Oral Presentation Palliative Care Nurses Australia Conference 2022

Perceptions of people in prison about the provision of person-centred palliative care: a systematic review and meta-synthesis (#43)

Isabelle Schaefer 1 , Michelle DiGiacomo 1 , Nicole Heneka 2 , Stacey Panozzo 3 4 , Tim Luckett 1 , Jane L Phillips 1 5
  1. IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
  2. Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
  3. St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
  4. University of Melbourne, Melbourne, VIC, Australia
  5. School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia

Introduction

People in prison experience poorer health outcomes, and a growing number are requiring palliative care while incarcerated. The need for more palliative care services in prisons globally is increasing as the prison population increases and ages. The perceptions and attitudes of people in prison about palliative care are poorly understood.

Aims

To identify and synthesise the perceptions and experiences of people in prison about palliative care and dying in prison, and difficulties and enablers of person-centred palliative care in prison.

Methods

A systematic review and meta-synthesis was conducted according to the PRISMA and ENTREQ reporting guidelines, searching articles from Pubmed, Medline, ProQuest Central, Web of Science, CINCH, and CINAHL. Keywords and MeSH terms related to palliative care and dying, and prison were used. Articles were limited to those containing qualitative data describing perceptions and experiences of people in prison about palliative care while incarcerated from high income countries and published in English. Data were extracted and analysed using Thomas and Harden’s approach to meta-synthesis.

Findings

A total of 2193 articles were retrieved, of which 12 met the inclusion criteria. Two broader analytical emerged during analysis: the expectations versus experiences of people in prison regarding palliative care, and the added complexity of accessing and providing palliative care in the prison context.

Discussion/Implications for practice

People in prison expected to receive equitable, empathetic and safe palliative care when facing an expected death. However, many reported that the significant barriers to palliative care they observed or experienced caused them to feel isolated and abandoned during advanced or terminal illness.

Conclusion

More people in prison are requiring palliative care each year. It is evident that structural and organisational barriers are limiting access to palliative care while in prison, and that people in prison feel they do not receive equitable care to people in the community. Further research should be done to consolidate existing evidence regarding barriers to care provision, and purpose-designed solutions to increase quality of palliative care during incarceration.

Funding acknowledgement

This work was supported by the Australian Federal Government Department of Health National Palliative Care Projects initiative [grant number 4-E1QGPSQ].