Lam Julia, Hurwitz Max, Ngankam Deklerk, Leland Natalie
Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, Pennsylvania, USA
Outreach Therapy, Pittsburgh, Pennsylvania, USA.
BMJ Case Rep. 2024 Dec 15;17(12):e262462. doi: 10.1136/bcr-2024-262462.
People experiencing homelessness (PEH) face higher rates of traumatic brain injury (TBI), which is associated with greater unmet healthcare and social needs and increased difficulty transitioning out of homelessness. While efforts have emerged to address this TBI disparity via screening, staff training and case management, gaps exist in the delivery of evidence-based TBI rehabilitation to PEH. This case report describes the delivery of interdisciplinary TBI rehabilitation to a male patient experiencing homelessness within a US context. Physical medicine and rehabilitation and occupational therapy focused on managing cognitive and chronic pain symptoms to improve daily life function across community settings (ie, outdoors, shelter, the transition to stable housing). After 4 months, the patient demonstrated improved daily life function with changes in objective measurements and housing status from unsheltered homelessness to housed. This case demonstrates the feasibility of delivering equitable TBI rehabilitation to PEH to mitigate health and housing disparities.
无家可归者面临着更高的创伤性脑损伤(TBI)发生率,这与更多未满足的医疗保健和社会需求以及脱离无家可归状态的难度增加有关。虽然已经通过筛查、工作人员培训和病例管理来努力解决这种创伤性脑损伤差异,但在为无家可归者提供循证创伤性脑损伤康复治疗方面仍存在差距。本病例报告描述了在美国背景下为一名无家可归男性患者提供跨学科创伤性脑损伤康复治疗的情况。物理医学与康复以及职业治疗专注于管理认知和慢性疼痛症状,以改善在各种社区环境(即户外、收容所、向稳定住房过渡)中的日常生活功能。4个月后,患者通过客观测量的变化以及住房状况从无庇护的无家可归转变为有住房,显示出日常生活功能得到改善。本病例证明了为无家可归者提供公平的创伤性脑损伤康复治疗以减轻健康和住房差距的可行性。