原创力文档recommendations for improving the end-of-life care system for homeless populations a qualitative study of the views of canadian health and social services professionals建议提高临终关怀无家可归人口系统的定性研究加拿大卫生和社会服务专业人员的意见.pdfVIP
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recommendations for improving the end-of-life care system for homeless populations a qualitative study of the views of canadian health and social services professionals建议提高临终关怀无家可归人口系统的定性研究加拿大卫生和社会服务专业人员的意见
McNeil et al. BMC Palliative Care 2012, 11:14
/1472-684X/11/14
RESEARCH ARTICLE Open Access
Recommendations for improving the end-of-life
care system for homeless populations: A
qualitative study of the views of Canadian health
and social services professionals
Ryan McNeil1*, Manal Guirguis-Younger2 and Laura B Dilley3
Abstract
Background: Homeless populations have complex and diverse end-of-life care needs. However, they typically die
outside of the end-of-life care system. To date, few studies have explored barriers to the end-of-life care system for
homeless populations. This qualitative study involving health and social services professionals from across Canada
sought to identify barriers to the end-of-life care system for homeless populations and generate recommendations
to improve their access to end-of-life care.
Methods: Semi-structured qualitative interviews were conducted with 54 health and social services professionals
involved in end-of-life care services delivery to homeless persons in six Canadian cities (Halifax, Hamilton, Ottawa,
Thunder Bay, Toronto and Winnipeg). Participants included health administrators, physicians, nurses, social workers,
harm reduction specialists, and outreach workers. Interviews were audio-recorded, transcribed verbatim and
analysed thematically.
Results: Participants identified key barriers to end-of-life care services for homeless persons, including: (1)
insufficient availability of end-of-life care services; (2) exclusionary operating procedures; and, (3) poor continuity of
care. Participants identified recommendations that they felt had the potential to minimize these barriers, including:
(1) adopting low-threshold strategies (e.g. flexible behavioural policies and harm reduction strategies); (2) linking
with population-specific health and social care providers (e.g
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