There is an absence of research investigating the perceptions of physiotherapy among people experiencing homelessness, or examining the barriers and enablers influencing their access to these services. The aim of this qualitative study is to explore the perceptions of physiotherapy, and identifying the barriers and enablers to service access for people experiencing homelessness.
Participants were purposively recruited from a specialist support centre in Manchester, United Kingdom, for people experiencing homelessness. Each participant was approached to take part in one face-to-face, audio recorded semi-structured interview which was guided by an interview schedule, and subsequently transcribed and analysed using an interpretative phenomenological analysis approach.
Eight participants (all male, age range 30-57) took part in the study, including three housed in temporary accommodation and five sleeping rough. Three overarching themes were highlighted: 1. accessibility and availability of services, 2. social impact of homelessness, 3. psychological impact of homelessness’. Participants showed mixed understanding of physiotherapy relating to previous experiences, but saw value in physiotherapy services in addressing their healthcare needs. Having to prioritise basic needs, the location of services, poor social connections, and a lack of autonomy were all seen as barriers to physiotherapy service access. Close proximity of physiotherapy services to other healthcare or specialist services, signposting from professionals, service flexibility, and positive professional attitudes were seen as enablers to physiotherapy service access.
Physiotherapy services should provide further education on the scope of physiotherapy practice to improve wider understanding and service use. Specialist physiotherapist services offer valuable support for people experiencing homelessness to access physiotherapy, however, more flexible and bespoke services may improve accessibility. Services should also include people experiencing homelessness in service development. Future research should explore similar topics with females experiencing homelessness and include individuals across the spectrum of homelessness in localities where specialist physiotherapy services are regularly available.
This project provides a platform for the experiences of people experiencing homelessness to guide future physiotherapy service development. The findings of this project also provide context for therapists, aiding in their own understanding of the impact of homelessness, which may directly impact the health outcomes of people experiencing homelessness. With better access to services, this project has the potential to address the disproportionate health inequalities faced by people experiencing homelessness, and provides a blueprint for their representation in physiotherapy research.
Inequalities
Specialist
