Palliative Nexus, St Vincent's Hospital Melbourne, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia; Parkville Integrated Palliative Care Service, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Australia.
Palliative Care Services, St Vincent's Hospital Melbourne, Melbourne, Australia.
J Pain Symptom Manage. 2020 Nov;60(5):984-991.e1. doi: 10.1016/j.jpainsymman.2020.05.024. Epub 2020 May 25.
Managing the care of an increasing and aging prisoner population, including providing palliative and end-of-life care, is a challenge worldwide. There is little known about the views of health professionals who provide palliative care to hospitalized prisoner patients.
To explore experiences and perspectives of health professionals regarding the provision of palliative and end-of-life care for hospitalized prisoner patients.
A qualitative study involving semistructured focus groups and interviews with 54 medical, nursing, and allied health staff engaged in the care of hospitalized prisoner patients. Purposive sampling from a metropolitan teaching hospital responsible for providing secondary and tertiary health care for prisoners in Victoria, Australia, for 40 years was used to identify and seek perspectives of staff from a variety of clinical disciplines. Inductive thematic analysis was conducted by two researchers.
Participants described significant constraints in how they provide palliative care to hospitalized prisoners. Key themes emerged describing constraints on prisoner health decisions, provision and place of care, patient advocacy, and how care is delivered in the last days of life. Participants highlighted a deep philosophical tension between prison constraints and the foundational principles of palliative care.
Clarity of correctional service processes, protocols, and aspects of security and related training for health professionals is needed to ensure improved care for prisoners with progressive and life-limiting illness. Further research is required to seek the views of prisoners facing end of life and their families.
管理日益增多和老龄化的囚犯人口的护理，包括提供姑息治疗和临终关怀，是一个全球性的挑战。对于为住院囚犯患者提供姑息治疗的卫生专业人员的意见，人们知之甚少。
探讨卫生专业人员在为住院囚犯患者提供姑息治疗和临终关怀方面的经验和观点。
这是一项定性研究，涉及 54 名参与住院囚犯患者护理的医疗、护理和辅助卫生专业人员的半结构式焦点小组和访谈。从澳大利亚维多利亚州一家负责为囚犯提供二级和三级医疗保健服务的大都市区教学医院进行有目的的抽样，以确定并寻求来自各种临床学科的工作人员的观点。由两名研究人员进行归纳主题分析。
参与者描述了他们为住院囚犯提供姑息治疗时存在的重大限制。出现了一些关键主题，描述了对囚犯健康决策、护理的提供和地点、患者权益倡导以及生命最后几天的护理方式的限制。参与者强调了监狱限制和姑息治疗基本原则之间存在深刻的哲学紧张关系。
需要明确惩教服务流程、协议以及卫生专业人员的安全方面和相关培训，以确保为患有进行性和生命有限疾病的囚犯提供更好的护理。需要进一步研究，以寻求面临生命终点的囚犯及其家属的意见。
