Sheltered versus nonsheltered homeless Women - Differences in health, behavior, victimization, and utilization of care
Sheltered versus nonsheltered homeless Women - Differences in health, behavior, victimization, and utilization of care
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DOI：
10.1046/j.1525-1497.2000.07007.x
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发表时间：
2000-08-01
影响因子：
5.7
通讯作者：
Gelberg, L
中科院分区：
文献类型：
--
作者：
Nyamathi, AM;Leake, B;Gelberg, L
目的：比较社会人口学特征，身心健康状况，物质使用，性行为，受害，和利用卫生服务之间的庇护和非庇护环境中居住的无家可归妇女。设计：横断面调查。采用结构化量表测量心理健康状况。身体健康状况，物质使用，性行为，成人受害的历史，和卫生服务的利用率进行了测量的内容特定的items.SETTING：庇护所（N = 47）和户外场所在洛杉矶。PARTICIPANTS：1051无家可归women.RESULTS：无家可归的妇女生活在街头比庇护妇女更有可能是白色和长期无家可归。控制社会人口特征，多元逻辑回归分析显示，无庇护的妇女有超过3倍以上的机会公平或不良的身体健康，超过12倍以上的机会不良的心理健康比庇护无家可归的妇女。他们也比庇护妇女更有可能报告使用酒精或非注射毒品，有多个性伴侣，并有身体攻击的历史。大约一半的整体样本报告利用各种医疗服务，但是，无家可归的妇女不太可能利用所有的医疗服务，包括药物治疗的评估，包括drug treatment.CONCLUSIONS：有一个积极的外展计划，提供心理健康服务和药物滥用治疗无家可归的妇女在街头的迫切需要。包括医疗保健、计划生育、预防暴力和减少行为风险在内的综合服务对无家可归的妇女，特别是那些生活在无庇护环境中的妇女可能特别有价值。
OBJECTIVE: To contrast sociodemographic characteristics, physical and mental health status, substance use, sexual behaviors, victimization, and utilization of health services between homeless women residing in sheltered and non-sheltered environments.DESIGN: Cross-sectional survey. A structured scale was used to measure mental health status. Physical health status, substance use, sexual behavior, history of adult victimization, and health services utilization were measured by content-specific items.SETTING: Shelters (N = 47) and outdoor locations in Los Angeles.PARTICIPANTS: One thousand fifty-one homeless women.RESULTS: Homeless women living on the streets were more likely than sheltered women to be white and longer-term homeless. Controlling for sociodemographic characteristics, multiple logistic regression analyses revealed that unsheltered women had over 3 times greater odds of fair or poor physical health, and over 12 times greater odds of poor mental health than sheltered homeless women. They were also more likely than sheltered women to report using alcohol or noninjection drugs, to have multiple sexual partners, and to have a history of physical assault. About half of the overall sample reported utilization of a variety of health services; however, unsheltered homeless women were less likely to utilize all of the health services that were assessed, including drug treatment.CONCLUSIONS: There is a critical need for aggressive outreach programs that provide mental health services and substance abuse treatment for homeless women on the streets. Comprehensive services that also include medical care, family planning, violence prevention, and behavioral risk reduction may be particularly valuable for homeless women, especially those living in unsheltered environments.