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

Multiple factors, including burnout and bullying, lead nurses to consider alternative career paths or early retirement, thereby creating a shortage of nurses. This study examined the impact of compassion fatigue, burnout, and bullying on correctional nurses. This study utilized a mixed-method approach combining quantitative correlational research and qualitative grounded theory to compare the relationships among variables, including demographics, levels of compassion fatigue, burnout, and bullying. Using SurveyMonkey, an emailed survey included the Professional Quality of Life Scale, the Negative Acts Questionnaire-Revised, and open-ended questions that allowed nurses to share their personal stories of bullying within the prison. There was a negative correlation between job satisfaction and burnout and a negative correlation between job satisfaction and bullying. Burnout and bullying were found to be positively correlated. Many participants reported bullying in the workplace, describing multiple instances of unprofessional behavior by coworkers and supervisors. The themes of hostile work environments, poor relationships with supervisors, and low job satisfaction were identified as impacting nurses' desire to remain in their positions. Further research is necessary to understand the relationships among burnout, compassion fatigue, and bullying among correctional nurses.

The global prison population has increased by 32% since 2000, driving higher demand for health care services within correctional facilities. Musculoskeletal disorders are prevalent among incarcerated people, with 52% diagnosed with chronic conditions. In-person treatments outside facility walls incur high costs and are further hindered by stigma. Telehealth services for musculoskeletal care offer a promising alternative to improve access, reduce costs, and enhance care quality. This article explores the impact and perspectives of physiotherapy-led telehealth consultations for spinal disorders in correctional facilities. A qualitative descriptive methodology was employed, using semistructured interviews with seven nurses from varying professional levels who supported telehealth consultations led by advanced practice physiotherapists. Four key themes emerged as follows: (1) on-site staff involvement in telehealth; (2) positive impacts of physiotherapy-led spinal telehealth; (3) perspectives on the telehealth approach; and (4) suggested improvements. Positive impacts included reduced anxiety and stigma, prevention of condition exacerbation, empowerment of incarcerated individuals, optimized resource allocation, and enhanced clinician care. Challenges highlighted the need for technological improvements. Physiotherapy-led telehealth improves health care quality and access to specialized services in correctional facilities, reducing health care inequalities and fostering multidisciplinary collaboration between nurses and physiotherapists.

Self-determination theory (SDT) is a behavior change framework emphasizing autonomy, competence, and relatedness. The Women's Initiative Supporting Health (WISH) intervention trains community health workers (CHWs) with lived experience of incarceration to support recently released women in accessing care for HIV, hepatitis C, and substance use. This article aims to assess CHW adherence to SDT principles within the WISH intervention and explore fidelity to motivational interviewing and trauma-responsive practices. Fifteen recorded WISH intervention sessions were transcribed and analyzed using a mixed-methods approach. Thematic coding was guided by SDT constructs and supplemented with supervisor field notes. Each session was also evaluated using the Health Care Climate Questionnaire (HCCQ) to quantify autonomy-supportive behaviors. Analysis was framed using the Health Equity Implementation Framework. CHWs demonstrated strong adherence to SDT principles, with frequent support for autonomy (56 instances), competence (54), and relatedness (39). Trauma-responsive approaches were noted in 22 cases. All HCCQ scores exceeded 7.0 on a 10-point scale (mean = 8.4), indicating good clinical practice. CHWs successfully implemented SDT-based strategies, fostering autonomy, competence, and relatedness. However, occasional directive advice highlighted opportunities to strengthen autonomy support. Ongoing training and feedback may enhance fidelity and sustainability of SDT-based interventions in community settings.

Youths on probation have difficulties accessing care. e-Connect, a clinical decision support system service linkage intervention, reduces these treatment disparities, but it is unclear whether juvenile probation officers' (JPOs') individual and organizational characteristics affect the success of e-Connect. Among JPOs using e-Connect, we explore whether attitudes, behaviors, and organizational characteristics related to youths' behavioral health (BH) treatment are associated with JPO referral practices and treatment initiation among youths. We used weighted, between-group correlations using data from 19 JPOs implementing e-Connect to evaluate self-reported attitudes related to referral and linkage behaviors gathered via survey and administrative data on the service referral and initiation of 78 youths. Female officers were more likely to engage in placement activities (i.e., behaviors aimed at helping youths initiate care), and youths on their caseload were more likely to access BH care. Conversely, officers with more authoritarian attitudes toward supervision were significantly less likely to engage in placement activities. Even within a program found to increase referral 11-fold and linkage to treatment nearly 17-fold, some JPOs fail to make referrals and connect youths to care. To enhance e-Connect's performance, agencies should target specific attitudes and behaviors around BH services referral and BH initiation.

Artificial intelligence (AI)-empowered data processing tools improve our ability to assess, measure, and enhance medical interventions. AI-based tools automate the extraction of data from histories, test results, imaging, prescriptions, and treatment outcomes, and transform them into unified, accessible records. They are powerful in converting unstructured data such as clinical notes, magnetic resonance images, and electroencephalograms into structured, actionable formats. For example, in the extraction and classification of diseases, symptoms, medications, treatments, and dates from even incomplete and fragmented clinical notes, pathology reports, images, and histological markers. Especially because the demographics within correctional facilities greatly diverge from the general population, the adoption of electronic health records and AI-enabled data processing will play a crucial role in improving disease detection, treatment management, and the overall efficiency of health care within prison systems.

In an effort to mitigate the elevated rates of sexual abuse reported by transgender adults incarcerated in state prisons, Washington State Department of Corrections has implemented policies that prioritize gender self-identification over birth-registered sex when making housing decisions. This has resulted in the transfer of males to the Washington Corrections Center for Women along with reports of negative impacts on incarcerated females. Any policy problem of unknown magnitude requires formal data collection and analysis. Washington State law, including one known as House Bill 1956, obstructs this process by preventing public access to information needed to evaluate the outcomes of incarcerated males and females of diverse gender identities. The Centers for Disease Control and Prevention has issued steps to ensure a fair and transparent policy process. To understand population-specific outcomes after a policy's implementation, health authorities recommend that demographics inclusive of sex and gender be collected, analyzed, and made available to stakeholders. Recommendations to balance the safety of vulnerable groups in Washington State detention facilities may require the expertise of a dedicated policy organization to navigate the legal and ethical challenges introduced by the law.

This article investigates health care access (i.e., health insurance coverage, usual source of care, doctor visit) among adults exiting carceral settings. Between 2022 and 2024, adults aged 18 and over (N = 202) enrolled in two health studies in San Diego, California. Surveys collected demographic and health care access data. Logistic regression models assessed factors independently associated with health care access. Overall, 27% of participants were uninsured, 66% had Medicaid insurance, and 21% lacked a usual place of care. In logistic regression models, adults released from custody within 6 months or who had high school or fewer years of education were significantly less likely to be insured. Increasing age and high school or fewer years of education, one to two chronic conditions, or a positive anxiety screener were significantly associated with having a usual source of care, whereas those recently returned to communities were less likely to have a usual source of care. Reliable transportation was significantly associated with a doctor visit in the past 6 months. Coordinated interventions are needed to bolster the social determinants of health among adults who have experienced incarceration; particularly education, employment, and transportation. Policy interventions (e.g., Medicaid expansion), expansive community outreach, and transportation supports for low-income or underemployed adults can address financial and logistical barriers to health care access.

People who are incarcerated are significantly more likely to have experienced traumatic events than others in the general population. Trauma-informed care (TIC) is an approach that recognizes and responds to the lasting effects of trauma on peoples' lives and health, going beyond individually focused, trauma-specific care and into broader change in policy and practice. Our objectives were to describe how TIC is implemented in correctional facilities, and evidence on the impacts of TIC in correctional facilities. We conducted a scoping review of academic and gray literature. Two team members screened titles and abstracts and reviewed full texts for eligibility. We included articles in English focused on TIC in any adult correctional facility and extracted relevant data. We categorized information on how TIC is implemented into structural, organizational, and individual levels, and organized evidence on the impacts of TIC into the Quintuple Aim for Health Care Improvement framework. We identified 45 relevant articles, including 14 studies that reported evidence on impacts of TIC across the Quintuple Aim components. While the correctional facility environment challenges TIC implementation, TIC interventions at the individual, structural, and organizational levels could improve health outcomes in correctional facilities.