scholarly journals Street Medical Consultation: health access of the Homeless People and intersectoral articulation

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Santos ◽  
G R Bombonati ◽  
D Marques ◽  
M F G Vilela ◽  
E M Silva
Keyword(s):  
Health Care ◽  
Harm Reduction ◽  
Social Assistance ◽  
Homeless People ◽  
Homeless Persons ◽  
Medical Consultation ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Barriers To Access ◽  
The Social

Abstract Background The Homeless People is marked by serious social vulnerability, related to the absence of human dignity. Requirements of personal and residential documents, reception and inadequate approaches are barriers to access these people. The creation of Street Medical Consultation (CnaR), based on the logic of harm reduction in association with the other services, is a strategy that seeks to expand access to the services of the Public Healthcare System (SUS) in Brazil. The research aimed to analyze the characteristics and vulnerabilities of this population, the performance of CnaR and its articulation with services from the health care and the social assistance care network. Methods Study of a qualitative approach using 8 semi-structured interviews and the Thematic Content Analysis method. The study scenario was the CnaR multiprofissional team in a city in the interior of São Paulo. Results Three categories were found: (1) Population in Street Situation - complexity of those who live on the street: prejudices, violence and barriers in society and health institutions constitute a process of invisibility. (2) CnaR's work in the perspective of harm reduction: it is organized to meet the clinical and alcohol and other drugs demands through fixed fields, mobile fields and team meeting. (3) Beyond CnaR - network relationships: bringing dynamics to relationships, being strengthened or weakened. Ignorance of the service and their performance also generates CnaR invisibility process. The strategies developed include coping, dialogue, building partnerships and the process of visibility and fighting for the rights of the Homeless Persons. Conclusions CnaR finds itself as an insufficient service to meet all the demands of this vulnerable population in isolation, needing the network to expand access to health and other goods. It is necessary to combat prejudice against this population among health professionals and develop more efficient intersectoral articulation. Key messages The Homeless People have serious vulnerability and need humanization, guaranteeing equity in assistance in all sectors of society, especially the health care and the social assistance. The Street Medical Consultation faces performance difficulties to guarantee access to the Homeless People within the intersectoral network, often being the sole responsible for this population.

scholarly journals On What Do the Homeless Base Their Happiness?

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1512
Author(s):  
Yaiza Cano-González ◽  
Carmen Portillo-Sotelo ◽  
María del Mar Rodríguez-del-Águila ◽  
María Paz García-Caro ◽  
Ana M. Núñez-Negrillo ◽  
...  
Keyword(s):  
Content Analysis ◽  
Satisfaction With Life ◽  
Homeless People ◽  
Self Esteem ◽  
Homeless Persons ◽  
Structured Interviews ◽  
Support Strategies ◽  
Northern Areas ◽  
The Relationship ◽  
The City

Objective: To determine the relationship between the characteristics and experiences of homeless persons and their state of happiness as a basis for designing appropriate social support strategies. Design: Exploratory observational study with an analytical and descriptive qualitative design. Setting: Participants were contacted, administered with questionnaires, and interviewed in the street (central and northern areas of the city) or at the “Asociación Calor y Café” center in Granada (Spain) between April 2017 and February 2018. Participants: Selected by intentional sampling, 25 participants completed questionnaires in the first study and 14 of these were administered with questionnaires and interviewed in the second study. Method: General and specific questionnaires were administered to determine the state of happiness and other variables. Descriptive statistics were followed by an analysis of the relationships between variables and the content analysis of semi-structured interviews. Results: A feeling of happiness was described by 64% of participants and confirmed by a happiness scale score of 50%. Participants who felt satisfied with their life were 4.5-fold more likely to feel happy (p = 0.021). Expectations for the future were not associated with happiness or satisfaction with life. Content analysis of interviews revealed three main themes: conditions for happiness, own happiness/unhappiness, and self-esteem. Conclusions: Many homeless people describe themselves as feeling happy and satisfied with their life. Material aspects, affective situations, daily life concerns, and self-esteem predominate in their discourse on happiness.

scholarly journals Contradictory and Intersecting Patterns of Inclusion and Exclusion of Street Youth in Salvador, Brazil

2016 ◽  
Vol 4 (4) ◽  
pp. 39-50 ◽  
Author(s):  
Marit Ursin
Keyword(s):  
Middle Class ◽  
Police Officers ◽  
Participant Observation ◽  
Homeless People ◽  
Homeless Persons ◽  
Street Youth ◽  
Poor People ◽  
Structured Interviews ◽  
The Everyday ◽  
Longitudinal Qualitative Research

Drawing on longitudinal qualitative research in Brazil involving participant observation and narrative interviews with young homeless persons, and semi-structured interviews with middle class residents, local businesses, and patrolling police officers, three overlapping yet contradictory dimensions of inclusion and exclusion are developed. First the hegemonic exclusionary discourse that tends to produce stigmatizing labels on poor people in general, and boys and young men on the street in particular, is mapped out. Second, socio-spatial exclusionary mechanisms involving architectural measures, surveillance cameras and violent policing, guarding the neighbourhood from stigmatised ‘others’ are examined. Third, the less recognised but equally important inclusionary mechanisms, facilitating street life and enabling a sense of belonging among young homeless people are explored. A simplistic and unidimensional conceptualisation of social exclusion is critiqued while demonstrating the multifaceted, intertwined, and contradictory character of homeless people’s social relationships with middle class residents, businesses, and police. Furthermore, the exclusion/inclusion dualism that is vivid in the existing literature is questioned. It is suggested that a nuanced picture is vital to increasing our understanding of the everyday lives of homeless populations and that further investigation and theorization of their exclusion as well as inclusion is needed.

scholarly journals Harm Reduction Outreach Services and Engagement of Chemically Dependent Homeless People Living with HIV/AIDS: An Analysis of Service Utilization Data to Evaluate Program Theory

2016 ◽  
Vol 23 (1) ◽  
pp. 26 ◽  
Author(s):  
Benjamin Shepard
Keyword(s):  
Health Care ◽  
Harm Reduction ◽  
Service Utilization ◽  
Access To Health Care ◽  
Homeless People ◽  
People Living With Hiv ◽  
Outreach Services ◽  
Low Threshold ◽  
Living With Hiv ◽  
Hiv Aids

This study examines service utilization patterns among a socially vulnerable population of homeless people living with HIV/AIDS and who have a history of chemical dependence, as they are engaged through outreach services. CitiWide Harm Reduction collaborates with Montefiore Medical Center to connect homeless people with health care through harm reduction outreach and low threshold medical services. Analysis of two cohorts – individuals engaged through harm reduction outreach and individuals who “walk-in” to engage in services at CitiWide Harm Reduction’s drop-in center – assesses the program’s theory that outreach engagement is a mediating variable increasing service utilization. These results demonstrate that low-threshold harm reduction outreach, a brand of outreach designed to reduce barriers to services, does increase access to health care and related services for a socially vulnerable, traditionally “hard-to-reach,” population. Harm reduction outreach is a valuable intervention for increasing service utilization among this highly marginalized group.

scholarly journals Anti-oppressive social work as a tool to reduce barriers to access health care services for homeless people

Kontakt ◽  
2018 ◽  
Vol 20 (3) ◽  
pp. e292-e297
Author(s):  
Kateřina Glumbíková ◽  
Alice Gojová ◽  
Barbora Gřundělová ◽  
Zuzana Stanková ◽  
Marie Špiláčková ◽  
...  
Keyword(s):  
Health Care ◽  
Social Work ◽  
Health Care Services ◽  
Homeless People ◽  
Care Services ◽  
Barriers To Access

scholarly journals Desempenho ocupacional de mulheres em situação de rua / Occupacional performance of homeless women

2018 ◽  
Vol 2 (1) ◽  
pp. 85-108
Author(s):  
Thayane de Cácia Brito Prudente ◽  
Rayssa Béder César Paiva ◽  
Daniela Tavares Gontijo
Keyword(s):  
Occupational Therapy ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Social Assistance ◽  
Occupational Therapists ◽  
Homeless Persons ◽  
Homeless Women ◽  
Occupational Performance ◽  
Structured Interviews

Introdução: A população em situação de rua caracteriza-se predominantemente pela falta de moradia regular, condição de pobreza extrema e vínculos rompidos ou fragilizados. No entanto, a vida na rua e o acesso aos serviços socioassistenciais tendem a não se configurar da mesma forma para homens e mulheres. Considerando a perspectiva do desempenho ocupacional, os terapeutas ocupacionais se preocupam com os fatores que influenciam o envolvimento dos sujeitos em ocupações. Objetivo: compreender o desempenho ocupacional de mulheres em situação de rua. Métodos: Estudo de abordagem qualitativa, com base na História Oral de Vida. A coleta de dados foi realizada em dois serviços socioassistenciais do Recife que atendem pessoas em situação de rua.  Os dados foram coletados através de entrevistas semiestruturadas e submetidos à Análise de Conteúdo Temática. Resultados/discussão: Foram entrevistadas 8 mulheres com idades entre 20 a 39 anos. A análise resultou em três categorias temáticas: Desempenho Ocupacional na infância, Ida para rua e Desempenho Ocupacional na rua. As categorias forma dividias em: Atividades de Vida Diária (AVDs), Atividades Instrumentais de Vida Diária (AIVDs), Trabalho, Lazer e Participação Social. Observou-se que as mulheres em situação de rua vivenciam um processo de privação ocupacional pela situação de desfiliação em que vivem, com repercussão negativa na qualidade de vida. Conclusão: Neste estudo pode-se observar a dificuldade das mulheres em realizar todas as ocupações, justificando a intervenção da Terapia Ocupacional para favorecer o empoderamento pessoal, a ressignificação do cotidiano e exercício da cidadania.  AbstractIntroduction: The population in street situation is predominantly characterized by a lack of regular housing, an extreme poverty and  weakened or broken bonds. However, street living and access to social assistance services tend not to be configured in the same way for men and women. Considering the perspective of occupational performance, occupational therapists are concerned with factors that influence the subjects' engagement in occupations. Objective: To understand the occupational performance of women who are homeless. Method: A qualitative study based on the Oral Story of Life. The data collection was performed in two social assistance services in the city of Recife that receive people who live on streets. Data were collected through semi-structured interviews and submitted to the Thematic Content Analysis. Results/Discussion: Eight women aged 20 to 39 years were interviewed. The analysis resulted in three thematic categories: Occupational Performance in childhood, Going to the streets and Occupational Performance in the streets. The categories were divided into Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), Work, Leisure and Social Participation. It was observed that homeless women experience a process of occupational deprivation with negative repercussions on the quality of life due to the situation of disaffiliation in which they live. Conclusion: In this study it is possible to observe the women's difficulty to perform all the occupations, justifying the intervention of the Occupational Therapy to favor the personal empowerment, the resignification of the daily life and the exercise of the citizenship.Keywords: Homeless persons, Autobiography, Gender identity, Women, social Vulnerability, Occupational therapy.

scholarly journals Nursing work process in Street Clinic to combat vulnerability of the Homeless Persons

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G R Bombonatti ◽  
D S Santos
Keyword(s):  
Harm Reduction ◽  
Participant Observation ◽  
National Health System ◽  
Homeless Persons ◽  
Essential Elements ◽  
Structured Interviews ◽  
Work Process ◽  
Content Analysis Method ◽  
Nursing Team ◽  
Health Demands

Abstract Background The Street Clinic was created to expand access to health for Homeless Persons. Within the service, the role of the nursing team is very important in accessing and establishing care, welcoming, bond building, promoting a save environment, health prevention and education, interdisciplinary communication, patient management and articulation with other services. The research aimed to analyze the objects, instruments, purposes and products in the nursing work process, considering the principle of equity of Brazilian National Health System and the serious vulnerability of the population in question. In this way, it is necessary to understand the valorization of nursing. Methods Study of qualitative approach with participant observation, field diary, application of three semi-structured interviews and use of thematic content analysis method. The study scenario was the nursing team of the Street Clinic in a city in the interior of São Paulo. Results The following elements of the nursing work process were analyzed: dwelling place, health demands and intersectionality of this population (objects); team organization, materials, harm reduction, communication with the intersectoral network, assistance, health guidance, opportunities for action, administration, management and personal and professional transformation (instruments); comprehensive and equitable care, building bonds and trust (purposes and products). Nursing, in this process and within a biomedical logic in the service, faces overload, pressure and devaluation. Conclusions Nursing is configured as a strategic category in the performance of the Street Clinic and in the equity of care. There are facilities and difficulties to act independently with the multiprofissional team, especially with the biomedical model present in the service. It is necessary to build recognition of the performance of nursing and the empowerment of professionals in this category. Key messages Nursing still needs professional empowerment and recognition of the importance of their work process as essential in addressing vulnerabilities and equity in care. Bonding, trust and harm reduction are essential elements in the nursing work process in addressing the vulnerability of the Homeless Persons.

scholarly journals Harm reduction in the context of psychoactive substances: nursing discourses in primary health care

2021 ◽  
Vol 55 ◽  
Author(s):  
Sarah Salvador Pereira ◽  
Maria do Perpétuo Socorro de Sousa Nóbrega ◽  
Angélica Martins de Souza Gonçalves ◽  
Simone Teresinha Protti-Zanatta ◽  
Priscila Maria Marcheti ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Harm Reduction ◽  
Interpersonal Relationships ◽  
Health Prevention ◽  
Psychoactive Substances ◽  
Structured Interviews ◽  
Physical Damage ◽  
Primary Health ◽  
Nursing Professionals

ABSTRACT Objective: To analyze the production of meanings on interventions considered as Harm Reduction in the discourses of nursing professionals working in Primary Health Care. Method: Qualitative study based on the theoretical-methodological framework of French Discourse Analysis. Semi-structured interviews were conducted with 14 nursing professionals working in Primary Health Care, from February to October 2019. Results: Most Harm Reduction practices performed by nursing professionals aim to minimize risks and physical damage. Harm Reduction actions that require welcoming, non-judgment and qualified listening were observed. Some nursing professionals perform Harm Reduction actions, but do not recognize them as such. Conclusion: The production of meanings in the discourses of nursing professionals presented evidence of biomedical and/or disease discursive formations, health prevention, interpersonal relationships and health promotion.

scholarly journals OS SEGMENTOS EXCLUÍDOS E OS MOVIMENTOS SOCIAIS: A PERSPECTIVA DOS BENEFICIÁRIOS DO PROGRAMA BOLSA FAMÍLIA

Revista LEVS ◽  
2017 ◽  
Vol 20 (20) ◽  
Author(s):  
Daniele Cristina Cintra NOBREGA ◽  
Daniela Emilena Santiago Dias OLIVEIRA ◽  
Carolina Cristina do Rosário RUIZ ◽  
Gabriela Flavia Pereira da Sil SIQUEIRA
Keyword(s):  
Social Movements ◽  
Social Services ◽  
Social Assistance ◽  
National Policy ◽  
Large Majority ◽  
Structured Interviews ◽  
Daily Lives ◽  
Quality Life ◽  
The Social ◽  
Bolsa Familia

Resumo: No Brasil tivemos um reavivamento dos movimentos sociais no ano de 2013, que teriam surgido em virtude do reajuste no valor das passagens de ônibus circular. Esse movimento mobilizou diversos segmentos e rapidamente, se espraiou para reivindicações de toda natureza. O que nos interessou, diante de todo esse contexto, foi entender como a população excluída, ou seja, população que não tem acesso a todos os serviços sociais dos quais necessitaria para sobreviver e ter uma vida de qualidade, percebe e compreende esse tipo de organização e mais, como se apropria dessas expressões. Para apreender essa realidade realizamos entrevistas semi-estruturadas com cinco representantes de famílias beneficiárias do Programa Bolsa Família a fim de identificar qual a perspectiva possuída por essas famílias a respeito dos movimentos sociais e dessa maneira identificar ainda de que maneira essas organizações populares teriam colaborado para a alteração de sua vivência cotidiana. Constatamos assim que os segmentos excluídos de referência para essa pesquisa, também são excluídos a tais formas de expressão, uma vez que grande maioria dos entrevistados mostrou-se alheia aos movimentos sociais organizados no Brasil.Palavras-chave: Movimentos Sociais; Exclusão; Bolsa Família; Política Nacional de Assistência Social. Abstract: In Brazil we had a revival of the social movements in the year 2013, which would have arisen because of the adjustment in the value of the circular passages. This movement mobilized several segments and quickly spread to demands of all kinds. What interested us in this context was to understand how the excluded population, that is, population that does not have access to all the social services that it would need to survive and have a quality life, perceives and understands this type of organization And more, how to appropriate those expressions. In order to understand this reality, we conducted semi-structured interviews with five representatives of beneficiary families of the Bolsa Família Program in order to identify the perspective of these families on social movements and thus to identify in what way these popular organizations would have collaborated for the Change in their daily lives. Thus, we find that excluded segments of reference for this research are also excluded from such forms of expression, since a large majority of respondents have shown themselves to be alien to organized social movements in Brazil.Keywords: Social Movements. Exclusion. Bolsa Família. National Policy on Social Assistance.

scholarly journals “A place to be safe, feel at home and get better”: Including the experiential knowledge of potential users in the design of the first wet service in Montreal, Canada

2021 ◽  
Author(s):  
ROSSIO MOTTA OCHOA ◽  
Natalia Incio-Serra ◽  
Hélène Poliquin ◽  
Sue-Ann MacDonald ◽  
Christophe Huỳnhe ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Harm Reduction ◽  
Research Approach ◽  
Structured Interviews ◽  
Complex Needs ◽  
Barriers To Access ◽  
Wide Range ◽  
A Site ◽  
Alcohol Programs

Abstract BackgroundThe harmful use of alcohol is one of the leading health risk factors for people’s health worldwide, but some populations, like people who experience homelessness, are more vulnerable to its detrimental effects. In the past decades, harm reduction interventions that target these complex issues has been developed. For example, wet services include a wide range of arrangements (wet shelters, drop-in centers, transitory housing, etc.) that allow indoor alcohol use and Managed Alcohol Programs provide regulated doses of alcohol in addition to accommodation and services. Although the positive impacts of these interventions have been reported, little is known about how to integrate the knowledge of people experiencing homelessness and alcohol dependence into the design of such programs. The aim of this study is to present the findings of such an attempt in a first wet service in Montreal, Canada. MethodsCommunity based participatory research approach and qualitative methods–including semi-structured interviews and focus groups–were used to collect the knowledge of potential users (n = 34) of the wet service. The data collected was thematically analyzed. ResultsParticipants reported experiencing harsh living conditions, poverty, stigmatization and police harassment, which increased their alcohol use. The intersection between participants’ alcohol dependence and homelessness with the high barriers to access public services translated into their exclusion from several of such services. Participants envisioned Montreal’s wet service as a safe space to drink, a place that would provide multiple services, a home, and a site of recovery. ConclusionsIntegrating the knowledge of potential users into the design of harm reduction interventions is essential to develop better and more adapted services to meet complex needs. We propose that it could fosters users’ engagement and contribute to their sense of empower, which is crucial for a group that is typically discriminated against and suffers from marginalization.

Internal coordination of social security in Sweden

2019 ◽  
Vol 21 (2) ◽  
pp. 174-182
Author(s):  
Jaan Paju
Keyword(s):  
Health Care ◽  
Social Security ◽  
Social Care ◽  
Local Governance ◽  
Social Assistance ◽  
County Council ◽  
Population Register ◽  
Applicable Law ◽  
The Social

This article begins with an overview of the structure of local governance in Sweden. It then examines the division of competences between municipalities and county councils, and the population register that determines the applicable law. Following this, the article focuses on health care schemes and the possibility for the competent county council to determine substantive health care. The municipalities’ responsibility for long term social care is then considered. Finally, the municipalities’ room for manoeuvre in relation to the social assistance scheme is reviewed. The concluding section discusses Sweden’s decentralised approach to social security.

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