Living arrangements, visit patterns, and health problems in a nurse-managed clinic for the homeless

The purpose of this article is to describe living arrangements, clinic visit patterns, and health problems of clients by age and gender in a nurse-managed clinic serving the homeless. The conceptual framework for this project was derived from a nursing perspective of community health. The problem classification scheme used included four domains of community health practice: environmental, psychosocial, physiological, and health-related behavior. Data were collected during each visit to a nurse-managed health clinic for the homeless for 18 months. The findings indicate that living arrangements and visit patterns vary by age and gender. Health problems associated with integument and income were identified as primary and secondary problems across all age groups. Six other health problems were shared across all age and gender groups as either primary or secondary: circulation, respiration, pain, nutrition, communication, and prescription medication. Substance misuse was not a primary problem noted by clients, but was commonly a secondary problem. Genitourinary problems were noted primarily to be problems of younger women. Implications for planning nursing services for the homeless are discussed.