Journal of correctional health care : the official journal of the National Commission on Correctional Health Care最新文献

Unaddressed grief and trauma may precipitate and maintain problematic substance use, criminal behavior, and resultant incarceration. We detail the implementation and evaluation of an evidence-based grief support group model conducted in seven groups in the two substance-use disorder treatment programs within a state correctional facility. The three aims of this project were to (1) train Department of Corrections mental health clinicians in the grief support group model, (2) conduct seven grief support groups facilitated by trained clinical social workers in two substance-use disorder treatment programs within the prison, and (3) evaluate impact of the grief support group model on participant grief. This is a pragmatic intervention feasibility evaluation of 69 incarcerated people in seven grief support groups facilitated by prison mental health clinicians trained in the grief support group model. The investigation resulted in high satisfaction and self-efficacy among clinician trainees, research feasibility being established, the intervention being found acceptable and practical, and client participants reporting clinically significant reductions in grief severity and grief improvement. The grief support group model holds promise as a complementary modality within a well-designed therapeutic program at the proper time for clients with severe grief.

Incarcerated individuals face many health care challenges, including limited sanitation, limitations of formularies, and difficulty obtaining routine medical care. This study characterizes skin conditions in incarcerated individuals in the Harris Health System in Houston, Texas. We performed a retrospective health record review on incarcerated inpatients and outpatients between 2011 and 2022, collecting data on diagnostic workups, diagnoses, and interventions. Skin and soft tissue infections and drug reactions (42.9%) were the most common inpatient conditions, compared with papulosquamous and eczematous diseases (34.8%) and neoplasms (31.5%) in outpatients. Many patients demonstrated challenges in management directly related to their incarceration. Overall, the distribution of skin conditions in the incarcerated population shares similarities with that of the general population. Dermatologists should overcome resource limitations, educate patients and jails, and promote improved jail protocols for this vulnerable population.

Many chronic medical conditions that can result from poor nutrition are more prevalent in the incarcerated population than in the general population. With the increasing prevalence of chronic medical conditions and limited knowledge on foods accessible to the population, this study assessed the 4-week menu fed to all incarcerated males at state-run facilities in Alabama. Compared with the Acceptable Macronutrient Distribution Range for the average incarcerated male, the percentage of energy from total fat, saturated fat, sodium, and cholesterol exceeded the recommendation. In contrast, the menu failed to provide the recommended fiber intakes and most vitamins and minerals met less than two thirds of recommendations. Small revisions in the menu could minimize the risk of developing chronic medical conditions and increase quality of life.

There is no standardized curriculum that teaches medical residents to navigate the ethical and logistical complexities of bedside care delivery to patients who are incarcerated. In this article, we describe resident physician bedside experiences at a community teaching hospital caring for patients who are incarcerated. From 2022 to 2023, residents in emergency medicine, general surgery, internal medicine, and obstetrics and gynecology were offered an anonymous survey, self-administered via REDCap software, to explore their experiences caring for this patient population. Of 168 resident physicians, 78 (46.4%) completed the survey. The majority were cisgender women (62.3%), 20 to 30 years old (78.2%), and White (70.5%). Of these residents, 98.7% had cared for a patient who was incarcerated or in custody, yet only 15.4% reported receiving formal education regarding caring for this patient population, and only 24.4% were aware of relevant institutional policies. Qualitative analysis revealed themes including barriers to care, permission and authorization, conditional treatment, inconsistency, and conflict. Resident curricula that target knowledge gaps related to procedure and policy and address ethical concerns at the bedside may improve the clinical learning environment and lead to more consistent, equitable care delivery for patients who are incarcerated.

This integrative review examines the use of appreciative inquiry in correctional health care settings, following the guidelines of Whittemore and Knafl. Using the Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool, it assessed the level and quality of the evidence. Search terms included appreciative inquiry AND healthcare, appreciative inquiry AND nursing practice, and appreciative inquiry AND criminal justice. Nine of the 92 articles reviewed used steps of the appreciative inquiry process and were selected for the final review and analysis. Most study authors recommended organizational change. In carceral settings, appreciative inquiry was used to reduce bias, increase empowerment, and improve workplace relationships. Wider dissemination of the usefulness of this process is needed to address workforce shortages.

In hospitals across the country, most patients admitted from jails or prisons receive their care in custodial restraints regardless of clinical concerns or public safety risk. Blanket restraint protocols are deemed necessary for public safety; however, the indiscriminate use of custodial restraints causes harm to patients physically, mentally, and through propagation of prejudice. Hospitals and correctional officials must create policies that allow for a case-by-case analysis of patients to develop an individualized custodial restraint plan that will balance public safety and patient care needs. In this Viewpoint, we recommend a collaborative stakeholder approach to address this needed public policy evolution. Now is the time for health care professionals, correctional and hospital administrators, those with lived incarceration experience, and community members to work together to create policies on custodial restraints that support patient healing and reduce physical harm, emotional distress, and prejudice while optimizing staff and public safety.

Limited data exist on cancer screening in carceral facilities. This study evaluates the feasibility and outcomes of a population-based lung cancer screening initiative in a carceral setting. This is a retrospective review of a lung cancer screening event at the Rhode Island Department of Corrections. Sentenced individuals meeting U.S. Preventive Services Task Force age criteria for lung cancer screening were mailed a letter asking about their smoking history. Low-dose computed tomography (LDCT) scans were offered to individuals who responded and met the criteria. Retrospective analyses examined patients' LDCT scoring using the American College of Radiology's Lung CT Screening Reporting and Data System (Lung-RADS v1.1). Among more than 2,000 incarcerated individuals, 282 met the age criteria and 117 (41.5%) replied with interest in screening, of whom 57 (48.7%) verified as eligible. All 57 (100%) received LDCT. Most scans (94.4%) were categorized as Lung-RADS 1 or 2, indicating negative or benign findings. Comparisons with general population estimates showed no significant differences in Lung-RADS scores. The screening identified 21 incidental findings, including aortic aneurysms and severe coronary artery calcification. The implementation of lung cancer screening in a carceral setting was shown to be feasible and accepted by the incarcerated population.

Individuals who work in medication-assisted treatment (MAT) programs that serve justice-involved populations face challenging conditions that can cause elevated levels of stress. Although some studies focus on stress faced by MAT professionals, few examine their coping mechanisms. This study applies the Mayo Clinic's "4A's" of stress management-accept, adapt, avoid, and alter-to better understand ways medical staff working in MAT programs manage stress. The research team used NVivo software to analyze original qualitative data from 83 MAT employees servicing justice-involved populations. The 4A's framework successfully applies to the MAT employee context. Specifically, respondents relied on the stress management techniques accept and adapt more often than avoid and alter. Descriptive demographic trends were found in the data, including Black females most often reporting they accept and adapt to stress at work. In contrast, White females chose acceptance over other management tactics, although they also reported avoidance more than other groups. MAT organizations should empower employees to amend stressors to improve personal and professional outcomes. Future studies should use qualitative and quantitative methods to examine stress in industries with compounding stressors, such as MAT professionals working in justice settings.