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Abstract：
BACKGROUND: Homelessness is associated with significant health disparities. Conventional health services often fail to address the unique needs and lived experience of homeless individuals and fail to include participatory design when planning health services. This scoping review aimed to examine areas of patient experience that are most frequently reported by people experiencing homelessness when seeking and receiving healthcare, and to identify existing surveys used to measure patient experience for this cohort.
METHODS: A scoping review was undertaken reported according to the PRISMA-ScR 2020 Statement. Databases were searched on 1 December 2022: MEDLINE, EMBASE, APA PsychINFO and CINAHL. Included studies focused on people experiencing homelessness, healthcare services and patient experience, primary research, published in English from 2010. Qualitative papers and findings were extracted and synthesized against a modified framework based on the National Institute for Health and Care Excellence guidelines for care for people experiencing homelessness, the Institute of Medicine Framework and Lachman\'s multidimensional quality model. People with lived experience of homelessness were employed as part of the research team.
RESULTS: Thirty-two studies were included. Of these, 22 were qualitative, seven quantitative and three mixed methods, from the United States of America (n = 17), United Kingdom (n = 5), Australia (n = 5) and Canada (n = 4). Health services ranged from primary healthcare to outpatient management, acute care, emergency care and hospital based healthcare. In qualitative papers, the domains of \'accessible and timely\', \'person-centred\', and values of \'dignity and respect\' and \'kindness with compassion\' were most prevalent. Among the three patient experience surveys identified, \'accessible and timely\' and \'person-centred\' were the most frequent domains. The least frequently highlighted domains and values were \'equitable\' and \'holistic\'. No questions addressed the \'safety\' domain.
CONCLUSIONS: The Primary Care Quality-Homeless questionnaire best reflected the priorities for healthcare provision that were highlighted in the qualitative studies of people experiencing homelessness. The most frequently cited domains and values that people experiencing homelessness expressed as important when seeking healthcare were reflected in each of the three survey tools to varying degrees. Findings suggest that the principles of \'Kindness and compassion\' require further emphasis when seeking feedback on healthcare experiences and the domains of \'safety\', \'equitable\', and \'efficiency\' are not adequately represented in existing patient experience surveys.
METHODS: A scoping review was undertaken reported according to the PRISMA-ScR 2020 Statement. Databases were searched on 1 December 2022: MEDLINE, EMBASE, APA PsychINFO and CINAHL. Included studies focused on people experiencing homelessness, healthcare services and patient experience, primary research, published in English from 2010. Qualitative papers and findings were extracted and synthesized against a modified framework based on the National Institute for Health and Care Excellence guidelines for care for people experiencing homelessness, the Institute of Medicine Framework and Lachman\'s multidimensional quality model. People with lived experience of homelessness were employed as part of the research team.
RESULTS: Thirty-two studies were included. Of these, 22 were qualitative, seven quantitative and three mixed methods, from the United States of America (n = 17), United Kingdom (n = 5), Australia (n = 5) and Canada (n = 4). Health services ranged from primary healthcare to outpatient management, acute care, emergency care and hospital based healthcare. In qualitative papers, the domains of \'accessible and timely\', \'person-centred\', and values of \'dignity and respect\' and \'kindness with compassion\' were most prevalent. Among the three patient experience surveys identified, \'accessible and timely\' and \'person-centred\' were the most frequent domains. The least frequently highlighted domains and values were \'equitable\' and \'holistic\'. No questions addressed the \'safety\' domain.
CONCLUSIONS: The Primary Care Quality-Homeless questionnaire best reflected the priorities for healthcare provision that were highlighted in the qualitative studies of people experiencing homelessness. The most frequently cited domains and values that people experiencing homelessness expressed as important when seeking healthcare were reflected in each of the three survey tools to varying degrees. Findings suggest that the principles of \'Kindness and compassion\' require further emphasis when seeking feedback on healthcare experiences and the domains of \'safety\', \'equitable\', and \'efficiency\' are not adequately represented in existing patient experience surveys.
摘要：
背景：无家可归与显著的健康差异有关。传统的卫生服务往往无法满足无家可归者的独特需求和生活经验，在规划卫生服务时也没有包括参与性设计。这项范围审查旨在检查在寻求和接受医疗保健时经历无家可归的人最常报告的患者经历领域，并确定用于衡量该队列患者体验的现有调查。
方法：根据PRISMA-ScR2020声明进行了范围审查。2022年12月1日检索数据库：MEDLINE，EMBASE,APAPsychINFO和CINAHL。包括针对无家可归人群的研究，医疗保健服务和患者体验，主要研究,从2010年开始以英文出版。根据国家健康与护理卓越研究所针对无家可归者的护理指南的修改框架，提取并综合了定性论文和发现。医学研究所框架和Lachman的多维质量模型。有无家可归经历的人被聘为研究团队的一部分。
结果：纳入32项研究。其中,22是定性的，七种定量方法和三种混合方法，来自美利坚合众国（n=17），英国（n=5），澳大利亚（n=5）和加拿大（n=4）。卫生服务范围从初级医疗保健到门诊管理，急性护理，紧急护理和医院医疗保健。在定性论文中，\'可访问和及时\'的域，\'以人为本\',“尊严和尊重”和“仁慈与同情”的价值观最为普遍。在确定的三项患者体验调查中，“可访问和及时”和“以人为本”是最常见的域。最不经常突出显示的域和值是“公平”和“整体”。没有问题解决\“安全\”域。
结论：初级保健质量-无家可归者问卷最好地反映了在经历无家可归者的定性研究中强调的医疗保健提供的优先事项。经历无家可归的人在寻求医疗保健时表示为重要的最常被引用的领域和价值观在三个调查工具中都有不同程度的反映。研究结果表明，在寻求有关医疗保健经验和“安全”领域的反馈时，“善良和同情”的原则需要进一步强调，\'公平\',和“效率”在现有的患者体验调查中没有得到充分体现。
方法：根据PRISMA-ScR2020声明进行了范围审查。2022年12月1日检索数据库：MEDLINE，EMBASE,APAPsychINFO和CINAHL。包括针对无家可归人群的研究，医疗保健服务和患者体验，主要研究,从2010年开始以英文出版。根据国家健康与护理卓越研究所针对无家可归者的护理指南的修改框架，提取并综合了定性论文和发现。医学研究所框架和Lachman的多维质量模型。有无家可归经历的人被聘为研究团队的一部分。
结果：纳入32项研究。其中,22是定性的，七种定量方法和三种混合方法，来自美利坚合众国（n=17），英国（n=5），澳大利亚（n=5）和加拿大（n=4）。卫生服务范围从初级医疗保健到门诊管理，急性护理，紧急护理和医院医疗保健。在定性论文中，\'可访问和及时\'的域，\'以人为本\',“尊严和尊重”和“仁慈与同情”的价值观最为普遍。在确定的三项患者体验调查中，“可访问和及时”和“以人为本”是最常见的域。最不经常突出显示的域和值是“公平”和“整体”。没有问题解决\“安全\”域。
结论：初级保健质量-无家可归者问卷最好地反映了在经历无家可归者的定性研究中强调的医疗保健提供的优先事项。经历无家可归的人在寻求医疗保健时表示为重要的最常被引用的领域和价值观在三个调查工具中都有不同程度的反映。研究结果表明，在寻求有关医疗保健经验和“安全”领域的反馈时，“善良和同情”的原则需要进一步强调，\'公平\',和“效率”在现有的患者体验调查中没有得到充分体现。
