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