The Quality of Life Perception Gap in Prison Health Care Settings: Rater Disparities among Incarcerated Patients and Peer Caregivers

Peer caregivers are specially-trained incarcerated persons who support the needs of patients in correctional health care settings. Their role is of particular importance in light of the growing population of older adult prisoners with complex health problems in U.S. prisons. The purpose of the current study was to examine the disparity between patient and peer caregiver ratings of patient quality of life (QoL) in a sample of correctional health dyads (n = 52) in a state prison system. The current study also aimed to identify which patient and caregiver characteristics were most closely associated with emerging disparities. The sample and measures were described using frequencies and descriptive statistics. Patient QoL was measured using the McGill Quality of Life Scale-Cardiff Short Form and rater disparity was calculated at the individual- and group-level. Potential correlates were identified using bivariate statistics. Main results indicate group-level disparities were smallest among psychological and physical QoL (d = .06), and largest regarding existential QoL (d = .22). Few bivariate relationships were meaningful in effect, though patient characteristics accounted for 79% of emerging associations (viz. primary diagnosis). Though disparities emerged, peer caregivers in correctional health settings have unique strengths regarding assessment of patient QoL. Implications related to reducing dyadic disparities and targeting caregiver training regarding the importance of patient existential QoL are discussed.