Characteristics of the study group
The study group consisted only of people in the crisis of homelessness staying at the support centers at the time of the study. Surveys were included in the analysis of 114 people, including 28 (24.6%) women, the youngest participant was 21 and the oldest 76 years old (Table
1). The average age was 55.9 ± 12.1 years.
In the study group, most people had vocational (45.6%) and secondary (27.2%) education. 1/5 of the study group (21.1%) had only primary education. The average period of homelessness was 86 months. Most of the respondents maintained social contacts with their families (43.0%). On the other hand, 1/4 (24.6%) of the group was only surrounded by people in the place of residence. More than half (53.5%) assessed their economic situation as neither good nor bad. 55.3% of respondents showed symptoms of depression seen in the Beck Depression Index, where they scored from 12 to 40 points. 36.0% of the group were satisfied with their health and 40.3% were dissatisfied. The following diseases were most frequently reported by the respondents: hypertension (n = 90, 78.9%), degenerative changes of the spine (n = 56, 49.1%), insomnia (n = 14, 12.3%), mental illness (n = 5, 4.4%). Almost all people included in the study smoked cigarettes (n = 103, 90.4%). One person admitted to gambling.
Table 1
Characteristics of the study group
Gender | Female | 28 | 24.6 |
Male | 86 | 75.4 |
Age | Up to 40 years old | 13 | 11.4 |
41–59 years old | 47 | 41.2 |
Over 60 years old | 54 | 47.4 |
Education | Primary | 25 | 21.9 |
Vocational | 52 | 45.6 |
High School | 31 | 27.2 |
Higher | 6 | 5.3 |
Stay length in the homelessness crisis | Up to 86 months | 78 | 68.4 |
Over 86 months | 36 | 31.6 |
Social contacts | Family | 49 | 43.0 |
Friends | 21 | 18.4 |
Family and friends | 16 | 14.0 |
None | 28 | 24.6 |
Economic situation | Very poor | 15 | 13.2 |
Poor | 17 | 14.9 |
Neither poor nor good | 61 | 53.5 |
Good | 20 | 17.5 |
Very good | 1 | 0.9 |
Beck Depression Index | 0–11 pts.– no depression | 51 | 44.7 |
12–26 pts.– mild depression | 49 | 43.0 |
27–49 pts.– moderately severe depression | 14 | 12.3 |
Health Satisfaction | Dissatisfied | 46 | 40.3 |
Neither dissatisfied nor satisfied | 27 | 23.7 |
Satisfied | 41 | 36.0 |
The main cause of homelessness was their family situation (n = 68, 59.6%), financial problems (n = 41, 36.0%) and the need to leave the apartment (n = 15, 13.2%). Abuse of alcohol before the homelessness crisis was reported by 96 (84.2%) respondents. After the homelessness crisis, 4 (3.5%) men admitted to drinking alcohol. The current source of income for the majority (n = 112, 98.2%) was the benefit paid by the Municipal Family Support Center (MOPR). 9 (7.9%) people received a pension.
A chance to get out of homelessness was seen by 108 (94.7%) respondents. Most of them expected help from their family (n = 46, 40.4%) or state institutions (n = 85, 74.6%).
They expected higher benefits from the state (77.2%), housing (41.2%) and employment (23.7%). On the other hand, psychological support (65.8%), love (40.4%), help in finding a job and a flat (10.5%) came from the family. Among the dreams mentioned by the study participants, they mainly mentioned having: a flat (93.9%), a job (64.9%), a normal family (13.2%), health (10.5%) and good upbringing of children (7.0%).
Quality of life
The WHOQOL– Bref questionnaire was used to assess the quality of life. The psychological domain was rated the highest (62.09 ± 16.94 points), followed by the social domain (56.17 ± 21.76 points) and the environmental domain (56.91 ± 16.17 points), the lowest somatic domain (53.25 ± 18.71 points).
In order to determine the factors influencing the assessment of the quality of life, basic demographic and social data were taken into account in the analysis. Although the study group was diverse in terms of age, gender and duration of homelessness, it was shown that gender, age, education, length of stay in the homelessness crisis and maintaining social contacts do not influence the assessment of the quality of life of people experiencing the homelessness crisis. In all domains of quality of life, the results were not statistically significant (p > 0.05).
The variable that showed a significant relationship with all areas of the quality of life was the economic situation: somatic (rs 0.33 p < 0.001), psychological (rs 0.39 p < 0.001), social (rs 0.41 p < 0.001), environmental (rs 0.40 p < 0.001). The assessment of the quality of life increased with the level of economic situation. The strength of the observed associations was moderately high.
In the next step, it was checked whether the level of respondents’ depression was related to the level of quality of life. A series of Spearman’s rs rank correlation analyses were performed, and all relationships turned out to be statistically significant (p < 0.05). The level of depression was negatively associated with the level of quality of life in all four domains. The assessment of the quality of life decreased as the level of depression of the surveyed people increased. The strength of the correlation between the level of depression and the quality of life in the somatic domain was high (rs -0.56), the remaining three relationships were moderately strong (psychological rs -0.49; social rs -0.34; environmental rs -0.38).
Health status also had a significant impact on the assessment of the quality of life in the surveyed group of people in the homeless crisis. In each of the four domains (somatic rs 0.70 p < 0.001; psychological rs 0.54 p < 0.001; social rs 0.47 p < 0.001; environmental 0.55 p < 0.001) the level of health satisfaction was positively related to the assessment of quality of life. The rating increased along with the feeling of better health. In terms of the social domain, the strength of this impact was moderately high, while for the other three domains it was high.
In order to determine the factor most significantly influencing the assessment of the quality of life of the homeless, multiple regression was performed for individual domains of the quality of life (Tables
2 and
3).
Table 2
Multiple regression results for the quality of life in the somatic and psychological domains
Free choice | | 3.89 | < 0,001 | | 4.11 | < 0.001 |
Gender | 0.091 ± 0.066 | 1.39 | 0.168 | -0.025 ± 0.075 | -0.33 | 0.745 |
Age | 0.030 ± 0.066 | 0.46 | 0.648 | 0.105 ± 0.076 | 1.38 | 0.170 |
Education | -0.072 ± 0.065 | -1.10 | 0.275 | 0.032 ± 0.075 | 0.42 | 0.673 |
Homelessness | -0.008 ± 0.066 | -0.13 | 0.899 | -0.092 ± 0.075 | -1.22 | 0.226 |
Social contacts | -0.082 ± 0.065 | -1.26 | 0.210 | -0.068 ± 0.074 | -0.92 | 0.361 |
Economic situation | 0.058 ± 0.069 | 0.83 | 0.407 | 0.230 ± 0.079 | 2.90 | 0.005 |
Depression | -0.393 ± 0.073 | -5.35 | < 0.001 | -0.410 ± 0.084 | -4.88 | < 0.001 |
Health status | 0.496 ± 0.078 | 6.35 | < 0.001 | 0.271 ± 0.089 | 3.03 | 0.003 |
The following variables turned out to be significant for the quality of life in the somatic domain: depression (p < 0.001) and health status (p < 0.001). The regression model explains 59.9% of the variation in quality of life in the somatic domain. Health status had a greater impact on the quality of life in the somatic domain than the level of depression.
The following variables turned out to be significant for the quality of life in the psychological domain: economic situation (p = 0.005), depression (p < 0.001) and health status (p = 0.003).
The regression model explained 47.4% of the variability in quality of life in the psychological domain. The increase in depression, worse economic situation and worse health condition in the respondents caused a decrease in the quality of life in the psychological domain. The greatest impact on the quality of life in the psychological domain had, in turn, the following: economic situation, health status and level of depression.
Table 3
Multiple regression results for quality of life in the social and environmental domains
Free choice | | 3.04 | 0.003 | | 2.31 | 0.023 |
Gender | 0.027 ± 0.088 | 0.31 | 0.758 | -0.018 ± 0.076 | -0.23 | 0.815 |
Age | -0.079 ± 0.088 | -0.90 | 0.372 | 0.232 ± 0.077 | 3.03 | 0.003 |
Education | -0.022 ± 0.088 | -0.25 | 0.805 | -0.071 ± 0.076 | -0.94 | 0.352 |
Homelessness | -0.018 ± 0.088 | -0.20 | 0.840 | -0.146 ± 0.076 | -1.92 | 0.058 |
Social contacts | -0.052 ± 0.087 | -0.60 | 0.547 | -0.047 ± 0.075 | -0.62 | 0.535 |
Economic situation | 0.218 ± 0.092 | 2.36 | 0.020 | 0.244 ± 0.080 | 3.04 | 0.003 |
Depression | -0.249 ± 0.098 | -2.54 | 0.012 | -0.192 ± 0.085 | -2.26 | 0.026 |
Health status | 0.248 ± 0.104 | 2.38 | 0.019 | 0.411 ± 0.091 | 4.54 | < 0.001 |
The following variables turned out to be significant for the quality of life in the social domain: economic situation (p = 0.020), depression (p = 0.013), and health status (p = 0.019). The regression model explained 28.4% of the variation in quality of life in the social domain. The greatest impact on the quality of life in the social domain had, in turn, the following: economic situation, health status and level of depression. The increase in depression, worse economic situation and worse health condition in the respondents caused a deterioration in the assessment of the quality of life.
The following variables turned out to be significant for the quality of life in the environmental domain: age (p = 0.003), economic situation (p = 0.003), depression (p = 0.026), and health status (p < 0.0001). The regression model explained 46.2% of the variation in quality of life in the environmental domain. Younger age, increased depression, worse economic situation and poorer health in the respondents caused a decrease in the quality of life in the environmental domain.
The greatest impact on the quality of life in the environmental domain had, in turn, health status, economic situation, age and level of depression.