Journal of forensic nursing最新文献

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.

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.

Background: Feelings of shame after interpersonal assault directly impact survivor well-being. Although the concept of trauma-related shame has been well defined and applied in psychology, the direct application to nursing care for victims of sexual assault is unclear.

Objective: The aim of this study was to perform an interdisciplinary concept analysis to clarify and synthesize the concept of trauma-related shame as it relates to interpersonal assault.

Method: A multidisciplinary literature search was conducted using the term "trauma-related shame." Article titles and abstracts were reviewed for significance to interpersonal assault. Rodgers' evolutionary method of concept analysis was used to identify attributes and related concepts and also clarify the contextual basis of trauma-related shame.

Results: The search resulted in 150 articles, 15 of which met the specified inclusion criteria. Fourteen of the selected articles were research studies, and one was a systematic review. A thematic analysis was used, and two attributes were identified: self-devaluation and self-isolation. An experience of trauma, fear, multivictimization, preexisting shame, low self-esteem, stigmatized events, and negative reactions from others were identified as antecedents. Finally, when reviewing for consequences, anxiety, depression, posttraumatic stress disorder, acute stress disorder, distress, poor health outcomes, social withdrawal, and suicidal tendencies were identified as common themes.

Conclusion: This concept analysis is a first step in the further development and implementation of trauma-related shame in nursing. It will be vital to the provision of holistic care for the profession to conduct research and publish literature related to shame for survivors of interpersonal traumatic events.

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.

Background: Child maltreatment is a significant global health concern with significant morbidity and mortality. Sexual assault forensic examiners (SAFEs) provide a valuable skill set and may be utilized in child maltreatment evaluations.

Aim: The purpose of the study was to describe patient characteristics and trends after implementation of a hospital-wide standardized child maltreatment protocol including forensic examiners in child maltreatment cases.

Methods: Data from January 2017 through December 2022 were retrospectively collected and reviewed on all children under 18 years old who had a child maltreatment evaluation after initiation of a standardized child maltreatment screening process and protocol incorporating SAFE forensic evaluations at a tertiary care Level 1 trauma center.

Results: From January 2017 through December 2022, there were 764 child maltreatment evaluations of 742 total patients completed, with 763 (99.9%) evaluations completed by a trained SAFE. There were 378 examinations (49%) completed in children under 2 years old, 281 (37%) in children 2 years old until the 10th birthday, and the remaining 105 (14%) in children 10 years and older. The overall number of cases increased since the initiation of standardized screening and protocol from 68 cases in 2017 to 158 cases in 2022, with peak of 167 cases in 2020.

Conclusion: SAFE-trained providers can be successfully incorporated in the multidisciplinary evaluation of child maltreatment patients and can add invaluable education, forensic documentation, and standardization of practice in the care of this vulnerable population.

Background: Although hotly disputed, coercive measures are widely used in mental health services globally. In Denmark, to ensure the rights of patients, special psychiatric legislation that emphasizes the imperative to always use the least intrusive intervention has been implemented. This raises the question of which coercive measures are perceived as being less intrusive than others.

Aim: The aim of this study was to investigate the perceptions of Danish mental health professionals regarding the intrusiveness of various coercive measures used in mental health settings.

Methods: We conducted a web-based survey among 132 mental health professionals (response rate: 22%). The participants rated the intrusiveness of different coercive measures using the visual analog scale (VAS).

Results: Mental health professionals perceived mechanical restraint as being the most intrusive coercive intervention (belt and strap fixation received a VAS rating of 92 out of 100). Conversely, body searches and observation were perceived as being among the least intrusive measures, with VAS ratings of 35 and 50, respectively. Participants with different professional backgrounds, including general and forensic mental health workers, tended to perceive the coercive measures included in this study as being equally intrusive.

Conclusion: The participating mental health professionals generally perceived belt fixation as a highly intrusive measure, whereas seclusion, which is currently illegal under Danish law, was considered less intrusive. Because of the small sample size in this study, caution should be exercised when drawing conclusions based on the findings. Nevertheless, the study may add to how the principle of using the least intrusive measure is interpreted.