Journal of forensic nursing最新文献

Background: Intimate partner violence (IPV) is a critical public health issue within the military. Nonfatal strangulation is a form of IPV that significantly raises the risk of future violence and increases the likelihood of homicide sevenfold.

Case reports: This article presents two case reports of women who presented to a military emergency department with the chief complaint of manual strangulation by their service member spouse. Their initial exam, injuries, and follow-up care are described.

Conclusion: IPV and nonfatal strangulation can cause severe internal damage regardless of visible external injuries. Thorough medical evaluation is essential to detect potentially life-threatening complications, including vascular, neurologic, or central nervous system damage. Enhanced prevention strategies in the military, along with adherence to evidence-based imaging and follow-up protocols, can mitigate the long-term physical and psychological effects of strangulation and improve family well-being and military readiness.

Introduction: Healthcare professionals play a vital role in the identification and assistance of individuals affected by trafficking who are seen in the healthcare setting. The objective of this project was to analyze a screening tool with newly added questions specifically geared at human trafficking and determine its efficacy in identifying trafficked persons who were seen in the emergency department or who were inpatients.

Methods: This retrospective cohort study occurred at a large Level 1 trauma center located in the Midwest. Nursing staff administered a mandatory Abuse Risk + Human Trafficking tool. A retrospective chart review was conducted. Data from the abuse screen were reviewed from April 1, 2021, to February 28, 2023.

Results: Of all positive screens on the Abuse Risk + Human Trafficking tool, 33% were positive for at least one human trafficking question. Among those with a positive screen on the human trafficking questions, 25 screenings (20 adults, five minors) were associated with patients who had documentation highly concerning for trafficking. There were also 11 screenings with documentation highly concerning for trafficking that did not screen positive on any human trafficking questions and were positive for the non-human-trafficking questions only.

Discussion: The addition of three human trafficking questions to create the Abuse Risk + Human Trafficking tool resulted in an increase in the identification of individuals exploited by human trafficking in this hospital setting when compared with the existing Abuse Risk tool that did not have the additional human trafficking questions.

Abstract: The Runaway Intervention Program (RIP) is a strengths-based, nurse-led home visitation and case management model for runaway youth at risk of sexual exploitation, violence, and mental health challenges. RIP aims to promote healthy development, reduce trauma responses, and lower risk behaviors. This study evaluates the effectiveness of three optional psychological interventions-individual therapy, group therapy, and combined therapy-administered by licensed mental health practitioners. Using archival data from 128 RIP participants enrolled between 2015 and 2019, the study assessed pretreatment and posttreatment posttraumatic stress disorder (PTSD) symptoms using the University of California Post t raumatic Stress Disorder Index.Statistical analysis suggested a reduction in PTSD symptoms from pretreatment ( M  = 35.33, SD = 15.29) to posttreatment ( M  = 22.91, SD = 16.31), regardless of treatment type. There was no significant difference in symptom reduction between the three treatment modalities, indicating comparable effectiveness across modalities. Across all treatment modalities, clinically significant change analysis showed that 41% of participants recovered, 51% showed no change, 2% improved, and 6% deteriorated. These findings suggest that although RIP interventions effectively reduce PTSD symptoms, no single modality outperformed the others. The results underscore the value of flexible therapeutic options to address the diverse needs of runaway youth.

Background: School nurses work in interprofessional teams to identify and care for youth involved in commercial sex trading. However, the school nurse role in the care of these youth is not well documented despite evidence suggesting youth who trade sex are attending U.S. public schools.

Study aim: To describe licensed school nurses' (LSNs) perspectives on interventions implemented to support youth who trade sex in Minnesota.

Methods: Twenty-one LSNs participated in an online focus group discussing their role in the support of youth who trade sex. Thematic analysis was used to identify and synthesize details about the interventions described.

Results: Four themes were identified: independent nursing interventions, collaborative interventions, barriers to intervention , and suggested support for improved intervention .

Conclusions and implications: School nurses rely on developing positive relationships with students, school staff, and community partners to intervene with youth who trade sex. Such relationships can facilitate identification of sexually exploited youth and may promote trauma-informed care when youth seek care from forensic nurses. Collaboration between forensic and school nurses is a promising yet underutilized school-based intervention for youth who trade sex.

Background: Commercial sexual exploitation of children (CSEC) is a critical public safety and health concern in the United States. While evidence exists on the healthcare needs of exploited youth, less is known about the barriers they face accessing care. Discrimination in health care is one barrier reported by exploited youth and can include the perception of being treated differently based on perceived intelligence, engagement in commercial sex, or not feeling heard by nurses or doctors.

Aims: To explore asa experienced or are at high risk of CSEC.

Methods: Survey data from a sample of 534 young people aged 13-24 years who experienced or are at risk of CSEC were collected via agency partnership and social media. Ordinary least squares and logistic regression models examined the associations among victimization histories and different perceived discrimination events in healthcare settings. CSEC disclosure is highly associated with discriminatory events in medical settings.

Results: Among evaluated victimization histories, CSEC experiences were the most highly associated with an increase in the odds of each discriminatory event in the present measure, compared to other victimization histories that yielded lower associations of discrimination in medical settings. Experiences of discrimination in health care are an underexamined barrier to CSEC victims seeking and engaging with health care.

Implications: By fostering a supportive, nonjudgmental environment, healthcare providers can improve healthcare experiences for CSEC survivors. Recommendations include enhancing training for healthcare professionals and creating more accessible and supportive healthcare services tailored to the unique needs of these young people.

Abstract: In the southeastern United States, sexual assault nurse examiners, registered nurses, and advanced practice registered nurses partnered with local, state, and federal law enforcement to provide comprehensive medical services to recovered persons of human trafficking. Medical services were provided in conjunction with Homeland Security Investigation's human trafficking recovery operations. Over five operations, 31 trafficked women were recovered and provided trauma-informed, holistic medical care. Medical services provided included pelvic exams, sexually transmitted infection testing and treatment, cancer screenings, pregnancy testing, and contraception. Supportive services such as nourishment, comfort items, and initial counseling sessions were also offered.

Abstract: Commercial sexual exploitation of children (CSEC) is a global public health crisis. CSEC is defined as the use of a child under the age of 18 years in a range of crimes and activities involving the sexual abuse or exploitation of the child for the financial benefit of any person or in exchange for anything of value given or received by any person. CSEC is a problem of epidemic proportions throughout the world including the United States. It is difficult to determine the true number of CSEC victims in the United States. However, the National Center for Missing & Exploited Children states that, in 2021, more than 17,200 reports of child sex trafficking were received from all 50 U.S. states and estimates that of the 25,000 children reported missing, one in six were likely victims of sex trafficking. CSEC can result in significant physical and mental health consequences for victims, even death. Studies indicate that CSEC victims are consumers of healthcare. Up to this point, the focus of healthcare related to CSEC has primarily been upon recognizing red flags that should raise CSEC concerns and the identification of victims. Although victim identification is critical, it is time for forensic nurses to understand their role in the prevention of CSEC. This narrative review will discuss the prevention of CSEC using a multitiered healthcare approach.

Abstract: The commercial sexual exploitation (CSE) of children occurs when individuals under the age of 18 years exchange sex/sexual acts for goods, services, drugs, or money. Current research suggests that many survivors of CSE had contact with a variety of professionals during their victimization experiences; however, many child CSE survivors are wary of those working with them in professional roles, including those seeking to engage them in regular care. The current study used qualitative interviews with professionals working with children who have experienced CSE to explore their strategies for facilitating trust. Qualitative data were collected from 80 diverse professionals from 11 different cities across the United States. Grounded theory analysis revealed three main themes regarding the facilitation of trust building: (a) clear communication, (b) humanization of experience, and (c) boundaries/limits. Findings from the current study offer practical implications for professionals, such as nurses, who are interested in facilitating rapport with children who have experienced CSE victimization in the interest of primary and tertiary prevention. Future research should focus on survivor perspectives to explore how professional's approaches are experienced by the populations they purport to serve.

Background: Human trafficking and sexual exploitation are pervasive issues in society. Forensic nurse examiners are skilled at identifying and assisting victims of trafficking and exploitation, who frequently seek healthcare. However, forensic nurse examiners often lack specialized training for trafficking cases, unlike their training for sexual assault, and may hold biases regarding a trafficking victim's appearance, complicating their response.

Aim: To bridge this knowledge gap, a Human Trafficking/Sexual Exploitation (HT/SE) Skills Lab was created and piloted by a multistate forensic nurse education program in a Midwest metropolitan area.

Methods: A survivor-centered approach was employed by collaborating with a human trafficking advocacy agency and a youth survivor panel to design curriculum, review scenarios, and co-instruct the lab. The lab used a combination of didactic and hands-on training to address gaps in both knowledge and skill.

Results: Nearly all participants reported an increase in knowledge, and over half showed skill improvement. Self-assessments showed 25% of learners progressed from "advanced beginner" to "competent" in handling trafficking cases. Facilitators rated learners' competence, with most participants showing advancement.

Conclusions: The pilot lab's success indicates that this HT/SE Clinical Skills Lab can be replicated across healthcare disciplines, potentially improving responses to HT/SE survivors beyond sexual assault contexts, but more practice is needed to reach true competence.