Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Exploring the Role of Rehabilitation Medicine Within an Inclusion Health Context: Examining a Population at Risk From Homelessness and Brain Injury in Edinburgh

Version 1 : Received: 25 April 2024 / Approved: 8 May 2024 / Online: 8 May 2024 (15:27:56 CEST)

How to cite: Eshun, E.; Burke, O.; Do, F.; Mohammed Jemseed, A. A.; Maciver, A.; Mathur, A.; Mayne, C.; Novak, L.; Siddique, A.; Smith, E.; Tapia-Stocker, D.; FitzGerald, A. Exploring the Role of Rehabilitation Medicine Within an Inclusion Health Context: Examining a Population at Risk From Homelessness and Brain Injury in Edinburgh. Preprints 2024, 2024050514. https://doi.org/10.20944/preprints202405.0514.v1 Eshun, E.; Burke, O.; Do, F.; Mohammed Jemseed, A. A.; Maciver, A.; Mathur, A.; Mayne, C.; Novak, L.; Siddique, A.; Smith, E.; Tapia-Stocker, D.; FitzGerald, A. Exploring the Role of Rehabilitation Medicine Within an Inclusion Health Context: Examining a Population at Risk From Homelessness and Brain Injury in Edinburgh. Preprints 2024, 2024050514. https://doi.org/10.20944/preprints202405.0514.v1

Abstract

People experiencing homelessness are at risk from a number of co-morbidities including traumatic brain injury, mental health disorders and various infections. Little is known about the rehabilitation needs of this population. This study took advantage of unique access to a specialist ‘Access’ GP practice for people experiencing homelessness and a local inclusion health initiative to explore the five year period prevalence of these conditions in a population of people experiencing homelessness, through electronic case record searches; and identify barriers and facilitators to healthcare provision for this population in the context of an interdisciplinary and multi specialist inclusion health team, through semi structured interviews with 12 staff working in primary and secondary care who interact with this population. The five year period prevalence of TBI, infections and mental health disorders was 9.5%, 4% and 22.8% respectively. Of those who had suffered a brain injury only 3, had accessed rehabilitation services. Themes from thematic analysis of interviews included: lack of resource, stigmatisation, under recognised multi-morbidity (including from brain injury) as barriers, trauma-informed, person-centred, adaptable, & integrated and collaborative models of care as facilitators. The combination of quantitative and qualitative data suggests a potential role for rehabilitation medicine in inclusion health initiatives.

Keywords

rehabilitation; traumatic brain injury; inclusion health, homelessness, multimorbidity

Subject

Medicine and Pharmacology, Other

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