Life is Hard: A phenomenological study of homeless women diagnosed as chronically mentally ill
The purpose of this phenomenological study was to generate data which describe women's experiences and meanings of being homeless and chronically mentally ill. The sample of availability consisted of 10 homeless women who have been treated by a psychiatric health care team for homeless persons. Experiential analysis and the ethnographic technique of participation were used by the researcher to gain entry and to establish credibility and trustworthiness in the field (Lincoln & Guba, 1985; Reinharz, 1979).
Participants were interviewed using the technique of talk/turning within--an open creative interview format (Ray, 1987). The taped interviews were transcribed and analyzed. Data analysis used Colaizzi's (1978) phenomenological technique. The unity of meaning of the study findings is in the statement: "Life is Hard."
Findings revealed five dimensions commonly experienced within contexts of homelessness. They are a sense of person, a sense of place, a sense of timing, a sense of community, and a sense of humor. An antecedent metatheme, Disequilibrium, emerged with themes of poverty, personal and family stressors, losing control, and repeated cycles of illness. Findings revealed four additional metathemes: personhood, uncertainties, creative survival tactics, and relationships.
Developing appropriate nursing diagnoses and using the nursing process has the potential for improving the quality of care of homeless persons. Baseline data about everyday challenges that homeless women face may facilitate greater understanding of homeless women's needs and risk factors that led to their homelessness. The nurse's awareness of how chronically mentally ill homeless women participate in their care would enhance use of the care-planning process. The nurse's increased awareness may contribute to further development of community health program-planning strategies and public policies that provide comprehensive supportive services and funding to chronically mentally ill homeless women.
The nurse's understanding of the meaning of experiences of homeless women diagnosed as chronically mentally ill may promote a means for improving client/nurse interactions, advocacy, care-planning strategies, access and utilization of available health care services. Nursing may play a more significant role in providing emergency and supportive services, identifying risk factors of homelessness, and intervening with persons on the verge of being homeless.