Crowley D, Van Hout M C, Murphy C, Kelly E, Lambert J S, Cullen W
Irish College of General Practitioners, Lincoln Place, Dublin, Ireland.
Public Health Institute, Liverpool John Moore's University, Liverpool, UK.
BMC Nurs. 2019 Jun 13;18:23. doi: 10.1186/s12912-019-0347-x. eCollection 2019.
Prisoners carry a greater burden of physical, communicable and psychiatric disease compared to the general population. Prison health care structures are complex and provide challenges and opportunities to engage a marginalised and poorly served group with health care including Hepatitis C Virus (HCV) screening, assessment and treatment. Optimising HCV management in prisons is a public health priority. Nurses are the primary healthcare providers in most prisons globally. Understanding the barriers and facilitators to prisoners engaging in HCV care from the perspectives of nurses is the first step in implementing effective strategies to eliminate HCV from prison settings. The aim of this study was to identify the barriers and facilitators to HCV screening and treatment in Irish prisons from a nurse perspective and inform the implementation of a national prison-based HCV screening program.
A qualitative study using focus group methodology underpinned by grounded theory for analysis in a national group of nurse managers ( = 12).
The following themes emerged from the analysis; security and safety requirements impacting patient access, staffing and rostering issues, prison nurses' skill set and concerns around phlebotomy, conflict between maintaining confidentiality and concerns for personal safety, peer workers, prisoners' lack of knowledge, fear of treatment and stigma, inter-prison variations in prisoner health needs and health service delivery and priority, linkage to care, timing of screening and stability of prison life.
Prison nurses are uniquely placed to identify barriers and facilitators to HCV screening and treatment in prisoners and inform changes to health care practice and policy that will optimi the public health opportunity that incarceration provides.
与普通人群相比，囚犯承受着更大的身体、传染病和精神疾病负担。监狱医疗保健结构复杂，为使边缘化且医疗服务不足的群体获得包括丙型肝炎病毒（HCV）筛查、评估和治疗在内的医疗保健带来了挑战和机遇。优化监狱中的HCV管理是一项公共卫生优先事项。在全球大多数监狱中，护士是主要的医疗服务提供者。从护士的角度了解囚犯接受HCV护理的障碍和促进因素，是在监狱环境中实施有效策略以消除HCV的第一步。本研究的目的是从护士的角度确定爱尔兰监狱中HCV筛查和治疗的障碍和促进因素，并为实施全国性的基于监狱的HCV筛查计划提供依据。
采用焦点小组方法进行定性研究，并以扎根理论为基础进行分析，研究对象为一组全国性的护士管理人员（n = 12）。
分析得出以下主题；安全要求影响患者就医，人员配备和排班问题，监狱护士的技能组合以及对静脉穿刺的担忧，保密与个人安全担忧之间的冲突，同伴工作人员，囚犯知识匮乏，对治疗的恐惧和耻辱感，监狱间囚犯健康需求和医疗服务提供及优先级的差异，与护理的联系，筛查时间和监狱生活的稳定性。
监狱护士处于独特地位，能够识别囚犯HCV筛查和治疗的障碍和促进因素，并为优化监禁所提供的公共卫生机会的医疗保健实践和政策变革提供依据。
