Prisoners' experience of health self-management: A qualitative study

Purpose: Among the noninstitutionalized population, health care is increasingly shifting from a paternalistic model toward promoting patients' involvement in decision-making and in managing their condition. This paradigm shift toward health self-management is less applicable to individuals in prison whose health management choices are limited. The aim of this study was to explore prisoners' health self-management needs and the strategies used to maintain health self-management in a highly restrictive prison environment. Design: A qualitative phenomenological study design was selected for this research. Methods: An interpretive phenomenological analysis was chosen to present the narratives of prisoners regarding their health self-management. Semi-structured interviews were conducted with 15 male prisoners followed by content analysis. Results: The analysis of the participants' narratives revealed four major themes: (1) “I thrive on the anger so I can turn it into some more sit-ups:” Initiating sporting activities (2) “Food shouldn't be that white…:” Prisoners' quest for healthier eating (3) “I felt I want more out of life…:” Avoiding an unhealthy lifestyle (4) “I want to be taken care of:” The struggle for better health care. Conclusions: The findings suggest that prisoners can overcome the challenges of maintaining health in prison and become committed to better health management. Prisoners who serve as health resources may help reduce the load on correctional facilities' health care systems and the public.