A Qualitative Analysis of Patient Beliefs and Acceptability of Social Risk Screening in the Emergency Department.

Abstract

Introduction: The emergency department is an appropriate location to screen for social risks because it serves as a safety net for some of the most vulnerable patients. Several institutions nationwide have adopted this practice, but little is known about patient attitudes toward such screening. The objective of this study was to qualitatively assess patient experience and acceptability of social risk screening in the emergency department.

Methods: This was a qualitative study conducted in the emergency department at an urban quaternary hospital. Semistructured interviews were conducted at the bedside with 17 patients who had undergone social risk screening. Reflexive thematic analysis was conducted to explore participants' experiences and attitudes toward social risks and the screening process.

Results: Patients were able to appreciate the ways in which social risks in their own lives affect their physical health. Despite the general perception that patients may find questions about social risks too sensitive, participants in this study overwhelmingly expressed feeling comfortable answering the screening questions. Four themes were identified encompassing these perspectives: (1) social risks affect physical health, (2) social risk screening benefits vulnerable patients, (3) patients feel comfortable answering social risk questions, and (4) screening questions are comprehensive. Patients identified previous health care experience as a missing component that was not evaluated by the screener despite this not traditionally being considered a social need.

Discussion: The findings from this study provide insight into patient attitudes and perspectives on social risk screening in the emergency department. Further work is needed to understand how questions about previous health care experience may contribute to the screening process.