Secondary care clinicians and staff have a key role in delivering equivalence of care for prisoners: A qualitative study of prisoners' experiences.
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
12
12
2019
revised:
28
05
2020
accepted:
29
05
2020
entrez:
5
10
2020
pubmed:
6
10
2020
medline:
6
10
2020
Statut:
epublish
Résumé
While challenging to provide, prisoners are entitled to healthcare equivalent to community patients. This typically involves them travelling to hospitals for secondary care, whilst adhering to the prison's operational security constraints. Better understanding of equivalence issues this raises may help hospitals and prisons consider how to make services more inclusive and accessible to prisoners. We used prisoners' accounts of secondary care experiences to understand how these relate to the principle of healthcare equivalence. We undertook a qualitative interview ( Experiences of hospital healthcare were analysed for themes relating to the principle of 'equivalence of care' using Framework Analysis. Participants described five experiences challenging 'equivalence of care' for prisoners: (1) Security overriding healthcare need or experience (2) Security creating public humiliation and fear (3) Difficulties relating to prison officer's role in medical consultations (4) Delayed access due to prison regime and transport requirements and (5) Patient autonomy restricted in management of their own healthcare. Achieving equivalence of care for prisoners is undermined by fear, stigma, reduced autonomy and security requirements. It requires co-ordinated action from commissioners, managers, and providers of prison and healthcare systems to address these barriers. There is a need for frontline prison and healthcare staff to address stigma and ensure they understand common issues faced by prisoners seeking to access healthcare, while developing strategies which empower the autonomy of prisoners' healthcare decisions.
Sections du résumé
BACKGROUND
BACKGROUND
While challenging to provide, prisoners are entitled to healthcare equivalent to community patients. This typically involves them travelling to hospitals for secondary care, whilst adhering to the prison's operational security constraints. Better understanding of equivalence issues this raises may help hospitals and prisons consider how to make services more inclusive and accessible to prisoners. We used prisoners' accounts of secondary care experiences to understand how these relate to the principle of healthcare equivalence.
METHODS
METHODS
We undertook a qualitative interview (
FINDINGS
RESULTS
Experiences of hospital healthcare were analysed for themes relating to the principle of 'equivalence of care' using Framework Analysis. Participants described five experiences challenging 'equivalence of care' for prisoners: (1) Security overriding healthcare need or experience (2) Security creating public humiliation and fear (3) Difficulties relating to prison officer's role in medical consultations (4) Delayed access due to prison regime and transport requirements and (5) Patient autonomy restricted in management of their own healthcare.
INTERPRETATION
CONCLUSIONS
Achieving equivalence of care for prisoners is undermined by fear, stigma, reduced autonomy and security requirements. It requires co-ordinated action from commissioners, managers, and providers of prison and healthcare systems to address these barriers. There is a need for frontline prison and healthcare staff to address stigma and ensure they understand common issues faced by prisoners seeking to access healthcare, while developing strategies which empower the autonomy of prisoners' healthcare decisions.
Identifiants
pubmed: 33015596
doi: 10.1016/j.eclinm.2020.100416
pii: S2589-5370(20)30160-7
pmc: PMC7525130
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100416Subventions
Organisme : Department of Health
ID : ICA-CDRF-2017-03-006
Pays : United Kingdom
Informations de copyright
© 2020 The Author(s).
Déclaration de conflit d'intérêts
CE reports grants from Wellcome Trust, grants from Surrey Heartlands Health and Care Partnership, grants from NIHR during the conduct of the study. All other authors declare no conflict of interest.
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