Reader Health Economics University of the West of England, Bristol, UK.
J Adv Nurs. 2010 Jun;66(6):1257-65. doi: 10.1111/j.1365-2648.2010.05296.x.
This paper is a report of a study of the views and experiences of nurses and other prison healthcare staff about their roles and the nursing care they provide to prisoners.
Nurses have become the key providers of healthcare in prison settings in England, replacing the previous prison service-run system. However, there is very little evidence about the health services they provide to meet the health needs of prisoners.
A ethnographic study was conducted. Participants were 80 healthcare staff working in 12 prisons of all security categories in England. Twelve individual interviews with general healthcare managers and 12 key informant focus group discussions with healthcare staff were undertaken in 2005 using a semi-structured interview schedule. Issues investigated included participants' thoughts and experiences of nursing roles and delivery of primary healthcare. The group discussions and interviews were analysed to identify emerging themes.
Participants gave accounts of day-to-day processes and the healthcare routine. They saw their work as identifying and meeting the health needs of prisoners and maintaining their health, and identified major influences that shaped their daily work, including new ways of working in primary care. They identified how policy and organizational changes were affecting their roles, and acknowledged the conflict between the custody regime and healthcare delivery.
The move towards a NHS-led primary healthcare service within prisons, predominantly delivered by nurses, has made positive changes to healthcare. Healthcare managers have benefited from the involvement of the local NHS in improving the health of prisoners.
本文报告了一项关于护士和其他监狱医疗保健人员对其角色以及为囚犯提供护理的看法和经验的研究。
在英格兰,护士已成为监狱环境中医疗保健的主要提供者,取代了以前由监狱服务部门管理的系统。然而,关于他们提供的健康服务以满足囚犯的健康需求的证据却很少。
采用人种学研究方法。参与者为英格兰 12 所不同安全级别的监狱的 80 名医疗保健人员。2005 年,使用半结构化访谈表对普通医疗保健经理进行了 12 次个别访谈,并对医疗保健人员进行了 12 次重点信息组讨论。调查的问题包括参与者对护理角色和初级保健的看法和经验。对小组讨论和访谈进行了分析,以确定出现的主题。
参与者描述了日常流程和医疗保健常规。他们将自己的工作视为识别和满足囚犯的健康需求并维持其健康,并确定了影响其日常工作的主要因素,包括在初级保健中采用新的工作方式。他们确定了政策和组织变革如何影响他们的角色,并承认监管制度和医疗保健提供之间存在冲突。
朝着由 NHS 主导的监狱内初级保健服务发展,主要由护士提供,这为医疗保健带来了积极的变化。医疗保健经理受益于当地 NHS 参与改善囚犯的健康。