PDF(Pubmed)
Abstract：
BACKGROUND: Homeless shelters have emerged as components of the social services network, playing an important role in providing health care to the homeless population. The aim of this study was to evaluate an individualized physical therapy intervention for people experiencing homelessness and to determine the relationship between self-perceived variables.
METHODS: Pre and post study, setting at the \"Santa y Real Hermandad de Nuestra Señora del Refugio y Piedad\" homeless shelter in Zaragoza, Spain. Participants were people experiencing homelessness with musculoskeletal disorders who attended a physical therapy service at shelter facilities. A physical therapy program was implemented including health education, exercise and manual therapy, electrotherapy, thermotherapy and bandaging. Demographic variables (age and gender), nationality, employment situation, educational level, pain location, number of painful areas, feeling of loneliness (3-Item Loneliness Scale; values from 3 to 9), pain intensity (Numerical Pain Rating Scale [NPRS]; from 0 to 10) and self-perceived health (Clinical Global Impression [CGI]; from 1 to 7).
RESULTS: Sixty-four homeless people (age of 46.4 ± 10.9 years) participated in the study. Musculoskeletal pain was reported by 98.4% of subjects, with moderate pain intensities (6.1), and 48.4% presenting with pain at multiple sites. Perceptions of loneliness were low (3.7 ± 2.5) and self-perceived health status was moderately ill (3.5 ± 1.7). Positive significant correlations were identified between pain intensity and self-perceived health. The average number of sessions was 1.5 (± 0.8), with manual therapy (35.6%) followed by health education (23.5%) being the most frequently used techniques. Both pain and self-perceived health improved after treatment, even following a brief intervention.
CONCLUSIONS: This study demonstrates the potentially negative impact of untreated pain on the self-perceived health of homeless individuals with musculoskeletal disorders that should be targeted for consideration. The findings suggest that a paradigm shift in pain management, including a physical therapy service in shelters, is needed to address the rehabilitation demands of these individuals in a real-life context. This study was approved by the Aragon Ethics Committee (PI19/438) and performed according to the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement.
METHODS: Pre and post study, setting at the \"Santa y Real Hermandad de Nuestra Señora del Refugio y Piedad\" homeless shelter in Zaragoza, Spain. Participants were people experiencing homelessness with musculoskeletal disorders who attended a physical therapy service at shelter facilities. A physical therapy program was implemented including health education, exercise and manual therapy, electrotherapy, thermotherapy and bandaging. Demographic variables (age and gender), nationality, employment situation, educational level, pain location, number of painful areas, feeling of loneliness (3-Item Loneliness Scale; values from 3 to 9), pain intensity (Numerical Pain Rating Scale [NPRS]; from 0 to 10) and self-perceived health (Clinical Global Impression [CGI]; from 1 to 7).
RESULTS: Sixty-four homeless people (age of 46.4 ± 10.9 years) participated in the study. Musculoskeletal pain was reported by 98.4% of subjects, with moderate pain intensities (6.1), and 48.4% presenting with pain at multiple sites. Perceptions of loneliness were low (3.7 ± 2.5) and self-perceived health status was moderately ill (3.5 ± 1.7). Positive significant correlations were identified between pain intensity and self-perceived health. The average number of sessions was 1.5 (± 0.8), with manual therapy (35.6%) followed by health education (23.5%) being the most frequently used techniques. Both pain and self-perceived health improved after treatment, even following a brief intervention.
CONCLUSIONS: This study demonstrates the potentially negative impact of untreated pain on the self-perceived health of homeless individuals with musculoskeletal disorders that should be targeted for consideration. The findings suggest that a paradigm shift in pain management, including a physical therapy service in shelters, is needed to address the rehabilitation demands of these individuals in a real-life context. This study was approved by the Aragon Ethics Committee (PI19/438) and performed according to the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement.
摘要：
背景：无家可归的庇护所已成为社会服务网络的组成部分，在为无家可归的人口提供医疗保健方面发挥着重要作用。这项研究的目的是评估针对无家可归者的个性化物理治疗干预措施，并确定自我感知变量之间的关系。
方法：研究前后，设置在萨拉戈萨的“圣诞老人真正的赫曼达·德·纳斯特拉·塞内奥拉·德·雷吉奥·皮埃达”无家可归者收容所，西班牙。参与者是患有肌肉骨骼疾病的无家可归者，他们参加了庇护所的物理治疗服务。实施了包括健康教育在内的物理治疗计划，运动和手动治疗，电疗,热疗和包扎。人口统计学变量（年龄和性别）国籍,就业形势,教育水平,疼痛位置,疼痛区域的数量，孤独感(三项孤独量表；值从3到9)，疼痛强度（数字疼痛评定量表[NPRS];从0到10）和自我感知的健康（临床总体印象[CGI];从1到7）。
结果：64名无家可归者（年龄为46.4±10.9岁）参加了这项研究。98.4%的受试者报告肌肉骨骼疼痛，中度疼痛强度（6.1），48.4％在多个部位出现疼痛。孤独感较低（3.7±2.5），自我感知的健康状况为中度疾病（3.5±1.7）。疼痛强度与自我感知健康之间存在正相关。平均会议次数为1.5（±0.8），最常用的技术是手动治疗（35.6％），其次是健康教育（23.5％）。治疗后疼痛和自我感觉健康都得到了改善，即使经过短暂的干预。
结论：这项研究表明，未经治疗的疼痛对患有肌肉骨骼疾病的无家可归者自我感知健康的潜在负面影响，应作为考虑的目标。研究结果表明，疼痛管理的范式转变，包括庇护所的物理治疗服务，需要在现实生活中解决这些人的康复需求。本研究由Aragon伦理委员会（PI19/438）批准，并根据非随机设计评估透明报告（TREND）声明进行。
方法：研究前后，设置在萨拉戈萨的“圣诞老人真正的赫曼达·德·纳斯特拉·塞内奥拉·德·雷吉奥·皮埃达”无家可归者收容所，西班牙。参与者是患有肌肉骨骼疾病的无家可归者，他们参加了庇护所的物理治疗服务。实施了包括健康教育在内的物理治疗计划，运动和手动治疗，电疗,热疗和包扎。人口统计学变量（年龄和性别）国籍,就业形势,教育水平,疼痛位置,疼痛区域的数量，孤独感(三项孤独量表；值从3到9)，疼痛强度（数字疼痛评定量表[NPRS];从0到10）和自我感知的健康（临床总体印象[CGI];从1到7）。
结果：64名无家可归者（年龄为46.4±10.9岁）参加了这项研究。98.4%的受试者报告肌肉骨骼疼痛，中度疼痛强度（6.1），48.4％在多个部位出现疼痛。孤独感较低（3.7±2.5），自我感知的健康状况为中度疾病（3.5±1.7）。疼痛强度与自我感知健康之间存在正相关。平均会议次数为1.5（±0.8），最常用的技术是手动治疗（35.6％），其次是健康教育（23.5％）。治疗后疼痛和自我感觉健康都得到了改善，即使经过短暂的干预。
结论：这项研究表明，未经治疗的疼痛对患有肌肉骨骼疾病的无家可归者自我感知健康的潜在负面影响，应作为考虑的目标。研究结果表明，疼痛管理的范式转变，包括庇护所的物理治疗服务，需要在现实生活中解决这些人的康复需求。本研究由Aragon伦理委员会（PI19/438）批准，并根据非随机设计评估透明报告（TREND）声明进行。
