title: Users' views of prison health services: a qualitative study.
abstract: OBJECTIVE
  This paper is a report of a study of the views of prisoners about health services provided in prisons.
  
  
  BACKGROUND
  Prison provides an opportunity for a 'hard to reach' group to access health services, primarily those provided by nurses. Prisoners typically have high health and social needs, but the views and experiences of prisoners about health services in prison have not been widely researched.
  
  
  METHODS
  Semi-structured interviews were carried out with 111 prisoners in purposively selected 12 prisons in England in 2005. Interviews covered both prisoners' views of health services and their own ways of caring for their health in prison. Interviews were analysed to develop a conceptual framework and identify dominant themes.
  
  
  RESULTS
  Prisoners considered health services part of a personal prison journey, which began at imprisonment and ended on release. For those who did not access health services outside prison, imprisonment improved access to both mental and physical health services. Prisoners identified accessing services, including those provided by nurses, confidentiality, being seen as a 'legitimate' patient and living with a chronic condition as problems within the prison healthcare system. At all points along the prison healthcare journey, the prison regime could conflict with optimal health care.
  
  
  CONCLUSIONS
  Lack of autonomy is a major obstacle to ensuring that prisoners' health needs are fully met. Their views should be considered when planning, organizing and delivering prison health services. Further research is needed to examine how nurses can ensure a smooth journey through health care for prisoners.
authors.affiliation: Faculty of Health and Social Care, University of the West of England, Glenside, Bristol, UK. louise.condon@uwe.ac.uk
authors.forename: Louise
authors.initials: L
authors.lastname: Condon
authors.forename: Gill
authors.initials: G
authors.lastname: Hek
authors.forename: Francesca
authors.initials: F
authors.lastname: Harris
authors.forename: Jane
authors.initials: J
authors.lastname: Powell
authors.forename: Terry
authors.initials: T
authors.lastname: Kemple
authors.forename: Sally
authors.initials: S
authors.lastname: Price
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005006:Ethnicity; D005260:Female; D006301:Health Services Needs and Demand / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D026684:Personal Autonomy; D011329:Prisoners / Q000523:psychology*; D011330:Prisons / Q000941:ethics / Q000458:organization & administration*; D013041:Specialties, Nursing / Q000941:ethics / Q000592:standards*; D006113:United Kingdom; D000078329:Workforce