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The complex self perceptions and relationships of patients who attended free clinics affected their attendance and ability to benefit from care

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 Q What are the lived experiences of patients attending free clinics? How do their evolving relationships with the clinic and staff affect their identities and self presentation?

DESIGN

Qualitative study using a grounded theory method.

SETTING

4 national governmental organisation’s and public hospital’s free clinics in the Paris area and a large provincial city in France.

PARTICIPANTS

94 patients (mean age 37 y, 60% men, 50% immigrants to France) living in precarious housing conditions. One third lived in their own homes, one third lived temporarily with friends or family, and the others were homeless or lived in a hotel, shelter, or squat. Health status varied among patients. Some visited the clinics for occasional benign disorders, whereas others had chronic diseases (eg, HIV or cancer). Some patients attended the clinic to visit social workers or to simply spend some time in a heated, friendly venue.

METHODS

94 face to face interviews (lasting an average of 45 min) were done. 37 staff members were interviewed individually and in groups. Almost all interviews were audiotaped and transcribed. The interviews discussed patients’ relationships with the free clinic, their use of healthcare and social services, their health perceptions and experiences, and their social situations. Data were analysed using a grounded …

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