The intersection of stigma and inequity : the impact of structural violence on people with lived and living experience of substance use and homelessness in the emergency department
department or school: Applied Science, Faculty of
department or school: Medicine, Faculty of
department or school: Nursing, School of
department or school: Population and Public Health (SPPH), School of
data provider: DSpace
degree campus: UBCV
creator: Wright, Patrice
issued: 2020-10-22T20:55:04Z
issued: 2020
related degree: Master of Public Health / Master of Science in Nursing - MPH/MSN
degree grantor: University of British Columbia
description: People with lived and living experience of substance use and homelessness (PWLESH) often face barriers when accessing care including stigma and discrimination, transportation costs, limited services hours and the need to present identification. Such barriers may lead people to leave prior to the completion of treatment, delay seeking care or avoid care altogether. Although PWLESH visit the emergency department at a rate seven times the general population, I could find no published research has explored access to healthcare specifically within the emergency department among adults. The purpose of this thesis was to understand: (a) the emergency department health care experiences, specifically in terms of access, of PWLESH; (b) how the culture within the emergency department and larger health care organization shapes these experiences; and (c) the factors that will positively contribute to providing more equitable health care. A critical ethnographic approach was used for data collection and analysis. Twelve in-depth interviews with PWLESH and thirty hours of observations were conducted in two emergency departments, and seven hospital documents were reviewed. Drawing on central tenets of intersectionality and stigma theories, thematic coding techniques detailed by Thorne (2008) were used during data analysis. This analysis revealed three themes including: (a) experiences of stigma, (b) effects of stigma, and (c) recommendations for equitable healthcare. Several implications for practice and policy and future research are made.
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/76333
note: THE INTERSECTION OF STIGMA AND INEQUITY: THE IMPACT OF STRUCTURAL VIOLENCE ON PEOPLE WITH LIVED AND LIVING EXPERIENCE OF SUBSTANCE USE AND HOMELESSNESS IN THE EMERGENCY DEPARTMENT by Patrice Wright B.Sc.N., R.N. McMaster University, 2012 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF PUBLIC HEALTH/MASTER OF SCIENCE IN NURSING in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (PUBLIC HEALTH/NURSING) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) October 2020 © Patrice Wright, 2020 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the thesis entitled: The Intersection of Stigma and Inequity: The Impact of Structural Violence on People with Lived and Living Experience of Substance Use and Homelessness in the Emergency Department submitted by Patrice Wright in partial fulfillment of the requirements for the degree of Master of Public Health/ Master of Science in Nursing in Public Health /Nursing Examining Committee: Dr. Colleen Varcoe, Professor, School of Nursing, UBC Supervisor Dr. Vicky Bungay, Professor, School of Nursing, UBC Supervisory Committee Member Dr. Bernie Pauly, Professor, School of Nursing, UVic Supervisory Committee Member Elder Roberta Price, Elder, School of Nursing, UBC Supervisory Committee Member iii Abstract People with lived and living experience of substance use and homelessness (PWLESH) often face barriers when accessing care including stigma and discrimination, transportation costs, limited services hours and the need to present identification. Such barriers may lead people to leave prior to the completion of treatment, delay seeking care or avoid care altogether. Although PWLESH visit the emergency department at a rate seven times the general population, I could find no published research has explored access to healthcare specifically within the emergency department among adults. The purpose of this thesis was…
has type: Thesis/Dissertation
date issued: 2020-11
is shown at: 10.14288/1.0394782
language: eng
degree discipline: Public Health / Nursing
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
type: Text
identifier URI: http://hdl.handle.net/2429/76333