multi-level gaps in housing and financial support; 3) implementing
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hospital-based Housing First teams; and, 4) offering sub-acute care with
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integrated substance use management.'
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affiliation: 'Hyshka, E (Corresponding Author), Univ Alberta, Sch Publ Hlth, Edmonton,
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AB, Canada.
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Hyshka, E (Corresponding Author), Royal Alexandra Hosp, Inner City Hlth \& Wellness
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Program, Edmonton, AB, Canada.
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Gehring, Nicole D.; Speed, Kelsey A.; Hyshka, Elaine, Univ Alberta, Sch Publ Hlth,
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Edmonton, AB, Canada.
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Gehring, Nicole D.; Speed, Kelsey A.; Dong, Kathryn; Salvalaggio, Ginetta; Hyshka,
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Elaine, Royal Alexandra Hosp, Inner City Hlth \& Wellness Program, Edmonton, AB,
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Canada.
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Dong, Kathryn; Salvalaggio, Ginetta, Univ Alberta, Fac Med \& Dent, Edmonton, AB,
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Canada.
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Pauly, Bernie, Univ Victoria, Sch Nursing, Victoria, BC, Canada.'
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article-number: '1138'
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author: Gehring, Nicole D. and Speed, Kelsey A. and Dong, Kathryn and Pauly, Bernie
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and Salvalaggio, Ginetta and Hyshka, Elaine
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author-email: ehyshka@ualberta.ca
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author_list:
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- family: Gehring
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given: Nicole D.
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- family: Speed
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given: Kelsey A.
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- family: Dong
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given: Kathryn
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- family: Pauly
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given: Bernie
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- family: Salvalaggio
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given: Ginetta
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- family: Hyshka
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given: Elaine
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da: '2023-09-28'
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doi: 10.1186/s12913-022-08498-x
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eissn: 1472-6963
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files: []
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journal: BMC HEALTH SERVICES RESEARCH
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keywords: 'Social needs; Social work; Social services; Structural vulnerability;
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Illegal drugs; Houseless; Acute care; Qualitative research'
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keywords-plus: 'HEALTH-CARE PROVIDERS; SUBSTANCE USE; EMERGENCY-DEPARTMENT; HOMELESS
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ADULTS; MENTAL-ILLNESS; SAFETY; STIGMA; WORK; INTERVENTIONS;
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DETERMINANTS'
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language: English
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month: SEP 8
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number: '1'
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number-of-cited-references: '64'
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orcid-numbers: 'Dong, Kathryn/0000-0002-0843-4618
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Speed, Kelsey/0000-0002-5728-5209'
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papis_id: 3c98705d2e417de0bd6b110226deb1b9
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ref: Gehring2022socialservice
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researcherid-numbers: 'Dong, Kathryn/JBS-4781-2023
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Hyshka, Elaine/AGG-3812-2022
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'
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times-cited: '0'
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title: 'Social service providers'' perspectives on caring for structurally vulnerable
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hospital patients who use drugs: a qualitative study'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000852400500001
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usage-count-last-180-days: '2'
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usage-count-since-2013: '5'
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volume: '22'
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web-of-science-categories: Health Care Sciences \& Services
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year: '2022'
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