Assaults by Scalding in British Prisons.

We describe the trends and severity of deliberate scald injuries from assaults within prisons presenting to Pinderfields Hospital in the United Kingdom. Data were obtained using local records of the International Burn Injury Database. Between 2003 and 2019, the hospital's Department of Plastic Surgery and Burns treated 22 cases from at least seven prisons, with 20 cases occurring in the last 4 years. Boiling water was used in most cases. Other substances included syrups of boiling water and sugar, and hot fat. Mean total body surface area was 2.8%, most commonly the face, neck, shoulders, and anterior chest. National data identified 267 cases with a similar rising trend. These injuries increase logistical and financial burdens on our burns service due to the need for added security and police escorts during treatment. "Copycat attacks" within same prisons, sometime on the same day, raise concerns that incidence of these injuries is likely to increase. Outreach nursing and telemedicine facilities may minimize the challenges during the management period.

Impact and trend of COVID-19 in the Brazilian prison system: an ecological study. / Impacto e tendência da COVID-19 no sistema penitenciário do Brasil: um estudo ecológico.

Given the rapid spread of new coronavirus within the prison system, this study's objective was to identify spatial clusters for the occurrence of COVID-19 in the incarcerated population and analyze temporal trends of confirmed cases in the Brazilian prison system. This ecological study considered the five Brazilian macro-regions to be units of analysis, with its 26 states and the Federal District. The population was composed of all COVID-19 cases confirmed from April 14th to August 31st, 2020. The source used to collect data was the COVID-19 Monitoring Panel from the National Prison Department. Descriptive analysis, scan statistics, and time series were performed. A total of 18,767 COVID-19 cases were reported among the incarcerated population, 4,724 in São Paulo. The scan statistic analysis resulted in 14 spatial risk clusters for COVID-19 among persons deprived of liberty; the highest-risk cluster was in the Federal District. Although the country ends the series with a decreasing behavior, a growing trend was verified in most of the study period. The conclusion is that there is a need to implement mass testing among the incarcerated population while continually monitoring and recording COVID-19 cases.

Tendo em vista a rápida disseminação do novo coronavírus no sistema prisional, o presente trabalho teve como objetivos identificar aglomerados espaciais para ocorrência da COVID-19 na população privada de liberdade (PPL) e analisar a tendência temporal dos casos confirmados no sistema penitenciário do Brasil. Estudo ecológico que considerou como unidades de análise as cinco macrorregiões do Brasil, seus 26 estados e o Distrito Federal. A população foi composta por todos os casos de COVID-19 confirmados, no período de 14 de abril a 31 de agosto de 2020. A fonte de dados utilizada foi o Painel de Monitoramento dos casos de COVID-19 nos sistemas prisionais do Departamento Penitenciário Nacional. Realizou-se análise descritiva, estatística de varredura e análise da tendência temporal. Foram notificados 18.767 casos de COVID-19 na PPL, dos quais 4.724 ocorreram no estado de São Paulo. A estatística de varredura possibilitou a identificação de 14 clusters espaciais de risco para COVID-19 na PPL, sendo o aglomerado de maior risco formado pelo Distrito Federal. Embora o país finalize a série com um comportamento decrescente, observa-se que no período de investigação a tendência apresentou um comportamento maioritariamente crescente. Evidencia-se a necessidade de testagem em massa, monitoramento e registro contínuo dos casos de COVID-19 na PPL do país.

Impacto e tendência da COVID-19 no sistema penitenciário do Brasil: um estudo ecológico / Impact and trend of COVID-19 in the Brazilian prison system: an ecological study

Resumo Tendo em vista a rápida disseminação do novo coronavírus no sistema prisional, o presente trabalho teve como objetivos identificar aglomerados espaciais para ocorrência da COVID-19 na população privada de liberdade (PPL) e analisar a tendência temporal dos casos confirmados no sistema penitenciário do Brasil. Estudo ecológico que considerou como unidades de análise as cinco macrorregiões do Brasil, seus 26 estados e o Distrito Federal. A população foi composta por todos os casos de COVID-19 confirmados, no período de 14 de abril a 31 de agosto de 2020. A fonte de dados utilizada foi o Painel de Monitoramento dos casos de COVID-19 nos sistemas prisionais do Departamento Penitenciário Nacional. Realizou-se análise descritiva, estatística de varredura e análise da tendência temporal. Foram notificados 18.767 casos de COVID-19 na PPL, dos quais 4.724 ocorreram no estado de São Paulo. A estatística de varredura possibilitou a identificação de 14 clusters espaciais de risco para COVID-19 na PPL, sendo o aglomerado de maior risco formado pelo Distrito Federal. Embora o país finalize a série com um comportamento decrescente, observa-se que no período de investigação a tendência apresentou um comportamento maioritariamente crescente. Evidencia-se a necessidade de testagem em massa, monitoramento e registro contínuo dos casos de COVID-19 na PPL do país.

Abstract Given the rapid spread of new coronavirus within the prison system, this study's objective was to identify spatial clusters for the occurrence of COVID-19 in the incarcerated population and analyze temporal trends of confirmed cases in the Brazilian prison system. This ecological study considered the five Brazilian macro-regions to be units of analysis, with its 26 states and the Federal District. The population was composed of all COVID-19 cases confirmed from April 14th to August 31st, 2020. The source used to collect data was the COVID-19 Monitoring Panel from the National Prison Department. Descriptive analysis, scan statistics, and time series were performed. A total of 18,767 COVID-19 cases were reported among the incarcerated population, 4,724 in São Paulo. The scan statistic analysis resulted in 14 spatial risk clusters for COVID-19 among persons deprived of liberty; the highest-risk cluster was in the Federal District. Although the country ends the series with a decreasing behavior, a growing trend was verified in most of the study period. The conclusion is that there is a need to implement mass testing among the incarcerated population while continually monitoring and recording COVID-19 cases.

Medical services policy in respect of detainees: evolution and outstanding issues.

Alleged and confirmed abuse of civilians arrested or detained by the UK Armed Forces has been the subject of four formal enquiries, and all have used medical evidence and/or addressed medical issues. After the first three, robust policies were put in place to ensure that all those arrested had appropriate medical examinations and that healthcare personnel acted appropriately. However, by the time of the Second Gulf War, the training and medical processes had lapsed and were found to be a contributory factor in not preventing abuse. The fourth enquiry has endorsed most of the lapsed policies but is ambiguous in two areas-on medical certification of fitness for interrogation and the timing to the first medical examination. This article summarises the medical aspects of the four enquiries and discusses the two ambiguous areas, arguing that to diverge from the policies eventually put in place in Northern Ireland is a retrograde step. It also discusses how training put in place to avoid the very events which occurred in the Second Gulf was discontinued.

Initial Views and Experiences of Vaping in Prisons: A Qualitative Study With People in Custody Preparing for the Imminent Implementation of Scotland's Prison Smokefree Policy.

INTRODUCTION: Scotland is one of the few countries in which e-cigarettes were available in prisons before the introduction of a comprehensive national smokefree policy, to assist in its implementation. This qualitative study explores the initial views and experiences of vaping in this specific context, from the perspective of people in custody (prisoners). AIMS AND METHODS: Twenty-eight people in custody were interviewed approximately 1-2 months after rechargeable e-cigarettes were made available in prisons and 2-5 weeks before implementation of a smokefree policy. Data were thematically analyzed to identify the range and diversity of views and experiences. RESULTS: Participants expressed support for e-cigarettes in preparation for the smokefree policy, describing their symbolic and practical value in this context. Uptake of vaping was strongly influenced by the need for participants to manage without tobacco in the near future. Participants evaluated their initial vaping experiences, either positively or negatively, in relation to the utility of e-cigarettes for mandated smoking abstinence and in providing satisfaction, pleasure, and novelty. Participant views on several issues related to e-cigarette use, both specific to the prison population (product choice and cost) and more generally (safety and long-term use), are explored. CONCLUSIONS: Our findings suggest possible benefits of e-cigarettes as one means of supporting smokefree policy in a population with many smokers. They also point to potential challenges posed by vaping in prisons and smokefree settings caring for similar populations. There is a need for ongoing measures to maximize the health benefits of smokefree settings and for further research on vaping in situations of enforced abstinence. IMPLICATIONS: To our knowledge, no published studies have explored views and experiences of vaping in prison, when rechargeable vapes were new and the removal of tobacco was imminent. The results can inform tobacco control policy choices, planning and implementation in prisons and similar settings. In prison systems that permitting vaping, it is important that other measures (eg, information campaigns and nicotine dependence services) are implemented concurrently to minimize potential risks to the health or personal finances of people in custody.

Reframing school-based restorative justice as a structural population health intervention.

School-based restorative justice has gained national prominence as an effective approach to interrupting the school-to-prison pipeline. Remarkably, despite its simultaneous positive association with academic success, school safety, and school connectedness, most scholars and practitioners do not associate restorative justice with health. Using ecosocial theory, we conceptualize school-based restorative justice as a structural population health intervention. Our findings indicate that students attending schools using restorative justice have lower odds of missing school due to adverse health and better academic outcomes compared to students who do not. Restorative justice shows promise as a structural intervention that can contribute to improving population health.

Previously incarcerated individuals with psychotic symptoms are more likely to report a history of solitary confinement.

We examined whether previously incarcerated individuals with self-reported psychotic symptoms were more likely to endorse a history of solitary confinement. A community-based sample of 176 previously incarcerated individuals residing in Baltimore or New York City were surveyed on prison experiences and mental health symptoms. Logistic regression found that previously incarcerated individuals who endorsed a schizophrenia diagnosis or past 12-month psychotic symptoms were significantly more likely to report a history of solitary confinement while incarcerated. This finding is consistent with other research suggesting that individuals with psychotic illness are disproportionately subjected to solitary confinement while incarcerated, which has important socio-legal implications.

Special Focus: Nursing in the Correctional Milieu.

In this issue, articles that embody the complexity and diversity of nursing care in correctional environments are showcased, highlighting the contributions of nursing leaders from across Canada and the United States. The papers featured herein represent unique educational initiatives, clinical practice contexts and research perspectives. Together their contributions challenge the notions of physical and professional "hiddenness" (Goddard et al. 2019) as they unmask the strides being made in the ongoing maturation of this nursing specialty.

Nursing Leadership Implications for Clinical Placements in Corrections.

Clinical placements in correctional settings offer nursing students unique opportunities for learning mental health and community health concepts, including social justice, restorative justice and the impact of poverty and marginalization on health and life choices. Although there is some evidence to suggest that a small number of nursing programs use clinical placements in correctional settings, relatively little scholarly literature addresses nursing education in such settings, or the implications for nursing leadership when students do have an opportunity to learn in correctional settings. In this paper, we examine the literature that is available on this topic and present the findings of a secondary analysis of interviews with undergraduate nursing students at our nursing program in relation to their clinical placements in correctional settings. Drawing on the students' perspectives, we have found that these placements, in particular, have fostered learning about caring for marginalized populations; themes of hope and restorative justice featured prominently in their descriptions of their learning. Students also emphasized that they learned a great deal about the expanded role of nurses and about caring for marginalized populations. With strong administrative and faculty support, these settings offer students exposure to expert registered nurse mentors who work with clients in an expanded role to facilitate their achievement and stabilization of a broad range of health challenges. They are also role models for students, by showing students that nurses can be agents of hope when working with a diverse client population and their families. We offer recommendations on how to maximize student learning in correctional settings, including a reflection on how to support students' integration of their learning experiences in their nursing practice, with the long-term view that these transformative student experiences have the potential to shape our future nurse leaders.

Freedom-deprived women: social representations of prison, violence, and their consequences.

OBJECTIVE: To understand the social representations that women deprived of their freedom have of imprisonment, violence, and their consequences. METHOD: An exploratory-descriptive qualitative study with 15 women from a female penitentiary in the State of São Paulo, Brazil. Semistructured interview was used. Data submitted to thematic content analysis and interpreted under Social Representations. RESULTS: Categories identified: "Enclosed and abandoned in the prison environment": loss of contact with relatives, difficulties living in prison, and right to be reinserted into society. "Imprisoned in a cycle of social inequality": lack of support, access to education and employment opportunities, leading them to engage in new illicit activities and consequent imprisonment. FINAL CONSIDERATIONS: The social representations of prisoners suggest that they perceive themselves to be doubly "imprisoned", either from the objective point of view, as an individual deprived of freedom; or subjective, as citizens who have their rights disrespected and their possibilities of rehabilitation limited by the prison system.

Respuestas de salud pública para manejo de la COVID-19 en centros reclusión: revisión de literatura / Public health responses for the management of COVID-19 in detention centers: literature review

RESUMEN Objetivo Identificar en la literatura las recomendaciones para la prevención y control de la COVID-19 en prisiones y centros de detención preventiva, con el fin de caracterizar las líneas de respuesta. Materiales y Métodos Se identificaron 88 publicaciones en bases datos y repositorios digitales usando términos clave. Luego de aplicar la metodología PRISMA, se seleccionaron 18 publicaciones para realizar el análisis cualitativo. Las publicaciones elegidas refieren a recomendaciones de académicos, investigadores y expertos. Para ilustrar el enfoque de la respuesta gubernamental, se analizan seis publicaciones emitidas por autoridades gubernamentales de Canadá, Bélgica, Francia y Estados Unidos. Se excluyeron publicaciones relacionadas con centros de detención para menores o pacientes psiquiátricos. Resultados Si bien hay poca literatura, se logró caracterizar las recomendaciones disponibles, agrupándolas en seis líneas de respuesta. En su caracterización resulta primordial el establecimiento de medidas físicas, administrativas, jurídicas, higiénicas y de salubridad. Asimismo, se plantea la necesidad de garantizar el manejo epidemiológico y la adecuación de los servicios de salud en concordancia con la carga de enfermedad y las vulnerabilidades de los detenidos. Conclusiones La respuesta a la COVID-19 en centros de reclusión es compleja y desafiante. Por ende, las medidas convencionales del orden higiénico, sanitario, médico y epidemiológico no son suficientes. Estas deben ir acompañadas por un ajuste de las políticas criminal y penitenciaria, con el fin de reducir y controlar la densidad poblacional, además de la adaptación permanente de la administración de justicia en función de las medidas de contención, mitigación o supresión de la pandemia.(AU)

ABSTRACT Objective To identify in the literature the recommendations for the prevention and control of COVID-19 in prisons and other preventive detention centers, in order to characterize the response lines. Materials and Methods 88 publications were identified in databases and digital repositories using key terms. After applying the PRISMA methodology, 18 publications were selected to carry out the qualitative analysis. The chosen publications refer to recommendations from academics, researchers and experts. 6 publications issued by the Governments of Canada, Belgium, France and United States of America were analyzed to make clear the government perspectives. Publications related to underage and psychiatric patients were not considered. Results Although there isn't enough literature, it was possible to characterize the available recommendations, grouping them into 6 lines of action. Within these lines, the establishment of physical, administrative, legal, hygienic and health measures is considered essential. In addition, it is necessary to ensure the epidemiological management and adaptation of health services based on the burden of disease and susceptibility of the persons under arrest. Conclusions The response to COVID-19 in detention centers is complex and challenging. Therefore, the conventional steps like hygienic, sanitary, medical and epidemiological care aren't enough. In fact, the adjustment of criminal and penitentiary policies and the transformation of the justice system are considered essential to reduce and control the residential density.(AU)

Developing a moral compass: Themes from the Clinical Ethics Residency for Nurses' final essays.

BACKGROUND: The Clinical Ethics Residency for Nurses was offered selectively to nurses affiliated with two academic medical centers to increase confidence in ethical decision-making. RESEARCH QUESTION/AIM: To discover how effective the participants perceived the program and if their goals of participation had been met. RESEARCH DESIGN: A total of 65 end-of-course essays (from three cohorts) were analyzed using modified directed content analysis. In-depth and recursive readings of the essays by faculty were guided by six questions that had been posed to graduates. ETHICAL CONSIDERATIONS: Institutional review board approval was granted for the duration of the program and its reporting period. Confidentiality was maintained via the use of codes for all evaluations including the essays and potentially identifying content redacted. FINDINGS: An umbrella theme emerged: participants had developed ethical knowledge and skills that provided a "moral compass to navigate the many gray areas of decision-making that confront them in daily practice." Six major themes corresponding to questions posed to the participants included the ability to advocate for good patient care; to support and empower colleagues, patients, and families; they experienced personal and professional transformation; they valued the multimodal nature of the program; and were using their new knowledge and skills in practice. However, they also recognized that their development as moral agents was an ongoing process. DISCUSSION: Findings support that enhancing nurse confidence in their moral agency with a multimodal educational approach that includes mentored practice in ethical decision-making, enhancing communication skills and role-play can mitigate moral distress. A majority found the program personally and professionally transformative. However, they recognized that ongoing ethics discussion involvement and supportive environments would be important in their continued development of ethical agency. CONCLUSION: Multimodal ethics education programs have potential to be transformative and enhance nurse confidence in their ethical decision-making.

Freedom-deprived women: social representations of prison, violence, and their consequences / Mujeres privadas de libertad: representaciones sociales de la prisión, la violencia y sus consecuencias / Mulheres privadas de liberdade: representações sociais de prisão, violência e suas consequências

ABSTRACT Objective: To understand the social representations that women deprived of their freedom have of imprisonment, violence, and their consequences. Method: An exploratory-descriptive qualitative study with 15 women from a female penitentiary in the State of São Paulo, Brazil. Semistructured interview was used. Data submitted to thematic content analysis and interpreted under Social Representations. Results: Categories identified: "Enclosed and abandoned in the prison environment": loss of contact with relatives, difficulties living in prison, and right to be reinserted into society. "Imprisoned in a cycle of social inequality": lack of support, access to education and employment opportunities, leading them to engage in new illicit activities and consequent imprisonment. Final considerations: The social representations of prisoners suggest that they perceive themselves to be doubly "imprisoned", either from the objective point of view, as an individual deprived of freedom; or subjective, as citizens who have their rights disrespected and their possibilities of rehabilitation limited by the prison system.

RESUMEN Objetivo: Comprender las representaciones sociales que las mujeres privadas de su libertad tienen sobre la prisión, la violencia y sus consecuencias. Método: Estudio cualitativo exploratorio-descriptivo realizado con 15 mujeres de una cárcel femenina del Estado de São Paulo, Brasil. Se utilizó una entrevista semiestructurada. Los datos se sometieron al análisis de contenido temático y fueron interpretados a la luz de las Representaciones Sociales. Resultados: Categorías identificadas: "Enclaustradas y abandonadas en el ámbito penitenciario": pérdida de contacto con los familiares, dificultades de convivencia en la prisión y en lo que se refiere al derecho a ser reintegradas en la sociedad. "Encarceladas en un ciclo de desigualdad social": falta de apoyo, acceso a la educación y oportunidades de empleo, llevándolas a involucrarse en nuevas actividades ilícitas y por consiguiente volver a ser encarceladas. Consideraciones Finales: Las representaciones sociales de las detenidas sugieren que ellas se sienten doblemente "encarceladas", tanto desde el punto de vista objetivo, como individuo privado de su libertad, como del subjetivo, ciudadanas cuyos derechos no son respetados y sus posibilidades de rehabilitación son limitadas por el sistema penitenciario.

RESUMO Objetivo: Compreender as representações sociais que mulheres privadas de liberdade têm sobre prisão, violência e suas consequências. Método: Estudo qualitativo exploratório-descritivo realizado com 15 mulheres de uma penitenciária feminina do estado de São Paulo, Brasil. Foi utilizada entrevista semiestruturada. Dados submetidos à análise de conteúdo temática e interpretados à luz das Representações Sociais. Resultados: Categorias identificadas: "Enclausuradas e abandonadas no ambiente prisional": perda de contato com familiares, dificuldades de convívio na prisão e direito de serem reinseridas na sociedade. "Aprisionadas em um ciclo de desigualdade social": falta de apoio, acesso à educação e oportunidades de emprego, levando-as ao envolvimento em novas atividades ilícitas e consequente aprisionamento. Considerações finais: As representações sociais das detentas sugerem que elas se percebem duplamente "aprisionadas", seja do ponto de vista objetivo, como indivíduo privado de liberdade; ou subjetivo, como cidadãs que têm seus direitos desrespeitados e suas possibilidades de reabilitação limitadas pelo sistema prisional.

Evaluación del impacto de las relaciones familiares sobre la salud de las personas privadas de libertad en España / Evaluation of the impact of family relations on prisoners' health in Spain

OBJETIVOS: La literatura ha puesto de manifiesto la elevada prevalencia de consumo de alcohol y otras drogas en la población penitenciaria. A pesar de que multitud de factores de riesgo han sido vinculados a este comportamiento en prisión, no es frecuente encontrar investigaciones donde se analice la influencia del contacto sociofamiliar en los centros penitenciarios. MATERIAL Y MÉTODO: Se realizó un estudio transversal analítico sobre 2.709 personas internas (2.484 hombres y 225 mujeres) en nueve prisiones de España. La información fue recogida mediante un cuestionario autosuministrado, incluyendo datos del ámbito sociodemográfico, el contacto sociofamiliar y el consumo de alcohol y otras drogas durante el último mes en prisión. RESULTADOS: Las personas internas sin contacto familiar en prisión presentaban una mayor prevalencia de consumo para la totalidad de las sustancias analizadas, mostrando los análisis de regresión logística binaria asociaciones estadísticamente significativas con el consumo de cannabis (razón de posibilidades [odds ratio, OR]: 1,86; p ≤0,001) o cocaína (OR: 3,40; p ≤0,001) en prisión. DISCUSIÓN: Un mayor conocimiento sobre este problema de salud pública por parte de los trabajadores en el medio penitenciario podría ser una herramienta de diagnóstico y prevención eficaz para reducir el consumo de alcohol y otras drogas durante el internamiento penitenciario

OBJECTIVES: Literature on this issue has shown a high prevalence of alcohol and other drug use in the prison population. Although many risk factors have been linked to this behavior in prison, it is not common to find research that analyses the influence of family/social contact in prison. MATERIAL AND METHOD: A cross-sectional study was carried out on 2,709 inmates (2,484 men and 225 women) in 9 prisons in Spain, data was collected through self-report questionnaires, including information at socio-demographic level, family-social contact and use of alcohol and other drugs in the last month in prison. RESULTS: Inmates with no family contact in prison show a higher prevalence of use for all the substances analyzed, binary logistic regression analysis shows statistically significant associations with the use of cannabis (OR: 1.86, p ≤0.001) or cocaine (OR: 3.40, p ≤0.001) in prison. DISCUSSION: More knowledge about this public health problem amongst social workers in the prison environment could be an effective diagnostic and preventive tool for reducing the use of alcohol and other drugs during imprisonment

"Who needs secure services for personality disorder?" Results of an expert Delphi study with professional staff.

BACKGROUND: Personality Disorder (PD) is an enduring, multi-faceted mental disorder, associated with adverse health effects, difficulties with interpersonal relationships and in some cases increased risk to others. A limited number of dedicated forensic mental health services are available for serious offenders with severe personality disorder. The recent Offender Personality Disorder (OPD) strategy aims to ensure that most such offenders are treated in prison rather than secure psychiatric services, except in highly complex cases where this is not possible. While the strategy sets out very broad criteria relating to this, greater clarity is needed to support decisions about appropriate transfer and hence enhance public protection. This study explored which characteristics professional experts associate with appropriate transfer from prison to forensic mental health services for high-risk offenders with PD. METHOD: A modified Delphi survey distributed through an online survey system was conducted in two-rounds with a group of professional experts recruited from forensic mental healthcare; criminal justice and specialist commissioning. RESULTS: Fifty-one (56%) respondents completed stage one of the Delphi and 34 (61%) of these completed stage two. Consensus was reached for a total of 22 items indicating complexity, including co-morbid mental illness, high level of risk, lack of progress in prison and high motivation for treatment. A preliminary checklist for these factors was developed. Panel members consistently emphasised the importance of the individual's presenting need, the overall clinical picture and formulation in their free text responses. CONCLUSIONS: Professionals face a complex picture when making decisions regarding suitability for hospital admission for high-risk male offenders with PD, with varied opinions amongst professional experts as to priorities for intervention and a focus on individual needs through formulation. It was, nevertheless, possible to condense these views into a set of consistent variables that can be used to highlight the need for transfer into hospital-based treatment services.

Partnership Between a Health System and a Correctional Center to Normalize Birth for Incarcerated Women.

Women of childbearing age make up a growing segment of the prison population; many are pregnant while incarcerated. The care this population has received during pregnancy often has been characterized by inattention to nutritional needs, failure to provide for safe sleeping in lower bunks, and lack of childbirth education. These women may be unprepared for childbirth and the early postpartum period. To improve care for these women, staff from a health system and a correctional center collaborated to develop an infrastructure that offered supportive care to incarcerated childbearing women in their community. Organizational policies and processes were aligned to promote a normal birth and early postpartum experience for incarcerated women and provide them with opportunities to bond with their newborns. Family-centered care offers incarcerated women the opportunity to be mothers rather than simply prisoners giving birth.

Design of a tailored and integrated violence prevention program in psychiatric wards and prisons.

BACKGROUND: Violence and threats of violence against personnel at psychiatric wards as well as in the prison service is a major work environment problem. To date results from interventions to prevent violence and threats in these sectors have been inconclusive or of small effect. One of the reasons may be that violence and threats of violence occur as a consequence of a complex interaction between employee-level and management-level factors. OBJECTIVE: To design a tailored and theory-based intervention program directed at violence prevention in psychiatric wards and prisons that integrates the employee-level and management-level, and development of an evaluation design building on the Context, Process, and Outcome Evaluation Model. METHODS: The study follows a stepped-wedged design with 16 work units entering the intervention in four groups with differing start dates from September 2017 to January 2019. The context and process evaluation includes: calculating the implementation degree; mapping of contextual factors; interviews with unit-leaders and employees before and after the intervention. The outcome evaluation includes performing multi-level statistical analysis on data from a three-monthly questionnaire to employees at the participating workplaces. RESULTS: The first results will be available in 2020. CONCLUSIONS: The comprehensive evaluation of the intervention will give insight into the processes and effects of the intervention.