What Do Nursing Students Know About the Homeless and Their Care Experiences? A Qualitative Study

2.50
Hdl Handle:
http://hdl.handle.net/10755/622011
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
What Do Nursing Students Know About the Homeless and Their Care Experiences? A Qualitative Study
Other Titles:
Nursing Students and the Care of Vulnerable Populations
Author(s):
Astroth, Kim Schafer; Kerber, Cindy H.; Jenkins, Sheryl Henry; Woith, Wendy M.
Lead Author STTI Affiliation:
Xi Pi
Author Details:
Kim Schafer Astroth, PhD, RN, Professional Experience: I have conducted research on civility, have presented several refereed presentation on civility, and have had peer-reviewed articles published on the topic. I have conducted research on homelessness and have had refereed presentations on homelessness. Author Summary: Dr. Astroth has conducted research on civility in nursing students, homelessness, and chronic disease. This has resulted in several refereed international and national presentations and peer-reviewed publications.
Abstract:

Purpose: The purposes of this qualitative study were to: a) explore the attitudes and knowledge of nursing students regarding the homeless, b) describe their experiences with the homeless, c) examine their perceptions of nursing care of the homeless, and d) identify possible strategies for teaching nursing students about care of the homeless. Vulnerable populations, especially homeless people, may be particularly at risk for experiencing uncivil behavior from nurses. Studies have demonstrated that homeless people believe they are not treated as well as others when seeking healthcare; they have reported experiencing incivility and lack of compassion by nurses. These nursing behaviors constitute a barrier to care of the homeless. There is little literature regarding nursing students’ attitudes toward the homeless and how these attitudes may impact the care of this vulnerable population.

Methods: We interviewed 19 undergraduate nursing students, aged 20 to 21, from a baccalaureate nursing program in the Midwestern United States. We obtained informed consent and demographic data immediately before initiating the audiotaped interviews. Audiotaped interviews took an average of thirty minutes to complete and were later transcribed verbatim. Field notes were maintained with each interview to allow for an audit trail. Qualitative data were analyzed through content analysis identification of themes. Coding categories were generated from the data, with final themes identified through an iterative process, until data saturation was reached. Themes were examined for fit with Leininger’s model and were also compared to themes found in the literature and examined for congruency. Descriptive statistics were used to explore participants’ characteristics. Trustworthiness was enhanced through use of an audit trail and member checking.

Results: Four major themes emerged from data analysis: a) student perceptions of the homeless, b) student experiences with the homeless, c) healthcare of the homeless, and d) how best to teach students about the homeless.

Student perceptions of the homeless. Students defined homelessness as lacking both a physical home and basic necessities, not having a job, and, interestingly, an absence of an emotional sense of belonging. Most students believed homelessness was primarily due to circumstances beyond the individual’s control. Some mentioned that homelessness may also be caused by poor personal choices, such as drug use, but they believed that this described only a minority of homeless people. In describing the appearance and behavior of homeless people, students asserted that the homeless wear old clothes in poor repair, have poor hygiene and grooming, and carry all their belongings with them in bags or boxes. Students envisioned a typical day for the homeless as one spent in looking for resources, food, shelter, money, and work. They described a typical night for the homeless as cold and frightening. Many thought it would be very difficult to find a safe place to sleep. Students also expressed a strong sense of empathy for the homeless. They felt sadness, shock, and humility as they described their experiences. A few reported feeling guilty if they ignored the homeless because they didn’t have anything to give them.

Student experiences with the homeless. Students reported both self-directed and community- directed experiences with the homeless. Self-directed experiences included chance encounters on the street in which they gave money, water, or left-over food to the people they met. Community-directed experiences included working at soup kitchens, food pantries, and homeless shelters with school or church groups. Some of the community-directed experiences were superficial in that students merely dished up food or bagged items without interacting with recipients. Others were deeper in that they actually spent time in conversation with the homeless. These students described trying to get to know them and understand their circumstances.

Healthcare of the homeless. Half of the students thought that homeless people usually did not seek professional healthcare, but instead tried to care for themselves. The other half said homeless people seek care at free clinics or hospitals. In addition, students believed that homeless people receive help from friends, family members, or strangers on the street. Lack of money or health insurance, inadequate transportation, fear of inequitable care, and stigma were described as major barriers to care. Students suggested nursing care of the homeless should be empathetic, attentive, compassionate, and equitable.

How best to teach students about the homeless. Students identified four specific teaching strategies. They suggested discussing homelessness as a topic inserted into an existing course. They also asserted that simulations in which students experience what it is like to be homeless could be informative and also give students an entirely new perspective. Several recommended developing clinical experiences in which students work in low income clinics or shelters to provide direct care for the homeless. Finally, a few students believed that cultural immersion, in which students interact with the homeless in natural environments, would be most helpful.

Conclusion: Nurses have a responsibility to advocate for the needs of vulnerable populations including the homeless. In order to be effective advocates, nurses and nursing students must thoroughly understand the issues related to homelessness. Students in this study had varying types of involvement with and knowledge of the homeless and their care experiences. Many of their perceptions were based on stereotypes, and some were patently erroneous, such as assertions that most homeless people have jobs, or that substance abuse has negligible impact on homelessness. This suggests that student nurses need more comprehensive education concerning the needs of this vulnerable population.

Keywords:
homeless; nursing care; nursing students
Repository Posting Date:
21-Jul-2017
Date of Publication:
21-Jul-2017
Other Identifiers:
INRC17I11
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleWhat Do Nursing Students Know About the Homeless and Their Care Experiences? A Qualitative Studyen_US
dc.title.alternativeNursing Students and the Care of Vulnerable Populationsen
dc.contributor.authorAstroth, Kim Schaferen
dc.contributor.authorKerber, Cindy H.en
dc.contributor.authorJenkins, Sheryl Henryen
dc.contributor.authorWoith, Wendy M.en
dc.contributor.departmentXi Pien
dc.author.detailsKim Schafer Astroth, PhD, RN, Professional Experience: I have conducted research on civility, have presented several refereed presentation on civility, and have had peer-reviewed articles published on the topic. I have conducted research on homelessness and have had refereed presentations on homelessness. Author Summary: Dr. Astroth has conducted research on civility in nursing students, homelessness, and chronic disease. This has resulted in several refereed international and national presentations and peer-reviewed publications.en
dc.identifier.urihttp://hdl.handle.net/10755/622011-
dc.description.abstract<p><strong><strong>Purpose: </strong></strong><span>The </span><strong>purposes</strong><span> of this qualitative study were to: a) explore the attitudes and knowledge of nursing students regarding the homeless, b) describe their experiences with the homeless, c) examine their perceptions of nursing care of the homeless, and d) identify possible strategies for teaching nursing students about care of the homeless. Vulnerable populations, especially homeless people, may be particularly at risk for experiencing uncivil behavior from nurses. Studies have demonstrated that homeless people believe they are not treated as well as others when seeking healthcare; they have reported experiencing incivility and lack of compassion by nurses. These nursing behaviors constitute a barrier to care of the homeless. There is little literature regarding nursing students’ attitudes toward the homeless and how these attitudes may impact the care of this vulnerable population.</span></p> <p><strong>Methods: </strong>We interviewed 19 undergraduate nursing students, aged 20 to 21, from a baccalaureate nursing program in the Midwestern United States. We obtained informed consent and demographic data immediately before initiating the audiotaped interviews. Audiotaped interviews took an average of thirty minutes to complete and were later transcribed verbatim. Field notes were maintained with each interview to allow for an audit trail. Qualitative data were analyzed through content analysis identification of themes. Coding categories were generated from the data, with final themes identified through an iterative process, until data saturation was reached. Themes were examined for fit with Leininger’s model and were also compared to themes found in the literature and examined for congruency. Descriptive statistics were used to explore participants’ characteristics. Trustworthiness was enhanced through use of an audit trail and member checking.</p> <p><strong>Results: </strong>Four major themes emerged from data analysis: a) student perceptions of the homeless, b) student experiences with the homeless, c) healthcare of the homeless, and d) how best to teach students about the homeless.</p> <p><strong><em>Student perceptions of the homeless.</em></strong><strong> </strong>Students defined homelessness as lacking both a physical home and basic necessities, not having a job, and, interestingly, an absence of an emotional sense of belonging. Most students believed homelessness was primarily due to circumstances beyond the individual’s control. Some mentioned that homelessness may also be caused by poor personal choices, such as drug use, but they believed that this described only a minority of homeless people. In describing the appearance and behavior of homeless people, students asserted that the homeless wear old clothes in poor repair, have poor hygiene and grooming, and carry all their belongings with them in bags or boxes. Students envisioned a typical day for the homeless as one spent in looking for resources, food, shelter, money, and work. They described a typical night for the homeless as cold and frightening. Many thought it would be very difficult to find a safe place to sleep. Students also expressed a strong sense of empathy for the homeless. They felt sadness, shock, and humility as they described their experiences. A few reported feeling guilty if they ignored the homeless because they didn’t have anything to give them.<strong></strong></p> <p><strong><em>Student experiences with the homeless.</em></strong><strong> </strong>Students reported both self-directed and community- directed experiences with the homeless. Self-directed experiences included chance encounters on the street in which they gave money, water, or left-over food to the people they met. Community-directed experiences included working at soup kitchens, food pantries, and homeless shelters with school or church groups. Some of the community-directed experiences were superficial in that students merely dished up food or bagged items without interacting with recipients. Others were deeper in that they actually spent time in conversation with the homeless. These students described trying to get to know them and understand their circumstances.</p> <p><strong><em>Healthcare of the homeless. </em></strong>Half of the students thought that homeless people usually did not seek professional healthcare, but instead tried to care for themselves. The other half said homeless people seek care at free clinics or hospitals. In addition, students believed that homeless people receive help from friends, family members, or strangers on the street. Lack of money or health insurance, inadequate transportation, fear of inequitable care, and stigma were described as major barriers to care. Students suggested nursing care of the homeless should be empathetic, attentive, compassionate, and equitable.</p> <p><strong><em>How best to teach students about the homeless</em></strong>. Students identified four specific teaching strategies. They suggested discussing homelessness as a topic inserted into an existing course. They also asserted that simulations in which students experience what it is like to be homeless could be informative and also give students an entirely new perspective. Several recommended developing clinical experiences in which students work in low income clinics or shelters to provide direct care for the homeless. Finally, a few students believed that cultural immersion, in which students interact with the homeless in natural environments, would be most helpful.</p> <p><strong>Conclusion: </strong>Nurses have a responsibility to advocate for the needs of vulnerable populations including the homeless. In order to be effective advocates, nurses and nursing students must thoroughly understand the issues related to homelessness. Students in this study had varying types of involvement with and knowledge of the homeless and their care experiences. Many of their perceptions were based on stereotypes, and some were patently erroneous, such as assertions that most homeless people have jobs, or that substance abuse has negligible impact on homelessness. This suggests that student nurses need more comprehensive education concerning the needs of this vulnerable population.</p>en
dc.subjecthomelessen
dc.subjectnursing careen
dc.subjectnursing studentsen
dc.date.available2017-07-21T16:15:58Z-
dc.date.issued2017-07-21-
dc.date.accessioned2017-07-21T16:15:58Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.