Kristin G. Cloyes

Time to Prison Return for Offenders With Serious Mental Illness Released From Prison A Survival Analysis

Serious mental illness (SMI) represents a major risk for repeated incarceration, yet recidivism studies often do not specifically focus on persons with SMI as compared to non-SMI offenders. The study reported here systematically identified Utah State prisoners released from 1998 to 2002 (N = 9,245) who meet criteria for SMI and compared SMI and non-SMI offenders on length of time to prison return. Findings indicate that 23% of the sample met criteria for SMI (n = 2,112). Moreover, survival analyses demonstrated a significant difference in return rates and community tenure for offenders with SMI compared to non-SMI offenders when controlling for demographics, condition of release, offense type, and condition of return (parole violation vs. new commitment). The median time for all SMI offenders to return to prison was 385 days versus 743 days for all non-SMI offenders, 358 days sooner (p < .001). Implications of these findings are discussed.

Philosophical approaches to the nursing informatics data-information-knowledge-wisdom framework.

Although informatics is an important area of nursing inquiry and practice, few scholars have articulated the philosophical foundations of the field or how these translate into practice including the often-cited data, information, knowledge, and wisdom (DIKW) framework. Data, information, and knowledge, often approached through postpositivism, can be exhibited in computer systems. Wisdom aligns with constructivist epistemological perspectives such as Gadamerian hermeneutics. Computer systems can support wisdom development. Wisdom is an important element of the DIKW framework and adds value to the role of nursing informaticists and nursing science.

Assessment of Psychosocial Impairment in a Supermaximum Security Unit Sample

This article concerns a study of Washington State supermaximum security unit (SMU) residents conducted to generate systematic, empirical data for this population and to investigate behavioral, institutional, and policy issues that affect their treatment. The Brief Psychiatric Rating Scale (BPRS) is used to standardize interview-based assessments of participants’ psychosocial functioning, in conjunction with other operational, situation-specific measures. Results indicate that the BPRS is a reliable and effective measure of psychosocial impairment in SMU residents. Comparison of factor-based BPRS scores in this sample with scores and factor analysis solutions achieved in other populations points to considerations specific to this population that require further study. Finally, assessment of SMU residents using the BPRS and convergent measures of impairment indicates that a significant number demonstrate psychosocial impairment and/or meet criteria for serious mental illness.

To be Truly Alive Motivation Among Prison Inmate Hospice Volunteers and the Transformative Process of End-of-Life Peer Care Service

Some US prisons are meeting the growing need for end-of-life care through inmate volunteer programs, yet knowledge of the motivations of inmate caregivers is underdeveloped. This study explored the motivations of inmate hospice volunteers from across Louisiana State (n = 75) through an open-ended survey, a grounded theory approach to analysis, and comparison of responses by experience level and gender. Participants expressed complex motivations; Inter-related themes on personal growth, social responsibility and ethical service to vulnerable peers suggested that inmate caregivers experience an underlying process of personal and social transformation, from hospice as a source of positive self-identity to peer-caregiving as a foundation for community. Better understanding of inmate caregiver motivations and processes will help prisons devise effective and sustainable end of life peer-care programs.

Women, serious mental illness and recidivism: A gender-based analysis of recidivism risk for women with SMI released from prison

&NA; Two groups now constitute the fastest growing segment of the U.S. prison population: women and persons with mental illness. Few large‐scale studies have explored associations among serious mental illness (SMI), gender, and recidivism, or compared factors such as illness severity and clinical history as these construct notably different situations for incarcerated women and men. We report on our recent study comparing prison recidivism rates, severity of mental illness, and clinical history for women and men released from Utah State Prison 1998–2002. Implications: While women generally have better recidivism outcomes than men, we find that SMI related factors have a greater negative effect on the trajectories of women in this sample as compared with the men. This suggests that programs and policies focused on the SMI‐specific risks and needs of women could significantly reduce prison recidivism and increase community tenure for this group, with far‐reaching effects for families and communities.

The grief experience of prison inmate hospice volunteer caregivers.

Correctional institutions are obligated to provide end-of-life care to a population with complex medical needs. Prison hospices are increasingly being formed to address this demand. Few empirical studies have examined the impact of caring for dying inmates on the hospice inmate volunteers, who, in several prison health care systems, provide direct care. In this study, experiences of the inmate hospice volunteers with death were investigated to illuminate their grief processes. Understanding the bereavement needs of hospice volunteers and how prison hospice volunteers navigate grief and remain committed to providing excellent hospice care can inform the grief processes and practices of hospice care professionals.

Characteristics of Prison Hospice Patients Medical History, Hospice Care, and End-of-Life Symptom Prevalence

Increasing numbers of prisoners in the United States are dying from age-related and chronic illnesses while incarcerated. This study is among the first to document characteristics of a population of prison hospice patients. Retrospective review of medical records for all patients admitted to the Louisiana State Penitentiary prison hospice program between January 1, 2004, and May 31, 2012 (N = 79) examined demographics, medical history, hospice diagnosis, length of stay, and end-of-life symptom prevalence on admission and during final 72 hours before death. Resulting data were contrasted with community-based end-of-life care study data, demonstrating a unique clinical profile of this group. As prisons consider adopting programs to meet the growing need for inmate end-of-life care, more research concerning the particular characteristics and unique needs of prison hospice patients will inform these efforts.

An ethic of analysis: an argument for critical analysis of research interviews as an ethical practice.

Nursing literature is replete with discussions about the ethics of research interviews. These largely involve questions of method, and how careful study design and data collection technique can render studies more ethical. Analysis, the perennial black box of the research process, is rarely discussed as an ethical practice. In this paper, I introduce the idea that analysis itself is an ethical practice. Specifically, I argue that political discourse analysis of research interviews is an ethical practice. I use examples from my own research in a prison control unit to illustrate what this might look like, and what is at stake.

Essential Elements of an Effective Prison Hospice Program

As the number of prison inmates facing end-stage chronic illness grows, more prisons across the U.S. must address the need for end-of-life care. Many will likely need to develop a plan with potentially limited resources and external support. This case study presents one long-running model of care, the Louisiana State Penitentiary Prison Hospice Program. Based on field observations and in-depth interviews with hospice staff, inmate volunteers and corrections officers, we identify five essential elements that have contributed to the long-term operation of this program: patient-centered care, an inmate volunteer model, safety and security, shared values, and teamwork. We describe key characteristics of each of these elements, discuss how they align with earlier recommendations and research, and show how their integration supports a sustained model of prison end-of-life care.

Social support needs: discordance between home hospice nurses and former family caregivers.

OBJECTIVE The two goals of our study were to (1) identify which of five types of social support (Informational, Esteem, Emotional, Tangible, Belonging) are most cited by hospice nurses and family caregivers and (2) determine the match in perception of support needs. METHOD As part of a larger multiphase project, focus groups were conducted with former family caregivers and hospice nurses to discuss their experiences of home hospice care and to gather their opinions on the important issues involved in that care. Transcripts of focus group discussions were coded for support type (Informational, Esteem, Emotional, Tangible, Belonging) based on definitions from the literature. Nurse and caregiver data were compared to assess for potential match. RESULTS Analysis of coded data suggested that nurses see different types of support to be needed in equal measure across their caseloads, while caregivers expressed priorities for some types of support. Illustrative examples of each type of support are provided and discussed. SIGNIFICANCE OF RESULTS Because matching support provided with the type of support desired has been linked to improved physical and psychological outcomes, it is important to focus on this match in healthcare populations particularly vulnerable to psychological stress, including family caregivers of home hospice patients. This research has implications for interventions to match support provision to caregiver needs, or for education for home hospice providers to ensure that they are not only sensitive to the possibility of a broad range of needs but also to the necessity to tailor care to those needs.