Prisoners carry a greater burden of physical, communicable and psychiatric disease compared to the general population. Prison health care structures are complex and provide challenges and opportunities to engage a marginalised and poorly served group with health care including Hepatitis C Virus (HCV) screening, assessment and treatment. Optimising HCV management in prisons is a public health priority. Nurses are the primary healthcare providers in most prisons globally. Understanding the barriers and facilitators to prisoners engaging in HCV care from the perspectives of nurses is the first step in implementing effective strategies to eliminate HCV from prison settings. The aim of this study was to identify the barriers and facilitators to HCV screening and treatment in Irish prisons from a nurse perspective and inform the implementation of a national prison-based HCV screening program. A qualitative study using focus group methodology underpinned by grounded theory for analysis in a national group of nurse managers (n = 12). The following themes emerged from the analysis; security and safety requirements impacting patient access, staffing and rostering issues, prison nurses’ skill set and concerns around phlebotomy, conflict between maintaining confidentiality and concerns for personal safety, peer workers, prisoners’ lack of knowledge, fear of treatment and stigma, inter-prison variations in prisoner health needs and health service delivery and priority, linkage to care, timing of screening and stability of prison life. Prison nurses are uniquely placed to identify barriers and facilitators to HCV screening and treatment in prisoners and inform changes to health care practice and policy that will optimise the public health opportunity that incarceration provides.

中文翻译：

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从护士管理者的角度看爱尔兰监狱的丙型肝炎病毒筛查和治疗——定性探索


与一般人群相比，囚犯承受着更大的身体、传染病和精神疾病负担。监狱医疗保健结构很复杂，为边缘化和服务较差的群体提供医疗保健服务（包括丙型肝炎病毒 (HCV) 筛查、评估和治疗）提供了挑战和机遇。优化监狱中的丙肝病毒管理是一项公共卫生优先事项。护士是全球大多数监狱的主要医疗保健提供者。从护士的角度了解囚犯参与丙肝病毒护理的障碍和促进因素是实施有效战略以消除监狱环境中丙肝病毒的第一步。本研究的目的是从护士的角度确定爱尔兰监狱中 HCV 筛查和治疗的障碍和促进因素，并为全国监狱 HCV 筛查计划的实施提供信息。一项定性研究，采用焦点小组方法，以扎根理论为基础，对全国护士管理人员小组 (n = 12) 进行分析。分析得出以下主题：影响患者就诊的安保和安全要求、人员配备和排班问题、监狱护士的技能和对放血的担忧、保密与个人安全之间的冲突、同侪工作人员、囚犯缺乏知识、对治疗和耻辱的恐惧、监狱在囚犯健康需求、医疗服务提供和优先顺序、与护理的联系、筛查时间和监狱生活稳定性方面存在差异。监狱护士具有独特的优势，可以识别囚犯丙型肝炎病毒筛查和治疗的障碍和促进因素，并告知医疗保健实践和政策的变化，从而优化监禁提供的公共卫生机会。