Health, illness, and homeless women: A phenomenological study
The purpose of this phenomenological study was to provide a description of the way homeless women view and handle their health. A convenience sample consisted of ten women theoretically representative of the women in an emergency shelter population. Respondents completed a demographic form and participated in an audiotaped interview. Interviews were transcribed and summarized. Data were analyzed for meanings and thematic relationships using phenomenology methodology. The emerging categories were belief system, health needs, health management, and health care roles.
Belief system, encompassing a deity or self as users of the environment and survivors of the situation, canopied like an umbrella over needs, management and roles. Sense of control and positiveness derived from the belief system were overriding influences in perceptions of health. Health needs of concern were physiological, developmental, or psychological in nature. Physiological needs were related to communicable diseases, chronic illnesses, or pregnancy. Developmental needs centered on dependent children. Psychological needs were associated with histories of family instability and substance or physical abuse. Health management included health promotion and protection. Health promotion activities focused on nutrition, exercise, personal hygiene, environmental hygiene, children, and attitude. Health protection included primary prevention avoiding specific health problems, secondary prevention facilitating early diagnosis and intervention, and tertiary prevention restoring optimum performance. Health care roles functioned as manipulators, participators, or spectators within the environment and situation. Manipulators exhibited proactive responses to health needs and management by exercising control and choice. Participators' responses were reactive choosing involvement with less control. Spectators expressed passive responses associated with lack of control and negativeness.
Findings indicated perceptions and management of health were more effective as a positive force and endeavor in which control existed. Respondents demonstrated considerable resilience in discovering ways to overcome and thrive. Homeless women were knowledgeable about health promotion and chose to access health care that was acceptable to them. Providers must listen to their needs and locate in the homeless environment with health promotion and prevention activity that fosters the individual's role as responsible for decisions. Further research in other environments is wan-anted to determine if beliefs, knowledge, and behaviors can be replicated.