Institute of Health Informatics, University College London, London, UK.
University College London Cancer Institute, London, UK.
Open Heart. 2023 Apr;10(1). doi: 10.1136/openhrt-2022-002235.
Homelessness is associated with an increased risk of cardiovascular disease (CVD), beyond impact of socioeconomic status. CVD is preventable and treatable, though barriers to interventions exist for people experiencing homelessness. Those with lived experience of homelessness and health professionals with relevant expertise can help to understand and address these barriers.
To understand, and make recommendations to improve, CVD care in homeless populations through lived and professional expertise.
Four focus groups were conducted in March-July 2019. Three groups included people currently or previously experiencing homelessness, each attended by a cardiologist (AB), a health services researcher (PB) and an 'expert by experience' (SB) who coordinated participants. One group included multidisciplinary health and social care professionals in and around London to explore solutions.
The three groups included 16 men and 9 women, aged 20-60 years, of whom 24 were homeless and currently living in hostels, and 1 rough sleeper. At least 14 discussed sleeping rough at some point.
Participants were aware of CVD risks and relevance of healthy habits but identified barriers to prevention and health access, starting with disorientation affecting planning and self-care, lack of facilities for food, hygiene and exercise, and experiences of discrimination.
CVD care for those experiencing homelessness should account for fundamental problems of the environment, be codesigned with service users and cover key principles: flexibility, public and staff education, integration of support and advocacy for health service rights.
除了社会经济地位的影响外，无家可归与心血管疾病（CVD）的风险增加有关。尽管无家可归者在接受干预方面存在障碍，但 CVD 是可以预防和治疗的。那些有过无家可归经历的人和有相关专业知识的卫生专业人员可以帮助理解和解决这些障碍。
通过生活和专业知识了解和建议改善无家可归人群的 CVD 护理。
2019 年 3 月至 7 月进行了 4 次焦点小组讨论。其中 3 个小组包括目前或以前有过无家可归经历的人，每个小组都有一名心脏病专家（AB）、一名卫生服务研究人员（PB）和一名协调参与者的“经验专家”（SB）参加。一个小组包括伦敦及其周边地区的多学科卫生和社会保健专业人员，以探讨解决方案。
三个小组共包括 16 名男性和 9 名女性，年龄在 20-60 岁之间，其中 24 人无家可归，目前住在旅馆里，还有 1 名露宿者。至少有 14 人曾在某个时候谈论过露宿街头。
参与者意识到 CVD 风险和健康习惯的相关性，但确定了预防和获得健康的障碍，首先是影响规划和自我保健的定向障碍、缺乏食物、卫生和锻炼设施，以及经历歧视。
为无家可归者提供的 CVD 护理应考虑到环境的基本问题，与服务使用者共同设计，并涵盖以下关键原则：灵活性、公众和工作人员教育、支持和倡导健康服务权利的整合。
