Google Scholar. Potential relevance was assessed in terms of generalizability or transferrable constructs between the population with which they had been developed and tested, and people experiencing homelessness. Tools were categorized to; 1) health screening or 2) health assessment. 1990;150(11):2325–30. SJG and NB made substantial contributions to the conception and design of the work. Article  The findings have not been differentiated by age group, sex, location or geography (which limits comparative insights into variability by sex, and among homeless populations globally). We estimated the power of the study for primary outcomes where data on prevalence were available. Firstly, articles were included when they described the application of health screening or assessment tools for health issues related to adults experiencing homelessness (aged 18 years and over). PubMed Central  J Public Health Med. Health assessment helps to identify the medical need of patients. Better information on the health needs of people experiencing homelessness is needed to inform effective resourcing, planning and service delivery by government and care organisations. Luo Y, McGrath C. Oral health status of homeless people in Hong Kong. Br J Nutr. Decayed and missing teeth and oral-health-related factors: predicting depression in homeless people. Conclusions The Comprehensive Health Assessment Program (CHAP) produced a substantial increase in GPs’ attention to the health needs of adults with intellectual disability with concomitantly more disease detection. a 30-fold increase in hearing tests), and 22 new cases of sensory loss were detected compared with one among controls. Effects on assessing sensory impairment were especially striking (e.g. Lo PC. The disability services that have implemented it plan to use it yearly, largely because this fits organizational patterns; it is yet to be established if this is optimal. 11), or. J R Coll Gen Pract. Recalling information over a set time period is a common element in most self-report tools, and this assumes that events of interest have occurred within that time period, and that an individual’s memory allows them to be accurately recalled and expressed. The database search and screening process is summarized in the PRISMA flow diagram (Fig. Percentages and risk ratios (with 95% CIs) were used to summarise and compare rates of health-related events in the two arms of the trial as randomized. The search strategy is provided in Additional file 1. The systemized training and structured abstraction process, and good inter-rater reliability should have limited the scope for imbalance. West J Nurs Res. Schanzer B, Dominguez B, Shrout PE, Caton CLM. Garcia-Rea E, Lepage JP. volume 19, Article number: 994 (2019) This process protects patients from the risks of unnecessary testing and is cost-effective. Heterogeneity of people experiencing homelessness supports the need for validated tools appropriate to specific subgroups, for example; different sex-age groups, or people with varying language and reading capabilities. Patient/family concernsBroad considerations should be made for a variety of characteristics e.g., poverty, homelessness, unemployment, sexual orientation, gender/gender identity, education level, social support.Resources: 1. Control follow-up began on the median starting date of the corresponding intervention group cluster. The latter reflects the specific nature of the study population, and includes additional testing for reliability and external generalizability. This will ensure that valid data is available to inform health policies and healthcare initiatives that are likely to be effective. That said, if research is asking, and by extension reporting on, the ‘wrong’ items and measures, there is significant potential for discord between what is espoused as needed, versus what should be triaged, to advance the health of homeless people. PubMed  The NHMRC hierarchy of evidence is internationally used in evidence reviews. Moreover, as values are often dependent on sampling strategies, sample size and comparison instruments, it generally requires a great deal more information to interpret a value, thus reporting a value on its own can be misinterpreted. aThyroid stimulating hormone (TSH) > 5 (Normal range 0.4–4.0). McLellan AT, Luborsky L, O’Brien CP, Woody GE. CAS  J Nerv Ment Dis. By using this website, you agree to our Google Scholar. The health assessment provides a wealth of data cost-effectively that can be used to tailor the wellness experience to each individual. These tools often have questions worded in a manner that assume that respondents sleep in a bed, and have access to food preparation and storage services, as well as bathroom and toilet facilities. Sullivan G, Dumenci L, Burnam A, Koegel P. Validation of the brief Toolal functioning scale in a homeless population. Community Dent Health. Cognitive functioning in a homeless population: the relationship of multiple traumatic brain injuries to neuropsychological test scores. Note: Values are percentages (numbers) unless stated otherwise. Eleven assessment tools in 13 studies had evidence of appropriate psychometric testing for the target population in domains of quality of life and health status, injury, substance use, mental health, psychological and cognitive function. statement and The development of a relationship with the patient begins with open, therapeutic communication. Am J Public Health. Food, health and eating among single homeless and marginalized people in London. Inadequate attention to disease prevention is also common, with, for example, cervical screening rates one quarter of that in the general population.3–5 Optimal response to these service deficiencies remains debatable. Dietary intake, nutritional status and mental wellbeing of homeless adults in Reading, UK. bOccurrence in previous year unless otherwise stated. S. J. Gordon. Not only could concerns be raised about the capacity and willingness of homeless people to complete written self-reports (because of literacy, vision or trust) but also question relevance to their circumstances. This was also true for patterns of clinical activity prior to intervention (Table 1), indicating the effectiveness of randomization in balancing the makeup of the two groups. The trial was conceived/initiated by N Lennox, who, with C Bain, R Bush and D Purdie and M Green, designed the study and obtained the funding. Screening for the social determinants of health in clinical practice is still widely debated. These were 1) McMaster University Quantitative Critical Review Form [18], 2) McMaster University Qualitative Critical Review Form [19] or 3) the Leeds Evaluative Tool for Mixed Method Studies [20]. 2004;12(3):221–32. 2005;29(4):311–9. Good oral health, adequate nutrient consumption and family support are associated with a reduced risk of being underweight amongst older Malaysian residents of publicly funded shelter homes. They comprised: Brain Injury Screening Questionnaire (BISQ) [58], Colorado Coalition for Homelessness Consumer Outcome Scale [34], Delighted-Terrible Faces Scale (DTFS) [40], Rural Homelessness Interview Schedule [35], Short Form Survey-12 (SF-12) and/or Short Form Survey-36 (SF-36) [39, 60, 41], World Health Organization Quality of Life 100 (WHOQoL 100) and/or World Health Organization Quality of Life BREF (WHOQoL-BREF) [26, 42, 43]. Take a few minutes to evaluate all that CINAHL Complete has to offer and you’ll see why hundreds of thousands of nurses and allied health professionals rely on this essential resource. Scand J Public Health. Appropriate in this context means that the assessment should use language, items, and constructs which are relevant to homelessness. Few studies have reported on validated and reliable health screening and assessment tools, informed by input from people experiencing homelessness. Secondly, the assessment and screening tools reported in these articles were aggregated to identify a sub-set, for which claims had been made about being developed for or with, and/or validated with people suffering homelessness. 2009;16(3):94–8. 2018. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/682001/Rough_Sleeping_Autumn_2017_Statistical_Release_-_revised.pdf (also https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsofhomelesspeopleinenglandandwales/2013to2017). It results in poorer physical and mental health than age matched people living in permanent housing. The conduct and reporting of the review findings follow the PRISMA guidelines [15]. The PRISMA group. Applying this definition, the Australian census found 116,000 people were homeless on Census night in 2016, representing 50 homeless people per 10,000 [5]. https://doi.org/10.3109/09638288.2014. On the basis of the findings of this review, information reported on chronic health conditions, demography, functional decline and frailty, nutrition and pelvic floor health in people experiencing homelessness, may not be valid indicators of their health. Of the residential staff, 26% (intervention) and 36% (control) were male, with mean ages of 47 and 50 years. Arch Intern Med. Neuropsychological functioning of homeless men. 1989;262(14):1973–9. Of 2122 identified studies, 37 were identified as potentially-relevant (Table 1). The identification of valid and reliable tools is the first step towards developing proactive health assessments that will be relevant and acceptable to people experiencing homelessness. Testing for validity establishes that the health screening or assessment tool captures all the constructs (or elements) that it purports to measure [14], and that the scores compare with other similar measures [14]. Thus, tool utility for the target population also needs to be considered in terms of its language and literacy levels, how long it takes to complete the items, and how many items the tool includes. The state of being homeless impacts significantly on health [7], resulting in higher rates of premature mortality [4], with the average age of death for men and women experiencing homelessness in England being 47 and 43 years respectively [7]. There were 118 residential staff (98%) and 120 GPs (92%) (Figure 1) recruited between January and August 1999. For having an identified vision or hearing impairment this was 10%.11 With 450 subjects in 34 clusters, an average of 14 subjects in each (SD = 15), and assuming a pairwise odds ratio within clusters to be 1.5, the design effect for this study design was estimated to be around 2.0.12 This gave a power of ∼ 80% to identify an increase in detection of vision or hearing impairment from 10% to 24%, at the 5% level of significance. Research evidence in this area is primarily focused on cultural competency training and its effects on practitioners’ knowledge, attitudes, skills and behaviour. https://doi.org/10.7416/ai.2017.2132. Luo Y, McGrath C. Oral health and its impact on the life quality of homeless people in Hong Kong. Vojnosanit Pregl. However, very few had been co-designed with people suffering homelessness, and many used language, wording, or situational descriptors that were not relevant to the target population. Dwellings had between 3 and 25 adults and residential staff. These definitions do not include people in hostels or shelters, people in campsites or other sites used for recreational purposes or organised protest, squatters or travellers [6]. 2006;15(3):400–5. Methods A cluster randomized controlled trial with matched pairs was carried out. A good health history assessment is the gateway to a successful nurse-patient relationship. Hunt SM, McEwan J, McKenna SP. However, it will be necessary to engage homeless people in determine which criteria are important to them. The CHAP also facilitates the organization of this process and stimulates contact with the GP who is then prompted to address known potential unmet health needs. 1992;30(6):473–83. Bonomi AE, Patrick DL. Follow-up was for 1 year post intervention, with outcomes extracted from GPs’ clinical records. Argeriou M, McCarty D, Mulvey K, Daley M. Use of the addiction severity index with homeless substance abusers. https://doi.org/10.1186/s12889-019-7234-y, DOI: https://doi.org/10.1186/s12889-019-7234-y. It prompted the systematic gathering of a health history and, subsequently, access to a GP for a guided health review and development of a health action plan. Moher D, Liberati A, Tetzlaff J, Altman DG. More than 2400 years ago the Athenians offered their capacity of assessing risk before making decisions (Bernstein, 1996).However, risk assessment and risk management as a scientific field is young, not more than 30–40 years old. Articles identified through the library database search were exported into EndNote v7 [16]. Health assessment is important and often first step in identifying the patient’s problem. Ocular telehealth screenings in an urban community. Search across a wide variety of disciplines and sources: articles, theses, books, abstracts and court opinions. A recent UK White Paper20 and a US Surgeon General's report21 have recommended instigation of similar strategies and two Australian states have implemented the tool, based on its perceived match to the needs of this population. People ‘living rough’ have been shown to have symptoms of aging much earlier than the general population [4, 7, 9, 10]. Prim Health Care Res Dev. In addition, it educated GPs and carers about core health issues for this population and did so where most applicable, in the consultation or the carer's work place.17–19. Ford PJ, Cramb S, Farah CS. An extensive element of these programs is the teaching of physical assessment skills, with most programs educating students to perform over 120 such skills.
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