Occupational experiences of homelessness: A systematic review and meta-aggregation

Scand J Occup Ther. 2020 Aug;27(6):394-407. doi: 10.1080/11038128.2019.1689292. Epub 2019 Nov 13.

Abstract

Background: Studies exploring the occupational experiences of homeless persons have grown in the past twenty years, and there is a need to identify, evaluate, and aggregate existing studies to direct future research.Objectives: To capture the scope and quality of literature exploring the occupational experiences of homeless persons in high-income countries, and to aggregate the findings of these studies to inform future research efforts.Method: Using Joanna Briggs Institute (JBI) guidelines, we conducted a systematic review including a critical appraisal, and meta-aggregation of themes in existing qualitative literature.Results: Fifteen studies were included and were of high quality (Mdn = 8/10; IQR = 2). Meta-aggregation resulted in four themes (n = 335 participants) describing the occupational experiences of homeless persons: 1) Restrictions on time use and activity engagement; 2) Activity as a means of belonging; 3) Institutional processes as determining time use; and 4) Transcending the self through doing.Conclusions: Homeless persons in high-income countries face multiple challenges to engaging in meaningful activity, which we argue is a disabling experience. Simultaneously, homeless persons demonstrate resilience by finding ways to engage in activities of meaning, and opportunities to connect with others in the face of multiple barriers.Significance: Implications for research and practice are discussed.

Keywords: Homeless persons*; activities of daily living*; meaningful engagement; occupational therapy*; social participation*.

Publication types

  • Systematic Review

MeSH terms

  • Activities of Daily Living* / psychology
  • Humans
  • Ill-Housed Persons* / psychology
  • Qualitative Research
  • Resilience, Psychological
  • Social Inclusion
  • Time Factors