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The WARM Study is a Pilot Study That Aims to Investigate the Impact of Environmental Factors on Acute and Chronic Wounds, Mental Illness, and Social Factors Among People Experiencing Housing Emergencies in Augsburg. (WARM)

2026년 6월 5일 업데이트: University Hospital Augsburg

Impact of Environmental Factors on Acute and Chronic Wounds, Mental Illness, and Social Factors Among People Experiencing Housing Emergencies in Augsburg

Providing healthcare to homeless people is a key and challenging task, both for society as a whole and for medical and psychosocial professionals. It must be noted that the standard healthcare system is hardly used, or can only be used to an insufficient extent, by homeless people, and therefore does not comprehensively reach this group. One low-threshold and acceptance-oriented service outside the standard care system is the Johanniter-Hilfsmobil, which was established on June 3, 2024, as an innovative approach to healthcare for homeless people in Augsburg and will be scientifically examined in the following study.

The aim is to compare acute and chronic wounds in people experiencing housing emergencies who are treated by the Johanniter-Hilfsmobil with those of patients who attend the outpatient wound clinic at the Clinic for Vascular Surgery at Augsburg University Hospital.

In addition, a saliva test will be carried out to estimate the amount and type of substance consumed, and a survey will be conducted among drug-dependent test subjects who present themselves either via the Johanniter-Hilfsmobil or via the substitution outpatient clinic of the Clinic for Psychiatry, Psychotherapy, and Psychosomatics at Augsburg District Hospital.

Another focus of research is the quantitative and qualitative analysis of the psychosocial living situation and environmental influences on users of the Johanniter-Hilfsmobil.

연구 개요

상세 설명

The primary endpoint is to identify positive and negative influences of environmental factors on the development, progression, and healing of somatic and psychiatric illnesses in homeless people in Augsburg. The answers to the resulting research questions listed below should contribute to the development of a sustainable diagnosis and therapy system by the Johanniter-Hilfsmobil for people in housing emergencies without access to the regular health care system in Augsburg, optimizing addiction treatment for homeless people in the region, and establishing a prevention program for people experiencing housing emergencies in Augsburg, thereby positively influencing the environmental factors described. The long-term plan is to set up a wound and vascular consultation service for people experiencing housing emergencies to improve medical treatment and reintegration into the regular healthcare system.

A comparison will be made between acute and chronic wounds in people experiencing housing emergencies who are treated by the Johanniter mobile emergency service and those of patients who attend outpatient wound consultations at the Clinic for Vascular Surgery at Augsburg University Hospital. The following data will be collected: wound area and volume, as well as qualitative and quantitative analysis of bacterial and/or fungal colonization by taking swabs from the wound bed and performing corresponding laboratory chemical analysis. In addition, the cause or origin of the wounds, the type of diagnostics performed, and causal therapeutic measures taken to date, as well as the number and regularity of check-ups performed, will be recorded. Furthermore, the influence of environmental factors (including temperature, light, radiation), comorbidities, and nutritional status on wound healing and the effects of dressing sets provided as part of the study on the healing process of the wounds will be analyzed. Data collection will be carried out on an outpatient basis during treatment in the Johanniter-Hilfsmobil. In addition, the existing cardiovascular risk factors will be assessed and a vascular step-by-step diagnosis will be performed, including pulse status assessment and, in the event of pathological findings, non-invasive vascular imaging using ankle-brachial index determination and color-coded duplex sonography (FKDS).

In addition, semi-quantitative and quantitative saliva tests and a questionnaire survey are conducted among drug-dependent subjects who present themselves either via the Johanniter-Hilfsmobil or via the substitution outpatient clinic of the Clinic for Psychiatry, Psychotherapy, and Psychosomatics at Augsburg District Hospital.

Another focus of research is the quantitative analysis of the psychosocial living situation due to exceptional environmental influences based on subjective and/or objective recording of the following constructs and categories among users of the Johanniter-Hilfsmobil using a standardized questionnaire: Life situation index (material situation, gainful employment, housing, health, safety, participation/social networks), environmental influences and weather conditions (heat/cold, precipitation, wind, air quality, noise, garbage/unhygienic conditions), opportunities for a healthy lifestyle (nutrition, access to drinking water, sleep, regeneration), use of public space and urban infrastructure (mobility, participation, defensive architecture), experiences of loneliness, and experiences with and access to the medical and psychosocial care system. The questionnaire integrates the following measurement instruments/scales, among others: "Life Situation Index for Homeless People", "RTLS - Rasch-Type Loneliness Scale".

However, since this is a very specific target group that has been largely neglected in scientific analysis, the questionnaire also requires some self-formulated items that are appropriate for the research project.

In a final step, a qualitative analysis will be conducted through guided interviews with users of the Johanniter-Hilfsmobil to gain a deeper understanding of the quantitative findings on the psychosocial living situation and the environmental influences to which they are exposed.

연구 유형

중재적

등록 (추정된)

100

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

  • Age over 18
  • Existing capacity to consent to participation in the study, which will be verified and documented by the study physicians
  • Inclusion of patients who present for wound treatment at the Johanniter-Hilfsmobil, the wound consultation hour of the Clinic for Vascular Surgery at Augsburg University Hospital and/or the substitution outpatient clinic of the Clinic for Psychiatry, Psychotherapy and Psychosomatics at Augsburg District Hospital
  • Written consent to participate in the study has been obtained from the test subject.

Exclusion Criteria:

  • Minderjährigkeit
  • Fehlende schriftliche Einwilligung zur Studienteilnahme
  • Instabiler somatischer Zustand der Betroffenen
  • Akute Selbst- und Fremdgefährdung

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 기초 과학
  • 할당: 무작위화되지 않음
  • 중재 모델: 병렬 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
간섭 없음: Saliva testing
Semi-quantitative and quantitative saliva tests and a questionnaire survey are conducted on drug-dependent subjects who present themselves either via the Johanniter-Hilfsmobil or via the substitution outpatient clinic of the Clinic for Psychiatry, Psychotherapy and Psychosomatics at Augsburg District Hospital.
실험적: Wound Care Treatment

A comparison will be made between acute and chronic wounds in people experiencing housing emergencies who are treated by the Johanniter mobile emergency service and those in patients who attend outpatient wound consultations at the Clinic for Vascular Surgery at Augsburg University Hospital.

The following data will be collected: wound area and volume, as well as qualitative and quantitative analysis of bacterial and/or fungal colonisation by taking swabs from the wound bed and performing the corresponding laboratory chemical analysis. Furthermore, the cause or origin of the wounds, the type of diagnostics performed and causal therapeutic measures taken to date, as well as the number and regularity of the checks carried out will be recorded.

A comparison will be made between acute and chronic wounds in people experiencing housing emergencies who are treated by the Johanniter mobile emergency service and those of patients who attend outpatient wound consultations at the Clinic for Vascular Surgery at Augsburg University Hospital.

The following data will be collected: wound area and volume, as well as qualitative and quantitative analysis of bacterial and/or fungal colonisation by taking swabs from the wound bed and performing the corresponding laboratory chemical analysis. In addition, the cause or origin of the wounds, the type of diagnostics performed and causal therapeutic measures taken to date, as well as the number and regularity of the checks carried out will be recorded. The influence of environmental factors, comorbidities and nutritional status on wound healing and the effects of the dressing sets provided as part of the study on the healing process of the wounds will also be analysed.

간섭 없음: Questionnaire on psychosocial life situation
The quantitative analysis of the psychosocial living situation due to exceptional environmental influences based on subjective and/or objective recording of the following constructs and categories among users of the Johanniter-Hilfsmobil using a standardised questionnaire: Life situation index (material situation, gainful employment, housing, health, safety, participation/social networks), environmental influences and weather conditions (heat/cold, precipitation, wind, air quality, noise, rubbish/unhygienic conditions), opportunities for a healthy lifestyle (nutrition, access to drinking water, sleep, regeneration), use of public space and urban infrastructure (mobility, participation, defensive architecture), experiences of loneliness, and experiences with and access to the medical and psychosocial care system.
간섭 없음: Guided interview on psychosocial circumstances
A qualitative analysis will be conducted through guided interviews with up to 15 users of the Johanniter-Hilfsmobil to gain a deeper understanding of the quantitative findings on the psychosocial living situation and the environmental influences to which they are exposed.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Identification of the positive and negative effects of environmental factors on the onset, progression and recovery from of chronic wounds among homeless people who use the Johanniter-Hilfsmobil in Augsburg
기간: 0-365 days

To answer the research question, the following data will be collected from study participants via a questionnaire and clinical examination:

  • Wound area and volume (wound length in cm, wound width in cm, wound area in cm², wound depth in cm),
  • Qualitative and quantitative analysis of bacterial and/or fungal colonisation by taking swabs from the wound bed and conducting the corresponding laboratory tests (incubation on culture media)
  • Determination of the cause of the wounds (for example caused by cold or heat) through medical history and clinical examination
  • Assessment of nutritional status by calculating the body mass index (kg/m²)
  • Assessment of existing cardiovascular risk factors (for example hypertension, or tobacco use)
  • Vascular assessment, including examination of the pulse status in the lower limbs and if pathological findings are observed non-invasive vascular imaging is performed using the ankle-brachial index and colour-coded duplex sonography
0-365 days
Identification of a discrepancy between the substance subjectively perceived to have been consumed and the substance objectively detectable in drug-dependent homeless individuals
기간: 0 - 365 days

In order to identify any discrepancies between the substance the study participant subjectively believes they have consumed and the substance objectively detected, saliva tests are carried out which are chemically analysed in the laboratory for the presence of the following groups of substances:

  • Amphetamines and derivatives
  • Benzodiazepines
  • Cocaine and cocaine metabolites
  • Cannabinoids
  • Other substances (including ketamine)
  • Synthetic cannabinoids

To determine the substance the participant subjectively perceives to have consumed, a questionnaire is administered to assess the participant's current substance use.

0 - 365 days
Assessing the impact of environmental factors on the psychosocial circumstances of users of the Johanniter mobile support service.
기간: 0 - 365 days

Quantitative analysis of the psychosocial circumstances of users of the Johanniter-Hilfsmobil due to exceptional environmental influences, using a standardised questionnaire.

The following metrics are to be collected:

  • Life circumstances index (material situation, gainful employment, housing, health, safety, participation/social networks)
  • Environmental factors and weather conditions (heat/cold, precipitation, wind, air quality, noise, litter/unhygienic conditions)
  • Opportunities for a healthy lifestyle (diet, access to drinking water, sleep, recovery)
  • Use of public spaces and urban infrastructure (mobility, participation, defensive architecture)
  • Experiences of loneliness
  • Experiences with and access to the medical and psychosocial care system.
0 - 365 days
Survey of the psychosocial circumstances and the environmental factors of which they are exposed of homeless people in Augsburg using the Johanniter-Hilfsmobil
기간: 0-365 days

As a final step, a qualitative analysis will be carried out through guided interviews with users of the Johanniter-Hilfsmobil to gain a deeper understanding of the quantitative findings regarding their psychosocial circumstances and the environmental factors to which they are exposed.

The following categories will be covered in the personal interview with the homeless persons:

  • General living situation
  • Public spaces and urban infrastructure
  • Environmental influences and weather conditions
  • Health
  • Social support
  • Medical, psychological and social care
0-365 days

기타 결과 측정

결과 측정
측정값 설명
기간
Difference in consumption patterns in relation to the season
기간: 0 - 365 days
In order to identify any seasonal variations in consumption patterns, a statistical analysis is carried out based on the results of saliva samples taken from drug-dependent individuals who present themselves either via the Johanniter-Hilfsmobil or via the substitution clinic at the Department of Psychiatry, Psychotherapy and Psychosomatics at Augsburg District Hospital.
0 - 365 days

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

일반 간행물

  • 1. Gerull S. Systematische Lebenslagenuntersuchung wohnungsloser Menschen 2018 [Available from: https://opus4.kobv.de/opus4-ash/frontdoor/index/index/docId/246 https://nbn-resolving.org/urn:nbn:de:kobv:b1533-opus-2465. 2. Gerull S. Wohnungslos in unsicheren Zeiten 2022 [1-57]. Available from: https://opus4.kobv.de/opus4-ash/frontdoor/index/index/docId/496 https://nbn-resolving.org/urn:nbn:de:kobv:b1533-opus-4961. 3. Gierveld JDJ, Tilburg TV. A 6-Item Scale for Overall, Emotional, and Social Loneliness:Confirmatory Tests on Survey Data. Research on Aging. 2006;28(5):582-98.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 6월 1일

기본 완료 (추정된)

2027년 12월 31일

연구 완료 (추정된)

2027년 12월 31일

연구 등록 날짜

최초 제출

2026년 3월 12일

QC 기준을 충족하는 최초 제출

2026년 6월 5일

처음 게시됨 (실제)

2026년 6월 11일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 6월 11일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 6월 5일

마지막으로 확인됨

2026년 6월 1일

추가 정보

이 연구와 관련된 용어

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

아니요

IPD 계획 설명

As people in housing emergencies are a particularly vulnerable group requiring protection, in accordance with the positive ethical opinion of the Ethics Committee at the Medical Faculty of Ludwig Maximilian University Munich, there are no plans to make the pseudonymised data available to other study centres for further processing.

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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