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High and variable use of primary care in prison. A qualitative study to understand help-seeking behaviour.

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Feron, Jean-Marc [UCL] Nguyen Tan, Lac Hong [UCL] Pestiaux, Dominique [UCL] Lorant, Vincent [UCL]

BACKGROUND: High and variable rates of attendance at GP consultations in prisons are observed. The aim of the study is to have a clearer understanding of social factors influencing inmates' help-seeking behaviour and demand for primary health care. METHODS: A qualitative study was carried out in five Belgian prisons (three Dutch-speaking and two French-speaking). Twenty-five male inmates were interviewed face-to-face and 18 caregivers (7 nurses and 11 GPs) in focus groups. RESULTS: Five main social factors explain inmates' help-seeking behaviour and demand for primary health care: (1) inmates' negative perception of imprisonment increases help-seeking behaviour; (2) inmates use their rights to health care as strategies to maintain some form of control over their lives; (3) the doctor's role distorts expression of need and demand; (4) health professionals' control over inmates' lives creates mistrust and a controlling therapeutic relationship; and (5) lack of alternatives to health care. These factors are mutually dependent and cause a confrontation in the inmates' and clinicians' agendas. CONCLUSION: The most important recommendation is to understand what the inmates are really seeking in their demands. This information can be used to develop appropriate alternatives in terms of human support and well-being facilities. The therapeutic and security roles of health care workers should be separated, in order to increase the trust that is central to the therapeutic relationship between them and inmates.

Document type Article de périodique (Journal article) – Journal Article
Access type Accès restreint
Publication date 2008
Journal information "International journal of prisoner health" - Vol. 4, no. 3, p. 146-55 (2008)
Peer reviewed yes
issn 1744-9200
e-issn 1744-9219
Publication status Publié
Affiliations UCL - MD/ESP - Ecole de santé publique
UCL - MD/RMED/CAMG - Centre académique de médecine générale
MESH Subject Adult ; Attitude to Health ; Belgium ; Health Services Accessibility - statistics & numerical data ; Health Services Needs and Demand - statistics & numerical data ; Humans ; Interpersonal Relations ; Male ; Patient Participation - statistics & numerical data ; Primary Health Care - methods ; Prisoners - psychology ; Prisons ; Professional-Patient Relations ; Qualitative Research ; Questionnaires
Links
  1. Long J., Allwright S., Barry J., Reynolds S. R., Thornton L., Bradley F., Parry J. V, Bird S. M, Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in entrants to Irish prisons: a national cross sectional survey Commentary: efficient research gives direction on prisoners' and the wider public health---except in England and Wales, 10.1136/bmj.323.7323.1209
  2. Andersen Ronald M., Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?, 10.2307/2137284
  3. Birmingham L., Doctors working in prisons, 10.1136/bmj.324.7335.440
  4. BIRMINGHAM L., Prison medicine: ethics and equivalence, 10.1192/bjp.bp.105.010488
  5. Comité des Ministres, Recommandation R (98) 7 du comité des ministres aux états membres relative aux aspects éthiques et organisationnels des soins de santé en milieu pénitentiaire (1998)
  6. De Viggiani Nick, Unhealthy prisons: exploring structural determinants of prison health : Exploring structural determinants of prison health, 10.1111/j.1467-9566.2007.00474.x
  7. Fazel Seena, Danesh John, Serious mental disorder in 23 000 prisoners: a systematic review of 62 surveys, 10.1016/s0140-6736(02)07740-1
  8. Feron J M, Substantial use of primary health care by prisoners: epidemiological description and possible explanations, 10.1136/jech.2004.022269
  9. Giacomini Mita K., Cook Deborah J., for the Evidence-Based Medicine Working Group, Users' Guides to the Medical Literature : XXIII. Qualitative Research in Health Care A. Are the Results of the Study Valid?, 10.1001/jama.284.3.357
  10. Green J., Qualitative methods for health research (p. 184) (2004)
  11. Howerton A., Byng R., Campbell J., Hess D., Owens C., Aitken P., Understanding help seeking behaviour among male offenders: qualitative interview study, 10.1136/bmj.39059.594444.ae
  12. Jaeger M., La consommation des médicaments psychotropes en prison. France: ERES (1996)
  13. Malterud Kirsti, Qualitative research: standards, challenges, and guidelines, 10.1016/s0140-6736(01)05627-6
  14. Marshall T, Use of health services by prison inmates: comparisons with the community, 10.1136/jech.55.5.364
  15. Mechanic David, Correlates of Physician Utilization: Why Do Major Multivariate Studies of Physician Utilization Find Trivial Psychosocial and Organizational Effects?, 10.2307/2955413
  16. Mechanic David, Sociological dimensions of illness behavior, 10.1016/0277-9536(95)00025-3
  17. Mechanic D., Policy and Law, 23, 661 (1998)
  18. Nurse J., Influence of environmental factors on mental health within prisons: focus group study, 10.1136/bmj.327.7413.480
  19. Phillips K., Health Service Research, 33, 571 (1998)
  20. International Pty Ltd, NUD*IST QSR N6. Australia (2002)
  21. Rogers A., Demanding patients? Analysing the use of primary care (pp. 1-6) (1999)
  22. The Lancet, Prison health: a threat or an opportunity?, 10.1016/s0140-6736(05)66795-5
  23. Waitzkin H., The politics of medical encounter: how patients and doctors deal with social problems (pp. 8-9) (1991)
Bibliographic reference Feron, Jean-Marc ; Nguyen Tan, Lac Hong ; Pestiaux, Dominique ; Lorant, Vincent. High and variable use of primary care in prison. A qualitative study to understand help-seeking behaviour.. In: International journal of prisoner health, Vol. 4, no. 3, p. 146-55 (2008)
Permanent URL http://hdl.handle.net/2078.1/22224