苏格兰四所监狱的痴呆症诊断前和诊断后护理。

IF 3 Q1 CRIMINOLOGY & PENOLOGY Health and Justice Pub Date : 2024-11-06 DOI:10.1186/s40352-024-00294-5
Rhoda MacRae, Natalie Chalmers, Debbie Tolson, James Taylor, Kirstin Anderson, Lindsay Thomson, Tom Russ
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引用次数: 0

摘要

背景和目的:全球监狱中的老年人数量正在增加。许多老年人身心健康状况不佳,头部受伤、认知障碍和痴呆症的发病率高于社区人群。满足这一弱势群体的复杂需求已成为监狱和监狱医疗服务部门日益关注的问题。这项多方法定性研究旨在调查苏格兰监狱是如何识别、评估和护理已确诊或疑似患有痴呆症的男性的。研究还探讨了四所监狱中被评估或诊断为痴呆症患者的生活经历。对来自 29 个访谈的数据进行了主题分析,并利用这些数据共同提出了监狱中痴呆症护理的原则,以及共同设计的护理路径:在收集数据时,几乎所有被诊断出患有痴呆症或疑似患有痴呆症的人都有复杂的健康和社会护理需求,其中一些人患有晚期痴呆症。监狱医护人员称,他们对诊断前后的护理采取 "因人而异 "的方法。由于没有负责老年人或痴呆症患者护理的组织领导,也没有指导工作人员的路径或模式,因此满足这些囚犯的需求变得更加复杂。监狱医疗团队往往难以获得专业社区服务来支持诊断。工作人员缺乏痴呆症教育,也不了解如何在这种环境下提供诊断前和诊断后的痴呆症护理。这项研究的结果为共同制定两项重要的循证创新提供了依据,即护理模式和诊断前后护理路径:这项研究为了解当前监狱环境中满足痴呆症相关需求的方法是否充分提供了重要见解。据我们所知,本文首次提出了共同制作的、以证据为依据的痴呆症诊断前后护理路径和护理模式,供监狱使用。这些都可以作为改革的工具,使监狱医护人员能够在正确的时间、由正确的人提供正确的护理,并为评估风险和规划未来护理提供机会。
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Pre and post diagnostic dementia care in four Scottish prisons.

Background and purpose: The number of older people in prisons is increasing across the globe. Many have poor physical and mental health, higher prevalence of head injury, cognitive impairment and dementia than found in community populations. Meeting the complex needs of this vulnerable group has become an increasing concern for prison and prison healthcare services. The aim of this multi method qualitative study was to investigate how men with diagnosed or suspected dementia were identified, assessed, and cared for in Scottish prisons. It also explored the lived experience of individuals being assessed for or diagnosed with dementia within four prisons. The data from twenty nine interviews was thematically analysed and used to collaboratively propose principles for dementia care in prison and present the resultant co-designed care pathway.

Results: At the time of data collection almost all the men known to have a dementia diagnosis or suspected dementia had complex health and social care needs, and some were living with advanced dementia. Prison healthcare staff reported taking a 'case by case' approach to their pre- and post-diagnostic care. Meeting these prisoner's needs was complicated by the absence of organisational leads for care of older adults or people with dementia and there was no pathway or model in place to guide staff. Prison healthcare teams often had difficulty accessing specialist community services to support diagnosis. There was a lack of dementia education and knowledge about how to provide pre and post diagnostic dementia care in this setting amongst staff. The findings arising from this research have informed the co-production of two important evidence informed innovations namely a Model of Care and a pre- and post-diagnostic Care Pathway.

Conclusion: This research adds insights critical to understanding the adequacy of current approaches to meeting dementia related needs within the prison setting. To our knowledge this paper offers the first co-produced evidence informed pre- and post- diagnostic dementia care pathway and model of care for use in prisons. These could serve as tools for change that could enable prison healthcare staff to deliver the right care, at the right time, by the right people, and provide an opportunity to assess risk and plan care for the future.

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来源期刊
Health and Justice
Health and Justice Social Sciences-Law
CiteScore
4.10
自引率
8.60%
发文量
34
审稿时长
13 weeks
期刊介绍: Health & Justice is open to submissions from public health, criminology and criminal justice, medical science, psychology and clinical sciences, sociology, neuroscience, biology, anthropology and the social sciences, and covers a broad array of research types. It publishes original research, research notes (promising issues that are smaller in scope), commentaries, and translational notes (possible ways of introducing innovations in the justice system). Health & Justice aims to: Present original experimental research on the area of health and well-being of people involved in the adult or juvenile justice system, including people who work in the system; Present meta-analysis or systematic reviews in the area of health and justice for those involved in the justice system; Provide an arena to present new and upcoming scientific issues; Present translational science—the movement of scientific findings into practice including programs, procedures, or strategies; Present implementation science findings to advance the uptake and use of evidence-based practices; and, Present protocols and clinical practice guidelines. As an open access journal, Health & Justice aims for a broad reach, including researchers across many disciplines as well as justice practitioners (e.g. judges, prosecutors, defenders, probation officers, treatment providers, mental health and medical personnel working with justice-involved individuals, etc.). The sections of the journal devoted to translational and implementation sciences are primarily geared to practitioners and justice actors with special attention to the techniques used.
期刊最新文献
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