Livet utanför : Hemlösa missbrukares upplevelse av hälsan och sjukvården

Sammanfattning: Background: A group severely affected by health issues, the experiences of homeless alcohol and drug abusers in the coverage of their medical care needs is not satisfactory. Aim: The aim of the study is to explore which factors experienced by homeless alcohol and drug abusers in Uppsala in regards to their living situation affected their health, their perception of access to healthcare, the character of treatment received and coping strategies used outside of the healthcare system. Method: Nine people who had experienced both homelessness and substance abuse problem were recruited for the study during their visit to Stadsmissionens facilities for the homeless. Data was collected through qualitative, semi-structured interviews including two women and seven men. Data was analyzed using qualitative content analysis according to Giorgi modified by Malterud.Results: Among homeless substance abusers interviewed experiences of unwelcoming and prejudiced healthcare were described. However, this negative treatment was in some cases explained as one-time occurrences related to that persons attitude at the time. The homeless substance abusers describe a life situation that is regarded as having a great affect on their health. Vulnerability in this situation is described by the homeless as sometimes leading to increased substance abuse. Discontent concerning the structure of the healthcare system or the feeling of not being worthy of treatment fuels the idea of a limited or even non-existent accessibility in this group. Due to the lack of accessibility, a situation arises where the homeless people consider themselves being left without help. To cope with this situation, self-medicating is sometimes practiced.Conclusion: Stigma and prejudice in treatment is not only affecting the quality of medical caring interaction but affects the extent to which homeless substance abusers choose to contact healthcare.