Through the looking glass: integrating male prisoners' perceptions and views of death

This mixed-method study consisted of two phases. Participants included 119 prisoners from Donaldson Correctional Facility and the Hamilton Prison for the Aged and Infirmed in Alabama. Due to the limited number of participants, SEM was not possible. Therefore, in Phase 1, a series of hierarchical regressions was used to examine male prisoners' attitudes toward dying as a function of health, social support, and perceptions measured through questionnaires. Results indicated inmate health and perceptions accounted for a significant amount of the variance in death anxiety and desire for hastened death. In Phase 2, content analysis was used to explore 32 in-depth qualitative interviews, regarding prisoners' lived experiences and attitudes towards chronic illness and dying in prison. Qualitative interviews inquired about personal: 1) difficulties with disability and mobility, 2) conceptualizations of a good death in prison, and 3) acquisition of services. Qualitative content analyses adopted a phenomenological perspective in order to explore the prisoners' lived experience in-depth and in their own words, enriching and expanding the quantitative data collected in Phase 1. Results indicated inmate's often faced mobility challenges due to poor health and facility accommodations. In addition, secondary issues were reported including concerns regarding access to care, staff responsiveness, and financial strain. Views regarding death in prison focused on physical details about the death, such as dying in your sleep or death occurring quickly with no pain. The current study considered implications for the relation of prisoners' physical, cognitive, and mental health to death attitudes. Findings have public policy implications by providing information regarding physical, cognitive, and mental health targets for prisoner wellness and quality of life interventions during advanced chronic illness to reduce the cost of end-of-life care in the cash-strapped prison system. These include provision of psychoeducation for employee professional development and inmate mental health, as well as incorporation of inmate hospice workers in end-of-life care. (Published By University of Alabama Libraries