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2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000433pmid: 36917656
ABSTRACT Globally, it is estimated that more than one billion children experience corporal punishment in the home despite the fact that the use of corporal punishment is associated with a variety of negative consequences for children. The International Association of Forensic Nurses opposes the use of corporal punishment and encourages screening and education on its effects in health and school settings.
Farzadfar, Samira; Jafaraghaee, Fateme; Karkhah, Samad; Javadi-Pashaki, Nazila; Kazemnezhad Leyli, Ehsan; Sedghi Sabet, Mitra
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000443pmid: 37590945
ABSTRACT Background Appropriate clinical decision making (CDM) is very important for emergency nurses when working with forensic patients with violence-related injuries and can improve patient outcomes. Therefore, it is essential for emergency nurses to have the basic skills to make the right clinical decisions when working with forensic patients. Aim The aim of this study was to evaluate the CDM of emergency nurses when caring for forensic patients. Methods This study was conducted using a cross-sectional design. Nurses working in the seven emergency departments of Rasht hospitals, Guilan Province, Iran, were recruited to take part in the study. Data collection was performed via census sampling from September to November 2019. Data were collected via a two-part questionnaire developed by the researcher(s) that addressed (a) demographic characteristics and (b) simulated scenarios that assessed their CDM in caring for forensic patients. Findings One hundred ninety-two emergency nurses participated in this study. The mean score of CDM in forensic nursing was moderate (56.46; 95% CI [54.49, 58.43]). Of the participants, 60.42% of the emergency nurses had moderate CDM knowledge related to forensic nursing, whereas only 2.8% had desirable knowledge of CDM. There was a statistically significant relationship between CDM in forensic nursing and the history of encountering forensic patients (p = 0.008). Conclusion CDM scores regarding emergency nurses' knowledge of forensic nursing were moderate. Knowledge of and CDM in forensic nursing is very important and provides high-quality safe care for forensic patients. Implications for Clinical Forensic Nursing Practice This study highlights the importance of additional education and professional development in forensic nursing, for emergency nurses, and should be considered further by nursing administrators and nursing educators.
van Beek, Janneke; Meijers, Jesse; Scherder, Erik J. A.; Harte, Joke M.
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000424pmid: 36745759
ABSTRACT Aim A prospective design was used to investigate the relationship of current psychiatric symptoms of incarcerated people with serious mental illness (SMI) and aggressive behavior on a penitentiary ward for crisis intervention. Methods One hundred sixty detainees with SMI, detained in a high-security penitentiary psychiatric facility, were screened every 2 weeks with the Brief Psychiatric Rating Scale-Extended (BPRS-E) by trained clinicians, to ensure that the data on psychiatric symptoms were up-to-date. Aggressive behavior was registered with the Staff Observation Aggression Scale–Revised. A binary logistic regression analysis was performed to examine the relationships between factor scores of the BPRS-E and aggressive behavior. Results Significant relationships between the BPRS-E factor hostility, antisocial traits, and aggressive incidents were found, but not between the positive symptoms or manic factor scores and aggressive incidents. Discussion Symptoms of SMI measured with the BPRS-E did not help to explain the occurrence of aggressive behavior. This is not in line with what is commonly found. The implication is that it can be expected that this population will display aggressive behavior but that symptoms do not help in predicting when this will occur. In addition, hostility and antisocial traits were related to aggressive behavior. For this specific population, an interactional approach might be more effective in the management of aggression than treatment of symptoms of SMI.
Downing, Nancy R.; Avshman, Elaine; Valentine, Julie L.; Johnson, Luke M.; Chapa, Hector
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000430pmid: 36917678
ABSTRACT Background An estimated 25,000 pregnancies result from sexual assault in the United States annually. Numerous professional healthcare organizations endorse offering emergency contraception (EC) as an integrated aspect of post-sexual-assault care. Lack of knowledge surrounding EC's mechanism of action, including misinterpreting ECs as abortifacients, might restrict patient access to this important healthcare option. Purpose We evaluated sexual assault nurse examiners' understanding of the mechanism of action of oral ECs levonorgestrel (LNG) and ulipristal acetate (UPA). Methods A cross-sectional survey of practicing sexual assault nurse examiners was conducted through the International Association of Forensic Nurses. Results Among 173 respondents, 96.53% reported they prescribed/dispensed EC at the time of medical forensic examinations. LNG was prescribed more frequently than UPA (57.80% vs. 38.2%, respectively). When asked if they agreed or disagreed if LNG and UPA can disrupt an established pregnancy, 83.2% selected disagree/strongly disagree for LNG versus 78.6% for UPA, which were not significantly different. When asked whether the Supreme Court ruling overturning Roe v. Wade would change their EC prescribing, 79.77% reported it will have no change, 6.94% said it would increase, and 12.72% reported they were unsure. Several commented they were concerned whether state laws would prohibit EC and at least one program stopped prescribing EC because of their state laws. Implications Addressing misinformation regarding EC's mechanism of action and increasing access to oral EC options after sexual assault have the potential to reduce the incidence of rape-related pregnancy.
Hornor, Gail; Hollar, Jessica; Landers, Timothy; Sherfield, Jennifer
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000402pmid: 35953086
ABSTRACT Introduction The overall goal of this study was to provide further information about the characteristics of commercial sexual exploitation of children (CSEC) victims by comparing the characteristics of a known victim pool to high-risk patients identified. The specific objectives of this study were to describe patient demographic characteristics, pediatric healthcare use, familial psychosocial characteristics, and child sexual abuse case characteristics present in youth identified as high risk for CSEC victimization compared with a sample of known victims. Methods A retrospective chart review was conducted on patients presenting to the emergency department or Child Advocacy Center for a concern of sexual abuse/assault at a midwestern U.S. academic pediatric medical center. Adolescents aged 12–21 years were included in the study. Results In the current study, multiple CSEC risk factors were noted to increase odds for CSEC victimization: homelessness or life on the streets, runaway behavior, living with mother only, placement in a juvenile detention center, placement in a residential treatment center or group home, and number of living arrangements (four or greater). Multiple elements of high-risk sexual behavior increased odds of CSEC victimization: legally age-inappropriate sex, gonorrhea diagnosis, trichomonas diagnosis, other sexually transmitted infection (STI) diagnoses, number of STIs, and chlamydia diagnosis. Discussion These findings suggest that age of sexual partners and number and types of STIs are associated with CSEC and should be validated in other groups. In addition, these data suggest that use of cocaine and opiates could serve as an important, yet underrecognized, risk factor.
Jenkins, Danisha; Burton, Candace; Holmes, Dave
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000401pmid: 35696445
ABSTRACT Objective The objectives of this study were to give voice to the lived experiences of nurses and law enforcement officers (LEOs) who interact with one another in acute hospital settings and to interpret and understand their unique perspectives and experiences. Methods This qualitative study employed interpretative phenomenological analysis in the interviews of registered nurses and LEOs. The analysis and discussion was underpinned by biopolitical theories of power and control, including Georgio Agamben, Michel Foucault, and Erving Goffman. Results There is a paucity of literature on nurse and law enforcement interactions in the hospital setting. Nurses and law enforcement exerted power and authority through several means. Overwhelmingly, participants described a contentious dynamic between nurses and LEOs in the hospital, wrought with argument, stress, and a feeling of coming from “different worlds.” Conclusion The results provide alarming examples of deformed caring practices and assert the necessity for continued unearthing and discussion of how nurses can, and should, navigate law enforcement interaction. The tangible interference of care is of particular importance and consideration for nurses. Inequity in care and unfavorable outcomes for already marginalized and vulnerable populations are of grave concern. Additional research is needed on the specific ways this struggle for power between institutions and their political actors impairs caring practices and the emotional and psychological sequelae of these interactions.
Pralong, Dominique; Tran, Nguyen Toan; Mary, Gérard; Renaud, Audrey; Meach, Francesco; Wolff, Hans
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000392pmid: 35320137
ABSTRACT Introduction Daily in-hand medication dispensing in prisons and jails is resource intensive, disempowering, and nonconfidential. This research aimed to assess a nurse-initiated, low-frequency medication dispensing system using personal lockable boxes. Methods A cross-sectional study was carried out in a Swiss prison involving 47 box users and 19 custodial officers. Findings Box users agreed or strongly agreed about the perceived advantages of the box system, including user-friendliness, lower theft risk, and increased dignity, confidentiality, compliance, and autonomy to self-manage medication. Officers, who must accompany nurses during dispensing rounds, concurred that medication boxes were more time-efficient and improved role differentiation between custodial and clinical staff. Patients and officers were overall satisfied with the system and would recommend scaling it up in other facilities. Discussion This study suggests that medication boxes are feasible, acceptable, easy to use, and secure. Boxes could promote patients' autonomy, protect confidentiality, and allow nurses to dedicate more time to individual visits and health promotion and prevention activities.
Asikainen, Jaana; Vehviläinen-Julkunen, Katri; Repo-Tiihonen, Eila; Louheranta, Olavi
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000436pmid: 36994993
ABSTRACT Background Safety is of paramount importance to patients and staff in forensic mental health hospitals. Previous research has focused on organizational and nurses’ perceptions of safety and violence in psychiatric wards. However, little is known about how patients view their safety. This study aimed to describe how patient debriefing can improve safety. Methods Qualitative research using thematic analysis was used. Data were collected by semistructured interviews and debriefing forms. Inpatient interviews (n = 45) were conducted between June and July 2018, with debriefing forms (n = 376) collected retrospectively. Results Forensic inpatient responses were divided into two main categories: psychological and physical security. Psychological safety included care culture and patient-related themes. Responses on care culture highlighted weaknesses in nurse–patient communication, whereas patient-related themes related to respondents’ descriptions of the challenges posed by mental illness. Physical safety related to both the environment and patient-related themes, with various restrictions and environmental distractions seen by respondents as negatively affecting patient safety. Conclusions Patients who participated in the study felt that care culture, especially communication with nurses, most significantly impacted their safety. Forensic hospitals should consider patients’ perceptions of their care while systematically gathering information through debriefing, as these practices can contribute to the development of a safer care environment. The next step will be clarifying how changes in nursing practices and the care environment can be used to prevent violence in psychiatric wards.
Kosteniuk, Brynn; Dell, Colleen Anne; Cruz, Maria; Chalmers, Darlene
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000435pmid: 36971692
ABSTRACT Canine-assisted interventions are a promising approach to help address substance use and mental health issues in prisons. However, canine-assisted interventions in prisons have not been well explored in relation to experiential learning (EL) theory, despite canine-assisted interventions and EL aligning in many ways. In this article, we discuss a canine-assisted learning and wellness program guided by EL for prisoners with substance use issues in Western Canada. Letters written by participants to the dogs at the conclusion of the program suggest that such programming can help shift relational dynamics and the prison learning environment, benefit prisoners' thinking patterns and perspectives, and help prisoners generalize and apply key learnings to recovery from addiction and mental health challenges. Implications are discussed in relation to clinicians' practices, prisoners' health and wellness, and prison programming.
Selvin, Mikael; Almqvist, Kjerstin; Fogelkvist, Maria; Lundqvist, Lars-Olov; Schröder, Agneta
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000409pmid: 36094459
ABSTRACT Patient participation is central in modern health care. However, it is a complex phenomenon that lacks a clear definition, and what constitutes participation varies depending on the context and theoretical perspective. It is known that patient participation in forensic psychiatric care is often rated as low by both patients and professionals, and it can be assumed that interventions to increase it are beneficial. In this process, management and staff could benefit from assessing perceived patient participation, and reliable and valid measurement instruments are essential. The aim of this study was to develop an instrument that could be used to measure experiences of participation in forensic psychiatric care from a patient perspective and test it for content validity. A definition of patient participation in forensic psychiatric care was formulated and operationalized in an instrument that an expert group, consisting of patients with ongoing care, evaluated for content validity. In total, 50 items were sorted into five different dimensions: to have good communication, to be involved, to have mutual trust, to trust the care, and to take responsibility. After psychometric testing, the instrument has the potential to become a tool to use in research, clinical work, and development work in the field of forensic psychiatric care. In addition to being used as a measure, the Patient Participation in Forensic Psychiatric Care can also be used to encourage a dialogue about their care and to make both patients and staff more aware of patient participation.
2023 Journal of Forensic Nursing
doi: 10.1097/jfn.0000000000000420pmid: 36700673
ABSTRACT Patients presenting to the emergency department after strangulation are in need of specialized care and treatment. Patient presentations after nonfatal strangulations vary dramatically; however, regardless of variation, no assumptions should be made about the seriousness of the injury. The clinician's goal should be a thorough assessment and evaluation, followed by treatment in accordance with individual patient needs. One way to ensure this comprehensive care is through the implementation of forensic nursing care and a detailed nonfatal strangulation assessment. In this case report, three different cases of women who reported to the emergency department after strangulation by their intimate partners are presented. Although all three patients presented differently, it is imperative to remember that not all patients present in the same manner, and therefore, bias associated with lack of injury, or presentation with injury, should not deter the treatment provided.