Understanding of the life experience of homeless women

Victimization, safety, and overdose in homeless shelters: A systematic review and narrative synthesis

The objective of this prospectively registered systematic review was to identify the factors that contribute to sense of safety, victimization, and overdose risk in homeless shelters, as well as groups that are at greater risk of shelter-based victimization. Fifty-five articles were included in the review. Findings demonstrated that fears of violence and other forms of harm were prominent concerns for people experiencing homelessness when accessing shelters. Service users' perceptions of shelter dangerousness were shaped by the service model and environment, interpersonal relationships and interactions in shelter, availability of drugs, and previous living arrangements. 2SLGBTQ+ individuals were identified as being at heightened risk of victimization in shelters. No studies examined rates of shelter-based victimization or tested interventions to improve safety, with the exception of overdose risk. These knowledge gaps hinder the establishment of evidence-based practices for promoting safety and preventing violence in shelter settings.

violência para mulheres em situação de rua

A probabilidade de que mulheres em situação de rua sofram violações de direitos, é grande. Nesse sentido, esta pesquisa buscou compreender como as mulheres em situação de rua percebem a violência nesse espaço e quais estratégias de enfrentamento adotam. Trata-se de um estudo qualitativo no qual foram realizadas entrevistas semiestruturadas nas ruas, com 17 mulheres em situação de rua, maiores de 18 anos, na região da Grande Florianópolis. Os dados foram analisados por meio de análise de conteúdo. Os resultados apontaram histórias de vida permeadas por situações violentas, que repercutem negativamente em suas vidas, sendo por elas utilizadas diferentes estratégias de enfrentamentos. Ademais, houve reflexões das entrevistadas sobre as diferenças das vivências entre homens e mulheres em situação de rua. Contudo, algumas mulheres buscaram desconstruir os estereótipos de fragilidade da mulher. 

Attention to Women's Sexual and Reproductive Health at the Street Outreach Office

The aim of study was to understand care strategies for homeless women, focusing on aspects of sexual and reproductive health from the perspective of Street Outreach Office strategy professionals. This is a qualitative study carried out in a large city in the countryside of São Paulo, Brazil. Data were collected from December 2020 to April 2021 through semi-structured interviews, and the results were obtained through content analysis and thematic modality. Nine health professionals participated in this study, and the analysis of the interviews allowed identifying three thematic categories: (i) being female and sex on the streets (violence and oppression); (ii) gynecology as a gateway to comprehensive care for homeless women; and (iii) pregnancy, puerperium and motherhood in the context of the streets. This study contributes to the reflection of professional practices within the Street Outreach Office, allowing the understanding of challenges in assisting homeless women, aiming to raise awareness of professionals and services that make up the health care network.

The Hidden Face of the Moon: Unveiling the Minutiae of a Black Woman’s Experience on the Streets

The homeless population is mostly male. When it comes to the female presence, especially when considering the markers of race, gender and class, the invisibility and delegitimization are even more insidious. The aim of this article is to identify the singularities of a black woman living on the streets and to understand them based on the relationships she establishes with the territory. The method used was the case study of a homeless black woman, constructed through body map storytelling. Thematic analysis of the empirical content was used in the light of decolonial criticism. Luna, the protagonist of the story, reveals in her narratives, the multiple dimensions of the presence of the female body on the street, the process of taking care of oneself and the other, considering the intrinsic relationships with the territory, with the use of drugs and with the male figure. Thus, unveiling society’s views in relation to the place of invisibility of these women and creating strategies to face the colonial, racist and patriarchal logic of valuing knowledge is what Luna makes explicit with her trajectory of struggle, survival, and resilience on the streets.

Combining Self-Determination Theory and Photo-Elicitation to Understand the Experiences of Homeless Women

Homelessness is a complex and gendered experience. To understand this complexity, novel theoretical frameworks and appropriate research methods are required. Most women living without homes have experienced some form of abuse or mental health issues before becoming, being or exiting homelessness and there is high prevalence of trauma in this vulnerable population. Researchers investigating women's homelessness need to ensure the research process is not retraumatising. This paper proposes a theoretical framework that combines self-determination theory (SDT) and photo-elicitation to support and guide research conducted with women who are at risk of negative effects of power imbalances and retraumatisation in research. The framework offers new opportunities to sensitively study women's homelessness by leveraging a strengths-based premise and empowering procedures to increase women's control in the research process. Embedding this method within the SDT research framework repositions women from objects of research to being competent, autonomous, active and empowered agents in the research process.

Interpersonal relationships and drug use over time among homeless people: a qualitative study

Background

Homelessness is one of the most severe forms of social exclusion and is an important public health issue. It is characterized by processes of weakening of interpersonal bonds. The objective of this study was, therefore, to elucidate how interpersonal relationships change over the life cycle of homeless drug and alcohol users.

Method

We used a qualitative methodology. The participants were adults who had a history of homelessness and use of alcohol and other drugs. The interviews were semi structured and used a timeline instrument. All interview were audio recorded, transcribed, and submitted to thematic analysis.

Results

Twenty individuals participated in the study. Reports on social exclusion over time stood out in respect of four main themes and their respective subthemes: Theme 1 – Childhood: instability upbringing, abuse, violence, and an absent or not very present father figure; Theme 2 – Adolescence: school dropout and failure; acceptance of gender and sexual orientation; birth of first child, living with a partner or getting married: Theme 3 – Adulthood: estrangement or conflicting relationship with family; health problems; drug trafficking and prostitution; Theme 4 – Cross-cutting factors: death of relatives and substance use.

Conclusion

The results suggest that interpersonal relationships are permeated by successive breakups, conflicts and other events that start in childhood and can have a cumulative effect in later stages of life, and cross the subsequent phases. Substance abuse and dependence are mentioned as cross-cutting factors that intensify social exclusion in all stages of life.

Supplementary Information

Supplementary information accompanies this paper at 10.1186/s12889-020-09880-2.

ENTRE A BENESSE E O DIREITO: AS POLÍTICAS DE ATENDIMENTO À POPULAÇÃO EM SITUAÇÃO DE RUA NA AMÉRICA LATINA

O presente trabalho analisou a literatura científica sobre políticas sociais e população em situação de rua nos países latino-americanos. Foram analisados 51 artigos buscados nas bases de dados Scielo, Lilacs e Redalyc, a partir da palavra-chave ‘População em Situação de Rua’, que apresentam experiências e reflexões acerca do atendimento a esse segmento na Argentina, Brasil, Chile, Colômbia e Cuba. Identificou-se que, apesar de perfis semelhantes, trata-se de um segmento bastante heterogêneo. As principais ênfases sobre as políticas sociais foram nas áreas da assistência social e saúde, e estas ainda tendem para o assistencialismo. Contudo, houve avanços na criação de legislações, serviços e políticas para a garantia de direitos. Enfim, nota-se a necessidade de aprofundar a discussão acerca da determinação produtora da desigualdade social e o avanço na implementação de políticas sociais que visem possibilitar o real acesso aos direitos sociais por esta população.

Homeless people's social representations about self-care

OBJECTIVES

To capture and analyze the structure of homeless people's social representations about self-care.

METHODS

Research based on the theory of social representations, with 122 people in street situation. A semistructured questionnaire and free evocation technique were applied with the inducing words "caring for myself is". The evocations were processed by the software Evoc and Iramuteq, allowing to identify central and peripheral elements and the connection between them.

RESULTS

For the group studied, "feeding oneself, personal hygiene, protecting oneself and visiting the doctor" are actions and attitudes that represent caring for themselves. In the streets, "feeding oneself" is an essential action for living/surviving that underpins the others.

FINAL CONSIDERATIONS

Despite behaviors based on the biomedical model, self-care was represented by extended actions to meet basic human needs. This study offers elements of reflection to rethink care practices developed by health professionals.

Needs, expectations and care production of people in street situation

OBJECTIVE

To understand the needs, expectations, and care production of people in street situations.

METHOD

This is a qualitative study based on social phenomenology, conducted with eight people in street situations. Data were collected through a phenomenological interview from September to December, 2016.

RESULTS

The needs of participants refer to survival and access to health services. Care production involves physico-biological, spiritual, and affective-social aspects. The expectations of these people involve a desire for health care that considers their singularities and offers them social apparatuses.

FINAL CONSIDERATIONS

This study has contributions to the practice, training on health, and nursing in collective health, regarding care planning and provision to the population in street situations based on their expectations and lifestyles, considered as tools to help fulfill the health needs of this social group.

Nursing Diagnoses of the Homeless Population in Light of Self-care Theory

BACKGROUND

A growing number of people find themselves in conditions of extreme poverty, which often makes living on the streets the only option. Living conditions in this setting exert a direct impact on health and self-care. Health care for the homeless population should be planned in an interdisciplinary and intersectoral manner. In this context, nursing diagnoses constitute an essential part of the systemization of care.

OBJECTIVES

The aims of the present study were to identify nursing diagnoses of a homeless population and propose nursing interventions based on the findings in light of the Nursing Outcomes Classification and Nursing Interventions Classification.

DESIGN AND SETTING

A descriptive, cross-sectional study with a quantitative approach was conducted on the streets of the city of Recife in northeastern Brazil.

PARTICIPANTS

The sample consisted of 274 male and female adult homeless individuals.

METHODS

Data collection involved the administration of a semi-structured interview, the Alcohol, Smoking and Substance Involvement Screening Test and the International Neuropsychiatric Interview.

RESULTS

The most prevalent diagnoses were related to risk-prone health behaviors (78.1%), inadequate health maintenance (67.1%), along with sleep deprivation (100%), feelings of hopelessness (100%) and low self-esteem (99%).

CONCLUSIONS

The experience enabled the identification of the peculiarities of the population, bringing nursing practice closer to health promotion for the homeless. Adequate public policies and training for health teams are needed to address the health needs of the homeless population.

Representações sociais do cuidado em saúde de pessoas em situação de rua

RESUMO Objetivo Identificar e analisar a estrutura e o conteúdo das representações sociais de pessoas em situação de rua sobre cuidados em saúde. Método Pesquisa qualitativa, fundamentada na abordagem estrutural da Teoria das Representações Sociais, com pessoas em situação de rua, vinculadas a duas unidades de acolhimento institucional. Para a produção dos dados, foi utilizado o teste de associação livre de palavras, cujos dados foram processados por dois software e analisados à luz da referida teoria. Resultados Participara da pesquisa 72 pessoas. O conjunto de evocações do quadro de quatro casas remete a ações individuais, sociais e culturais. Os termos médico, cuidar de si e alimentação compuseram o núcleo central da representação, sinalizando dimensões imagética e funcional do objeto investigado. A nuvem de palavras confirmou a centralidade dos termos. Conclusão O grupo investigado representa o cuidado em saúde como uma ação dinâmica, vinculado à pessoa e ao contexto e ancorado em elementos da concepção higienista.