Grazioli Véronique S, Hangartner Evelyne, Bodenmann Patrick, Schaad Luana, Grosjean Léa, Nikles Justin, Campbell David J T, Hyvert Laurent, Varela Tshahé Anongba, Collins Susan E, Leblanc Caroline, Loignon Christine, Berna Chantal
Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland.
Departments of Medicine, Community Health Sciences & Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
BMC Complement Med Ther. 2025 May 6;25(1):166. doi: 10.1186/s12906-024-04727-4.
People experiencing homelessness (PEH) are disproportionately affected by health issues yet remain underserved by the health care system. Emerging findings suggest that complementary medicine (CM) approaches might help address the low access to earlier treatment and the complex needs of this population. Very little research has explored this topic in Europe. Thus, this study aimed to explore perceptions, experiences, and interests in CM among PEH in Switzerland.
Participants (N = 123) were PEH in French-speaking Switzerland who completed a questionnaire assessing their use of and interest in CM. A subsample of the survey participants (n = 18) and 14 professionals working in the homeless-serving sector participated in semi-structured interviews exploring perceived utility of CM for PEH. Descriptive statistics and conventional content analysis were used to analyze quantitative and qualitative data, respectively.
Quantitative findings showed that despite high levels of interest in CM, less than 30% of participants reported using CM at least once in the previous 6 months. The five CM modalities with the highest interest were osteopathy (61.5% interested or very interested), therapeutic massage (59.2%), nutritional supplements (57.1%), music therapy (50.8%), and acupuncture (49.1%). The qualitative findings reinforced the substantial interest in CM. They revealed that CM approaches were perceived as useful to mitigate some health and social issues frequently encountered in this population, ultimately contributing to improved health and well-being. Participants made recommendations for practices that would help engage and retain PEH in a CM program, such as making it accessible and equitable, and following certain steps to earn the trust of PEH. Finally, a minority of participants questioned the relevance of a CM program for this population, arguing instead that more urgent social and conventional medical needs must be addressed first.
Taken together, these findings suggest that integrative medicine, which incorporates conventional and complementary approaches to medical and social services may represent a suitable offering for PEH to address their competing bio-psycho-social needs. Using a community-based participatory approach to co-develop such a program might help to ensure effectiveness and thereby increase health equity.
无家可归者（PEH）受健康问题的影响尤为严重，但在医疗保健系统中仍未得到充分服务。新出现的研究结果表明，补充医学（CM）方法可能有助于解决该人群早期治疗机会少和需求复杂的问题。在欧洲，很少有研究探讨这个话题。因此，本研究旨在探索瑞士无家可归者对补充医学的看法、经历和兴趣。
参与者（N = 123）为瑞士法语区的无家可归者，他们完成了一份问卷，评估他们对补充医学的使用情况和兴趣。调查参与者的一个子样本（n = 18）和14名在为无家可归者服务部门工作的专业人员参与了半结构化访谈，探讨补充医学对无家可归者的感知效用。分别使用描述性统计和传统内容分析法来分析定量和定性数据。
定量研究结果表明，尽管对补充医学兴趣浓厚，但不到30%的参与者报告在过去6个月中至少使用过一次补充医学。兴趣最高的五种补充医学方式是整骨疗法（61.5%感兴趣或非常感兴趣）、治疗性按摩（59.2%）、营养补充剂（57.1%）、音乐疗法（50.8%）和针灸（49.1%）。定性研究结果强化了对补充医学的浓厚兴趣。结果显示，补充医学方法被认为有助于缓解该人群经常遇到的一些健康和社会问题，最终有助于改善健康和福祉。参与者对有助于让无家可归者参与并留在补充医学项目中的做法提出了建议，例如使其易于获得且公平，并采取某些措施赢得无家可归者的信任。最后，少数参与者质疑补充医学项目对该人群的相关性，认为应首先满足更紧迫的社会和传统医疗需求。
综合来看，这些研究结果表明，将传统医学和补充医学方法结合用于医疗和社会服务的整合医学，可能是满足无家可归者复杂的生物心理社会需求的合适选择。采用基于社区的参与式方法共同开发这样一个项目可能有助于确保其有效性，从而提高健康公平性。
