Reflections on health among women in homelessness: A qualitative study

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Previous research reports that people in homelessness have poor physical and mental health and are excluded from society with risk for loneliness and social exclusion. Women in homelessness face particularly vulnerable circumstances with significant risks of harm. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Feelings of having a home is a basis for meeting physical, psychosocial, and existential needs related to health. Being involved in authentic relationships and caring for others gives women in homelessness a sense of worth. To be accepted by others and feeling like an equal was important for experiences of preserved dignity. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses need to recognize and support women in homelessness for their capacity to heal and to experience health. To regard women in homelessness as active health-seekers, instead of passive victims, can improve women's experiences of care provided by mental health professionals. Nurses can promote health by regarding women as resourceful and active, despite the fact that they live in homelessness.

Abstract: INTRODUCTION: Mental health issues are common among women in homelessness, alongside undertreated chronic physical conditions leading to serious and unnecessary complications. Even though homelessness and risks of impaired health have been researched, broader perspectives of health are absent.

Aim: To describe reflections on health among women with experiences of homelessness.

Method: We conducted 13 interviews with women in homelessness using researcher-driven photograph elicitation. Together with an advisory board of women with lived experience of homelessness, researchers were guided by the DEPICT model for collaborative data analysis and performed a thematic analysis.

Findings: Women with experiences of homelessness emphasized three main resources for achieving health and well-being: feelings of having a home, being involved in authentic relationships and experiences of preserved dignity.

Implication for practice: Healthcare needs to integrate the perceived resources for health and well-being when caring for women in homelessness. It is imperative since women will return to the healthcare setting only if they feel safe and secure, and only if dignity is preserved or restored. The results promote utilization of an integrative nursing approach; understanding that the health of women in homelessness is inseparable from their environment and social determinants for health, such as housing and social integration.

Keywords: health; health equity; homeless persons; photograph-elicitation; women's health.