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Rosenblad AK, Klarare A, Rapaport P, Mattsson E, Gaber SN. Health literacy and its association with mental and spiritual well-being among women experiencing homelessness. Health Promot Int 2024; 39:daae019. [PMID: 38430507 PMCID: PMC10908353 DOI: 10.1093/heapro/daae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2024] Open
Abstract
Low health literacy (HL) has been linked to low self-rated health, reduced efficacy of behaviour change, and challenges in preventing, treating, or managing health conditions. People experiencing homelessness are at risk of poor HL; however, few studies have investigated HL in relation to mental and spiritual well-being among people experiencing homelessness in general, or women experiencing homelessness specifically. This cross-sectional study of 46 women experiencing homelessness in Stockholm, Sweden, recruited during the period October 2019-December 2020, aimed to examine how HL was associated with mental and spiritual well-being among women experiencing homelessness. Participants answered questions about socio-demographic characteristics (age, length of homelessness, education) and digital technology (mobile phone/the Internet) use, in addition to Swedish language versions of three questionnaires administered through structured, face-to-face interviews: the Communicative and Critical Health Literacy Scale, the General Health Questionnaire 12 and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being. Data were analysed using linear regression, which revealed statistically significant associations between HL and mental well-being (p = .009), and between HL and spiritual well-being (p = .022). However, neither socio-demographic characteristics nor digital technology use were significantly associated with HL. In conclusion, promoting HL may improve mental and spiritual well-being in this vulnerable population. An advisory board of women with lived experiences of homelessness (n = 5) supported the interpretation of the findings and emphasised the need to consider HL in relation to basic needs such as 'housing first'. Moreover, health information and services should be accessible to people with different degrees of HL.
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Affiliation(s)
- Andreas Karlsson Rosenblad
- Department of Statistics, Uppsala University, Box 513, 751 20, Uppsala, Sweden
- Department of Medical Sciences, Division of Clinical Diabetology and Metabolism, Uppsala University, Akademiska sjukhuset, 751 85, Uppsala, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Anna Klarare
- Department of Women’s and Children’s Health, Healthcare Services and e-Health, Uppsala University, Akademiska sjukhuset, 751 85, Uppsala, Sweden
- Department of Healthcare Sciences, Marie Cederschiöld University, Box 11189, 100 61, Stockholm, Sweden
| | - Penny Rapaport
- Division of Psychiatry, Faculty of Brain Sciences, University College London, Maple House, W1T 7BN, London, UK
| | - Elisabet Mattsson
- Department of Women’s and Children’s Health, Healthcare Services and e-Health, Uppsala University, Akademiska sjukhuset, 751 85, Uppsala, Sweden
- Department of Healthcare Sciences, Marie Cederschiöld University, Box 11189, 100 61, Stockholm, Sweden
| | - Sophie Nadia Gaber
- Department of Women’s and Children’s Health, Healthcare Services and e-Health, Uppsala University, Akademiska sjukhuset, 751 85, Uppsala, Sweden
- Department of Healthcare Sciences, Marie Cederschiöld University, Box 11189, 100 61, Stockholm, Sweden
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Gaber SN, Rosenblad AK, Mattsson E, Klarare A. The relationship between attitudes to homelessness and perceptions of caring behaviours: a cross-sectional study among women experiencing homelessness, nurses and nursing students. BMC Womens Health 2022; 22:159. [PMID: 35546674 PMCID: PMC9092332 DOI: 10.1186/s12905-022-01744-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/29/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Women experiencing homelessness have complex and multifaceted healthcare needs and yet they are an underserved population across healthcare services. Nurses are trained to perform an integral role in the provision of equitable healthcare and their attitudes towards homelessness may therefore influence the care that women experiencing homelessness receive. This study aimed to examine correlations between attitudes towards homelessness and caring behaviours, and to test if these correlations differed between the groups of women experiencing homelessness, registered nurses, and nursing students. METHODS A cross-sectional design using convenience sampling was used to recruit women experiencing homelessness (n = 37), registered nurses (n = 90), and nursing students (n = 138) in Stockholm, Sweden between August 2019 and December 2020. The participants answered two questionnaires: the Attitudes Toward Homelessness Inventory and the Caring Behaviours Inventory-24. Correlations between ordinal variables were calculated using Spearman's rank correlation ρ. Tests of equality between two independent correlations were performed using a Z-test applied to Fisher's z-transformed correlations. An advisory board of women with lived experience of homelessness supported the interpretation of the results. RESULTS Weak, negative correlations were identified between the Attitudes Toward Homelessness Inventory and Caring Behaviours Inventory-24. The Attitudes Toward Homelessness Inventory mean total scores (SD) were 4.1 (0.6), 4.2 (0.6), 4.1 (0.5) points for the women experiencing homelessness, registered nurse, and nursing student groups, respectively, with the corresponding scores for the Caring Behaviours Inventory-24 being 4.1 (1.1), 5.2 (0.5), 4.8 (0.7) points, respectively. CONCLUSIONS To promote equitable health for women experiencing homelessness, healthcare providers and nurse educators should consider the role of stigmatising attitudes in relation to caring behaviours.
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Affiliation(s)
- Sophie Nadia Gaber
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden.
- Department of Women's and Children's Health, Healthcare Sciences and E-Health, Uppsala University, Uppsala, Sweden.
| | - Andreas Karlsson Rosenblad
- Department of Medical Sciences, Division of Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Solna, Sweden
| | - Elisabet Mattsson
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- Department of Women's and Children's Health, Healthcare Sciences and E-Health, Uppsala University, Uppsala, Sweden
| | - Anna Klarare
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
- Department of Women's and Children's Health, Healthcare Sciences and E-Health, Uppsala University, Uppsala, Sweden
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