Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Faculty of Medicine, Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada.
Otolaryngol Head Neck Surg. 2023 Jun;168(6):1301-1311. doi: 10.1002/ohn.214. Epub 2023 Jan 29.
Access to and use of physician services is limited for those experiencing homelessness. Homelessness may predispose patients to several Otolaryngology-Head and Neck Surgery (OHNS) health conditions and barriers to care may leave these unaddressed. The aim of this review was to synthesize the literature on OHNS health needs and community-based interventions for patients experiencing homelessness.
English literature was searched in MEDLINE, EMBASE, and CINAHL.
Studies were included if they reported on OHNS-related conditions in patients experiencing homelessness and/or interventions related to providing OHNS care to this patient population.
Twelve hundred and one articles were screened, and 12 articles were included. Most studies reported on otologic conditions (n = 8) and head and neck-related conditions (n = 6). Nasal trauma, chronic rhinosinusitis, dysphonia, hearing loss, and cancerous/precancerous head and neck lesions were common OHNS conditions reported in this patient population. Identified barriers to care included lack of transportation, financial considerations, and lower health literacy. Three articles on community-based interventions were included. Most of these interventions were single visits to shelters, and ensuring adequate follow-up was identified as a challenge.
The current literature brings attention to certain OHNS diseases that are prevalent in this unique patient population and identifies unique barriers these patients experience when accessing care. Future studies should focus on further delineating the impact of OHNS diseases in patients experiencing homelessness and screening interventions that can be employed to mitigate the impact of diseases of the head and neck.
无家可归者获得和使用医生服务的机会有限。无家可归可能使患者易患几种耳鼻喉头颈外科 (OHNS) 健康状况，而护理障碍可能使这些问题得不到解决。本综述的目的是综合有关 OHNS 健康需求和面向无家可归者的社区干预的文献。
在 MEDLINE、EMBASE 和 CINAHL 中搜索英文文献。
如果研究报告了无家可归者的 OHNS 相关疾病和/或与向这一患者群体提供 OHNS 护理相关的干预措施，则纳入研究。
筛选了 1201 篇文章，纳入了 12 篇文章。大多数研究报告了耳鼻喉疾病（n=8）和头颈部相关疾病（n=6）。无家可归者常见的 OHNS 疾病包括鼻外伤、慢性鼻-鼻窦炎、发声障碍、听力损失和头颈部癌前/癌性病变。发现的护理障碍包括缺乏交通工具、经济考虑和较低的健康素养。纳入了 3 篇关于社区干预的文章。这些干预措施大多是对收容所的单次访问，并且确定了确保充分随访是一个挑战。
目前的文献引起了人们对这种独特患者群体中常见的某些 OHNS 疾病的关注，并确定了这些患者在获得护理时所经历的独特障碍。未来的研究应重点进一步阐明 OHNS 疾病对无家可归者的影响，并筛选可用于减轻头颈部疾病影响的干预措施。
