Evidence map›Paper›PMID 39623357›Full record

ArticleBMC palliative care2024

The central role of housing key workers in supporting healthcare interactions for people experiencing homelessness and implications for palliative care: a qualitative study.

Merryn Gott, Lisa Williams, Janine Wiles, Stella Black, Tess Moeke-Maxwell, Jackie Robinson, Te Ārai Palliative Care and End of Life Research Group

Abstract read
In one paragraph

Article in BMC palliative care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Merryn GottTe Kura Tapuhi/The School of Nursing, Waipapa Taumata Rau/The University of Auckland, 85 Park Road, Auckland, Aotearoa New Zealand. m.gott@auckland.ac.nz.
Lisa WilliamsTe Kura Tapuhi/The School of Nursing, Waipapa Taumata Rau/The University of Auckland, 85 Park Road, Auckland, Aotearoa New Zealand.
Janine WilesThe School of Population Health, Waipapa Taumata Rau/The University of Auckland, Auckland, Aotearoa New Zealand.
Stella BlackTe Kura Tapuhi/The School of Nursing, Waipapa Taumata Rau/The University of Auckland, 85 Park Road, Auckland, Aotearoa New Zealand.
Tess Moeke-MaxwellTe Kura Tapuhi/The School of Nursing, Waipapa Taumata Rau/The University of Auckland, 85 Park Road, Auckland, Aotearoa New Zealand.
Jackie RobinsonTe Kura Tapuhi/The School of Nursing, Waipapa Taumata Rau/The University of Auckland, 85 Park Road, Auckland, Aotearoa New Zealand.
Te Ārai Palliative Care and End of Life Research Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople experiencing homelessness access specialist palliative care late in their illness trajectory, if at all. There is also little evidence they receive generalist palliative care or are given opportunities to engage in Advance Care Planning. This qualitative study describes the central role of key workers in supporting access to healthcare in homeless communities and identifies implications for improving palliative care provision.

methodsQualitative data were collected via focus groups and individual interviews with staff working for a key provider of support and housing/accommodation for people experiencing homelessness in an urban area of Aotearoa New Zealand.

resultsThe ability to provide palliative care for people experiencing homelessness is dependent upon supporting engagement with mainstream health services. It is here that we identified the key worker role as central due to the complex and expert work they undertake to facilitate healthcare access for their clients. As a result of the high burden of chronic conditions this community experiences, most of this work related to support managing serious conditions, as well as death and dying. Key workers often went 'above and beyond' to support their clients in engaging with mainstream health services, during outpatient appointments, hospital admissions and in emergency department settings. They felt clinicians in these settings did not recognise the knowledge they held about the person, or their skills in terms of providing trauma informed care. The inflexibility of current care provision, as well as people experiencing homelessness feeling stigmatised, and neither valued nor respected in these settings, also created barriers to receiving care.

conclusionsNew models of palliative care are required which recognise the central role of non-health care key support staff and engage them more actively in supporting people experiencing homelessness when they interact with mainstream health services. Such models will need to be responsive to the nature and complexity of palliative care need in this population and facilitate support for people who typically do not see healthcare spaces as safe. The trusted relationships key workers have developed over time are crucial resources for identifying palliative care need and supporting access to palliative care for people experiencing homelessness.

Indexed as

Focus GroupsIll-Housed PersonsPalliative CareQualitative ResearchAdultFemaleHealth Services AccessibilityHousingHumansMaleMiddle AgedNew ZealandEmergency departmentEquityHealthcareHomelessnessHospitalHousing key workerPalliative care

Identifiers

PMID39623357
PMCPMC11613513

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.