Date of Award

2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Ginette G. Ferszt

Abstract

Homelessness remains a significant global issue with substantial health consequences related to the experiences of homelessness. The consequences for people who experience homelessness are typically associated with high levels of risk, violence, and negative health outcomes. Developmental levels and gender contribute significantly to outcomes. As a developmental stage, adolescence is a time of establishing healthy practices for adulthood. Adolescent experiences with homelessness have negative consequences for future health as well as some economic status. Homeless youth have been identified as a medically underserved and vulnerable population.

A significant body of literature has explored the outcomes of mental health, sexual practices, risky behaviors, and substance abuse related to adolescents who are homelessness. However, exploration of the lived experiences of adolescent females while homeless related to strengths used for caring for their health is limited. This includes a need to understand how women who experienced homelessness during adolescence engaged in health promotion and accessed health information. Adolescent females are at greater risk for acts of violence against them, have specific physical and emotional needs as well as perspectives regarding their health and well-being.

The purpose of this study was to explore how women who experienced homelessness during adolescence met basic health needs, utilized resources and negotiated met while trying to maintain their health.

A qualitative exploratory approach to inquiry using semi-structured interviewing was used with a purposive convenience sample of nine women obtained from a community-based agency. Inclusion was limited to women who experienced homelessness during adolescence, defined as between the ages of 12-24, who are English speaking and not actively suicidal or psychotic. Qualitative content analysis (QCA) was used to analyze transcripts with attention to manifest and latent content. Processes to maintain trustworthiness were implemented.

Six categories were identified and two themes emerged from the analysis of the data. The categories are listed as (1) hunger; (2) staying safe, warm and rested; (3) keeping clean; (4) resourcefulness; (5) challenges encountered; (6) insights and recommendations. The two themes that emerged and were (1) survival takes precedence; and (2) remaining invisible.

Implications for nursing knowledge, practice and education were discussed. Recommendations included further research specific to female adolescents who are homeless, education of nurses and nursing students related to meeting the needs of female adolescents who are homeless, and policy implications.

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