Journal of forensic nursing最新文献

Background: Implementation of trauma-informed care (TIC) into forensic clinical practice may contribute to positive outcomes for both patients and staff.

Aim: The current study aimed to describe forensic mental health nurses' perceptions and experiences of using TIC within a high-secure forensic hospital.

Method: Twenty-seven forensic mental health nurses were interviewed regarding their experiences of using TIC within a high-secure hospital.

Results: Participants recognized the importance of understanding the past traumatic experiences of patients in their care but described a number of barriers to the implementation of TIC. A lack of organizational support, the negative impact of patient psychopathology on nurse well-being, and environmental factors were all perceived to negatively impact the successful delivery of TIC. Participants also discussed a widespread lack of knowledge and confidence in the application of TIC but expressed great desire for training to improve service delivery.

Implications for clinical forensic nursing practice: The application of TIC into daily clinical practice appears to be suboptimal. To support nurse and patient well-being and contribute to a highly skilled trauma-informed workforce, further training in this area is vital.

Conclusion: Training in TIC may contribute to enhanced patient outcomes and promote nurse well-being and should be supported organizationally with sufficient resources.

Objective: The objective of this article was to provide a first-person account of the vulnerable aspects of my life where I questioned if VT had influenced my thought processes and to uncover the potential health risks associated with exposure to patients' repeated stories of trauma. I questioned whether I was experiencing VT or other disorders such as burnout, posttraumatic stress disorder, or compassion fatigue. The scholarly literature was reviewed after my personal reflection to analyze my personal experiences and to gain clarity on how VT and/or other related concepts may impact the professional and personal lives of SANEs.

Methods: Methods used to produce my personal stories have been done via self-reflection and journaling. Three stories that I believe may resemble VT are shared and analyzed vis-à-vis the literature. My personal vignettes are compared with signs and symptoms of VT and illustrate how they may manifest in the daily lives of SANEs.

Implications: To date, researchers have neglected to explore concrete examples of the personal depth VT may exhibit in an individual's life. By disclosing and synthesizing my personal stories, I hope to encourage SANEs to be open about their experiences, spread awareness and prevention strategies regarding VT, and, ultimately, further enhance well-being and promote increased longevity in their careers.

Introduction: Workplace violence (WPV) is a common experience among healthcare workers in the United States. Although WPV may affect workers physically, WPV can also affect workers' mental health. Emergency department (ED) workers' perceptions of available and necessary WPV support have not been previously reported.

Methods: A cross-sectional survey design was used to examine ED workers' perceived level of WPV support and emotional impact that WPV causes them. This study was conducted at six Midwestern U.S. EDs. Respondents confidentially completed an adapted version of the Survey of Violence Experienced by Staff. Data analysis included descriptive statistics, t test, and Kruskal-Wallis test.

Results: Respondents (N = 206) who experienced WPV served as the analytical sample. Respondents predominantly agreed or strongly agreed that support was available after WPV (n = 129, 63.2%). The predominant source of support after WPV was another colleague from the department (n = 127, 62.3%). Less than half of respondents (n = 96, 47.1%) indicated they agreed/strongly agreed that managers were supportive after verbal abuse, but 63.6% (n = 126) indicated that managers were supportive after physical assault. There was no statistical difference between the emotional impact of verbal abuse compared with threats/assaults.

Discussion: Forensic nurses and emergency nurses with forensic nursing training are situated to combine their expertise in trauma-informed care, evidence collection, and expert testimony to support victimized ED workers. Timely support should be offered regardless of the category of WPV experienced. Insight into why support is perceived as available and accessible but may not be used warrants further study.

Introduction: Hypermasculine prison culture produces hierarchies based on individuals' ability to assert dominance through strength and violence. Pain can impact physical strength, thereby limiting the ability to elevate or maintain social status within such hierarchies.

Aim: The aim of the study was to explore the pain experiences of incarcerated men who were embedded into hypermasculine prison culture.

Methods: Interpretive description co-positioned with relational ethics informed the study design. Twelve males participated in 1-hour interviews, which were transcribed verbatim and analyzed inductively to identify themes. The data analysis occurred in three phases: sorting and organizing, making sense of patterns, and transforming patterns into findings.

Results: We found that correctional settings were characterized by a social culture of toxic hypermasculinity that influenced the pain experiences of people who were incarcerated. Individuals who experienced pain were more vulnerable to self-isolation in situations in which pain threatened their ability to defend themselves and their previously established social status within the prison hierarchy. Yet, those who felt secure in subordinate hierarchical positions and had effective peer relationships perceived greater safety in communal settings, which proved to be a distraction from pain.

Conclusion: In the context of incarceration, positive peer relationships and perceptions of safety positively influenced individuals' experience of pain.

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.