HOUSING AND HEALTH: AN EXPLORATION OF HOUSING NEED IN CHILDREN WITH MEDICAL COMPLEXITY
Notice bibliographique
Résumé
Abstract BACKGROUND Children with medical complexity (CMC), are defined by at least one chronic condition, functional limitation requiring technology support, multiple subspecialist involvement, and high healthcare utilization. A potentially significant social determinant that has yet to be examined in this population is that of “housing need.” According to the Canada Mortgage and Housing Corporation, “housing need” refers to housing that is crowded, unaffordable, or in need of major repairs. Given the known associations between housing and health, we hypothesize that housing need could be particularly relevant in CMC. Population-specific housing considerations may include in-home medical services, housing space, and disability accommodations. OBJECTIVES 1) Determine the prevalence of housing need in families with CMC and 2) Explore the experience and meaning of housing need of caregivers of CMC. DESIGN/METHODS We conducted a mixed methods study using questionnaires and semi-structured interviews. Recruitment occurred through a tertiary paediatric hospital. Research ethics board approval was obtained. All participants were English-speaking primary caregivers of CMC living in the same household. Questionnaires were completed in person, by phone, or online via REDCap, a secure data collection application. Questionnaires explored safety, affordability, and accommodations and were analyzed using descriptive statistics. Following the questionnaire, participants were invited to be interviewed in person or by phone. Interview questions were developed iteratively and were analyzed using grounded theory. RESULTS Of the 354 eligible caregivers, 93 participated in the questionnaire. A total of 36 caregivers (40%) reported some difficulties paying for housing each month. In addition, 56 participants (62%) described unmet need for accommodations (i.e. a lift, toilet accommodations, etc.). A total of 65 participants (83%) reported that their child’s condition(s) affected their preferred housing location, while 55 participants (70.5%) felt it affected their preferred housing type. Of the fifteen interviews completed, several themes emerged including limited housing options for families with CMC and financial, physical, and mental health consequences of housing challenges. In addition, caregivers felt counseling was lacking on 1) safe evacuation and 2) housing requirements, such as space and equipment, as children age. CONCLUSION This is the first in-depth exploration of housing need amongst families of CMC. Challenges identified include affordability, disability accommodations, and restrictions on housing type and location due to children’s illnesses. Clinicians can support families of CMC by offering counseling on evacuation planning and common housing requirements for CMC.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,002 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».