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Nurses' Perspectives on Cancer Care for People Who Experience Incarceration in British Columbia, Canada: Challenges
Mar'yana Fisher1, Leah K Lambert2,3, Olga Petrovskaya1
1School of Nursing, University of Victoria, Victoria, Canada.
Abstract:
Cancer is the leading cause of death for Canadians. Research by Canadian scholars has highlighted that people who experience multiple and intersecting socio-economic barriers are more likely to receive a diagnosis only after cancer has become advanced. For people who experience incarceration, structural barriers to cancer treatment and care are further exacerbated. Yet, few studies in Canada have focused specifically on the provision of cancer care in provincial correctional settings. This study explored how nurses understand and navigate the delivery of cancer care to people who are incarcerated in British Columbia. Guided by Interpretive Description (ID) and informed by actor-network theory (ANT), the research aimed to generate practice-relevant insights by examining nurses' perspectives, experiences, and the systemic factors shaping their clinical realities. Findings from this study illustrate nurses' views that the prison's focus on security shapes how, when, and whether cancer care is delivered. Drawing on interviews with nurses, the analysis produced the following insights: 1) institutional priorities often complicated the delivery of cancer care; 2) nurses perceived systemic stigma and institutional mistrust toward patients who are incarcerated; and 3) lack of confidentiality during healthcare encounters hindered patient-centred cancer care. Despite this, nurses frequently found ways to navigate the professional tensions arising from dual responsibilities to patient care and incarceration. These insights show how cancer care is often contingent on nurses' ability to navigate systemic constraints and relational barriers, underscoring the need for integrated, trauma-informed, and equity-oriented approaches that support continuity of care across correctional and healthcare systems.
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