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

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.