Journal of forensic nursing最新文献

Background: Adolescent violence in emergency departments (EDs) is a serious problem.

Aim: To examine outcomes of a violence reduction intervention among adolescents seen in EDs.

Methods: Aggressive Behavior Risk Assessment Tool for Emergency Departments was used to identify patients at high risk. Following a baseline period, a Phase 1 intervention of signage posting and a Phase 2 intervention of additional behavioral emergency response team huddles were implemented. A subset analysis of adolescents aged 10-18 years was performed.

Results: Among 8,658 adolescents, 156 had ≥1 violent event (1.80%). The violence rate during Phase 1 showed a 34% reduction compared with the baseline (p=0.035); no significant reduction was observed in Phase 2 compared with Phase 1.

Conclusion: Signage posting appears to be an effective strategy contributing to reducing violent events among adolescents visiting EDs. The use of a validated screening tool to identify high-risk adolescents facilitated targeted preventive intervention efforts.

Background: Interpersonal violence (IV) is a global pandemic. Geographic borders represent unique spaces that are often shaped by cultural clashes, economic inequality, and jurisdictional complexities. Given the intricate social dynamics along the U.S.-Mexico border, this region provides a compelling yet understudied setting to advance research on the geographic dimensions of IV. However, communities situated alongside the U.S.-Mexico border are noticeably absent from this body of research, which is problematic as these regions often face unique social and structural challenges.

Method: This retrospective study examined the spatial distribution of a subset of zip code data that represented IV incidences between 2017 and 2022 in the El Paso, Texas region. The source of the IV data was medical records of patients that were seen by sexual assault nurse examiners for IV-related injuries at a Level 1 trauma center.

Results: The retrospective study included 384 IV incidents. In terms of IV survivors' characteristics, the mean age of trauma survivors was 26 years (SD = 14 years), with the majority in the 25- to 59-year age range (39.4%). Most of the survivors were identified as Hispanic, Latino, or Spanish (78.2%). The findings illustrate the uneven spatial distribution of IV incidence rates in El Paso, emphasizing the presence of high-risk zones within the inner city.

Conclusion: This study examined the spatial distribution and characteristics of IV incidents in the El Paso region. The combination of spatial analysis, hotspot identification, and establishment overlay mapping offers a holistic perspective on the spatial dynamics of IV. The identification of hotspots and exploration of regions with high IV occurrence contribute to actionable insights for the development and implementation of targeted interventions. By understanding IV occurrence within the community, forensic nurses can target trauma survivor prevention efforts and integrate education and resources for nurses caring for survivors in emergency situations. In addition, forensic nurses become proactive agents of change, tackling IV at its source with targeted recognition, response, and safety protocols.

Purpose: To identify factors influencing the intention to use mental health services by persons in custody.

Methods: Two hundred and three adult male and female persons in custody in South Korea completed a written questionnaire. Data were collected between May 1 and October 31, 2023. Descriptive statistics, t -tests, ANOVA, and multiple regression were completed.

Results: Regression analyses indicated that mental health literacy ( ß  = 0.20, p  = 0.003), social support ( ß  = -0.15, p  = 0.018), and the need for mental health services ( ß  = 0.16, p  = 0.021) were significant factors contributing to intention to use mental health services ( F  = 11.12, p  < 0.001).

Conclusion: To increase use of mental health services, it is essential to assess what persons in custody need, identify health literacy levels and tailor information as needed, and establish mental health systems that connect to social resources.

Background: Forensic nursing is an evolving specialty focusing on healthcare when legal issues are involved. Valid tools are needed to assess emergency department (ED) nurses' performance of forensic nursing role behaviors and their corresponding perceptions. We aimed to translate and culturally adapt the original English version of the "Emergency Department Forensic Nursing Survey" (EDFNS) into Persian and evaluate its psychometric properties among ED nurses.

Methods: This methodological study was conducted in 2022. The EDFNS was translated into Persian. Face and content validity, along with construct validity (exploratory/confirmatory factor analyses) and reliability (internal consistency/test-retest reliability), were assessed.

Results: The EDFNS-P (EDFNS-Persian) items were appropriate, clear, and relevant in face validity assessment. Content validity was satisfactory for all items (content validity ratio = 0.66/content validity index = 0.92). In total, 274 nurses completed the questionnaires. The EDFNS-P consisted of five factors, namely, identifying forensic cases, acting as a forensic nurse specialist, assisting with legal investigations, providing holistic supportive care, and protecting forensic evidence, explaining 56.49% of the total variance. Confirmatory factor analysis assessment showed a good model fit. The EDFNS-P demonstrated acceptable internal consistency and stability (α = 0.902/intraclass correlation coefficient = 0.938).

Conclusion: The concept of forensic nursing role behaviors within Iranian EDs is multidimensional. The EDFNS-P is a 37-item reliable and valid scale. It can help identify areas requiring improvement, promote better collaboration among healthcare professionals, and increase recognition of the specialty. Future studies examining the factor structure in different contexts are suggested to validate the findings. Further research is needed to assess the Persian version of the EDFNS in countries where forensic nursing roles are increasingly emerging.

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.

Background: Violence against sexual and gender minorities is a significant concern on university campuses.

Methods: A needs assessment self-report survey was administered to LGBTQIA+ university campus community members to assess perceptions of vulnerability, interest in, and beliefs related to personal safety/self-defense (PS/SD) training at a public Midwestern university.

Results: Forty-three LGBTQIA+ campus community members responded to the survey. Thirty-six percent of those surveyed reported a history of physical or sexual interpersonal violence. Respondents reported being fearful or occasionally fearful for their personal safety in a variety of day-to-day situations surveyed. Using rideshares, going out alone after dark, and going to parties were some of the most frequently feared situations. Most, 73%, believed that PS/SD training would increase their feelings of overall safety and would improve their ability to defend themselves, with up to 66% expressing interest in attending PS/SD training held in a format of 2-hour sessions occurring weekly.

Conclusions: This survey supports the need for inclusive and accessible PS/SD training tailored to the specific needs of LGBTQIA+ university campus community members to enhance campus safety.

Introduction: The relationship between sexual violence victimization (SVV) and suicidal thoughts and behaviors (STBs) has been established. However, when applied to LGBTQ+ (i.e., lesbian, gay, bisexual, transgender, and queer) populations, the impact of SVV on the severity of STBs experienced requires further exploration. Suicide is a major public health problem, with youth aged 10-24 years accounting for 14% of all suicides seen in the United States. The association between SVV, STBs, and other psychopathologies, such as anxiety and depression, is stronger in sexual minorities (LGBQT+) than in the heterosexual population. A cross-sectional secondary analysis of the 2021 Youth Risk Behavior Survey (YRBS) was completed to investigate the association between SVV and STBs in LGBTQ+ youth populations when compared with their heterosexual peers and to determine if sexual orientation is a potential moderator in this relationship.

Methods: Sexual orientation, questions related to STBs, and sexual assault/rape and intimate partner violence experiences were extracted from the 2021 YRBS. Binary logistic regression considering the complex sample survey design of the YRBS was utilized to assess associations of SVV with STBs while controlling for sexual orientation.

Results: Sexual minority youth exhibit higher odds of both experiencing SVV and exhibiting STBs compared with their heterosexual peers. Some aspects of STBs in the presence of SVV are moderated by sexual orientation.

Conclusion: Further investigation is needed into this association in LGBTQ+ youth populations who have experienced sexual violence to better understand this relationship.

Introduction: This case report describes a model for identification and response to adolescents at risk for human trafficking/sexual exploitation in an emergency department setting. The Short Screen for Child Sex Trafficking is used, and then identified high-risk individuals are provided a forensic nurse examiner (FNE) assessment.

Case presentation: The patient presented to an emergency department three times for mental health care and was screened using the Short Screen for Child Sex Trafficking, which showed significant human trafficking/sexual exploitation risk. This triggered FNE interventions that led to disclosure of exploitation, connection to resources, and progress in the patient's understanding and ability to seek support. While the patient's substance dependency and mental health concerns persisted, highlighting gaps, systematic screening paired with trauma-informed, patient-directed FNE response facilitated meaningful intervention without requiring self-identification or relying on provider recognition.

Conclusions: This is a replicable model for health care settings seeking to improve identification and support of at-risk youth.