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International Journal For Equity in... Jul 2019People experiencing homelessness are often marginalized and are known to face barriers to accessing acceptable and respectful healthcare services. This study examines...
BACKGROUND
People experiencing homelessness are often marginalized and are known to face barriers to accessing acceptable and respectful healthcare services. This study examines the experience of accessing hospital-based services of persons experiencing homelessness or vulnerable housing in southeastern Ontario and considers the potential of Equity-Oriented Health Care (EOHC) as an approach to improving care.
METHODS
Focus groups and in-depth interviews with people with lived experience of homelessness (n=31), as well as in-depth interviews of health and social service provider key informants (n=10) were combined with qualitative data from a survey of health and social service providers (n=136). Interview transcripts and written survey responses were analyzed using directed content analysis to examine experiences of people with lived experience of homelessness within the healthcare system.
RESULTS
Healthcare services were experienced as stigmatizing and shaming particularly for patients with concurrent substance use. These negative experiences could lead to avoidance or abandonment of care. Despite supposed universality, participants felt that the healthcare system was not accountable to them or to other equity-seeking populations. Participants identified a system that was inflexible, designed for a perceived middle-class population, and that failed to take into account the needs and realities of equity-seeking groups. Finally, participants did identify positive healthcare interactions, highlighting the importance of care delivered with dignity, trust, and compassion.
CONCLUSIONS
The experiences of healthcare services among the homeless and vulnerably housed do not meet the standards of universally accessible patient-centered care. EOHC could provide a framework for changes to the healthcare system, creating a system that is more trauma-informed, equity-enhancing, and accessible to people experiencing homelessness, thus limiting identified barriers and negative experiences of care.
Topics: Delivery of Health Care; Focus Groups; Health Equity; Ill-Housed Persons; Humans; Ontario; Social Problems; Social Work; Surveys and Questionnaires; Vulnerable Populations
PubMed: 31262310
DOI: 10.1186/s12939-019-1004-4 -
Social Work Dec 2022As a profession, social work has codified within its ethical guidance and educational policies a commitment to social justice. While a commitment to social justice is... (Review)
Review
As a profession, social work has codified within its ethical guidance and educational policies a commitment to social justice. While a commitment to social justice is asserted in several of our profession's guiding documents, social work continues to lack consensus on both the meaning and merit of social justice, resulting is disparate and sometimes discriminatory practice even under a "social justice" label. This study examines how social justice has been operationalized in social work via a conceptual review of the literature. Findings show that social work leans heavily on John Rawls's definition of social justice, Martha Nussbaum's and Amartya Sen's capabilities approach, and the definition of social justice included in The Social Work Dictionary. Unfortunately, none of these adequately align with the National Association of Social Workers' Code of Ethics, which drives the profession. This conceptual review is a call to social workers to join together in defining the guiding principle of the profession.
Topics: Humans; Social Work; Social Justice; Social Workers
PubMed: 36323284
DOI: 10.1093/sw/swac042 -
Social Work Dec 2019
Topics: Humans; Organizational Culture; Professional Competence; Self Care; Social Work; Social Workers
PubMed: 31840166
DOI: 10.1093/sw/swz049 -
Social Work Dec 2023
Topics: Humans; Social Work
PubMed: 38041412
DOI: 10.1093/sw/swad050 -
Journal of Gerontological Social Work 2020
Topics: Aged; Aged, 80 and over; Ageism; COVID-19; Geriatrics; Humans; Pandemics; Policy; SARS-CoV-2; Social Isolation; Social Work
PubMed: 33350900
DOI: 10.1080/01634372.2020.1827838 -
Social Work Dec 2022
Topics: Humans; Social Work
PubMed: 36409998
DOI: 10.1093/sw/swac051 -
Journal of Social Work in End-of-life &... 2024
Topics: Humans; Dementia; Social Work; Terminal Care
PubMed: 38386510
DOI: 10.1080/15524256.2024.2320884 -
Journal of Gerontological Social Work 2020
Topics: Geriatrics; Periodicals as Topic; Social Work
PubMed: 33353530
DOI: 10.1080/01634372.2020.1859857 -
Journal of Gerontological Social Work Jul 2020
Topics: Geriatrics; Humans; Social Work
PubMed: 32744190
DOI: 10.1080/01634372.2020.1780048 -
Social Work Jun 2023In recent years, social workers have paid increased attention to ethical issues. The profession's literature has burgeoned on topics such as ethical dilemmas in social...
In recent years, social workers have paid increased attention to ethical issues. The profession's literature has burgeoned on topics such as ethical dilemmas in social work practice, ethical decision making, boundary issues and dual relationships, ethics-related risk management, and moral injury. This noteworthy trend builds on social work's rich and long-standing commitment to the development of core values and ethical standards evident throughout its history. Unlike allied human service and behavioral health professions, social work's ethics-related literature has not focused on the critically important issue of moral disengagement. Moral disengagement is typically defined as the process whereby individuals convince themselves that ethical standards do not apply to them. In social work, moral disengagement can lead to ethics violations and practitioner liability, particularly when social workers believe that they are not beholden to widely embraced ethical standards in the profession. The purpose of this article is to explore the nature of moral disengagement in social work, identify possible causes and consequences, and present meaningful strategies designed to prevent and respond to moral disengagement in the profession.
Topics: Humans; Social Work; Morals; Social Workers
PubMed: 37185937
DOI: 10.1093/sw/swad014