MSN Revised - Thea - For Merge

CENTRAL LUZON DOCTORS HOSPITAL EDUCATIONAL INSTITUTION
(MASTER OF SCIENCE IN NURSING) 1

IMPACT OF PRISON ENVIRONMENT TO HEALTH OF DETAINEES IN
TARLAC PROVINCIAL JAIL: BASIS FOR HEALTHCARE ENHANCEMENT
A Research Paper
Presented to the Faculty of the Department of Nursing
Central Luzon Doctor’s Hospital Educational Institution
San Pablo, Tarlac City
In Partial Fulfillment
of the requirements for the Course
Nursing Research
By:
MAMINTA, Eric Vincent R.
MISLANG, John John
SUBA, Thea Laurene

ABSTRACT
The purpose of this study is to define or conclude the Impact of prison
environment to the health of the detainees in Tarlac Provincial Jail, and serve as a basis
for health care enhancement in the institution.
This study used Quantitative method, wherein descriptive research method will be
wrought appropriately and under this method the researchers have decided that social
survey were used. The research used survey questionnaire as the instrument to expend.
To establish the impact of prison to health of detainees, 56 trustees among the detainees
were surveyed and appraised. Questionnaire was prepared and was distributed to the
trustees and these trustees serve as the subjects of the study, to ensure the safety and
security of the researchers. The data gathered were categorized, tallied, tabulated and
interpreted by the researchers. Frequency distribution and weighted mean were be used as
statistical treatment.
At the end of the study, the researchers will come up with a proposal of programs
that will serve as an enhancement for better health care delivery system for the detainees
of Tarlac Provincial Jail.
Findings:
Keywords: Healthcare delivery, Trustees

CHAPTER I
THE PROBLEM AND THE BACKGROUND OF THE STUDY
Introduction
“Prisoners suffer a disproportionate burden of health problems as their
health needs are often neglected” according to World Health Organization (WHO). In
addition, The United Nations (1990) Basic Principles for the Treatment of Prisoners set
out that "prisoners shall have access to the health services available in the country
without discrimination on the grounds of their legal situation" (Principle 9,
A/RES/45/111). There are many ways to preserve human life and protect the health in an
environment. The environment itself must not be an encumbrance to people living in. In a
prisoner’s life, environment must be taken earnestly and should not be overlooked or
deserted for it is a necessity and essential not an option. To protect the health of a
detainee, everyone should have an equal fair access to health and safe environment.
According to Jean-Daniel Tauxe, the International Committee of the Red Cross
(ICRC) head of delegation in Manila, they have seen that the overcrowding of jails and
prisons has serious consequences for detainees, access to safe water, sanitation,
healthcare, and acceptable living conditions are a major problem in overcrowded
detention facilities. He also added that, the steady spread of tuberculosis had become a
serious concern. The environment is an enormous factor for supporting and upholding
health and life. It is significant to continuously contemplate the needs in order to have a
clean and innocuous environment. Through this, it could benefit and protect the health of
an individual living in a prison environment.

Life in prison is based on deprivation of liberty, which is markedly different than
the freedom of action and choice enjoyed by the members of the outside community
(Castellano, 1997). The ample change in a prison’s way of living is way different from
outside. These changes might affect the detainee’s daily routine in dealing with the
different situations, changes that can alter the detainee’s physical, emotional and mental
health.
Physical and mental health might be deeply affected because of different aspects;
one of these factors is the environment, which is a huge change for a person’s way of
living inside the jail. Mental health might as well be affected because of stress and
degradation, the limitations and boundaries as well as the adaptation with the rules and
regulations. The entire change of the environment and way of living may influence the
entire health of an individual. A clean or clear environment is a need for a person’s well-
being. People interrelate with the environment and environment has something to do with
the quality of life that people live in.
The researchers’ study concentrates on the health of the detainees with the arising
problems that might come across when it comes to the environment inside the jail. This
will be a basis for enhancing the healthcare delivery system of Tarlac Provincial Jail. The
occurring health problems with such an environment of the detainees pushed the
researchers to conduct this study. The research team wants to pursue this research study
to establish and expound quantities of indications that the environment inside the jail
accompanies the health of the detainees. Another thing the researchers want to present in
this study, is to generate the knowledge of the institution on how do they enhance their
healthcare services for better healthcare delivery system and outcomes, and the impact of
prison environment to the health of detainees in Tarlac Provincial Jail, Dolores, Tarlac.
The researchers will be mostly guided by the different theories in nursing. One of
these theories is by Florence Nightingale (1860/1969), which is the Environmental
Theory. Florence stated in her nursing notes that “nursing is an act of utilizing the
environment of the patient to assist him in his recovery” (Nightingale 1860/1969). This
denotes that the nurse must give importance and deeply consider the environment
accordingly to help in patient’s gradual restoration of health, and must also consider and
take note of the external triggers that might affect the condition of the patient. The
researchers can relate to this study with the external factors specifically the environment
that might affect the health of the detainees. This implies that physical environment
deeply influence the health of every individual.
The theory of Abraham Maslow, which is the Humanistic theory of Learning,
implies that higher level of necessities cannot be met unless certain lower level needs
have been achieved. Abraham Maslow’s hierarchy of needs is composing of five levels;
these levels must be achieved accordingly to satisfy an individual’s needs. The first level
is composed of the Physiologic needs, this includes water, air, breathing and among
others. An individual needs these in order to maintain and have a good life because this
deals with the maintenance of a human body that is vital to being. Then second level is
the need for safety and security. These level includes own safety that would keep an
individual from any harm and security when it comes to personal and financial securities.
In this level, health, environment, shelter and job securities are very particular. Stability
is important in achieving the hierarchy of needs and same as with an individual who does
not feel safe in an environment; it can alter the process and its goal in achieving the
highest level. The third level pertains to love and belongingness, composing of affection,
intimacy, acceptance, family, friendship and as well as social needs. These needs can be
met by an agreeable and gratifying affiliation or connection. And if so, this will result to
reception by others. After physiologic and security needs have been attained, an
individual can look for a relationship where love and belongingness can be reached
effectively. The fourth level is attaining self-esteem. After love and belongingness have
been achieved, an individual will start to believe himself. This is the stage where gaining
of self-confidence begins. Gaining self-confidence is having self-esteem, these includes
respect, accomplishments and achievements. The last and the highest level is self-
actualization. This pertains to gaining ones’ potential in accomplishing his goals.
Attaining the uppermost level is having self-fulfillment to pursue everything that would
satisfy him and to have growth, both personal and career through experiences and grow
as a whole. The researchers can relate to this theory for it reflects on how a detainee can
adapt to his environment and help him accept the situation. This will test the resiliency of
every detainee towards the situation inside the prison. Every detainee needs to meet his
physiologic needs in order to survive and maintain his body’s needs and health. Every
detainee’s need when it comes to personal safety and security must be achieved for every
detainee must have a sense of having of own safety and away from any harm. He also
needs to feel the love and affection from his support groups specifically his family to
have a sense of belongingness and same as with his co-detainees, this will them adapt
with the environment and the situation. From that, he will gain self-confidence and self-
esteem and the feeling of sense of fulfillment. He will gain respect from others and to be
accepted again in the society as a productive and a healthy individual.
The researchers decided to use conceptual framework to place a prominence on
the impact of prison environment to health of detainees in Tarlac Provincial Jail as a basis
for healthcare delivery enhancement. In General System Theory, the input data included
will be the environment’s description in terms of; number of occupants per cell,
ventilation and warming, lighting, noise, cleanliness and nutrition. It will also include the
health problems reported by the institution within 3 years, the healthcare services offered,
and the enhancement healthcare programs that can be proposed for better healthcare
delivery. Based from the data, the control process will use quantitative method
specifically descriptive research method to determine the different edges of the problem,
allowing them to generate the accurate inferences for the exemplification of the precise
evidences. After the exploration and scrutiny, the output will be produced and will
deliver information about the impact of prison environment to the health of the involved
study participants and serve as a basis for enhancement of healthcare delivery system.
Statement of the Problem
This study aims to determine the status and problems occurring in the
environment and in the health of the detainees in Tarlac Provincial Jail.
Specifically, the study seeks to clarify the following:
1. What are the demographic profile of the respondents in terms of the
following:
1.1 Name(Optional)
1.2 Age
1.3 Sex
1.4 Length of stay
2. How is the prison environment described in terms of:
2.1 Number of occupants per cell
2.2 Physical Structure
2.3 Nutrition
2.4 Sanitation
3. What are the reported health problems of the institution within three
years?
3.1 Communicable Disease
3.2 Non- Communicable diseases
3.3 Water and food-borne diseases
4. What are the healthcare services offered by the institution in terms of the
following?
4.1 Health Promotion
4.2 Health Protection
4.3 Disease Prevention
5. What enhancement healthcare program can be proposed for better
healthcare delivery?
6. What is the significant relationship of prison environment to the health
problem being reported?
Significant Of Study
The findings of this study be utilized as basis for further study on the impact of
prison environment to the health of detainees and will served as a basis for a better
healthcare delivery. The following will get the benefits of this study:
For The Detainees. This study shall show the health and environment condition
of detainees inside the jail during there imprisonment, furthermore this study will help to
develop a program and strategies to manage and echnace healthcare delivery service.
For Nursing Practice. The study will run the healthcare staffs specifically the
nurses with further and sufficient knowledge in the delivery of healthcare to the detainees
of Tarlac of Provincial Jail.
For Paramedic Service. The outcome of the study will provide them information
about the problems occurring in the institution. Furthermore this study will help and
assist in developing and implementing strategies for foster management in healthcare
delivery.
For the Administration. This study will serve as an eye- opener for the
institution about the impact of the environment that could affect the health of the
detainees thus, providing them ways or alternatives that could enhance the healthcare
delivery system
METHODS AND MATERIALS
The study is a quantitative research method specifically descriptive method of
research, were 30 detainees from the total population were surveyed regarding their
environment behind the bars. Those who are so-called “trustees” among the detainees
were acknowledged and recognized as the main respondents of this study. This is due to
the ensuring and keeping the safety and security of the researchers in conducting study.
Descriptive research method was utilized. Social survey-questionnaire was the primary
instrument used in gathering the data.
A survey was conducted to the 30 trustees to identify the frequency of
occurrences being glued in prison environment such as the environment inside the cell,
the programs being rendered by the personnel and the common reported diseases inside
the jail. To conclude the ins and outs or causes why prison environment affects the
health of the detainees, Likert Scale was used by the researchers. A detainee’s response
was measured according to the following: Always, sometimes, never.
The focus and substance of the study were the trustees who spend their stay in the
jail for more than 2 years among all the detainees to ensure the safety and security of the
researchers in Tarlac Provincial Jail, Dolores, Tarlac City, Province of Tarlac.
The researchers formulated the survey questionnaire as the main instrument in the
collecting the data desired. The questionnaire for the respondents is consisting of three
parts. The first asks about the environment specifically the frequency and presence of the
following facilities inside the jail. The second part asks about the frequency and the
occurrence of the programs inside the jail and lastly the frequency and the occurrence of
the common reported diseases in Tarlac Provincial Jail. The questionnaire was prepared
and submitted to the adviser for scrutiny and modifications. The questionnaire was
distributed to the respondents; the respondents were comprehensively briefed regarding
the questionnaire. The researchers reinforced the instructions verbally restating it
thoroughly that the respondents’ must answer the questionnaire honestly. And the
researchers rest assured the information will not be disclosed. Time frame of testing is 5
to 10 minutes and the data gatherings was implemented immediately as possible, as soon
as the warden of the Tarlac Provincial Jail accepted and permitted the study and officially
or properly talk over the research study between the warden and the researchers.
RESULTS AND DISCUSSIONS
I. Demographic profile of respondents
A total of 30 repondents were chosen for this study, and all of them are
detainees of TPJ who serve as trustees.
Figures 1, 2, and 3 show the frequency distribution of the
sociodemographic profile of respondents in terms of age, sex, and years of
stay at TPJ.
Figure 1
Sociodemographic Profile: Age
16 15
14
12
No. of Respondents
10
8
8
6
4
4 3
2
0
18-25 years old 26-35 years old 36-45 years old 46-55 years old
Age
Age. The majority of the respondents are ages 26 to 35, which comprises 15
respndents or 50%. This is followed by 36 to 45 (8 or 27%), 46 to 55 (4 or 13%), and 18
to 25 (3 or 10%) years old. Hence, most respondents are in their early adulthood.
Figure 2.
Sociodemographic Profile: Sex
Female, 14
Male, 16
Sex. The sex of respondents is almost equally distributed, which comprises 16
males (53%) and 14 females (47%).
Figure 3.
Sociodemographic Profile: Years of Stay at TPJ
9
8 8
8
7
No. of Respondents
6
6
5
5
4
3
3
2
1
0
1 year 2 years 3 years 4 years 5 years and
above
Years of Stay
Years of stay. Most respondents have been incarcerated at TPJ for 3 years and 5
years and above, comprising 27%. These are followed by 4 years (20%), 2 years (16%),
and 1 year (10%).

II. Environment
Table 1 shows the response of detainees and jail guards on the physical structure
of TPJ.
Table 1. Response of detainees on the physical structure of TPJ.
PHYSICAL STRUCTURE Always Sometimes Never Weighted Description

Mean
1. Prison cell well lighted 17 13 0 2.57 Always
2. Prison cell well ventilated 7 23 0 2.23 Sometimes
3. Crowded prison cell 26 3 1 2.83 Always
4. Availability of bed per
detainee 5 16 9 1.87 Sometimes
5. Availability of shower and

comfort rooms 12 16 2 2.33 Sometimes
Total Weighted Mean: 2.37 Sometimes
Table 1 shows that, the respondents believe that prison cells are always well
lighted, comprising 2.57 weighted mean, in contrast to the cells being always crowded
(2.83). Prison cells, however, are sometimes well ventilated (2.23), have available bed
per detainee (1.87), and shower and comfort rooms are sometimes available (2.33).
Hence, the physical structure of TPJ sometimes met the quality standard set for all
provincial jails; all but crowdedness of prison cells.
According to Jean-Daniel Tauxe, the ICRC's head of delegation in Manila. “They
have seen that the overcrowding of jails and prisons has serious consequences on
detainees living conditions and health. The usual practice of recommending
improvements and providing technical support to the detaining authorities was not
enough, so we developed a new, complementary strategy.
NUTRITION Always Sometimes Never Weighted Description

Mean
1. Eat at least 3-5 times a day. 25 5 0 2.83 Always
2. Equal servings of meat and
vegetables per meal. 10 16 4 2.20 Sometimes
3. Diet serving according to
reported health condition. 4 20 6 1.93 Sometimes
4. Drink water at least 8-10
glasses a day. 28 2 0 2.93 Always
5. Meal serves on time. 16 13 1 2.50 Always
Total Weighted Mean: 2.48 Always
Table 2. Response of detainees on nutrition inside TPJ.
Table 2 shows the response of detainees on nutrition inside TPJ. The respondents
believe that they always eat for at least 3-5 times a day (2.83 weighted mean), drink water
for at least 8-10 glasses a day (2.93), and that meals are always served on time (2.50).
Equal servings of meat and vegetables per meal are sometimes served to the repondents,
comprising 2.20 weighted mean. Additionally diet servings are sometimes in accordance
to reported health condition (1.93). Overall, nutrition conditions inside TPJ are always
satisfactory, and that all meals are adequate, balanced, and in accordance to reported
health conditions.
According to WHO (2015), the quality and quantity of food available in a prison
has a major influence on the quality of a prisoner’s life. The availability of safe and
healthy food is essential in maintaining and improving prisoners’ health. Supporting and
ensuring a safe and healthy food supply in prison will help to prevent diet-related
diseases and promote better overall health of prisoners.
Table 3. The sanitation of TPJ as perceived by the detainees.
SANITATION Always Sometimes Never Weighted Description

Mean
1. Clean comfort rooms and

shower rooms. 19 13 0 2.77 Always
2. Clean area within the cell. 19 11 0 2.63 Always
3. Presence of hazard (rats,

coackroach, cobwebs, etc.) 3 23 4 1.97 Sometimes
4. Segregation of waste
materials. 13 8 9 2.13 Sometimes
5. Change bed linens. 17 12 1 2.53 Always
Total Weighted Mean: 2.41 Always
As shown in Table 3, sanitation of TPJ is being described differently by the
respondents. TPJ has always clean comfort and shower rooms (2.77 weighted mean), has
clean area within the cell (2.63 weighted mean), has proper segregation of waste
materials (2.13 weighted mean), and always has change bed linens (2.53 weighted mean).
Apparently there are occasional presences of hazards such as vermin, cockroaches,
cobwebs, etc (1.97 weighted mean). Overall, the sanitation conditions of TPJ are beyond
satisfactory, as a result of the cleanliness programs of the present TPJ administration.
Tumbaga (2004) said, It has to be realized that (jail) physical plant and
facilities are critical to the overall management and administration of inmates so that in
the delivery of basic services and programs will be compliant with the acceptable
standard‖. Over populated jails find it difficult to program purposeful activities for
inmates. Inmates‘rehabilitation in that given situation may not be as rigid as when all the
jail services will be received by inmates to the utmost. When the jail is congested, there is
the possibility that hygiene and sanitation will deteriorate.
III. Common Reported Diseases
The following tables show the common reported diseases occurred at TPJ for the
past three years.
Table 4. The common communicable diseases occurred at TPJ as

known by the respondents.
COMMUNICABLE
Always Often Sometimes Weighted
DISEASES
Mean
1. Influenza 5 12 13 1.73 Often
2. Tuberculosis 12 7 6 1.87 Often

3. Acute Respiratory Tract
Infection 7 13 10 1.90 Often
4. Pneumonia 3 8 19 1.47 Sometimes
5. Dengue fever 2 4 24 1.27 Sometimes

Total Weighted Mean 1.65 Sometimes
The alarming prevalence of communicable diseases among prisoners poses a
serious public health problem. Overcrowded conditions and poor health education in
prisons, as well as weak community-based public health programs, exacerbate the
problem. DM Dumont - 2012
The Table 4 shows the common communicable diseases occurred at TPJ as
known by the respondents. Apparently dengue fever, pneumonia, and influenza occurred
minimally at TPJ, with weighted mean of 1.27, 1.47, and 1.73, respectively. In contrast,
tuberculosis has high probability of occurrence among detainees at TPJ, with 1.87
weighted mean of the respondents who agreed. Acute respiratory tract infection falls in
the middle, where it occurs often at TPJ (1.90 weighted mean).
Table 5. The non-communicable diseases at TPJ as perceived by the

respondents.
NON-COMMUNICABLE
Always Often Sometimes
DISEASES Weighted
Mean
1. Hypertension 19 8 3 2.53 Always
2. Diabetes Mellitus 5 14 11 1.80 Often
3. Asthma 13 12 5 2.27 Often
4. Rheumatoid Arthritis 7 15 8 1.97 Often
5. Heart Diseases 5 17 8 1.90 Often
Total Weighted Mean: 2.09 Often
Table 5 shows the non-communicable diseases at TPJ as described by
the respondents. These include hypertension, diabetes mellitus, asthma,
rheumatoid arthritis, and heart diseases. As perceived by the respondents,
hypertension and asthma always occur at TPJ (2.53 and 2.27 weighted mean,
respectively). Furthermore diabetes mellitus, rheumatoid arthritis, and heart
diseases often occur at TPJ, with weighted mean of 1.80, 1.97, and 1.90,
respectively.
Table 6. Food and water-borne diseases at TPJ as described by the
respondents.
FOOD AND WATER-BORNE

Always Often Sometimes Weighted
DISEASES
Mean Column1
1. Acute Watery Diarrhea 6 13 11 1.83 Often
2. Food poisoning 1 6 23 1.27 Sometimes
3. Typhoid fever 2 8 20 1.40 Sometimes
4. Hepatitis A and C 1 9 20 1.37 Sometimes
5. Amoebiasis 1 7 22 1.30 Sometimes
Table 6 shows the food and water-borne diseases at TPJ as described by the
respondents. At some times, amoebiasis, hepatitis A and C, typhoid fever, and food
poisoning occur, with weighted mean of 1.30, 1.37, 1.40, and 1.27, respectively.
However, acute watery diarrhea occurs often, which gave a response of 1.30 weighted
mean.
IV. Programs
Different programs on health promotion, health protection, and disease
prevention are being practiced at TPJ, as discussed below.
.
Table 7. Health promotion on TPJ as perceived by the respondents.
HEALTH PROMOTION Always Sometimes Never Weighted

Mean Column1
1. Nutritional Programs (Feeding
Programs) 5 18 7 1.93 Sometimes
2. Exercise (zumba, taebo, etc.) 13 17 0 2.43 Always

3. Mental Health Programs
(Mental Awareness Celebration) 5 19 6 1.97 Sometimes
4. Smoking Cessation Programs 4 22 4 2.00 Sometimes
5. Healthy Lifestyle Programs 9 21 0 2.30 Sometimes

Table 7 shows the response of respondents on health promotion at TPJ. The
majority of them agree that different programs on health promotion are occasionally
given to them. These include nutritional programs (1.93 weighted mean), exercise
(2.43weighted mean), mental health programs (1.97 weighted mean), smoking cessation
programs (2.00 weighted mean), and healthy lifestyle programs (2.30 weighted mean).
Notably, none of the respondents believe that no exercise and healthy lifestyle are being
practiced at TPJ.
As discussed by Dr. Nola Pender (2015), health promotion focuses on helping
people achieve higher levels of well-being. It encourages health professionals to provide
positive resources to help patients achieve behavior specific changes. The goal of the
HPM is not just about helping patients prevent illness through their behavior, but to look
at ways in which a person can pursue better health or ideal health.

HEALTH PROTECTION Always Sometimes Never Weighted

Mean
1. Medical screening 11 18 1 2.33 Sometimes
2. Healthcare waste
management programs 10 16 4 2.20 Sometimes
3. Oral hygience and dental
care programs 8 21 1 2.23 Sometimes
4. Occupational health hazard
programs 6 20 4 2.07 Sometimes
5. Water and sanitation
programs 7 17 6 2.03 Sometimes
Table 8. Health protection at TPJ as described by the respondents.
As shown in Table 8, health protection at TPJ is viewed unanimously by the
respondents. Sometimes medical screening (2.33 weighted mean), healthcare waste
management programs (2.20 weighted mean), oral hygiene and dental care programs
(2.23 weighted mean), occupational health hazard programs (2.07 weighted mean), and
water and sanitation programs (2.03 weighted mean) are being enjoyed by detainees and
jail guards alike.

Table 9. Disease prevention at TPJ as described by the respondents.
DISEASE PREVENTION Always Sometimes Never Weighted

Mean Column1
1. Flu Vaccine Immunization 3 12 15 1.60 Never
2. Tuberculosis control and
testing program 19 11 0 2.63 Sometimes
3. Educational and Social
services (STD services, risk
reduction services, etc.) 12 17 1 2.37 Sometimes
4. HIV Screening 6 24 0 2.20 Sometimes
5. Hepatitis B vaccine 5 11 14 1.70 Sometimes
Total Weighted Mean 2.10 Sometimes
Table 9 shows the disease prevention at TPJ as described by the respondents. The
tuberculosis and testing program has been always satisfactorily implemented (2.63
weighted mean). Educational and social services (STD services, risk reduction services,
etc) and HIV screening are sometimes performed at TPJ (2.37 and 2.20 weighted mean,
respectively). However, flu vaccine immunization (1.60 weighted mean) and hepatitis B
vaccine (1.70 weighted mean) has never been given to TPJ detainees and employees.
Table 10
Summary of Prison Condition at TPJ
Qualitative
Summary of Prison Condition at TPJ Weighted Mean
Interpretation
A. Physical condition 2.42 Always
B. Programs 2.13 Sometimes
C. Common reported diseases 1.72 Sometimes
Grand Mean 2.09 Sometimes
In summation of the data shown in the Table 10, Grand Mean is 2.09 which
equates to occurring sometimes at TPJ. The physical conditions and programs are
sometimes satisfactory, i.e. have met satisfactory conditions. However, common reported
diseases sometimes occur despite satisfactory conditions and programs implemented by
the TPJ administration.
IV. Significant Association between the Physical condition and Common Reported
Diseases at TPJ
Table 11
Association between Physical structure and common reported diseases
Computed
PHYSICAL STRUCTURE Interpretation
Pearson r
A. Communicable diseases 0.524 Not Significant

B. Non-communicable diseases 0.643 Not Significant
C. Food and water-borne diseases 0.377 Not Significant
Average 0.515 Not Significant
1. Physical Structure
The table above shows the association between the physical structure and
common reported diseases as described by the respondents. Physical structure includes
prison cell being well lighted, prison cell being well ventilated, crowdedness of prison
cells, availability of bed per detainee, and availability of shower and comfort rooms. The
overall average computed Pearson r value is 0.515. The decision is to accept the null
hypothesis therefore there is no significant association between the physical structure of
TPJ and the common reported diseases.
Table 12
Association between Nutrition and common reported diseases
Computed
NUTRITION Interpretation
Pearson r
A. Communicable diseases -0.570 Not Significant

2. Nutrition
Table 12 shows the association between nutrition and common reported
diseases. Nutrition includes detainees eat at least 3-5 times a day, equal portions of meat
and vegetables are being served, diet servings according to reported health condition,
detainees drink at leat 8-10 glasses a day, and meals being served on time. The overall
computed Pearson r value is 0.011. The decision is to accept the null hypothesis therefore
there is no significant association between nutrition at TPJ and the common reported
diseases.
Table 13
Association between Sanitation and common reported diseases
Computed
SANITATION Interpretation
Pearson r
A. Communicable diseases -0.076 Not Significant

3. Sanitation
Table 13 shows the association between sanitation and common reported diseases.
Sanitation includes having clean comfort rooms and shower rooms, clean area within the
cell, presence or absence of hazards (rats, cockroaches, etc.), segregation of waste
materials, and change of bed linens. The overall computed Pearson r value is 0.129. The
decision is to accept the null hypothesis therefore there is no significant association
between sanitation at TPJ and the common reported diseases.

The Proposed programs for Healthcare Enhancement
Programs that can give better health care delivery system must be affordable
and accessible. Every instution needs programs that can constantly improve the quality of
service in the institution, and can be achieved through an organized and effective
managing scheme.
The researchers proposed these programs regarding health care enhancement
base on tne results from the data gathered at TPJ. The program consists of objectives,
activities, startegies, people involved, and the expected outcome that should be carried
out.
I. Acitvities/Program: Prison cell crowding
Objective: to be able to resolve and avoid the overcrowding in
the prison cell.
Schemes:
Persons Invovled: Employees, detainees
Expected outcomes: provide a spacious and free from crowding cells in
the jail.
II. Activities/Program: Occupational safety and Health Program
Objective: to be able to provide knowledge and impart skills
And trainings regarding occupational hazards that
Occurs and may occur in the institution.
Schemes: Formulate an occupational health and safety
committee. Identify the hazards present in the jail.

Formulate a plan or guidelines to each problem
occurring in the jail.
Person Involved: employees of the jail, paramedic staffs and other
detainees (preferably trustees).
Expected outcomes: that the committee may successfully identify the
presence of hazards in the jail and implement the
plans and guidelines formulated.
III. Activites/Program: Nutritional Development Program
Objective: to be able to give guidelines in giving proper diet
according the health conditions of the detainees.
Schemes: attend trainings and seminars to enhance and gain
knowledge in making a diet plan for the detainees
and to be updated on diseases including the diet
plans.
Person Involved: paramedic staffs, Nutrition and Dietetics services.
Expected outcomes: the paramedic staffs and Nutrition and dietetics
service will be able to collaborate and will be able
to provide diet plan according to reported health
condition of the detainees inside the jail.
IV. Acitvities/Program: Water Disposal Management Program
Objective: To be able to formulate guidelines in managing p
roper waste disposal and segregation.

Schemes: form a proper waste disposal management
committee, and formulate guidelines regarding the
rules and regulations of proper waste disposal.
Person Involved: Waste Disposal Management Committee
Expected Outcomes: That the guidelines will be followed in managing
proper waste disposal.
V. Activities/Program: Healthcare Services and Detection Program
Objective: To be able give quarterly or annually medical
assessment and screening according to the health
condition of detainees, to recorded and properly
documented Medical information and Mental status.
Schemes: formulate a rountine schedule and prioritize
detainees with special condition, coordinate to other
Health Institutions, form diagnostic process which
will eventually determine the most appropriate
rehabilitation program for the inmate.
Person Involved: paramedic staffs, jail employees and inmate
Expected Outcomes: that may address successfully determine health
condition of detainess and to ensure there healthy
status inside the jail and it needs.
VI. Activities/Program: Sport and Recreational Program

Objective: for the inmates enjoyment sunrise by participating
in daily calisthenics and promote camaraderie
among inmates.
Schemes: Construct camaraderie, good sportsmanship and
team-building among jail inmates and staff
Person Involved: jail employees and inmate
Expected Outcomes: inmates develop skills and promote good working
environment and camaraderie.
CONCLUSIONS
This study aims to provide background information on prison environment to
detainees of Tarlac Provincial Jail (TPJ) which will be used as a basis for health care
enhancement. A total of 30 respondents, which are trustees among the detainees, were
used in the study to gather information through questionnaires.
The prison cells at TPJ are always crowded, however are always well lighted and
sometimes ventilated. Beds per detainee, shower rooms, and comfort rooms are
sometimes available to them. Despite crowdedness, they always have clean prison cells,
comfort rooms, and shower rooms. The detainees also practice proper waste segregation
and change bed linens. However there is still occasional presence of hazards such as
vermin and cockroaches. The detainees, fortunately, always eat 3-5 times and drink water
8-10 glasses a day. Equal servings of meat and vegetables per meal are sometimes being
served, in accordance to reported health conditions.

Ample health promotion programs are being implemented at TPJ, such nutritional
programs, exercise, mental health programs, smoking cessation programs, and healthy
lifestyle. Sometimes medical screening, healthcare waste management programs, oral
hygiene and dental care programs, occupational health hazard programs, and water and
sanitation programs are being enjoyed by detainees and jail guards alike. Tuberculosis
control and testing program is performed on a regular basis. Educational and social
services (STD services, risk reduction services, etc) and HIV screening are sometimes
performed at TPJ. However, flu vaccine immunization and hepatitis B vaccine has never
been given to TPJ detainees.
Fortunately dengue fever, pneumonia, and influenza occurred minimally at TPJ. In
contrast tuberculosis has high probability of occurrence, while acute respiratory tract
infection falls into the middle. Hypertension and asthma always occur at TPJ, whereas
diabetes mellitus, rheumatoid arthritis, and heart diseases often occur. At some time,
amoebiasis, hepatitis A and C, typhoid fever, and food poisoning occur. However, acute
watery diarrhea occurs often.
Additonally there are no significant associations on the physical structure,
nutrition, and sanitation with the common reported diseases.

BIBLIOGRAPHY
Lydia M. Venzon & Ronald M. Venzon (2010).
Introduction to Nursing Research: The Quest for Quality Nursing through
Evidence-based Practice Edition 3. C&E Publishing Inc.
Jean-Daniel Tauxe (2010).
https://www.icrc.org/eng/resources/documents/update/philippines-update-
030210.htm
Sir James Allan D. Tumbaga (2004)
Insight and Foresight on Philippine Penology,
World Health Organization – Europe
http://www.euro.who.int/en/health-topics/health-determinants/prisons-and-
health/focus-areas/nutrition
Dr. Nola Pender developed “Health Promotion Model (HPM)” (2015)
http://study.com/academy/lesson/what-is-the-health-promotion-model-definition-
theory.html
DM Dumont (2012)
https://www.ncbi.nlm.nih.gov › NCBI › Literature › PubMed Central (PMC)
http://www.who.int/topics/prisons/en/
http:/www.ohchr.org/EN/profesionalinterest/pages/basicprinciplesTreatmentOf
Prisoners.aspx
http://reliefwed.int/report/philippines/philippines-icrc-bulletin-no-012010-
protecting-life-and-dignity-place-detention.
http://www.bucor.gov.ph/programs/health.html
http://www.unafei.or.jp/english/pdf/RS_No67/No67_09PA_Alvor.pdf
Association between Physical Structure and the Common Reported Diseases
Computed Decision Interpretatio

VARIABLE Df
Pearson r Ho n
A. PHYSICAL
STRUCTURE
1. Communicable diseases 0.524 3 Accepted NS
2. Non-communicable 3
0.643 Accepted NS
diseases
3. Food and water-borne 3
0.377 Accepted NS
diseases
B. NUTRITION
-0.570 3 Accepted NS
1. Communicable diseases
0.155 Accepted NS
diseases
0.449 Accepted NS
diseases
C. SANITATION
-0.076 3 Accepted NS
1. Communicable diseases
0.064 Accepted NS
diseases
0.398 Accepted NS
diseases

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CENTRAL LUZON DOCTORS HOSPITAL EDUCATIONAL INSTITUTION

(MASTER OF SCIENCE IN NURSING) 1

TARLAC PROVINCIAL JAIL: BASIS FOR HEALTHCARE ENHANCEMENT

Presented to the Faculty of the Department of Nursing

Central Luzon Doctor’s Hospital Educational Institution

San Pablo, Tarlac City

of the requirements for the Course

MAMINTA, Eric Vincent R.

MISLANG, John John

SUBA, Thea Laurene

The purpose of this study is to define or conclude the Impact of prison

for health care enhancement in the institution.

of Tarlac Provincial Jail.

Keywords: Healthcare delivery, Trustees

THE PROBLEM AND THE BACKGROUND OF THE STUDY

“Prisoners suffer a disproportionate burden of health problems as their

without discrimination on the grounds of their legal situation" (Principle 9,

According to Jean-Daniel Tauxe, the International Committee of the Red Cross

healthcare, and acceptable living conditions are a major problem in overcrowded

an individual living in a prison environment.

the quality of life that people live in.

these theories is by Florence Nightingale (1860/1969), which is the Environmental

deeply influence the health of every individual.

The theory of Abraham Maslow, which is the Humanistic theory of Learning,

of self-confidence begins. Gaining self-confidence is having self-esteem, these includes

actualization. This pertains to gaining ones’ potential in accomplishing his goals.

accepted again in the society as a productive and a healthy individual.

The researchers decided to use conceptual framework to place a prominence on

Statement of the Problem

environment and in the health of the detainees in Tarlac Provincial Jail.

Specifically, the study seeks to clarify the following:

1. What are the demographic profile of the respondents in terms of the

1.4 Length of stay

2. How is the prison environment described in terms of:

2.1 Number of occupants per cell

2.2 Physical Structure

3.1 Communicable Disease

3.2 Non- Communicable diseases

3.3 Water and food-borne diseases

4.1 Health Promotion

4.2 Health Protection

4.3 Disease Prevention

5. What enhancement healthcare program can be proposed for better

problem being reported?

of Tarlac of Provincial Jail.

assist in developing and implementing strategies for foster management in healthcare

The study is a quantitative research method specifically descriptive method of

instrument used in gathering the data.

A survey was conducted to the 30 trustees to identify the frequency of

was measured according to the following: Always, sometimes, never.

researchers in Tarlac Provincial Jail, Dolores, Tarlac City, Province of Tarlac.

distributed to the respondents; the respondents were comprehensively briefed regarding

the questionnaire. The researchers reinforced the instructions verbally restating it

RESULTS AND DISCUSSIONS

I. Demographic profile of respondents

detainees of TPJ who serve as trustees.

Figures 1, 2, and 3 show the frequency distribution of the

sociodemographic profile of respondents in terms of age, sex, and years of

respndents or 50%. This is followed by 36 to 45 (8 or 27%), 46 to 55 (4 or 13%), and 18

males (53%) and 14 females (47%).

and 1 year (10%).

Table 1. Response of detainees on the physical structure of TPJ.

PHYSICAL STRUCTURE Always Sometimes Never Weighted Description