title: Ethical issues of prison nursing: A qualitative study in Northern Italy.
abstract: BACKGROUND
  Prisons are contexts where nurses are required to have specific skills to ensure that, in a setting designed for the expiation of crime, prisoners receive the same type of care as anyone else. But this is not always the case, giving rise to ethical issues.
  
  
  OBJECTIVE
  'How do correctional nurses describe their working experience in prisons? What issues emerged?'
  
  
  METHODS
  This is a qualitative descriptive study. Following purposive sampling, we conducted five focus groups. Thematic analysis was used to analyse the data. Participants and research context: Our sample included 31 correctional nurses in seven prisons in Northern Italy. Ethical considerations: The scientific merit of this study was recognized by the Academic Board of the University of Genoa. Approval to conduct the study was obtained from the Liguria Regional Government that funded this study and from the Local Health Authority that was the prison nurses' employer. Formal consent was obtained from all the nurses who volunteered to participate in this study.
  
  
  RESULTS
  Five themes emerged from the focus groups: (1) prisoners' healthcare needs, (2) negotiation between custody and care, (3) satisfaction of working in prisons, (4) obstacles to quality care and (5) safety. 'Manipulation' was a transversal theme that emerged from all the focus groups.
  
  
  CONCLUSIONS
  The problems generated by the clash between prison security and nursing care priorities did not enable nurses to practice autonomously and provide the best possible to care prisoners, giving rise to ethical issues and moral distress. This in turn causes high nursing turnover rates that negatively impact continuum of care.
  
  
  CONCLUSIONS
  In Italy, correctional nurses urgently require specific education interventions with the participation of all those who work in prisons. Interventions based on the post-modern concept of restorative nursing could offer prison nurses the opportunity to both resolve ethical issues and reduce moral distress.
authors.forename: Loredana
authors.initials: L
authors.lastname: Sasso
authors.affiliation: University of Genoa, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Delogu
authors.affiliation: Local Health Agency, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Carrozzino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Aleo
authors.affiliation: University of Genoa, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Bagnasco
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004993:Ethics, Nursing; D005260:Female; D017144:Focus Groups; D006801:Humans; D007558:Italy; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D011330:Prisons / Q000941:ethics*; D036301:Qualitative Research
keywords: Ethical issues; manipulation; moral distress; prison nursing; relational interspace; relational narrative; restorative nursing