Meaning and Reas: the Balance of Life and Death

The purposes of this article are to describe family experiences, both childhood and later, of homeless individuals, to propose some theoretical considerations of the influence of the family on homelessness, and to suggest programmatic structures and philosophies that consider the effect of these family experiences on the homeless experience. As part of a study of homeless people's health concerns, 40 homeless people were interviewed for 11/2–6 hours, each time using a semi-structured format. During the course of being interviewed, all individuals discussed experiences in their families. The commonalities among individuals' family stories were striking. As a result, experience of family was identified as an important theme in homeless people's lives. A thematic analysis of family stories was performed. As the result of the power of these stories, some theoretical considerations about homelessness that include the experience of family are proposed. Programmatic implications for psychiatric nursling's care of homeless people is discussed.     

Families of origin of homeless and never-homeless women

Naturalistic inquiry was used to compare the characteristics of families of origin of homeless women with never-homeless women. The women's experiences in their families of origin were explored during in-depth interviews using Lofland and Lofland's conceptions of meanings, practices, episodes, roles, and relationships to guide the analysis. The two groups were similar with respect to family abuse history, transience, and loss. The never-homeless women had support from an extended family member who provided unconditional love, protection, a sense of connection, and age-appropriate expectations, as contrasted with homeless women who described themselves as being without, disconnected, and having to be little adults in their families of origin. The experience of family love and connection seemed to protect never-homeless women from the effects of traumatic life events in childhood. These findings provide support for the influence of a woman's family of origin as a precursor to homelessness.     

Stories from the streets: people's experiences of homelessness

This study explores how people speak about their experiences of homelessness, and how these experiences have affected their identity claims and their mental health. The mental health of the homeless population is a growing concern for the UK government and non-governmental agencies. There is however, little research looking at the mental health needs of homeless people and their experiences. For this study, a qualitative, narrative approach was used. Eight people were interviewed who described themselves as homeless. The subsequent data were analysed through a narrative analysis process paying particular attention to how people construct their identities. Although each participant is homeless, they speak about their experiences very differently. People's identities have been affected by their experiences, and because of the trauma and indignity of homelessness, their identities have had to be reshaped. While it might be considered normal for people's identities to relate to families and occupation, homeless people construct identities around illness, drugs and exclusion. Experiences of homelessness negatively affect people's sense of identity to destructive proportions. Nevertheless, participants demonstrate a way of coping by forming strong opinions about policy and service provision.     

Homelessness: health-care implications

The homeless population is changing in relation to age, race, income status, educational level, gender, and composition of families. Economic, social, and political factors are identified as increasing the risk of becoming homeless. The implications of homelessness on the health of an individual and strategies to improve the health status from multiple avenues is explored.     

Parents' perspectives on homelessness and its effects on the educational development of their children.

This qualitative study explored parents' perceptions of how their homelessness affected the development and academic achievement of their children. Grounded theory with symbolic interactionism was the framework for this study. Data were collected through semistructured interviews with 34 homeless families in a variety of settings. Multiple factors were found, including unstable relationships, abuse and violence, abdication of parental responsibility, poor parenting models, and resilient children. The findings present a case for supportive educational services for homeless school-age children. School nurses play a dual role. They can ensure that school personnel and resource providers understand the culture of homelessness, and they can develop and implement innovative programs for parents and school personnel to help homeless children.     

A narrative inquiry: moving on from homelessness for individuals with a major mental illness

This narrative study explores the experience of 'moving on' from homelessness for individuals with major mental illnesses, after they have obtained permanent housing with supports. Twelve participants were interviewed up to three times over 6 months. There were various routes to homelessness, participants were homeless for varying lengths of time, and they described different journeys of 'moving on' in their lives. Place, and a series of places, were central for participants in this experience. The experience of homelessness for many could be described as 'on the move', in a circular pattern from shelter to shelter or street. Permanent housing and supports allowed participants to 'move on', reconnecting with family, getting jobs and planning for the future. Several participants wanted their stories used to send messages of hope, courage and survival. This study highlights the need for nurses to be aware of the concept of 'place' in the process of recovery from mental illness.     

Mental Ill Health in Homeless Women: A Review

Research indicates that homeless women are reported to experience more mental health issues than women who are not homeless and are an increasing proportion of the overall homeless population. In addition, homeless women are more likely to have alcohol and/or other drug use disorders. We provide a comprehensive review of the contemporary literature that revealed homeless women experience a range of mental health problems including depression, anxiety, post-traumatic stress disorder and alcohol and other drug use disorders. Studies in this literature review indicate that some women have pre-existing mental health issues which precipitate homelessness while others develop mental illness because of their homelessness; domestic violence was also recognised as an antecedent to homelessness, although further research is needed in this area. The results of this study indicate that the homeless cohort is a complex one with distinct needs. We provide information that can help refine assessment processes and plan appropriate services to address the mental health needs of homeless women. Finally, recommendations for mental health nursing practice in regard to caring for homeless women are made.     

Nurses’ perceptions on the skills,knowledge, and attributes required to provide healthcare to people experiencing homelessness in Australia: A qualitative study

BackgroundPeople experiencing homelessness have unmet healthcare needs often related to chronic health conditions and injury. Nurses are often the first and only point of contact for people experiencing homelessness accessing healthcare. However, education that prepares them to meet the needs of this vulnerable population is limited.AimTo qualitatively explore nurses’ perceptions on the skills, knowledge, and attributes required to provide healthcare to people experiencing homelessness in Australia that could underpin an educational pathway.DesignSemi-structured interviews with registered nurses and nurse practitioners.MethodsParticipants of a national survey were invited to undertake an interview. Interview data were analysed thematically and reported here in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.FindingsThe registered nurses (n = 11) and nurse practitioners (n = 6) had varying levels of experience providing care for homeless Australians. Overarching themes that arose from the registered nurse and nurse practitioner participants included equitable access to care, knowledge around homelessness, contribution of nursing, and nurses’ role. However, nurse practitioners had a greater sense of agency and empowerment to enact care, while registered nurses perceived being underprepared and overwhelmed by the unmet needs of people experiencing homelessness.ConclusionsThe findings suggest that nursing practice holds opportunities to improve access and care provision for people experiencing homelessness. Capitalising on these opportunities requires that nurses are educationally prepared with the skills, knowledge, and attributes to meet the needs of this vulnerable population without necessarily becoming nurse practitioners. These findings will be used to underpin the development of an educational pathway for nurses to enhance their response to homeless populations.     

A Nursing Model For Addressing The Health Needs Of Homeless Families

Homelessness in the United States continues to be a major social problem directly affecting an estimated three million persons, of whom nearly 30 percent belong to families without permanent shelter. This paper reviews recent research concerning homeless families and the conditions in which they live and outlines the significant health and mental health problems that these families experience. Effective nursing interventions for homeless families using Peszneckers' Model of Poverty are proposed. Nurses must advocate for changes in the social and political conditions that bring about homelessness since the resources to meet the needs of these families are either nonexistent or woefully inadequate.     

A qualitative exploration of nursing students’ perceptions of the homeless and their care experiences

The health care needs of the homeless are more complex than those of the population at large. The purpose of this qualitative study was to explore undergraduate nursing students’ perceptions of the homeless. Thematic content analysis of responses from 19 undergraduate nursing students yielded four themes describing student experiences with the homeless, their perceptions of homelessness and the health care of the homeless, and their suggestions for best teaching strategies. Students in this study had varying amounts of experience with and knowledge of the homeless. While our participants strongly believed that homeless people deserved compassionate, equitable nursing care, many of their statements suggested an implicit bias toward the homeless. This suggests that student nurses need more comprehensive education concerning the homeless and the health care needs of this vulnerable population. Few interventions aimed at educating student nurses about homelessness and changing their attitudes to mitigate bias are based on research, particularly research conducted from the perspective of the homeless, and few explore the impact of civil interactions on health outcomes. The findings of this study may assist nurse educators in developing education interventions to improve students’ knowledge of homelessness.     

Women''s Perspectives on Homelessness

An increase in the number of individuals who are homeless since the 1980s has made homelessness a major social, economic, and political problem in the United States. The number of homeless in this country is estimated as high as 3 million, with women and children constituting the fastest growing subgroup of this population. A study of eight homeless women using a shelter in a southeastern city was conducted to explore the experience of homelessness from the women's perspectives. A modified ethnographic approach using a semistructured interview provided qualitative data. The constant comparative method of analysis identified themes of heightened awareness, guarding, identification of needs, and strategies for resolution. This study provides a new understanding of how some women experience homelessness, as well as the responses they take to solve this problem.     

Homelessness as culture: How transcultural nursing theory can assist caring for the homeless

The concepts of culture and homelessness are both complex and contested. This paper examines homelessness through the lens of transcultural nursing theory, increasing understanding of both homelessness and transcultural theory. We argue that homelessness can be usefully conceptualised as a culture and that the application of transcultural theory to caring for homeless people will add further to the utility of these theories. The application of transcultural theory can add to the repertoire of skills the nurse needs to care for not only homeless clients, but, for a diverse range of client groups.     

Adolescent homelessness, nursing, and public health policy

Homelessness among American adolescents is not a new phenomenon. The United States has a long history of youth who are runaways and/or homeless. The majority of adolescents who are homeless believe that they have no acceptable housing placement options. The foster care system often fails to help youth deal with problems. The impact of homelessness on youth's social functioning and health status should be raised at the community level, particularly by community nurses and other health professions who interact with adolescents who are homeless. By using Kingdon's multiple streams model, nurses can advocate for homeless youth by accurately defining and reframing adolescent homelessness for policy makers and including provision of shelter as a policy priority.