Armes Jo, Visser Renske, Lüchtenborg Margreet, Huynh Jennie, Wheatcroft Sue, X Anthony, Barber Alyce-Ellen, Plugge Emma, Taylor Rachel M, Hunter Rachael Maree, Davies Elizabeth Anne
School of Health Sciences, University of Surrey, UK.
Faculty of Education, University of Oulu, Finland.
EClinicalMedicine. 2024 Apr 29;72:102540. doi: 10.1016/j.eclinm.2024.102540. eCollection 2024 Jun.
Approximately 82,000 people are in prison annually in England and Wales. Limited research has investigated cancer in this population and none has explored experiences of imprisoned people with cancer. This study aimed to address this gap.
We conducted 55 semi-structured, qualitative, audio-recorded interviews with: imprisoned people with cancer (n = 24), custodial staff (n = 6), prison healthcare staff (n = 16) and oncology specialists (n = 9). Data were collected 07/10/2019-20/03/2020. Patients were recruited by prison healthcare staff and interviews were conducted face-to-face. Professionals were recruited via professional networks and interviews were conducted face-to-face or via telephone. Transcribed interviews were analysed using reflexive thematic analysis. We also analysed relevant National Cancer Patient Experience Survey (NCPES) questions for those diagnosed in prison (n = 78) and in the general population (n = 390).
Our findings highlight the complexities of cancer care for imprisoned people. We identified three core themes: control and choice, communication, and care and custody. Whilst people in prison follow a similar diagnostic pathway to those in the community, additional barriers to diagnosis exist including health literacy, the General Practitioner appointment booking system and communication between prison and oncology staff. Tensions between control and choice in prison impacted aspects of cancer care experience such as symptom management and accessing cancer information. NCPES results supported the qualitative findings and showed people in prison reported significantly poorer experiences than in the general population.
Our findings demonstrate the complexity of cancer care in custodial settings, identifying barriers and enablers to equitable cancer care provision and offering insights on how to improve care for this population.
National Institute for Health and Social Care Research Delivery Research Programme 16/52/53 and Strategic Priorities Fund 2019/20 Research England via University of Surrey.
在英格兰和威尔士，每年约有8.2万人入狱。针对这一人群的癌症研究有限，且尚无研究探讨过狱中癌症患者的经历。本研究旨在填补这一空白。
我们对以下人员进行了55次半结构化、定性的录音访谈：狱中癌症患者（n = 24）、监管人员（n = 6）、监狱医护人员（n = 16）和肿瘤专家（n = 9）。数据收集时间为2019年10月7日至2020年3月20日。患者由监狱医护人员招募，访谈采用面对面的方式进行。专业人员通过专业网络招募，访谈通过面对面或电话方式进行。对转录的访谈内容采用反思性主题分析法进行分析。我们还分析了国家癌症患者体验调查（NCPES）中针对狱中确诊患者（n = 78）和普通人群（n = 390）的相关问题。
我们的研究结果凸显了狱中癌症患者护理工作的复杂性。我们确定了三个核心主题：控制与选择、沟通以及护理与监管。虽然狱中人员的诊断途径与社区人员相似，但诊断存在额外障碍，包括健康素养、全科医生预约系统以及监狱与肿瘤科室工作人员之间的沟通。监狱中控制与选择之间的矛盾影响了癌症护理体验的多个方面，如症状管理和获取癌症信息。NCPES的结果支持了定性研究结果，表明狱中人员报告的体验明显比普通人群差。
我们的研究结果表明了监禁环境中癌症护理的复杂性，确定了公平提供癌症护理的障碍和促进因素，并就如何改善这一人群的护理提供了见解。
国家卫生与社会保健研究所研究交付研究计划16/52/53以及2019/20战略优先基金，由萨里大学通过英国研究与创新署提供资金。
