Populations at Risk Across the Lifespan: Population Studies
Administrators' Perspectives on Changing Practice in End-of-Life Care in a State Prison System
Article first published online: 5 AUG 2013
© 2013 Wiley Periodicals, Inc.
Public Health Nursing
Volume 31, Issue 2, pages 99–108, March/April 2014
How to Cite
Penrod, J., Loeb, S. J. and Smith, C. A. (2014), Administrators' Perspectives on Changing Practice in End-of-Life Care in a State Prison System. Public Health Nursing, 31: 99–108. doi: 10.1111/phn.12069
- Issue published online: 3 MAR 2014
- Article first published online: 5 AUG 2013
- National Institutes of Health/National Institute for Nursing Research. Grant Number: 1R01NR011874
- health care systems;
- palliative care;
Sentencing trends have created a demographic shift in prison populations. Greater numbers of inmates are aging and dying in prison, creating a demand for enhanced end-of-life (EOL) care. Changing practice to meet escalating care demands in correction settings is complicated by economic constraints, attitudinal barriers, and organizational features. This study explored perspectives of EOL care held by administrators in a state prison system to reveal challenges to changing practice to meet the needs of inmates suffering advanced illness and dying in prison.
Design and Sample
Qualitative interviews were conducted with 12 administrators from the central office of a state department of corrections.
Semi-structured discussion guide.
Key influences impacting EOL care services included: local prison culture, treatment versus security focus, case-by-case consideration, public sentiment, budget neutral approaches, and conflicting views of service targets.
These findings revealed the organizational structures, attitudes, and beliefs held by the administrative echelon of a state prison system and were used to guide the derivation of discrete approaches to changing practice in this complex system. Contextual evaluation permitted a much deeper understanding of the influences on changing practice in this hierarchical bureaucracy. This type of preliminary evaluation is crucial to infusing new practice initiatives in complex organizations caring for stigmatized, at-risk populations.