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Ever go to a conference and have a poster really make you think? then hope you see the authors publish the work?
Well this happened to me last year @AHAMeetings #QCOR19 & I found the paper in #HeartLung this wk!
Time for a #CQOSpotlight on a study by @APendyal_MD
Ever go to a conference and have a poster really make you think? then hope you see the authors publish the work?
Well this happened to me last year @AHAMeetings #QCOR19 & I found the paper in #HeartLung this wk!
Time for a #CQOSpotlight on a study by @APendyal_MD
2/ Let's dive into a paper by @APendyal_MD @marjoriesue @SpatzErica @Alison586Alison et al @YaleMed “When you're homeless, they look down on you”: A qualitative, community-based study of homeless individuals with HF" in #HeartLung https://www.sciencedirect.com/science/article/pii/S0147956320303174?via%3Dihub
3/ Background - managing HF requires a high degree of self-care. Homelessness = likely to affect this. Goal of study was to understand the perspectives of adults experiencing homelessness towards managing their HF & interacting w/ health system. @MKushel @ARamsdell3 @KellyMDoran
4/ This was a qualitative study of individuals experiencing homelessness in New Haven, CT. Had to be > 18 years age and have a dx of HF. Purposive sampling and a community-partnered approach was used to identify participants.
5/ Definition of a homeless person = an individual without permanent housing who may live on the streets; stay in a shelter, mission, single room occupancy facilities, abandoned building or vehicle; or in any other unstable or nonpermanent situation. https://nhchc.org/understanding-homelessness/faq/
6/ Authors conducted in-depth, 1:1 interviews; analysis done using grounded theory.
NOTE
Interviews were conducted in settings of participants’ choosing = to me this is an important point for community-partnered studies!! @CornellCHEQ @uncCHER @HealthEquityCT
NOTE
Interviews were conducted in settings of participants’ choosing = to me this is an important point for community-partnered studies!! @CornellCHEQ @uncCHER @HealthEquityCT
7/ Study had 19 participants, mean age 56 yrs, mostly men, nearly half self-identified as black (47%), 47% had HFrEF. Mean number of prior HF hospitalizations was 8!! (range of 0 to 37!!) - these are people who are in and out of the hospital, a lot..
8/
Theme 1. Instability from Homelessness Impedes HF Care (ex: purchasing meds, weighing self, appointments)
Theme 2. Tradeoffs (ex: secure shelter vs manage HF)
Theme 3. Stigmatization by Healthcare Providers Influences the Experiences of Homeless Individuals w/ System
Theme 1. Instability from Homelessness Impedes HF Care (ex: purchasing meds, weighing self, appointments)
Theme 2. Tradeoffs (ex: secure shelter vs manage HF)
Theme 3. Stigmatization by Healthcare Providers Influences the Experiences of Homeless Individuals w/ System
9/ A powerful quote from the paper (I see this in primary care sometimes too) -
"I lied. I told my cardiologist that I had a place to live."
"I lied. I told my cardiologist that I had a place to live."
10/ Overall, study offers new insights into perceptions and difficulties in HF self-care for HF patients.
Study also points to potential interventions at clinician, patient, and system levels
Fig = what interventions might be...
Q @APendyal_MD - which are most realistic?
Study also points to potential interventions at clinician, patient, and system levels
Fig = what interventions might be...
Q @APendyal_MD - which are most realistic?
11/ Study also speaks to recent position paper in @CircOutcomes by @KBreathettMD @Lisa_Jackson_MD
@KiarriKershaw et al on Housing and CV health. @bnallamo @gradydoctor @AHA_Research
Link here: https://www.ahajournals.org/doi/10.1161/HCQ.0000000000000089?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Housing = important #SDOH
#CQOSpotlight
End thread/
@KiarriKershaw et al on Housing and CV health. @bnallamo @gradydoctor @AHA_Research
Link here: https://www.ahajournals.org/doi/10.1161/HCQ.0000000000000089?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Housing = important #SDOH
#CQOSpotlight
End thread/
