Palliative and end of life care in prisons: a mixed-methods rapid review of the literature from 2014–2018

Abstract

ObjectivesTo explore current practice in relation to palliative and end of life care in prisons, and to make recommendations for its future provision.DesignA rapid literature review of studies using qualitative, quantitative and mixed-methods, with a narrative synthesis of results.Data sourcesSix databases searched between January 2014 to December 2018: ASSIA, CINAHL, Embase, MEDLINE, National Criminal Justice Reference Service Abstracts and Scopus.Eligibility criteriaPrimary research articles reporting qualitative or quantitative findings about palliative and end of life care in prisons, published in peer-reviewed, English language journals between January 2014 to December 2018.ParticipantsPrisoners, prisoners’ families, prison healthcare staff and other prison staff.Data extraction/synthesisData extracted included: citation, design, aim, setting, sample/population, methods and key findings. Data were analysed thematically then subject to a narrative synthesis in order to answer the research questions.Quality appraisalTwo researchers independently appraised articles using the Qualsyst tool, by Kmet et al (2004). Aggregate summary quality scores are included with findings. Articles were not excluded based on quality appraisal.Results23 articles were included (16 qualitative, 6 quantitative, 1 mixed methods). Top three findings (by prevalence) were: fostering relationships with people both inside and outside of prison is important to prisoners with palliative and end of life care needs, inmate hospice volunteers are able to build and maintain close relationships with the prisoners they care for and the conflicting priorities of care and custody can have a negative impact on the delivery of palliative and end of life care in prisons.ConclusionsThe key findings are: relationships are important to prisoners at the end of life, inmate hospice volunteers can build close bonds with the prisoners in their care and the prison environment and regime conflicts with best practices in palliative and end of life care. Directions for future research are also identified.PROSPERO registration numberPROSPERO ID: CRD42019118737. Registered January 2019.

Caring, sharing, preparing and declaring: how do hospices support prisons to provide palliative and end of life care? A qualitative descriptive study using telephone interviews

“…It is not possible to conclude from this study whether the support provided by hospices is adequate to meet the needs of those who may die in Scotland’s prisons; further research will be required to evaluate this. However, hospice support for prisons in Scotland is at an early stage in its development, and ageing and dying while incarcerated is still a common fear for many people in prison, 11 partly due to worries about the perceived inadequacy of palliative care provision. 34 Unmet healthcare needs are a common feature for those who are in prison, both during and at the end of life.…”

“…Approaches to delivering palliative care in prisons vary between countries, and include (but are not limited to) dedicated hospices within the prison walls, and support from specialist palliative care providers outside the prison. Much of the literature on palliative care in prisons comes from the USA, 1 , 11 where prison-based hospices are comparatively common. 10 In contrast, a recent international mapping exercise by the European Association of Palliative Care (EAPC) indicated that there were no prison hospices in Australia, Belgium, Czech Republic, France, Portugal or Slovakia.…”

“…It also aimed to establish the roles played by community hospices in supporting prisons to provide palliative care, and to identify knowledge of and barriers and facilitators to palliative and end of life care in prison staff. The first step in this project – a rapid review of recent literature 11 – has already been published, and this article will outline the findings of a qualitative study which focussed on the role of community hospices in supporting prisons to provide palliative care.…”

A thematic analysis of Prison and Probation Ombudsman fatal incident reports involving prisoners on palliative/end-of-life care pathways in the long-term high security estate in England and Wales

“…A qualitative methodology is used in this study, comprising a short literature review building upon the existing literature described in McParland and Johnston (2019) and through analysis of PPO reports. The data collection and analysis is comprised of five stages: -…”

“…In their mixed-methods, rapid review of the literature, McParland and Johnston (2019) seek to explore the current practices of palliative and end of life care in prisons and make recommendations for improvement in prisoner care. The review engages with the prisoner voice, their families, prison officers and prison healthcare staff as the basis for generating insights into;…”