Busen Nancy H, Engebretson Joan C
Department of Integrative Nursing Care, School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA.
J Am Acad Nurse Pract. 2008 Nov;20(11):567-75. doi: 10.1111/j.1745-7599.2008.00358.x.
The purposes of this evaluation project were to describe a group of homeless adolescents and street-involved youth who utilized a mobile unit that provided medical and mental healthcare services and to assess the efficacy of the services provided in reducing their health risk behaviors.
The records of 95 youth aged 15-25 years who used the medical mobile unit for an average of 14 months were examined and evaluated according to the national health indicators related to risk reduction. Current literature related to health risk behavior among homeless youth was reviewed, synthesized, and provided the background for this article.
Data were obtained from the records of mostly heterosexual youth with a mean age of 20.5 years. Approximately one third of the participants were high school graduates and most were without health insurance. Living situations were transient including friends, shelters, crash pads, or the streets. Abuse accounted for the majority leaving home. Psychiatric conditions and substance abuse were common. Medical conditions were related to transient living situations, substance abuse, and sexual activity. Success of the program was associated with sustained counseling, stabilizing youth on psychotropic medications, decreasing substance use, providing birth control and immunizations, and treating medical conditions.
Homeless youth are one of the most underserved vulnerable populations in the United States with limited access and utilization of appropriate healthcare services. Nurse practitioners often serve as care providers but are also in a position to effectively lobby to improve health care for homeless youth through professional organizations and community activism. Furthermore, when designing and evaluating healthcare services, multidisciplinary teams need to consider risk reduction for homeless youth in the context of their environment.
本评估项目的目的是描述一群使用移动医疗单位提供医疗和心理保健服务的无家可归青少年及涉足街头的青年，并评估所提供服务在降低他们健康风险行为方面的效果。
对95名年龄在15至25岁之间、平均使用移动医疗单位14个月的青年的记录，根据与风险降低相关的国家健康指标进行了检查和评估。对与无家可归青年健康风险行为相关的现有文献进行了综述、综合，并为本篇文章提供了背景。
数据来自大多为异性恋青年的记录，平均年龄为20.5岁。约三分之一的参与者是高中毕业生，大多数人没有医疗保险。生活状况不稳定，包括与朋友同住、住收容所、临时住所或街头。多数人因受虐待而离家。精神疾病和药物滥用很常见。医疗状况与不稳定的生活状况、药物滥用和性活动有关。该项目的成功与持续的咨询、使青年在精神药物治疗上保持稳定、减少药物使用、提供节育和免疫接种以及治疗医疗状况有关。
无家可归青年是美国服务最不足的弱势群体之一，获得和利用适当医疗服务的机会有限。执业护士经常担任护理提供者，但也有能力通过专业组织和社区行动有效地游说，以改善无家可归青年的医疗保健。此外，在设计和评估医疗服务时，多学科团队需要在无家可归青年的环境背景下考虑降低他们的风险。
