Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study
Tóm tắt
The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.
Từ khóa
#Quality of Life ResearchTài liệu tham khảo
Williams JI: Ready, set, stop: reflections on assessing quality of life and the WHOQOL-100 (U.S. version). World Health Organization Quality of Life. Journal of Clinical Epidemiology 2000, 53(1):13–17. 10.1016/S0895-4356(99)00122-5
Browne JP, McGee HM, O'Boyle CA: Conceptual Approaches to the Assessment of Quality of Life. Psychology and Health 1997, 12: 737–751. 10.1080/08870449708406736
Caton CL, Dominguez B, Schanzer B, Hasin DS, Shrout PE, Felix A, McQuistion H, Opler LA, Hsu E: Risk factors for long-term homelessness: findings from a longitudinal study of first-time homeless single adults. Am J Public Health 2005, 95(10):1753–1759. 10.2105/AJPH.2005.063321
Edgar B, Doherty J, Meert H: Review of statistics on homelessness in Europe. In European Federation of National Organizations Woriking with the Homeless. Brussels.
Hubley AM, Russell LB, Palepu A, Hwang SW, Hubley AM, Russell LB, Palepu A, Hwang SW: Subjective quality of life among individuals who are homeless: A review of current knowledge. Social Indicators Research 2012. In press
Martinez TE, Gleghorn A, Marx R, Clements K, Boman M, Katz MH: Psychosocial histories, social environment, and HIV risk behaviors of injection and noninjection drug using homeless youths. Journal of Psychoactive Drugs 1998, 30(1):1–10. 10.1080/02791072.1998.10399665
Johnson TP, Freels SA, Parsons JA, Vangeest JB: Substance abuse and homelessness: social selection or social adaptation? Addiction 1997, 92(4):437–445. 10.1111/j.1360-0443.1997.tb03375.x
Zuvekas SH, Hill SC: Income and employment among homeless people: the role of mental health, health and substance abuse. J Ment Health Policy Econ 2000, 3(3):153–163. 10.1002/mhp.94
Bhui K, Shanahan L, Harding G: Homelessness and Mental Illness: A Literature Review and a Qualitative Study of Perceptions of the Adequacy of Care. International Journal of Social Psychiatry 2006, 52(2):152–165. 10.1177/0020764006062096
Hwang SW: Homelessness and health. CMAJ 2001, 164(2):229–233.
Hwang SW, Colantonio A, Chiu S, Tolomiczenko G, Kiss A, Cowan L, Redelmeier DA, Levinson W: The effect of traumatic brain injury on the health of homeless people. CMAJ 2008, 179(8):779–784. 10.1503/cmaj.080341
Wolitski RJ, Kidder DP, Fenton KA: HIV, homelessness, and public health: critical issues and a call for increased action. AIDS Behav 2007, 11(6 Suppl):167–171.
Housing Supply Working Group: Affordable Rental Housing Supply: The Dynamics of the Market and Recommendations for Encouraging New Supply. 2001. Accessed August 13, 2012 http://ginsler.com/sites/ginsler/files/HSWGinterimreport-e.pdf
Martins DC: Experiences of homeless people in the health care delivery system: a descriptive phenomenological study. Public Health Nurs 2008, 25(5):420–430. 10.1111/j.1525-1446.2008.00726.x
De Maeyer J, Vanderplasschen W, Broekaert E: Exploratory study on drug users' perspectives on quality of life: More than health-related quality of life? Social Indicators Research 2009, 90: 107–126. 10.1007/s11205-008-9315-7
Den Oudsten BL, Lucas-Carrasco R, Green AM, Whoqol-Dis Group: Perceptions of persons with Parkinson's disease, family and professionals on quality of life: An international focus group study. Disability and Rehabilitation: An International, Multidisciplinary Journal 2011, 33: 2490–2508. 10.3109/09638288.2011.575527
Grant M, McMullen CK, Altschuler A, Mohler MJ, Hornbrook MC, Herrinton LJ, Wendel CS, Baldwin CM, Krouse RS: Gender differences in quality of life among long-term colorectal cancer survivors with ostomies. Oncology Nursing Forum 2011, 3(8):587–596.
Markham C, van Laar D, Gibbard D, Dean T: Children with speech, language and communication needs: Their perceptions of their quality of life. International Journal of Language & Communication Disorders 2009, 44: 748–768. 10.1080/13682820802359892
Morgan D: Focus groups. Annual Review of Sociology 1996, 22: 129–152. 10.1146/annurev.soc.22.1.129
Krueger RA: Focus groups: A practical guide for applied research. 2nd edition. Sage, Thousand Oaks, CA; 1994.
Lehman AF: A quality of life interview for the chronically mentally ill. Evaluation and Program Planning 1988, 11: 51–62. 10.1016/0149-7189(88)90033-X
Schalock RL, Brown R, Cummins RA, Felce D, Matikka L: Conceptualization, measurement, and applicaiton of quality of life for persons with intellectual disabilities: Report of an international panel of experts. Mental Retardation 2002, 40: 457–470. 10.1352/0047-6765(2002)040<0457:CMAAOQ>2.0.CO;2
Power M, Kuyken W: World Health Organization Quality of Life Assessment (WHOQOL): Development and general psychometric properties. Social Science & Medicine 1998, 46(12):1569–1585. 10.1016/S0277-9536(98)00009-4
Irestig R, Burstrom K, Wessel M, Lynoe N: How are homeless people treated in the healthcare system and other societal institutions? Study of their experiences and trust. Scand J Public Health 2010, 38(3):225–231. 10.1177/1403494809357102
Nickasch B, Marnocha SK: Healthcare experiences of the homeless. J Am Acad Nurse Pract 2009, 21(1):39–46. 10.1111/j.1745-7599.2008.00371.x
Grinman MN, Chiu S, Redelmeier DA, Levinson W, Kiss A, Tolomiczenko G, Cowan L, Hwang SW: Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status. BMC Public Health 2010, 10: 94. 10.1186/1471-2458-10-94
Meschede T: Accessing Housing: Exploring the Impact of Medical and Substance Abuse Services on Housing Attainment for Chronically Homeless Street Dwellers. Journal of Human Behavior in the Social Environment 2010, 20(2):153–169. 10.1080/10911350903269880
Kushel MB, Gupta R, Gee L, Haas JS: Housing instability and food insecurity as barriers to health care among low-income Americans. J Gen Intern Med 2006, 21(1):71–77. 10.1111/j.1525-1497.2005.00278.x
Lee BA, Greif MJ: Homelessness and hunger. J Health Soc Behav 2008, 49(1):3–19. 10.1177/002214650804900102
Hwang SW: Mortality among men using homeless shelters in Toronto, Ontario. JAMA 2000, 283(16):2152–2157. 10.1001/jama.283.16.2152
Hwang SW, Lebow JM, Bierer MF, O'Connell JJ, Orav EJ, Brennan TA: Risk factors for death in homeless adults in Boston. Archives of Internal Medicine 1998, 158(13):1454–1460. 10.1001/archinte.158.13.1454
Cheung AM, Hwang SW: Risk of death among homeless women: a cohort study and review of the literature. CMAJ 2004, 170(8):1243–1247. 10.1503/cmaj.1031167
Hwang SW, Wilkins R, Tjepkema M, O'Campo PJ, Dunn JR: Mortality among residents of shelters, rooming houses, and hotels in Canada: 11 year follow-up study. BMJ 2009, 339: b4036. 10.1136/bmj.b4036
Quality of Life for Homeless and Hard-to-House Individuals (QoLHHI) Inventory: Administration and Scoring Manual. Accessed August 13, 2012 http://educ.ubc.ca/faculty/hubley/qolhhi.html