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Summary
This article, the fourth in a five-part series, explores the management of long-term conditions in the prison population, as well as patient-centred approaches to care and the challenges this may present. It discusses the effective management of chronic diseases and the importance of evidence-based practice in improving offender health care. The need for an understanding of the sociological and psychological perspectives of living with a long-term condition is explained.
Keywords
Behavioural change, care management, case management, long-term conditions, prison health, self-care
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MORE THAN 1 7.5 MILLION PEOPLE in the UK have a long-term condition, which for some will cause great distress and discomfort (Department of Health (DH) 2005a). Reports suggest that people are living longer, but with poorer health (Denny and Earle 2009). The long-term conditions agenda aims to address many of the problems, with an emphasis on moving away from a reactive use of secondary care through acute admissions to a proactive policy that supports and empowers patients in a community setting (DH 2005a).
Individuals in the prison setting tend to have poorer health than the general population as behaviours such as smoking, drinking and the misuse of substances are common (Royal College of Nursing (RCN) 2009). Health promotion is a key role for any nurse working in the criminal justice system. Equivalence in health care for offenders, providing access to services and treatments as for the general population, remains a major aim in offender health care. Guidance through national service frameworks is as relevant to offender health as to the wider community (RCN 2009).
Research by Condon et al (2007) found that the health needs of prisoners are much greater than those of the wider community and that health needs, health promotion and chronic disease management place a high demand on services.
The complexity of health needs and the higher incidence of chronic disease in the prison population are key factors in offender health care. Support is...