Biomedical subjects
Publications and source records attributed to Tony Hostick.
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The prison population is increasing and the health problems of prisoners are considerable. Prison is designed with punishment, correction and rehabilitation to the community in mind and these goals may conflict with the aims of health care. A literature review showed that the main issues in prison health care are mental health, substance abuse and communicable diseases. Women prisoners and older prisoners have needs which are distinct from other prisoners. Health promotion and the health of the community outside prisons are desirable aims of prison health care. The delivery of effective health care to prisoners is dependent upon partnership between health and prison services and telemedicine is one possible mode of delivery.
BACKGROUND: Quality issues are being given renewed emphasis through clinical governance and a drive to ensure service users' views underpin health service development. AIMS: To establish service users' reasons for discontinuation of community based mental health appointments in one National Health Service Trust. METHOD: A two-phase survey of all non-completers over a year. Phase one using a structured postal questionnaire. Phase two using structured interviews with respondents to phase one by post, telephone and face to face. RESULTS: A total of 243 discharges because of non-completion were identified by local services over the 12 months of the study and followed up by initial questionnaire. This represents 8.19% of all discharges (2967) within the same period. Forty-four users were engaged and followed up within phase two of the survey. Data were subject to both quantitative and qualitative analysis. CONCLUSIONS: Analysis of responses suggests that the main reasons for non-completion are because of dissatisfaction although the reasons are varied and the interplay between variables is complex. Whilst this user group are not apparently suffering from 'severe mental illness', there is clear, expressed need for a service. RELEVANCE TO CLINICAL PRACTICE: Whoever provides such a service should be responsive to expressed need and a non-medical approach seems to be favoured. If these needs are appropriately met then users are more likely to be engaged and satisfaction is likely to be improved. Although this in itself does not necessarily mean improved clinical outcomes, users are more likely to stay in touch until an agreed discharge. Practical problems of applied health service research are discussed and recommendations are made for a review of referral systems, service delivery and organization with suggestions for further research.
The study identified barriers to research implementation experienced by nurses, midwives and health visitors in five trusts and one health authority in Yorkshire, UK. Funk et al. (Appl. Nurs. Res. 4(1) (1991a) 39, Appl. Nurs. Res. 4(2) (1999b) 90) developed the BARRIERS to research utilisation questionnaire over 10 years ago, but no replication, in size (n = 1989) and extent, of that study appeared to have occurred. The staff population (n = 4501) were sent the BARRIERS questionnaire. 44.6% (n = 2009) were returned. Findings suggested nurses need time to read and apply research; authority to change practice; critical appraisal skills, an understanding of statistics and support of managers and peers (particularly doctors) to achieve successful practice change.