A qualitative evaluation of the physiotherapy service for homeless people in Glasgow

FUNDING ACKNOWLEDGEMENTS: Greater Glasgow Primary Care Trust, 'Involving People' grant scheme.PURPOSE: The purpose of this study was to explore homeless peoples' views and experiences of a specialist physiotherapy service for homeless people in Glasgow, Scotland. RELEVANCE: Evidence suggests that homelessness increases the risk of poor health and makes access to appropriate healthcare difficult. Benefits of specialist health services for homeless people have been identified and can improve access to appropriate healthcare. In Glasgow, a specialist physiotherapy service has existed since 1996. The aim of this study was to evaluate the physiotherapy service from the perspective of homeless people. This would allow for the development of a service which is responsive to the needs of the population it serves. PARTICIPANTS: A sample of convenience of twelve homeless people (11 males, 1 female, mean age: 47 13.6 years) was recruited from a homeless drop-in centre in Glasgow. METHODS: Ethical approval to carry out this study was granted from Greater Glasgow Primary Care NHS Trust ethics committee. Using a qualitative approach, 1-hour semi-structured interviews and a focus group were conducted with 12 homeless people. Five participants had experience of the specialist physiotherapy service, 7 had not. Interviews were conducted within a private room, were audio-taped and transcribed verbatim. ANALYSIS: Using an interpretive phenomenological approach to data analysis, recurrent themes were identified from interview transcripts. Member checking of identified themes was undertaken. RESULTS: The findings revealed that participants who had used the physiotherapy service were positive about this and valued the one-to-one contact they had with their physiotherapist. The fact that the physiotherapist came to them in their hostel or at a drop-in clinic meant that it was easily accessible. Despite the availability of direct access to the service none of the participants had initiated a self-referral and instead relied on a support or hostel worker for this. Participants felt that physiotherapy was for people who had sustained serious injuries, such as car accidents or for people with sports injuries. As a result physiotherapy was not felt to be relevant to them and their problems. While good health was valued, poor health was often tolerated as an expected consequence of homelessness. CONCLUSIONS: Homeless people in this study were positive about their experiences of the specialist physiotherapy service. However there was limited awareness of what physiotherapy might offer and this could reduce participants' self-referring to the physiotherapy service. A strength of this study was that it allowed individuals to voice their opinions of the physiotherapy service. A weakness is that the sample comprised of self-selecting participants. Further research on how to support homeless people to access physiotherapy services is needed. IMPLICATIONS: The study revealed a need to raise awareness about physiotherapy and the services available amongst homeless people and those who work closely with them. Homeless people experience difficulties accessing appropriate and timely healthcare and may require support to do so.sch_phypub2695pu