"When you're homeless, they look down on you": A qualitative, community-based study of homeless individuals with heart failure.
Akshay Pendyal, Marjorie S Rosenthal, Erica S Spatz and 3 others
PMID 32792114WHAT IT FOUND
Homeless patients with heart failure said instability made routines like medications and daily weights hard, shelter and food often came first, and stigma kept some from seeking care or revealing their housing status.
Key findings
01Instability from homelessness made heart failure self-management routines, including medications and daily weights, difficult to establish.
02Participants described trade-offs in which securing shelter and meeting immediate needs took precedence over heart failure self-management and long-term planning.
03Stigma discouraged some participants from seeking timely care or disclosing housing status, and some described non-stigmatizing provider language as eliciting hope and greater self-efficacy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one city, New Haven, Connecticut, so experiences may not match other places. It included 19 participants and is qualitative, so it cannot show what treatments or care models improve heart failure outcomes. All participants reported Medicaid, and 14 participants were male, so it may not describe experiences of homeless patients without Medicaid or of more women. Some participants were no longer homeless at interview, and the authors note recall bias as a possible limitation. Recruitment used shelters, libraries, social service offices, community organizations, and healthcare contacts, which may not reach people who avoid services.
Declared interests
The authors declare no relationships or competing interests. The supplied publication types indicate NIH extramural research support.
The easy way to misread this
Do not read this as evidence that medical respite, simplified regimens, or non-stigmatizing language improve heart failure outcomes. The study reports patients' experiences and themes, not tested interventions or measured clinical results.