The experience of living in community-based housing for people with disability and complex support needs: a qualitative systematic review using an ecological perspective.

Abstract

This systematic review aimed to identify, appraise, and synthesise qualitative research relating to the experience of people with disability and complex support needs (aged 18-65) living in community-based housing and the factors that influence these experiences. We adopted an ecological perspective using Bronfenbrenner's bioecological model (2005) to frame our interpretive analysis. Seventeen articles were identified and selected, detailing experiences from the perspectives of people with disability, family members, and support staff. Our qualitative synthesis resulted in a conceptual framework of twelve themes which describe the bidirectional relationship between an individual and their environment resulting in their experience of community-based housing. The themes of c<i>hoice and control, safety and security,</i> and <i>inclusion</i> were foundational to achieve positive outcomes within the home including a <i>sense of identity</i>, <i>belonging</i> and <i>health and well-being</i>. Five <i>environmental</i> themes and <i>personal characteristics</i> influenced these experiences, with environmental themes relating to support staff, societal attitudes, disability service organisations, and the physical structure of home playing a significant role in shaping experiences of community-based housing. Individualised housing and housing which embraced a rights-based approach of choice, control, and inclusion most often resulted in positive experiences for people with disability.