Replicating Evidence in a New Context: A Cross-Sectional Study of Multidomain Quality of Life in Serbian Prisons

Abstract

This cross-sectional study assessed Quality of Life (QOL) using the WHOQOL-BREF among 600 prisoners (14% female, 71% in closed regimes) across five large Serbian facilities, aiming to replicate and extend international findings. Four QOL domains and their correlates, gender differences, and the contributions of each domain to overall QOL were examined. Mean scores ranged from 55.48 (environmental) to 67.02 (psychological), with overall QOL averaging below 60. Regression analysis revealed that physical health was the strongest predictor of overall QOL (β = .35), followed by environmental QOL (β = .32), diverging from U.S. data, and that males reported significantly higher QOL than females. While partially replicating earlier data, these findings provide the first detailed QOL profile of Serbian prisoners and reveal context-specific differences in correlates and demographic patterns. These findings fill a major geographical gap, confirm that QOL is profoundly compromised, and underscore the need for environment- and health-oriented prison reforms in Serbia.

Plain Language Summary

What Life Is Like in Serbian Prisons: A Study of Health, Safety, and Daily Living Conditions for Men and Women

People in prison often live under challenging conditions that can affect their physical and mental well-being. However, very little is known about what everyday life feels like for prisoners in Serbia. This study sought to understand how prisoners in Serbia rate their quality of life and whether men and women have different experiences. We worked with 600 adults held in five major prisons across the country. We asked them about four main areas of their lives: their physical health, their emotional well-being, their relationships with others, and the quality of their living environment. This type of study, conducted at a single point in time, helps show what conditions look like at that time. Overall, prisoners rated their quality of life as low. The weakest area was the living environment. Many people described problems with safety, noise, overcrowding, and access to resources. The strongest area was emotional well-being, although scores were still low compared with those of people living in the community. When we looked at what mattered most for overall well-being, physical health played the most significant role. People who felt healthier also reported better overall quality of life. The living environment was the next most important factor. We also found that men, on average, reported a better quality of life than women, suggesting that women in prison may require additional support. These results are significant because they offer the first detailed picture of daily life for prisoners in Serbia. They show that improving health care, safety, and living conditions should be major priorities. They also highlight the need for gender-sensitive services, as women’s experiences and needs may differ from men’s. The findings can help guide future reforms to create safer, healthier, and more humane prison environments.