Journal of forensic nursing最新文献

Background: NCCR is a form of sexual violence that complicates the traumatic physical and emotional experience of sexual assault. Correlates to victimization include being a racial or sexual minority and being in nonexclusive, noncommitted relationships, or transactional relationships. Decreased confidence, guilt and worry, fear, depression, or a history of sexual abuse are correlates to being a victim.

Aim: To present a case of nonconsensual condom removal (NCCR), also known as stealthing, in a 25-year-old transexual male sexual assault patient.

Case summary: A 25-year-old transexual male, hereafter known as AK, presented to the emergency department (ED) requesting to be seen by a sexual assault nurse examiner (SANE). The partner put the condom on; during sex, AK could see that the condom was no longer in place. He asked the man to stop but was ignored. Thoughtful care was given during the exam, with attention to patient preference about use of a speculum. Prophylactic treatment for sexually transmitted infections, human immunodeficiency virus, and pregnancy were indicated and given. Follow-up care with an advocacy agency was provided. Research, policy, and practice must be developed to address this increasingly common practice.

Introduction: The literature suggests that humor is of central importance in the staff-patient relationship. However, within forensic mental health, the most recent review underlines a scarcity of research focusing on the use of humor from a forensic patient perspective. Therefore, this study investigated the characteristics of forensic mental health inpatients' perceptions of staff and their own use of humor within a forensic mental health setting.

Method: The project explored this through semistructured interviews with 11 forensic mental health inpatients and subsequent thematic analysis.

Results: Overall, the patients found that staff should keep practicing humor during admission. The study showed that inpatients viewed the use of humor in terms of "identity" and "community and closer relationships" providing possibilities for "contagious social therapy" if managed according to "power: insight, context, and intention." These elements of humor were used to "deescalate conflicts" and to create a "positive therapeutic alliance" if carried out with (a) relational sensitivity, (b) situational sensitivity, (c) person-centeredness, and (d) humor being power informed.

Conclusion: The inpatients recommended nursing staff use of humor during admission.

Background: Interpersonal violence results in adverse individual, interpersonal, community, and societal impacts, including medical and legal burdens. In many cases, interpersonal violence is reported for the first and often only time in a hospital-based setting where injuries are documented by a forensic examiner.

Aim: To describe ways in which technology can enhance the documentation of forensic and medical evidentiary exams and improve information-sharing.

Methods: A narrative literature review and qualitative synthesis of 35 articles was conducted.

Results: Relevant trends in applying digital technologies to improve documentation quality and processes, standardization, and de-siloing systems, and to outline resource limitations were identified.

Conclusions: Standardization and improved documentation can improve the quality and consistency of exams and provide other benefits to patients, such as improved holistic care. Resource constraints can act as a barrier to implementing standardized documentation practices, information sharing, and deployment of new technologies.

Aims: To describe the demographic characteristics and prevalence of individual, relational, and community-level risk factors among adolescents in a therapeutic program for survivors of domestic minor sex trafficking and commercial sexual exploitation of children in Georgia, United States (U.S.).

Methods: A retrospective secondary data analysis was conducted on youth admitted to a transitional housing and rehabilitation program from 2020 to 2021. Study was guided by the Institute of Medicine/National Research Council Guide, which integrates Bronfenbrenner's ecological model. Intake data, including demographics, medical records, physical examinations, laboratories, and sexual assault nurse examiner examinations, were analyzed to identify risk factors across ecological levels.

Results: Among 108 adolescents (average age 15), 60% identified as Non-Hispanic Black, and 68% were in state custody. Participants had high adverse childhood experiences scores (mean: 4.8), with significant rates of self-harm (49%) and substance use (39%).

Discussion: Findings highlight the complex vulnerabilities of trafficked youth and emphasize the need for trauma-informed care models to guide targeted prevention, identification, and intervention strategies for at-risk adolescents.

Introduction: Exposure to and experiences of violence are identified as factors contributing to the issue of murdered Indigenous girls and women.

Methods: Descriptive, correlational study of public access data with a sample of 64 murdered Indigenous girls ranging in age from 14 months to 18 years.

Results: Indigenous girls under 5 years (59%) had the highest report of domestic violence in their history and were more likely to be in foster care (36.3%; p =0.03). Age of victim was related to perpetrator sex, with girls under age 5 years more likely to be murdered by a familial or caretaker relationship female (78.6%), whereas 100% of adolescent girls were murdered by males with higher rates of sexual assault (74.5%; p =0.003).

Discussion: Forensic nurses and health professionals are in a key position to conduct routine screenings, response-oriented interventions, violence prevention, and education on healthy relationships through person-centered care to Indigenous girls experiencing violence.

Background: Current Sexual Assault Nurse Examiner (SANE) education guidelines outline the minimum instruction needed for nurses to practice as SANEs. However, the same patients facing a higher prevalence of sexual violence are experiencing complex structural determinants of health, as well as ongoing stigma and discrimination in the health care setting. Therefore, SANE education should prepare nurses to care for survivors who disproportionately experience sexual violence.

Aim: To present our equity-focused SANE curriculum designed to build competencies for nurses caring for survivors disproportionately impacted by sexual violence.

Methods: Our SANE curriculum development was guided by cultural safety and intersectionality frameworks.

Conclusions: We believe our enhanced SANE curriculum has the potential to more effectively prepare nurses to fully care for all survivors, particularly those who disproportionately experience sexual violence. Implementation and long-term evaluation of patient care outcomes are warranted.

Background: Over 100,000 women present for emergency care after sexual assault (SA) annually in the United States. No large-scale prospective studies have assessed SA survivor experiences with police.

Aims: To evaluate SA survivor experiences with the police.

Methods: A large-scale longitudinal study was conducted of women who received SA nurse examiner examinations after presenting to the emergency department following SA at 12 sites (n = 706).

Results: At six weeks (n = 630), most women were interested in speaking with the police (75%), spoke with police, and reported positive experiences. Latinas and women with lower income were less likely to speak with police (χ2 = 4.76, p = 0.0370; χ2 = 11.37, p = 0.0008). Survivors with greater posttraumatic stress and previous trauma report worse experiences with police. Qualitative comments provide key points for police to consider.

Discussion: This study demonstrates high contact and overall satisfaction with police. However, disparities remain among Latinas, survivors with lower socioeconomic status, and survivors with previous life trauma.

Background: Forensic nursing (FN) is slowly increasing as an area of nursing practice in German-speaking Switzerland, particularly following the implementation of the Istanbul Convention.

Objectives: To explore FN roles, barriers, and support structures in this part of Switzerland.

Methods: Qualitative descriptive study involving 10 expert interviews with FNs.

Results: FNs aim to improve care for patients affected by violence, balancing direct patient contact with interprofessional collaboration. While they feel confident in their responsibilities, challenges include limited role awareness among other professionals and unclear role definitions. Interprofessional collaboration remains underdeveloped but significantly affects FN responsibilities. The integration of FNs into the Swiss health care system depends on various factors, including positive political pressure and funding.

Conclusions: Improved communication, clearer role definitions, and further research on FN practices in Switzerland are needed. Overcoming challenges is crucial if Swiss FNs are to meet international standards and maximize their role within the national health care framework.