SATISFACTION WITH HEALTH CARE IN A SAMPLE OF INDIGENTS

WOULD THEY RATHER BE TREATED BY PHYSICIANS OR NURSE PRACTIONERS?

In the United States, health care is often unavailable for the homeless. This heterogeneous group of men and women, includes longterm street dwellers, residents of shelters, the chronically mentally ill, the economically debased, and alienated youth---all of whom are subject to a broad range of acute and chronic diseases, intensified by unsuitable living conditions, stress and sociopathic behavior.

Trauma, pulmonary tuberculosis, infestations, and peripheral vascular disease are common problems among the homeless, and often incomplete and/or fragmentary medical care permits exacerbation of chronic disorders (Sebastian, 1994). Outreach health care programs, commonly consisting of teams of physicians, nurses, and social workers are used to reestablish and maintain health services for these disenfranchised persons.

Despite differences in community demographics, Carter, Green, Green, and Dufour (1994) have noted that most indigents encounter the roughly the same obstacles in seeking health care: bureaucracy, transportation, accessibility, present-time orientation, limited resources, frustration, and anxiety.

The authors feel that the best answer to the health care needs of indigents are nurse-managed free clinics.

It is pointed out that in outreach programs while a physician essentially deals only with clients' immedia

. . .
ing, crisis intervention, provision of prescribed medical treatment, health monitoring, and counseling. The nurse practioner role is said to be that of mediating community systems for homeless clients using either a case management or an agency coalition approach. Essentially, both of these approaches consist of "brokering" services. The approaches require the nurse practioner to coordinate all care received by the client, to follow up on referrals and, basically, to connect the client with all needed services while helping him or her to learn those skills necessary to maximize the use of services. The usefulness of the two approaches lies in the fact that they both recognize and attempt to meet the multifaceted needs of homeless clients. What needs to be noted here is that the indigent clients providing data in the proposed research will all be drawn from settings that fit the conceptual model just delineated. Moreover, the nurse practioners who have worked with these clients will deliver services within the context described by the Nichols, Wright and Murphy (1986) model of health care service provision to the homeless. Purpose of the Study The primary purpose of the proposed research will be to examine whether a samp
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Some common words found in the essay are:
MARITAL STATUS, Gelberg Freeman, Kiess Bloomquist, Green Dufour, Green Carter, Wright Murphy, Satisfaction Questionnaire, Statement United, Linton Gallo, Analysis Variance, health care, nurse practioners, services received, homeless clients, nurse practioner, care homeless, satisfaction levels, services provided, satisfaction services, test instrument, services received program, health care homeless, health care services, satisfaction services received, physicians nurse practioners,
Approximate Word count = 3607
Approximate Pages = 14 (250 words per page)

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