Accommodating illness: the experience of suffering in a physically unwell homeless population

Jacob Clark

Research output: ThesisDoctoral Thesis

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The knowledge relating to objective health outcomes in the homeless population is extensive, but our understanding of illness experience and subjective health indicators is based on limited evidence. This study examines suffering, the experience of distress in circumstances which threaten sense of self, in a sample of 48 homeless persons hospitalised with physical illness. It addresses the questions: are illness related suffering (SIS) and suffering related to housing difficulties (SHS) associated? Does SIS or SHS predict quality of life, distress and well-being?
A significant small positive correlation between SIS and SHS was observed, supporting the hypothesis. Multiple regression analyses found SIS independently accounted for the variance in distress and quality of life, but not well-being. SHS did not predict quality of life, distress or well-being. Many participants placed illness and housing related suffering inside-self.
The findings suggest that physically unwell homeless persons experience suffering related to illness, as distinct to suffering related to housing difficulties. The predictive value of SIS is discussed with respect to the unique experience of hospitalisation for this population. The quantitative and qualitative data build on prior literature by highlighting novel threats to homeless persons’ autonomy, dignity and integrity. The findings generate important questions regarding the conceptualisation of suffering for this population and this may be a promising avenue for developing collaborative health practices with unwell homeless persons. The cross-sectional design and heterogeneous sample limit the generalisability of findings. This thesis concludes with a recognition of the study strengths in engaging with a clinical sample, advancing the psychological understanding of homeless health, and the involvement of experts with experience.

Original languageEnglish
Awarding Institution
  • Royal Holloway, University of London
  • Farquharson, Lorna, Supervisor
Award date1 Nov 2017
Publication statusUnpublished - 1 Sept 2017


  • Homelessness
  • Suffering
  • Health
  • Illness
  • Quality of Life
  • Wellbeing
  • Distress
  • Hospital

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