Capella FPX 4015 Assessment 4

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Capella university

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

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Date

Caring for Special Populations: Educational Presentation

Overview of Homelessness and Health Care Barriers

Individuals experiencing homelessness form a high-risk population confronted by multiple health disparities rooted in economic hardship and insufficient social networks. This educational presentation explores the complex health issues unique to the homeless community, including barriers to preventative services. It also sheds light on the cultural nuances and social determinants influencing their healthcare outcomes. Nurses serve a pivotal role by advocating for equitable, empathetic care that acknowledges individual backgrounds. Through education, active community partnerships, and cultural understanding, nurses can help reduce healthcare inequities faced by this marginalized group.

Understanding the Healthcare Needs of People Experiencing Homelessness

Epidemiology and Health Vulnerabilities

Homelessness continues to be a critical public health concern in the United States. As of 2024, approximately 771,480 individuals were reported as homeless, translating to 23 per 10,000 people (De Sousa & Henry, 2024). This diverse group includes chronically homeless adults, families with children, military veterans, and unaccompanied youth. They often suffer from multiple health conditions, such as cardiovascular diseases, respiratory illnesses, diabetes, and untreated infections. Furthermore, mental health disorders, substance abuse, and trauma are commonly observed, compounded by unstable housing, poor hygiene facilities, and food insecurity (Padgett, 2020).

The absence of a permanent address often prevents access to health insurance, follow-up care, and necessary medications. Distrust of healthcare providers, stigma, and logistical hurdles also discourage them from seeking medical attention. As a result, they frequently prioritize immediate survival needs over chronic disease management. Nurses can respond more effectively by embracing trauma-informed care that prioritizes respect, safety, and compassion (Brais & Riva, 2024). Effective care should be culturally responsive and tailored to the lived realities of this group.

Cultural Beliefs and Healthcare Perspectives

Survival-Driven Values and Spiritual Coping

Homeless individuals often share survival-centered values, regardless of their race, religion, or background. Securing basic needs such as shelter, safety, and food generally takes precedence over preventive health measures (Zhao, 2022). Due to repeated experiences of neglect or discrimination, many people without housing lack trust in the medical system and delay seeking care. Spirituality or religious practices often serve as critical coping tools, helping individuals deal with trauma and adversity (Fitzpatrick, 2020).

Cultural norms—such as dress, dietary preferences, or communication styles—may also affect how homeless individuals interact with healthcare providers. Respecting autonomy, treating patients with dignity, and allowing for shared decision-making are key to fostering trust (Miller et al., 2024). True cultural competence in this context involves understanding both the individual’s culture and their experience of homelessness.

Health Disparities and Systemic Challenges

Environmental and societal factors significantly contribute to the health inequities faced by homeless populations. Key social determinants include poverty, lack of education, limited job opportunities, inadequate nutrition, and unstable housing (Lee et al., 2023). These barriers complicate chronic disease management and limit access to timely, quality care. Homeless individuals are disproportionately affected by physical illnesses, psychiatric conditions such as PTSD and schizophrenia, and co-occurring substance use disorders.

Due to a lack of insurance, transportation, or primary care access, many rely on emergency services, which are both inefficient and costly. Preventive services like vaccinations and screenings are often out of reach. Language and cultural barriers can further hinder care for children in homeless families. As such, there is a pressing need for trauma-sensitive, practical, and equitable nursing strategies that address these disparities with empathy and understanding (Zhao, 2022).

Strategies for Culturally Competent Nursing Practice

Implementing Trauma-Informed Care and Community Partnerships

Culturally competent care for homeless individuals includes recognizing past traumas and offering dignity-centered, nonjudgmental support. Many have experienced domestic abuse, systemic racism, or street violence. Nurses must acknowledge these histories and provide consistent, respectful care that values the person’s autonomy (Brais & Riva, 2024). This builds trust and promotes engagement with health services.

Partnering with shelters, mosques, churches, or community centers can create culturally safe environments where patients feel supported emotionally and spiritually (Fitzpatrick, 2020). These collaborations improve outreach and continuity of care, especially for marginalized or religiously observant individuals.

Case-Based Applications of Competent Care

Real-World Examples

In Southern Oregon, a specialized care initiative targeted the homeless population through a culturally responsive, trauma-informed model (OHSU School of Nursing, n.d.). Nurses received training to manage tri-morbidity—mental illness, substance use, and chronic diseases—and provided care in familiar environments, reducing anxiety and increasing compliance.

Another case involved a Somali refugee suffering from homelessness and asthma. Due to her religious attire and prayer needs, she previously avoided clinics. A nurse learned about her spiritual customs and coordinated care that accommodated prayer times and cultural norms. A local mosque assisted with temporary housing, leading to improved medication adherence and follow-up visits (Fang et al., 2023). These examples underscore how integrating cultural awareness into care can foster healing and trust.

Educational Resources for Nurses

Enhancing Cultural Sensitivity and Clinical Skills

To build their skills, nurses can access resources such as the National Health Care for the Homeless Council (NHCHC), which offers toolkits and training in trauma-informed care and cultural competency (NHCHC, n.d.). The Substance Abuse and Mental Health Services Administration (SAMHSA) also provides evidence-based resources focusing on co-occurring disorders and homelessness (SAMHSA, n.d.).

Engaging in local outreach efforts and ongoing education in ethics, cultural humility, and health disparities further strengthens nursing competencies. Hands-on experiences are essential for delivering care that respects the unique narratives of individuals living without housing.

Conclusion

Meeting the healthcare needs of homeless individuals requires a blend of cultural humility, trauma-informed care, and system-level advocacy. Nurses can play a transformative role by removing barriers, embracing diverse perspectives, and tailoring care to each patient’s lived experiences. Long-term solutions involve promoting trust, accessibility, and dignity in healthcare delivery. Continued professional learning, interagency collaboration, and a focus on social justice remain essential to improving outcomes for this vulnerable population.

References

Brais, H., & Riva, M. (2024). Towards a “trauma-informed spaces of care” model: The example of services for homeless substance users. Progress in Human Geography, 48(6). https://doi.org/10.1177/03091325241269757

De Sousa, T., & Henry, M. (2024). The 2024 Annual Homelessness Assessment Report (AHAR) to Congress. https://www.huduser.gov/portal/sites/default/files/pdf/2024-AHAR-Part-1.pdf

Fang, M. L., Canham, S. L., & Battersby, L. (2023). Supporting intersecting cultural needs of gender and age by increasing cultural safety and humility for Housing First initiatives. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-15955-7

Fitzpatrick, L. K. (2020). “Meet them where they’re at”: Faith-based and secular homeless outreach approaches. ScholarWorks at University of Montana. https://scholarworks.umt.edu/etd/11482

Lee, J. J., Jagasia, E., & Wilson, P. R. (2023). Addressing health disparities of individuals experiencing homelessness in the U.S. with community institutional partnerships: An integrative review. Journal of Advanced Nursing, 79(5). https://doi.org/10.1111/jan.15591