Patients, prisoners, or people? Women prisoners' experiences of primary care in prison: a qualitative study.
BACKGROUND
The development of primary care services within prisons has been central to improvements in the provision of health care in this setting over the past decade. Despite national imperatives to involve patients in the development of services and numerous policy initiatives, there has been no systematic evaluation of changes in the delivery of primary care and little published evidence of consultation with prisoners.


OBJECTIVE
To explore women prisoners' experiences of primary healthcare provision in prison.


METHODS
Qualitative study using focus groups and interviews.


METHODS
Two women's prisons in southern England.


METHODS
Six focus groups involving 37 women were conducted, as well as 12 semi-structured individual interviews. Focus groups and interviews were recorded, transcribed, and analysed thematically.


RESULTS
Women prisoners' perceptions of the quality of prison health care were mixed. There were accounts of good-quality care where practitioners were regarded as knowledgeable and respectful, but many perceived that the quality of care was poor. They complained about difficulties accessing care or medication, disrespectful treatment, and breaches of confidentiality by practitioners. They voiced the belief that staff were less qualified and competent than their counterparts in the community.


CONCLUSIONS
The prison environment presents unique challenges to those providing health care, and much work has been done recently on modernizing prison health care and improving professional standards of practice. However, the accounts of women prisoners in this study suggest that there is a gap between patient experience and policy aspirations.
Plugge
Emma
E
Department of Public Health, University of Oxford, Oxford, UK. emma.plugge@dphpc.ox.ac.uk
Douglas
Nicola
N
Fitzpatrick
Ray
R
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003219:Confidentiality / Q000592:standards; D004739:England; D005260:Female; D017144:Focus Groups; D015276:Health Care Rationing; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008875:Middle Aged; D011320:Primary Health Care / Q000592:standards; D011329:Prisoners / Q000523:psychology*; D011330:Prisons; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards*; D014932:Women's Health Services / Q000592:standards*; D055815:Young Adult
J Adv Nurs. 2001 Dec;36(5):652-8
11737497
Lancet. 2002 Feb 16;359(9306):545-50
11867106
BMJ. 2003 Aug 30;327(7413):480
12946970
Qual Health Care. 1994 Jun;3(2):107-13
10137583
BMJ. 1995 Jul 1;311(6996):42-5
7613329
J Adv Nurs. 2007 May;58(3):216-26
17474910
BMJ. 1997 Nov 29;315(7120):1420-4
9418090
Addiction. 2006 Feb;101(2):181-91
16445547
BMJ. 2006 Jul 1;333(7557):1-2
16809674
BMJ. 2007 Feb 10;334(7588):303
17223630
BMJ. 1995 Jul 29;311(7000):299-302
7633241