"From the prison door right to the sidewalk, everything went downhill," A qualitative study of the health experiences of recently released inmates
"From the prison door right to the sidewalk, everything went downhill," A qualitative study of the health experiences of recently released inmates
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DOI：
10.1016/j.ijlp.2011.07.002
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发表时间：
2011-07-01
影响因子：
2.3
通讯作者：
Steiner, John F.
中科院分区：
文献类型：
--
作者：
Binswanger, Ingrid A.;Nowels, Carolyn;Steiner, John F.
在许多州，预算限制促使监狱囚犯提前获释。先前的研究表明，释放后的死亡率上升，但对前囚犯从监狱过渡到社区的健康经历知之甚少。本研究的目的是了解寻求健康的经验，风险的看法，以及医疗和心理健康需要的前囚犯在释放后的头两个月从监狱。参与者由29名前囚犯组成，他们从监狱释放到科罗拉多地区的丹佛后的头两个月内。使用定性的方法，训练有素的采访人员进行了个人，面对面，半结构化的采访，探索参与者的经验与健康，心理健康和医疗保健，因为释放。访谈记录进行编码和分析，利用团队为基础的方法进行归纳分析。我们发现，与健康相关的行为发生在复杂的生活经历的背景下，情绪困扰加剧了后勤问题。主要主题包括1）过渡性挑战; 2）认知反应，包括对个人风险，知识和优先事项的看法; 3）情绪反应，包括明显的压力，恐惧，焦虑，失望;和4）健康行为。前囚犯报告说，他们面临多重挑战，释放前的过渡准备工作很差，在严重的情绪困扰和焦虑的情况下，身心健康护理不充分或缺乏连续性。改进释放规划，协调医疗、心理健康和刑事司法系统，可以减少这一人群健康状况不佳的风险。(C)2011爱思唯尔有限公司保留所有权利。
In many states, budget constraints are prompting earlier release of prison inmates. Prior studies have demonstrated elevated mortality rates in the post-release period but little is known about the health experiences of former inmates in the transition from prison to the community. The objective of this study was to understand the health-seeking experiences, perceptions of risk, and medical and mental health needs of former prisoners in the first two months after release from prison. Participants consisted of 29 former inmates within the first two months after their release from prison to the Denver, Colorado area. Using qualitative methods, trained interviewers conducted individual, in-person, semi-structured interviews exploring participants' experiences with health, mental health, and health care since release. Interview transcripts were coded and analyzed utilizing a team-based approach to inductive analysis. We found that health-related behavior occurred in the context of a complex life experience, with logistical problems exacerbated by emotional distress. Major themes included 1) transitional challenges; 2) cognitive responses including perceptions about personal risk, knowledge and priorities; 3) emotional responses including pronounced stress, fear, anxiety, disappointment; and 4) health behaviors. Former inmates reported multiple challenges, poor transitional preparation preceding release, and inadequate or absent continuity of mental and physical health care in the context of significant emotional distress and anxiety. Improved release planning, coordination between the medical, mental health and criminal justice systems may reduce the risk of poor health outcomes for this population. (C) 2011 Elsevier Ltd. All rights reserved.