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McParland C, Johnston B, Ouwehand IEI. Caring for people in prison with palliative and end-of-life care needs. Curr Opin Support Palliat Care 2023; 17:224-230. [PMID: 37399538 DOI: 10.1097/spc.0000000000000661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
PURPOSE OF REVIEW The prison population is growing and ageing, and many people will die from natural causes while incarcerated. This article provides a contemporary review of key issues related to palliative and end-of-life care in prisons. RECENT FINDINGS Few countries have integrated prison hospices. Palliative care needs may go unrecognised in prison. Older offenders may not trust the prison to care for them and may benefit from segregation. Cancer remains a major cause of death. Training staff remains a priority, and technology can help facilitate this. The coronavirus disease 2019 (COVID-19) had a significant impact on prisons, less is known about its impact on palliative care. Compassionate release is underutilised, and the issue of medically assisted dying adds complexity to decisions around end-of-life care. Peer carers can provide reliable symptom assessment. Family members are often absent when someone dies in prison. SUMMARY Palliative and end-of-life care in prisons requires a joined-up approach, and staff must understand the challenges of both this and custodial care in general. The relational network both inside and outside of the prison should be involved, and when possible and appropriate, we should consider alternatives to dying whilst incarcerated, such as compassionate release.
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Affiliation(s)
- Chris McParland
- School of Medicine, Dentistry and Nursing, University of Glasgow
- NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Bridget Johnston
- School of Medicine, Dentistry and Nursing, University of Glasgow
- NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
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Schaefer I, Heneka N, DiGiacomo M, Panozzo S, Phillips JL. The importance of developing palliative care quality indicators for the prison setting: why now, and next steps. BMC Palliat Care 2023; 22:69. [PMID: 37291537 DOI: 10.1186/s12904-023-01150-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/22/2023] [Indexed: 06/10/2023] Open
Abstract
Palliative care is increasingly important in the prison setting, but information about the quality and accessibility of this care is extremely limited. Developing and implementing standardised quality indicators will provide transparency, accountability, and a platform for quality improvement at both local and national levels.
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Affiliation(s)
| | - Nicole Heneka
- University of Southern Queensland, Toowoomba, QLD, Australia
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Larkin P. Public health palliative care: a 'new' message for palliative care nursing. Int J Palliat Nurs 2022; 28:451-452. [PMID: 36269288 DOI: 10.12968/ijpn.2022.28.10.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Philip Larkin
- Professor; Chair of Palliative Care Nursing, Palliative and Supportive Care Service and Institute of Higher Education and Research in Healthcare, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Isailă O, Hostiuc S. Malpractice Claims and Ethical Issues in Prison Health Care Related to Consent and Confidentiality. Healthcare (Basel) 2022; 10:1290. [PMID: 35885817 PMCID: PMC9324339 DOI: 10.3390/healthcare10071290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
Respecting the consent and confidentiality of a patient is an underlying element in establishing the patient’s trust in the physician and, implicitly, obtaining the patient’s compliance. In particular, cases of inmate patients require increased attention in order to fulfill this goal against a background of institutional interferences, which, in certain situations, may endanger the autonomy of the physician and their respect for the inmate’s dignity. The purpose of this article is to depict the characteristics of consent and confidentiality in a prison environment, in special cases, such as hunger strikes, violent acts, HIV testing, COVID-19 measures, and drug use, bringing into focus the physician and the inmate in the context of the particular situation where the target is disciplining someone in order for them to conform to social and juridical norms. Respecting the dignity of the inmate patient requires an adequate approach of informed consent and confidentiality, depending on each case, considering the potential unspoken aspects of the inmate’s account, which can be key elements in obtaining their compliance and avoiding malpractice claims.
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Gilbert E, Turner M, de Viggiani N, Selman L. Developing a typology of models of palliative care delivery in prisons in high-income countries: protocol for a scoping review with narrative synthesis. BMJ Open 2022; 12:e060886. [PMID: 35487724 PMCID: PMC9058786 DOI: 10.1136/bmjopen-2022-060886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION A combination of punitive sentencing practices within ageing populations, compounded by the health challenges faced by people in prison, means that dedicated palliative care provision within prisons is a pressing requirement. However, evidence about exactly how quality palliative and end-of-life care is delivered in this environment remains sparse.This review aims to develop a typology of models of palliative and end-of-life care delivery within prisons in high-income countries to inform service development and policy. METHODS AND ANALYSIS We will conduct a scoping review of published studies and grey literature, following the Arksey and O'Malley framework. We will report data on models of palliative and end-of-life care delivery in prisons in high-income countries. Searches will be undertaken in Medline, EMBASE, CINAHL, Social Sciences Citation Index and PsyINFO for all study types, published from 1 January 2000 to December 2021, and reference lists from key reviews and studies will be screened for additional references. We will also screen grey literature from within other high-income countries using a targeted search strategy. For published reports of original research, study quality and risk of bias will be assessed independently by two reviewers using the Mixed Methods Appraisal Tool. A narrative synthesis of the data will be undertaken, integrating the results of the quality assessment. ETHICS AND DISSEMINATION Approval by research ethics committee is not required since the review only includes published and publicly accessible data. We will publish our findings in a peer-reviewed journal as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidance. PROTOCOL REGISTRATION The final protocol was registered with the Research Registry on 26 November 2021 (www.researchregistry.com).Unique ID number: reviewregistry1260.
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Affiliation(s)
- Emma Gilbert
- Palliative and End of Life Care Research Group, Bristol Medical School, University of Bristol, Bristol, UK
| | - M Turner
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Nick de Viggiani
- School of Health and Social Wellbeing, University of the West of England Bristol, Bristol, UK
| | - Lucy Selman
- Palliative and End of Life Care Research Group, Bristol Medical School, University of Bristol Faculty of Health Sciences, Bristol, UK
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Schaefer I, DiGiacomo M, Heneka N, Panozzo S, Luckett T, Phillips JL. Palliative care needs and experiences of people in prison: A systematic review and meta-synthesis. Palliat Med 2022; 36:443-461. [PMID: 34965778 DOI: 10.1177/02692163211068278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Globally, the prison population is growing and ageing, as is the need for palliative care. Yet, little is known about how people in prison perceive palliative care provision in this setting. AIMS To identify the: (i) perceptions of palliative care provision and dying in custody by people in prison; and (ii) perceived barriers and facilitators of person-centred palliative care provision in prison. DESIGN A systematic review and meta-synthesis was registered and undertaken in accordance with the reporting guidelines. DATA SOURCES Keywords and MeSH headings encompassing (i) palliative care, end-of-life care, death; and (ii) prison; were used to search Pubmed, Medline, CINAHL, PsycINFO, Web of Science, CINCH and ProQuest Central. Articles published in English, from high income countries, and containing qualitative data exploring perceptions of people in prison of palliative care in custody were included. Findings were reporting using the ENTREQ guidelines. FINDINGS Of the 2193 articles identified, 12 were included. Experiences of people in prison regarding palliative care related to two themes: (1) expectations versus experiences of palliative care; and (2) prison context complicates access to and provision of palliative care. People in prison with palliative care needs want to feel safe, cared for, and acknowledged as they face an expected death. The prison environment can severely restrict access to palliative care, leaving people in prison feeling isolated and powerless. CONCLUSIONS People in prison expect to receive high-quality palliative care, but their experiences often do not match their expectations. Numerous structural and organisational challenges complicate the provision of palliative care in prisons, limiting accessibility of care.
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Affiliation(s)
| | | | - Nicole Heneka
- University of Technology Sydney, Sydney, NSW, Australia
| | | | - Tim Luckett
- University of Technology Sydney, Sydney, NSW, Australia
| | - Jane L Phillips
- Queensland University of Technology, Brisbane, QLD, Australia
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Johns L, Weightman S, Blackburn P, McAuliffe D. A systematic literature review exploring the psychosocial aspects of palliative care provision for incarcerated persons: a human rights perspective. Int J Prison Health 2021; 18:443-457. [PMID: 34902234 DOI: 10.1108/ijph-02-2021-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study is to explore the psychosocial aspects of palliative care provision for incarcerated persons drawing on a human rights perspective. DESIGN/METHODOLOGY/APPROACH Seven databases were searched to identify empirical studies published from 2010 to 2020. Articles included were qualitative, quantitative, mixed methods, written in English and with westernised health/prison settings, with a key focus on the psychosocial aspects of palliative care provision and human rights. The quality of the articles was appraised using the Mixed Methods Assessment Tool (2018). FINDINGS The results from 26 articles revealed multiple models of care, with the US prison hospice program depicted as optimal, because of the use of trained incarcerated caregivers, working as aides to the interprofessional team. The bereavement needs of caregivers were highlighted. The barriers to adequate psychosocial care were negative public discourse, prison processes and resources, provider attitudes and the incarcerated person's level of knowledge and trust. Identified facilitators were related to incarcerated persons' caregiving programs, a sense of purpose and visitation leniency. Human rights principles were identified in studies that featured compassionate release and advance care planning. RESEARCH LIMITATIONS/IMPLICATIONS There is inconsistency in the literature regarding what constitutes psychosocial care, which meant that the authors needed to draw on multiple literature sources to formulate a definition. Additionally, the review only included studies written in English, meaning some high-quality studies could have been missed. The articles that conducted interviews with incarcerated individuals were undertaken in male prisons only and not female prisons. PRACTICAL IMPLICATIONS Understanding the importance of psychosocial care for incarcerated persons with a life-limiting illness requires a shift in negative public discourse and the need for a stronger human rights focus. Some countries, such as the USA and UK, are achieving effective outcomes; however, countries such as Australia are yet to contribute to this knowledge base. ORIGINALITY/VALUE If palliative care is a human right, then its philosophy should be considered in its entirety, with the inclusion of psychosocial care.
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Affiliation(s)
- Lise Johns
- School of Health Sciences and Social Work, Logan Campus, Meadowbrook, Australia
| | - Stacey Weightman
- School of Health Sciences and Social Work, Logan Campus, Meadowbrook, Australia
| | - Pippa Blackburn
- Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Donna McAuliffe
- School of Health Sciences and Social Work, Logan Campus, Meadowbrook, Australia
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Turner M, Chassagne A, Capelas ML, Chambaere K, Panozzo S, Teves CM, Riegler E. Mapping palliative care provision in European prisons: an EAPC Task Force Survey. BMJ Support Palliat Care 2021:bmjspcare-2020-002701. [PMID: 33888490 DOI: 10.1136/bmjspcare-2020-002701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Prison populations around the world are ageing and numbers are rising, leading to greater demand for palliative care for prisoners approaching the end of life. This paper reports a survey that was undertaken by the European Association for Palliative Care Task Force on mapping palliative care provision for prisoners in Europe. The Task Force was established to begin to address the gap in research knowledge by exploring prison systems and care provision across different countries. METHODS The survey, developed by the Task Force Steering Committee, consisted of 40 questions in six sections. It was completed through online searches; only data that were publicly available on the internet were included. Numerical data were analysed using descriptive statistics, and thematic comparisons were made of free-text data. FINDINGS The survey was completed for eight countries: Australia, Belgium, Czech Republic, England and Wales, France, Portugal, Scotland and Slovakia. Three main findings are reported here: healthcare and palliative care provision in prisons, deaths in custody and compassionate release. Despite increasing numbers of older prisoners, relatively few prisons provide inpatient care, and only one country has any prisons that provide dedicated palliative care services. Early release on compassionate grounds is extremely rare in most countries. CONCLUSION For the principle of equivalence to be adhered to, facilities for sick and dying prisoners need to be improved, or many more people need to be released on compassionate grounds at the end of life. This mapping study has identified key issues in relation to palliative care in prison and provides the basis for further international research.
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Affiliation(s)
- Mary Turner
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Aline Chassagne
- Clinical Investigation Centre, University of Burgundy Franche-comté, Besançon, France
| | - Manuel Luis Capelas
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
| | | | - Stacey Panozzo
- Palliative Nexus, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Carla Marinho Teves
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Edith Riegler
- Drug Prevention and Health Branch, United Nations Office on Drugs and Crime, Vienna, Austria
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McParland C, Johnston B. Caring, sharing, preparing and declaring: how do hospices support prisons to provide palliative and end of life care? A qualitative descriptive study using telephone interviews. Palliat Med 2021; 35:563-573. [PMID: 33302784 PMCID: PMC7975864 DOI: 10.1177/0269216320979194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Older adults in prison have complex healthcare needs, and many will need palliative care before their sentence ends. Compared with prison-based hospices, little is known about the role played by community-based hospices in providing palliative care to people in prison. AIM To describe the roles Scottish hospices have adopted to support prisons to provide palliative care, and to discuss the international relevance of these findings in addressing the knowledge gap around community hospices supporting people in prison. DESIGN A qualitative descriptive study using semi-structured telephone interviews. SETTING/PARTICIPANTS Representatives from all Scottish adult hospices were invited to take part in a short telephone interview and all (N = 17) participated. RESULTS Four roles were identified: caring, sharing, preparing and declaring. Most hospices employed different combinations of roles. Five (30%) hospices were engaged in caring (providing direct care at the prison or the hospice). Eleven (65%) hospices were engaged in sharing (supporting the prison by sharing knowledge and expertise). Eleven (65%) hospices were engaged in preparing (making preparations to support prisons). All seventeen hospices were described as declaring (expressing a willingness to engage with prisons to provide care). CONCLUSIONS There are differences and similarities in the way countries provide palliative care to people in prison: many are similar to Scotland in that they do not operate prison-based hospices. Variations exist in the level of support hospices provide. Ensuring that all people in prison have equitable access to palliative care will require close collaboration between prisons and hospices on a national level.
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Affiliation(s)
- Chris McParland
- School of Medicine, Dentistry and
Nursing, University of Glasgow, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow,
UK
| | - Bridget Johnston
- School of Medicine, Dentistry and
Nursing, University of Glasgow, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow,
UK
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Panozzo S, Bryan T, Marco D, Collins A, Lethborg C, Philip J. End of life in hospitalised prisoners: a group comparison of palliative medicine and hospital use. BMJ Support Palliat Care 2021:bmjspcare-2020-002703. [PMID: 33602722 DOI: 10.1136/bmjspcare-2020-002703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Providing optimal palliative and end-of-life care for people in prison with advanced progressive disease is a growing challenge. This study aimed to examine hospital and palliative care utilisation for people in prison who are hospitalised during the final 3 months of life and to compare with a disease-matched non-incarcerated patient cohort. METHODS A retrospective cohort study of people in prison who died between 2009 and 2019 in an Australian public hospital that provides tertiary-level healthcare for 18% of Australia's prison population. Demographic, clinical and service use data were extracted from medical records of eligible patients experiencing incarceration (prison group) and a disease-matched, non-incarcerated patient comparator group (comparator group). RESULTS At the time of death, patients in the prison group were aged a median of 20 years younger than the comparator group (median age 58 vs 78 years, p<0.01). The prison group experienced more than double the mean length of acute care hospital stay at the end of life. A higher proportion of patients in the prison group experienced an intensive care unit episode (22% vs 12%). More than two-thirds (71%) of the prison group patients were seen by palliative care prior to death, similar to the comparator group (p=0.44). Those transferred to the palliative care unit had a shorter length of stay and were admitted later, just prior to death (median 5 vs 8 days). CONCLUSIONS People in prison have prolonged acute care public hospital stays and are more likely to experience escalation of care at the end of life. Future opportunity may exist for increased access to formal subacute care settings for people in prison with life-limiting illness to receive optimal palliative and end-of-life care.
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Affiliation(s)
- Stacey Panozzo
- Palliative Nexus, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Tamsin Bryan
- Palliative Care Services, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
| | - David Marco
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Palliative Care, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
| | - Anna Collins
- Palliative Nexus, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Carrie Lethborg
- Department of Social Work, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Jennifer Philip
- Palliative Nexus, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
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McParland C, Johnston BM. Palliative and end of life care in prisons: a mixed-methods rapid review of the literature from 2014-2018. BMJ Open 2019; 9:e033905. [PMID: 31874895 PMCID: PMC7008433 DOI: 10.1136/bmjopen-2019-033905] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/12/2019] [Accepted: 11/28/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To explore current practice in relation to palliative and end of life care in prisons, and to make recommendations for its future provision. DESIGN A rapid literature review of studies using qualitative, quantitative and mixed-methods, with a narrative synthesis of results. DATA SOURCES Six databases searched between January 2014 to December 2018: ASSIA, CINAHL, Embase, MEDLINE, National Criminal Justice Reference Service Abstracts and Scopus. ELIGIBILITY CRITERIA Primary research articles reporting qualitative or quantitative findings about palliative and end of life care in prisons, published in peer-reviewed, English language journals between January 2014 to December 2018. PARTICIPANTS Prisoners, prisoners' families, prison healthcare staff and other prison staff. DATA EXTRACTION/SYNTHESIS Data extracted included: citation, design, aim, setting, sample/population, methods and key findings. Data were analysed thematically then subject to a narrative synthesis in order to answer the research questions. QUALITY APPRAISAL Two researchers independently appraised articles using the Qualsyst tool, by Kmet et al (2004). Aggregate summary quality scores are included with findings. Articles were not excluded based on quality appraisal. RESULTS 23 articles were included (16 qualitative, 6 quantitative, 1 mixed methods). Top three findings (by prevalence) were: fostering relationships with people both inside and outside of prison is important to prisoners with palliative and end of life care needs, inmate hospice volunteers are able to build and maintain close relationships with the prisoners they care for and the conflicting priorities of care and custody can have a negative impact on the delivery of palliative and end of life care in prisons. CONCLUSIONS The key findings are: relationships are important to prisoners at the end of life, inmate hospice volunteers can build close bonds with the prisoners in their care and the prison environment and regime conflicts with best practices in palliative and end of life care. Directions for future research are also identified. PROSPERO REGISTRATION NUMBER PROSPERO ID: CRD42019118737. Registered January 2019.
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Affiliation(s)
- Chris McParland
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Bridget Margaret Johnston
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow, Glasgow, UK
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Prost SG, Holland MM, Hoffmann HC, Dickinson GE. Characteristics of Hospice and Palliative Care Programs in US Prisons: An Update and 5-Year Reflection. Am J Hosp Palliat Care 2019; 37:514-520. [PMID: 31808349 DOI: 10.1177/1049909119893090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Individuals with terminal illness are dying behind bars and many state prison administrators have incorporated on-site hospice and palliative care services. Little is known, however, about these programs since a 2010 study of prison hospice characteristics. We provide an updated description and reflection of current hospice and palliative care programs in state prisons serving incarcerated persons with terminal illness. A cross-sectional survey was sent to representatives of all known prisons offering hospice and palliative care programs and services (N = 113). Questions were drawn from an earlier iteration regarding interdisciplinary team (IDT) membership, training length and topics, peer caregivers, visitation policies, bereavement services, perceived stakeholder support, and pain management strategies. Additional questions were added such as estimated operational costs, peer caregiver input in patient care, and the strengths and weaknesses of such programs. Frequency distributions were calculated for all study variables. Responding representatives (n = 33) indicated IDTs remain integral to care, peer caregivers continue to support dying patients, and perceived public support for these programs remains low. Reduced enthusiasm for the programs may negatively influence administrative decision-making and program resources. Further, peer caregiver roles appear to be changing with caregivers charged with fewer of the identified tasks, compared with the 2010 study.
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Affiliation(s)
- Stephanie Grace Prost
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | | | - Heath C Hoffmann
- Department of Sociology and Anthropology, College of Charleston, Charleston, SC, USA
| | - George E Dickinson
- Department of Sociology and Anthropology, College of Charleston, Charleston, SC, USA
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Abstract
The number of people aging and dying behind bars is growing, bringing greater attention to the need for prison palliative care. While this trend has rightly led to increased scholarship, a focus on understanding the most effective way to deliver prison palliative care has overshadowed thinking about why the need itself has arisen, as well as deeper ethical thinking about how the nursing profession should respond. This article interweaves 4 strands of analysis-contextual, relational, social, and political-to produce a framework to guide ethical action in prison palliative care nursing, relevant to practice, research, policy, and education.
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14
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Affiliation(s)
- Mary Turner
- Reader in Health Services Research, University of Huddersfield
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