Journal of forensic nursing最新文献

Objective: The aim of this study was to analyze the factors associated with elder abuse according to the levels of social determinants.

Methodology: This is a quantitative and multicentric study, with a cross-sectional cut. It was developed in two teaching hospitals in Paraíba, Brazil, with 323 older adults, from July 2019 to February 2020. Data were collected using the Hwalek-Sengstock Elder Abuse Screening Test and Conflict Tactics Scale-1 and then analyzed using descriptive and inferential statistics.

Results: There was a significant association between risk for violence and female gender (p = 0.004), residing with grandchildren (p = 0.025), and having four or more comorbidities (p < 0.00). Physical violence was associated with income (p = 0.048). A positive correlation was observed between the number of comorbidities and the risk for violence score (p < 0.001), psychological violence (p = 0.004), and physical violence (p = 0.005). The probability of presenting a risk to violence increased by 2.08 times for women, 1.03 times for those who were illiterate, and 7.03 times for those with four or more comorbidities.

Conclusion: The social determinants of health that integrate the macrosystem, such as income and number of comorbidities, correlate with situations of violence.

Aims: This article explores the underreporting of sexual violence (SV) in higher education, highlighting serious implications for survivors who may silently cope with its aftermath instead of accessing crucial resources.

Methods: We utilize Bolman and Deal's four-frame model for organizational change to assess how internal factors within organizations may influence reporting of SV. The four frames-symbolic, structural, human resources, and political-offer a systematic analysis of the internal organizational context in higher education institutions concerning SV reporting.

Results: Our suggested approach offers concrete dimensions and probing questions for examination. Derived from a qualitative study, our recommendations align with Bolman and Deal's four-frame model, aiding in assessing the organizational environment. This approach assists stakeholders in identifying barriers/facilitators in the internal organizational context of higher education institutions, enabling effective planning for improved SV reporting/disclosure.

Conclusions: A thorough analysis is essential for understanding factors influencing campus SV reporting. Our proposed critical analysis and recommendations serve as a starting point to identify organizational barriers/facilitators, informing the revision of SV policies and processes, including reporting.

Potential impact of improved sexual assault reporting in higher education institutions on forensic nursing and survivors/victims allies: Enhanced reporting of sexual assault in higher education benefits forensic nurses and allies, like student affairs, advocacy groups, unions, SV coordinators, health centers, equity departments, human rights officers, and administration. Improved analysis of institutional and cultural contexts allows for tailored services to better meet survivors' needs. Increased reporting should lead institutions to higher service utilization, requiring careful planning for resource allocation.

Introduction: Sexual assault nurse examiners (SANEs) provide specialized medical forensic care to survivors of sexual assault, often working in stressful conditions, with routine exposure to the traumatic experiences of their patients. SANEs experience high levels of both vicarious trauma and burnout.

Purpose: The purpose of this article was to describe the development of a SANE support application, accessible to all SANEs, that utilizes self-care and positive coping strategies to enhance SANE resilience and thereby reduce burnout.

Methods: The conceptual framework for the SANE support application was psychological first aid, an evidence-informed, manualized intervention to assist individuals in the immediate aftermath of exposure to potentially traumatic events. Focus groups with SANEs informed the content of the application named "SANE Well."

Result: SANE Well delivers these helpful coping elements within an easy-to-use, mobile platform, at no cost. User testing during two SANE clinical skills laboratory trainings revealed the app had smooth and efficient functionality and meets its intended goals without unnecessary complexities.

Conclusion: There is an urgent need for SANEs to protect their well-being while they care for individuals who have experienced sexual assault. The SANE Well application offers a novel way to provide and encourage positive coping strategies for nurses to reduce burnout.

Background: The implementation of the recovery model into forensic mental health care promotes hope and has important implications for inpatients' community reintegration.

Aim: This study aimed to describe forensic mental health nurses' perceptions and experiences of providing care using the recovery model within a high-secure forensic hospital in Queensland, Australia.

Methods: Twenty-seven forensic mental health nurses were interviewed regarding their perceptions and experiences of providing recovery-oriented care within a high-secure forensic hospital.

Results: The participants described an individualized approach to recovery, both in the goals developed and in the level of support they required. There was an overarching shared goal across the participant group, which was focused on supporting patients to reintegrate back into the community. Inadequate resources (both internal and external), the severity of patient psychopathology, legal constraints, and the nursing role within the broader treating team were all perceived to present challenges to utilizing the recovery model within a high-secure forensic hospital.

Implications for clinical forensic nursing practice: To fully realize the potential of the recovery model, a system-wide reconceptualization is necessary.

Abstract: Since the popularization of the #MeToo movement, the prevention and management of sexual violence (SV) has become prominent in North American public discourse, including in the province of Québec (Canada). Despite such an important visibility in the public sphere, there is little scientific evidence of how nursing practice has adapted to the popularization of the #MeToo movement, led by victims of SV. Drawing on critical feminist theories, we describe the results from a literature review on nursing practice in the context of SV on college and university campuses since the #MeToo movement. A literature search was performed in five databases using keywords targeting nursing practice in the context of SV. In total, 45 articles were selected for analysis. Eight studies were added for their relevance (obtained outside the databases). Next, a reflexive thematic analysis inspired by Braun and Clarke (2006) was conducted. The literature review was then used to compare current practices in Québec. The results identify the persistence of numerous myths and stereotypes that contribute negatively to the credibility of persons experiencing SV. The results also describe the difficulty of public institutions to change structures aimed at preventing and managing SV in response to the popularization of the #MeToo movement. The results indicate the relevance of using an intersectional feminist theoretical framework to better understand the complexities of SV. Through our analysis, we show that, more than ever, the evolution of forensic nursing practice must be informed by political and testimonial activism driven by persons experiencing SV.

Objective: This scoping review aimed to summarize the published literature on patient involvement in violence risk assessment. Two research questions reviewed the extent of patient involvement and what evidence exists.

Inclusion criteria: English-language peer-reviewed published articles of any methodology related to violence risk assessment toward others were included. Articles were related to forensic and mental health practice and involve patients directly in the process.

Methods: Five electronic databases were comprehensively searched, as well as the reference lists of included articles. Both authors reviewed articles for inclusion and extracted data from included articles.

Results: Fifteen articles met the inclusion criteria. Articles reported on three approaches to patient engagement in structured violence risk assessment: how patients were involved or experienced the process, using rating scales, and using questions related to patient self-perceived risk. In relation to what evidence existed, four main themes emerged: patient views about risk and their involvement in risk assessment, comparing the predictive accuracy of patient self-rated tools with clinician-rated tools, predictive accuracy of a patient self-rated tool, and comparing risk ratings between patients and clinicians.

Conclusions: There is a dearth of research published about involving patients in their own risk assessment. Patients report both positive and negative experiences of the process. From cohort-type studies, results have shown that patient self-risk assessment can have a similar predictive ability to the clinician ratings related to adverse violence outcomes. Findings from studies can pave the way for future clinical research around the tools that have been developed thus far.

Abstract: Student mental health nurses have greater patient contact than registered nurses, and this is appreciated by patients. This phenomenological study explored the impact of patients and student mental health nurses' time shared on forensic units for men carrying a personality disorder diagnosis. Phenomenology was the underpinning philosophy of this research. Patients and student mental health nurses in forensic hospitals participated in unstructured hermeneutic interviews. The time students and patients shared together was considered a gift, enabling them to feel that they were "just people" and valued, strongly impacting on their sense of person. The impact the students have on patients' quality of life is meaningful. When the students and patients connected, it had powerful implications for their sense of humanness and value, highlighting the reciprocal impact they each have on another and the importance of having student nurse clinical placements in forensic wards and facilities.Implications for Clinical Forensic Nursing Practice: This article offers a unique contribution to forensic practice by exploring the experiences of the time patients and students share together in forensic units. Students, who often have the greatest contact with patients, represent the present and future of nursing, and their time is appreciated by patients. Previous research focuses on attitudes and therapeutic relationships, rather than the impact of shared contact. In addition to this, patients in forensic services with personality disorder diagnoses can be the most stigmatized group in mental health care, and exploration of their experiences is lacking. These experiences must be shared.

Introduction: The relationship between sexual violence (SV) experiences and suicidal ideation (SI) is known. However, when applied to lesbian, gay, bisexual, transgender, queer, and more (LGBTQ+) populations, the impact that experiences with SV have on the severity and magnitude of SI continues to be explored. A scoping review of the literature was conducted to summarize the current literature related to SI experienced by LGBTQ+ adolescents and young adults (AYAs) who have experienced SV.

Methods: Studies were found by searching electronic databases. To be included in the review, the study must have (a) been written in the English language, (b) been conducted in the United States, (c) presented empirical data, (d) been exclusively focused on LGBTQ+ AYAs, (e) focused on experiences with SV or have analyses separate from other types of violence, and (f) investigated suicidality as an outcome. All relevant studies published to date were included. Forty-one articles were retrieved for full-text review, of which five were determined to meet eligibility.

Results: LGBTQ+ AYAs were significantly associated with increased rates of SI compared with their cisgender heterosexual peers. LGBTQ+ AYAs were also associated with higher rates of SV victimization, ranging from intimate partner violence to previous child sexual abuse. Higher rates of depression were also associated with the population studied in each included article.

Conclusion: The relationship between SV and SI in this population is not well studied, as highlighted through this completed review. Targeting this knowledge gap through future research can lead to intervention development for this population niche.

Background: Child sexual abuse (CSA) is a preventable national public health problem that results in adverse health consequences. Research suggests youth experiencing CSA are often of school age. Screening for early detection of health issues is integral to school nurse (SN) practice. Still, there is little evidence that routine screening when CSA is suspected is occurring in schools, despite recommendations that it should be. Lack of confidence and knowledge related to screening and reporting for CSA contribute to a SN's missed opportunity for early intervention.

Purpose: The aim of this study was to describe SNs' knowledge and self-efficacy associated with screening for and reporting suspected CSA in school settings.

Methods: A descriptive cross-sectional survey design was employed. The Child Abuse Report Intention Scale was sent to over 2,000 members of the National Association of School Nurses.

Results: Among SN respondents (N = 123), the main findings showed almost half reported being concerned a youth was experiencing CSA but may have missed identifying it. Self-efficacy and professional responsibility were predictors of SNs' intention to screen as well as knowledge about obvious and serious signs of abuse were predictors of SNs' intention to report in this sample.

Implications: An educational partnership between forensic nurse examiners and SNs can facilitate improving SNs' knowledge about nonspecific physical and behavioral indicators of abuse that are not overtly obvious. The development of a screening tool specific for use by SNs can empower their confidence to screen by providing a resource for them to use as a guide when they are uncertain about the evidence.

Background: Survivors of intimate partner violence are at a high risk for having a brain injury because of high rates of strangulation and head and face injuries sustained from physical abuse. In addition to acute physical injuries, survivors experience various health complications.

Problem: Many survivors do not seek medical attention for their injuries, and when they do, their brain injury often goes unrecognized and untreated. Research indicates that screening for brain injury can be an effective intervention to increase the identification of brain injuries and medical referrals for diagnosis and treatment. Unfortunately, brain injury screening is not a standard of care.

Methods: Shelter-seeking clients were routinely screened for brain injury using a modified HELPS screening tool. A positive screen prompted a medical referral.

Intervention: A modified HELPS screening tool was utilized with permission for the project.

Results: Before implementation, 36 individuals entered shelter, 0 were screened for brain injury, and the medical referral rate was 19.4% (n = 7). After implementation, 40 clients entered shelter, 36 were screened for brain injury, 77.8% (n = 28) screened positive, and the medical referral rate was 80.6% (n = 29).

Conclusions: Brain injury screening may be an effective evidence-based intervention for shelter-seeking survivors of intimate partner violence to increase medical referrals.