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Introduktion: Forensisk omvårdnad blir ett allt mer aktuellt ämne för hälso- och sjukvårdspersonal då brottsliga handlingar ökar i dagens samhälle. Forensisk omvårdnad beskrivs som en specialitet både inom omvårdnad och rättsmedicin. Att bedöma, dokumentera och behandla skador, beträda eventuell brottsplats på korrekt sätt och vetskap om var eventuella fynd kan finnas som tyder på att ett brott har begåtts är exempel på vad som ingår i den forensiska omvårdnaden. Ambulanspersonal arbetar i många olika miljöer och situationer vilket innebär att de omedvetet eller medvetet kan behöva beträda en brottsplats. Syfte: Att beskriva ambulanspersonalens erfarenheter av forensisk omvårdnad vid misstänkt eller bekräftad brottsplats. Metod: Kvalitativ intervjustudie med ambulanssjukvårdare, sjuksköterskor och ambulanssjuksköterskor. Totalt 13 personer deltog rekryterande från hela Sverige. Intervjuerna analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i fem underkategorier: Prioritering är att rädda liv, Vikten av den egna tryggheten och säkerheten, Varierande förutsättningar i att beträda och agera, Strävan efter att inte förstöra bevismaterial och Bristande kunskap och utbildning. Av dessa skapades därefter en kategori: Att hantera forensisk omvårdnad i med och motgång på misstänkt eller bekräftad brottsplats. Slutsats: Ambulanspersonalens primära fokus är att rädda liv oavsett om de arbetar på en brottsplats. Trygghet och säkerhet främjar omhändertagandet av patienten, men ambulanspersonalen har bristande kunskap i hur platsen ska beträdas och hur bevismaterial skall behållas intakt. Av den anledningen är det betydande att implementera utbildning och riktlinjer för att stödja ambulanspersonalen i att hantera dessa situationer på bästa sätt. Ytterligare forskning i området är behövs för att kunna ge mer kunskap i området.

Introduktion: Varje år avlider 4,4 miljoner människor till följd av våld. Forensisk omvårdnad innebär att vårda våldsoffer, förövare och familjer som drabbats av våld samt samla in och bevara potentiellt bevismaterial som senare kan användas för att fälla en eventuell förövare. Ambulanspersonal har en unik möjlighet att upptäcka om en person blir utsatt för våld då ambulanspersonal ofta är först på plats och kan utvärdera patienten i dess hemmiljö. Vidare har ambulanspersonalen möjlighet att intervjua patienten under transporten in till sjukhus och samtidigt göra en närmare undersökning utan eventuell förövare i närheten. Syfte: Beskriva forensisk omvårdnad inom ambulanssjukvård. Metod: En systematisk integrativ litteraturstudie genomfördes och analyserades enligt Whittemore och Knafl´s femstegsmodell. Totalt inkluderades 14 artiklar i studien. Resultat: Fyra huvudkategorier identifierades. Identifiering av ett forensiskt fall, omvårdnadsåtgärder kopplade till forensisk omvårdnad, ambulanspersonalens behov av utbildning och verktyg och rädsla att göra fel. Konklusion: Det förelåg kunskapsluckor i att upptäcka tecken och symtom på våld som inte var tydligt framträdande. Ett behov av tydligare riktlinjer och mer utbildning inom forensisk omvårdnad inom ambulanssjukvård fanns., Introduction: Every year 4.4 million people suffer as a result of violence worldwide. Forensic nursing involves caring for victims, perpetrators and families affected by violence, and collecting and preserving of evidence in the chain of custody. Paramedics have a unique opportunity to identify a person who is exposed to violence since they are often first on scene and can evaluate the patient in its home environment. Paramedics have the opportunity to interview the patient during transport to the hospital and also do a closer examination without a possible perpetrator nearby. Aim: To describe forensic nursing in ambulance care. Method: A systematic integrative literature review was used and analysed using Whittemore and Knafl's five-step model. A total of 14 articles were included in the study. Results: The analysis resulted in four main categories. Identification of a forensic case, nursing care linked to forensic nursing, paramedics need for training and tools and fear of making mistakes. Conclusion: There is gap to be filled in detecting signs and symptoms of violence that are not obvious. Evident guidelines and more training in forensic nursing are needed in ambulance medical care.

Introduktion: Varje år avlider 4,4 miljoner människor till följd av våld. Forensisk omvårdnad innebär att vårda våldsoffer, förövare och familjer som drabbats av våld samt samla in och bevara potentiellt bevismaterial som senare kan användas för att fälla en eventuell förövare. Ambulanspersonal har en unik möjlighet att upptäcka om en person blir utsatt för våld då ambulanspersonal ofta är först på plats och kan utvärdera patienten i dess hemmiljö. Vidare har ambulanspersonalen möjlighet att intervjua patienten under transporten in till sjukhus och samtidigt göra en närmare undersökning utan eventuell förövare i närheten. Syfte: Beskriva forensisk omvårdnad inom ambulanssjukvård. Metod: En systematisk integrativ litteraturstudie genomfördes och analyserades enligt Whittemore och Knafl´s femstegsmodell. Totalt inkluderades 14 artiklar i studien. Resultat: Fyra huvudkategorier identifierades. Identifiering av ett forensiskt fall, omvårdnadsåtgärder kopplade till forensisk omvårdnad, ambulanspersonalens behov av utbildning och verktyg och rädsla att göra fel. Konklusion: Det förelåg kunskapsluckor i att upptäcka tecken och symtom på våld som inte var tydligt framträdande. Ett behov av tydligare riktlinjer och mer utbildning inom forensisk omvårdnad inom ambulanssjukvård fanns., Introduction: Every year 4.4 million people suffer as a result of violence worldwide. Forensic nursing involves caring for victims, perpetrators and families affected by violence, and collecting and preserving of evidence in the chain of custody. Paramedics have a unique opportunity to identify a person who is exposed to violence since they are often first on scene and can evaluate the patient in its home environment. Paramedics have the opportunity to interview the patient during transport to the hospital and also do a closer examination without a possible perpetrator nearby. Aim: To describe forensic nursing in ambulance care. Method: A systematic integrative literature review was used and analysed using Whittemore and Knafl's five-step model. A total of 14 articles were included in the study. Results: The analysis resulted in four main categories. Identification of a forensic case, nursing care linked to forensic nursing, paramedics need for training and tools and fear of making mistakes. Conclusion: There is gap to be filled in detecting signs and symptoms of violence that are not obvious. Evident guidelines and more training in forensic nursing are needed in ambulance medical care.

Introduktion: Forensisk omvårdnad blir ett allt mer aktuellt ämne för hälso- och sjukvårdspersonal då brottsliga handlingar ökar i dagens samhälle. Forensisk omvårdnad beskrivs som en specialitet både inom omvårdnad och rättsmedicin. Att bedöma, dokumentera och behandla skador, beträda eventuell brottsplats på korrekt sätt och vetskap om var eventuella fynd kan finnas som tyder på att ett brott har begåtts är exempel på vad som ingår i den forensiska omvårdnaden. Ambulanspersonal arbetar i många olika miljöer och situationer vilket innebär att de omedvetet eller medvetet kan behöva beträda en brottsplats. Syfte: Att beskriva ambulanspersonalens erfarenheter av forensisk omvårdnad vid misstänkt eller bekräftad brottsplats. Metod: Kvalitativ intervjustudie med ambulanssjukvårdare, sjuksköterskor och ambulanssjuksköterskor. Totalt 13 personer deltog rekryterande från hela Sverige. Intervjuerna analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i fem underkategorier: Prioritering är att rädda liv, Vikten av den egna tryggheten och säkerheten, Varierande förutsättningar i att beträda och agera, Strävan efter att inte förstöra bevismaterial och Bristande kunskap och utbildning. Av dessa skapades därefter en kategori: Att hantera forensisk omvårdnad i med och motgång på misstänkt eller bekräftad brottsplats. Slutsats: Ambulanspersonalens primära fokus är att rädda liv oavsett om de arbetar på en brottsplats. Trygghet och säkerhet främjar omhändertagandet av patienten, men ambulanspersonalen har bristande kunskap i hur platsen ska beträdas och hur bevismaterial skall behållas intakt. Av den anledningen är det betydande att implementera utbildning och riktlinjer för att stödja ambulanspersonalen i att hantera dessa situationer på bästa sätt. Ytterligare forskning i området är behövs för att kunna ge mer kunskap i området.

Inledning: Med ökad förekomst av våld i Sverige blir forensisk omvårdnad ett alltmer aktuellt ämne inom vården. Forensisk omvårdnad är länken som binder samman sjukvård och rättsväsende. Patientgruppen består av förövare, brottsoffer och anhöriga. Insamling och bevarande av bevis är förekommande saker inom forensisk omvårdnad. Syfte: Var att beskriva sjuksköterskans erfarenheter av forensisk omvårdnad i mötet med vuxna brottsoffer. Metod: Allmän litteraturöversikt med kvalitativ ansats, nio artiklar analyserades och bearbetades. Resultat: Två kategorier arbetades fram i resultatet; hinder i omhändertagandet av bevis och sjuksköterskans emotionella utmaning. Två underkategorier var; brist på kunskap, rutiner samt protokoll och brist på tid. Behandling som inger empati och trygghet är viktig. Utan utbildning i forensisk omvårdnad blir det svårt för sjuksköterskor att identifiera och ge adekvat samt korrekt vård till patientgruppen. Slutsats: Forensisk omvårdnad kan bidra till att gärningsmän fälls, skapa upprättelse för brottsoffer och säker vård. Sjuksköterskans arbete för att upptäcka och förebygga våldsbrott är viktigt. Därmed är sjuksköterskors utbildning i forensisk omvårdnad avgörande. Det finns behov av ytterligare forskning inom området för att kunna tillföra mer kunskap., Introduction: With increased incidence of violence in Sweden, forensic nursing is becoming an increasingly topical topic in healthcare. Forensic nursing is the link that connects healthcare and the justice system. The patient group consists of perpetrators, victims and relatives. Collection and preservation of evidence are things occurring in forensic nursing. Purpose: To describe the nurse's experiences of forensic nursing in the meeting with adult crime victims. Method: Literature review with a qualitative approach, nine articles were analyzed and processed. Results: Two categories were worked out in the results; barriers in handling evidence and the nurse's emotional challenge. Two subcategories were; lack of knowledge, routines and protocols and lack of time. Treatment that instills empathy and security is important. Without training in forensic nursing, it becomes difficult for nurses to identify and provide adequate and correct care to the patient group. Conclusion: Forensic nursing can contribute to the conviction of perpetrators, create redress for crime victims and safe care. The nurse's work to detect and prevent violent crimes is important. Thus, nurses' training in forensic nursing is crucial. There is a need for further research in the area in order to add more knowledge.

Psykiskt trauma är vanligt hos patienter inom rättspsykiatrisk vård. Det finns idag effektiva metoder som traumamedveten omvårdnad för att vårda trauma. Det saknas forskning om hur sjuksköterskor inom denna vårdkontext upplever arbetet med trauma. Huvudsyftet med studien var att utforska sjuksköterskans arbete med trauma inom rättspsykiatrisk vård. Sju semistrukturerade intervjuer genomfördes med sjuksköterskor som arbetade inom rättspsykiatrisk vård. Intervjuerna transkriberades och analyserades med konventionell innehållsanalys med induktiv ansats. Resultatet var tre huvudteman: Sjuksköterskans arbete med trauma, Hinder i att arbeta med patientens trauma och Utvecklingsmöjligheter inom vården. Sjuksköterskor använder olika sätt att identifiera trauma och önskar mer kunskap i ämnet. Sjuksköterskor erfar hinder såsom patientens egna svårigheter och organisatoriska brister. Som slutsats konstateras att sjuksköterskor beskriver svårigheter med att arbeta omvårdnadsmässigt med trauma hos patienter inom rättspsykiatrisk vård, som bristande kunskap, bristande rutiner och bristande avdelningskulturer. Sjuksköterskorna har en vilja att upptäcka, förebygga och vårda trauma genom att förändra rutiner och lära sig mer om evidensbaserade behandlingsmetoder i vårdandet av trauma. Vidare beskrivs att den finns en medvetenhet om att delar av den rättspsykiatriska vården kan vara potentiellt traumatiserande eller retraumatiserande. Sjuksköterskorna beskriver att de har metoder för att förebygga denna risk genom att till exempel arbeta med tydlig information och lugn., Mental trauma is common among patients in forensic psychiatric care. Today, there are such as Trauma-informed Care to There is a lack ofresearch on how nurses within forensic psychiatry experience their work with trauma. The main purpose of the study was to explore how nurses describe their work with trauma in forensic psychiatric care. Seven semi-structured interviews were conducted with nurses working in forensic psychiatric care. The interviews were transcribed and analyzed with a conventional content analysis with inductive approach. The result ended up in three main themes: How the nurse works with trauma, The difficulties in working with the patients’ trauma and Opportunities for Development in Care. Nurses use different ways to identify effective methods nurture trauma. trauma and want more knowledge of the subject. Nurses experience obstacles such as the patient's own difficulties and organizational shortcomings. In conclusion, it is stated that nurses describe difficulties in working with nursing the trauma of patients in forensic psychiatric care, such as lack of knowledge, lack of routines and lack of ward cultures. Nurses have a desire to detect, prevent and nurture trauma by changing routines and learning more about evidence-based treatment methods in the care of trauma. It is further described that there is an awareness that parts of forensic psychiatric care can be potentially traumatic or retraumatizing. The nurses describe that they have methods for preventing this risk by, for example, working with clear information and being calm.

Background: Forensic psychiatric care (FPC) encompasses involuntary care and treatment of those who have committed a crime. On the one hand, FPC is constructed regarding the respect for the individual’s freedom and autonomy, and on the other hand, it is constructed on societal protection. Being a carer in FPC is intertwined with being faced with a distinct ethical dimension of care, as it involves caring for patients who are deprived of their freedom, meaning dealing with the tension of care and custody. Caring means often finding oneself in encounters with individuals with inevitable elements of rules, coercion, threats, and violence. In this complex environment, a caring relationship is to be established, which is intended to be built on trust, as a forensic nurse’s main purpose is creating wellbeing and care, based on the patient’s perspective. It is in the everyday encounters that occur often spontaneously that the carer–patient relationship should be established. It is in these encounters that the carer is given the opportunity to relive suffering. The encounter becomes the focal point where the lifeworlds of the carer and patient meet. Dealing with the duality of FPC and contradictory emotions requires a deeper understanding, which encourages to self reflect the meaning of these encounters and oneself as a carer. Aim: The overarching purpose of the thesis was to obtain a deeper understanding of carers’ lived experience of encounters with patients with mental illness in forensic inpatient care. Method: The thesis consists of four studies (I, II, III, IV) with qualitative design, based on ontological and epistemological reasonings of phenomenology and hermeneutics. The studies illuminated the lived experience and are conducted with phenomenological hermeneutics (I, III), hermeneutics (II), and reflective lifeworld research (IV). Findings: Encounters with patients are characterised with the duality of acting upon the patients’ needs and managing rules and norms s, Bakgrund: Rättspsykiatri (FPC) omfattar tvångsvård, behandling och omvårdnad av individer som begått brott. FPC är konstruerat ur avseende för respekten för individens frihet och autonomi, å andra sidan om samhällsskydd. Att vara vårdare i FPC är sammanflätad med att ställas inför en distinkt etisk dimension av vården, eftersom det handlar om att ta hand om patienter som är berövade sin frihet, det vill säga att hantera spänningen mellan omsorg och samhällsskydd. Omsorg innebär ofta att befinna sig i möten med individer med oundvikliga inslag av regler, tvång, hot och våld. I denna komplexa miljö ska en omtänksam relation etableras, som är tänkt att bygga på förtroende, då rättspsykiatrins huvudsakliga syfte är att skapa välbefinnande och utgå från patientens perspektiv. Det är i de vardagliga möten som ofta uppstår spontant, vård- och patientrelationen ska etableras. Det är i dessa möten vårdaren ges möjlighet att lindra lidande. Mötet blir samlingspunkten där vårdarens och patientens livsvärldar kan mötas. Att hantera dualiteten av FPC och motsägelsefulla känslor kräver en djupare förståelse som uppmuntrar till självreflektion angående innebörden av dessa möten och därmed sig själv som vårdare. Syfte: Det övergripande syftet med avhandlingen var att få en djupare förståelse av vårdares levda erfarenhet av mötet med patienter med psykisk ohälsa inom rättspsykiatrisk slutenvård ur vårdarnas perspektiv. Metod: Avhandlingen består av fyra studier (I, II, III, IV) med kvalitativ design, baserad på ontologiska och epistemologiska resonemang inom fenomenologi och hermeneutik. Studierna belyser den levda erfarenheten och är bedriven enligt fenomenologisk hermeneutik (I, III), hermeneutik (II) och reflekterande livsvärldsforskning (IV). Resultat: Mötet med patienter kännetecknas av dualiteten att agera utifrån patienternas behov och hantera regler och normer som fastställs i lagar och förordni

Forensic nurses engaged in medicolegal death investigations experience trauma-induced responses in responding to, investigating, and documenting sudden unexpected deaths. The trauma of these repeated experiences often results in diminished performance, job dissatisfaction, and burnout. The principles of trauma-informed care are not new but have not been incorporated into death investigation practices. When coupled with medicolegal death investigation procedures, application of these principles can help to alleviate distress for forensic nurses, colleagues, and decedents of concerned families. This case series illustrates how the principles of trauma-informed care can be implemented to enhance communication, deescalate emotional or threatening situations, and prevent retraumatization in the context of medicolegal death investigations.

Although numerous training options exist for sexual assault nurse examiner certification, most focus on specific certification-related content rather than on creating a holistic preparation for sexual assault nurse examiner (SANE) practice. Holistic preparation may be preferable for SANE trainees who are early in their nursing careers or who have practiced in limited clinical environments. This article describes a holistic training approach implemented at a SANE training site funded by the Advanced Nursing Education initiative of the Health Resources and Services Administration. Training covers hands-on pelvic and anal examinations, community education, underserved communities, self-care, and other topics that support newly trained SANEs in establishing and maintaining practice. This content has prepared trainees for a wide variety of patient encounters as well as for engaging with the community. With this approach, our trainees have the opportunity to enhance their ability to provide SANE care and to provide additional resources within their primary practice environments.

En akutsjuksköterska möter varje dag patienter som utsatts för våld. Detta skapar osäkerhet och oro hos akutsjuksköterskan eftersom brist på utbildning och verktyg genom-syrar arbetet med den forensiska patienten. Vårdmötet med patienten som utsatts för våld ställer stora krav på akutsjuksköterskans kunnande att både bedriva en säker forensisk omvårdnad samtidigt som vårdmötet ska ske med omsorg och värdighet. Syftet med studien är att utforska tillgänglig litteratur gällande akutsjuksköterskors kunskap gällande forensisk omvårdnad på akutmottagning. Examensarbetet genomfördes som en systematisk och integrativ litteraturstudie där 13 artiklar med både kvalitativ och kvantitativ ansats granskades. Det redovisade resultatet innehåller artiklar från sex kontinenter vilket visar på en geografisk spridning. En tematisk analys genomfördes. Resultatet redovisas i tre teman: Kunnandet om det forensiska arbetet, rutiner och riktlinjer om det forensiska arbetet och mötet med våldsutsatta patienter. Resultatet visade att akutsjuksköterskan upplever stora brister i utbildning och tillgång på verktyg som kan användas i det forensiska arbetet. Dessa brister skapar otrygghet och rädsla hos akutsjuksköterskan i omhändertagandet av den våldsutsatta patienten. Avsaknad av rutiner och policydokument leder till att akutsjuksköterskan inte vill vara en del av den forensiska omvårdnaden. Känslorna som akutsjuksköterskan upplever påverkar vårdmötet med patienten som utsatts för våld. Akutsjuksköterskan behöver fokusera på att skapa ett omtänksamt vårdmöte och vara närvarande för att minska patientens lidande. Genom ett öppet förhållningssätt och förmågan att visa medmänsklighet kan akutsjuksköterskan lindra framtida men för patienten som utsatts för våld., Every day, an emergency nurse meets patients who have been subjected to violence. That creates uncertainty and anxiety for the emergency nurse as lack of training, education and available praxis affects the work around the forensic patient. To meet with patients who are victims of violence puts high demands on the emergency nurse knowledge to operate forensic nursing and at the same time nurse for the patient vid dignity and care. The aim of this study is to explore all available litterature about the emergency nurse’s knowledge among forensic nursing in the emergency department. This thesis was carried out as a systematic integrative litterature review where 13 articles with both qualitative and quantitative data were analysed. The carrying result includes articles from 6 continents which shows a widespread. A thematic analyse was carried out through the method designed by Braun and Clarke. The result is presented in three themes: the knowledge of the forensic work, routines and guidelines in the forensic and meeting with the patient who are victim of violence. The results show that the emergency nurse experiences major deficiencies in training and access to tools that can be used in forensic work. These shortcomings create insecurity and fear among the emergency nurse in the care of the abused patient. Lack of routines and policy documents leads to the emergency nurse not wanting to be part of the forensic care. The feelings experienced by the emergency nurse affect the care meeting with the patient who has been subjected to violence. The emergency nurse needs to focus on creating a caring meeting and be present to reduce the patient's suffering. Through an open approach and the ability to show compassion, the emergency nurse can alleviate future but for the patient who has been subjected to violence.

En akutsjuksköterska möter varje dag patienter som utsatts för våld. Detta skapar osäkerhet och oro hos akutsjuksköterskan eftersom brist på utbildning och verktyg genom-syrar arbetet med den forensiska patienten. Vårdmötet med patienten som utsatts för våld ställer stora krav på akutsjuksköterskans kunnande att både bedriva en säker forensisk omvårdnad samtidigt som vårdmötet ska ske med omsorg och värdighet. Syftet med studien är att utforska tillgänglig litteratur gällande akutsjuksköterskors kunskap gällande forensisk omvårdnad på akutmottagning. Examensarbetet genomfördes som en systematisk och integrativ litteraturstudie där 13 artiklar med både kvalitativ och kvantitativ ansats granskades. Det redovisade resultatet innehåller artiklar från sex kontinenter vilket visar på en geografisk spridning. En tematisk analys genomfördes. Resultatet redovisas i tre teman: Kunnandet om det forensiska arbetet, rutiner och riktlinjer om det forensiska arbetet och mötet med våldsutsatta patienter. Resultatet visade att akutsjuksköterskan upplever stora brister i utbildning och tillgång på verktyg som kan användas i det forensiska arbetet. Dessa brister skapar otrygghet och rädsla hos akutsjuksköterskan i omhändertagandet av den våldsutsatta patienten. Avsaknad av rutiner och policydokument leder till att akutsjuksköterskan inte vill vara en del av den forensiska omvårdnaden. Känslorna som akutsjuksköterskan upplever påverkar vårdmötet med patienten som utsatts för våld. Akutsjuksköterskan behöver fokusera på att skapa ett omtänksamt vårdmöte och vara närvarande för att minska patientens lidande. Genom ett öppet förhållningssätt och förmågan att visa medmänsklighet kan akutsjuksköterskan lindra framtida men för patienten som utsatts för våld., Every day, an emergency nurse meets patients who have been subjected to violence. That creates uncertainty and anxiety for the emergency nurse as lack of training, education and available praxis affects the work around the forensic patient. To meet with patients who are victims of violence puts high demands on the emergency nurse knowledge to operate forensic nursing and at the same time nurse for the patient vid dignity and care. The aim of this study is to explore all available litterature about the emergency nurse’s knowledge among forensic nursing in the emergency department. This thesis was carried out as a systematic integrative litterature review where 13 articles with both qualitative and quantitative data were analysed. The carrying result includes articles from 6 continents which shows a widespread. A thematic analyse was carried out through the method designed by Braun and Clarke. The result is presented in three themes: the knowledge of the forensic work, routines and guidelines in the forensic and meeting with the patient who are victim of violence. The results show that the emergency nurse experiences major deficiencies in training and access to tools that can be used in forensic work. These shortcomings create insecurity and fear among the emergency nurse in the care of the abused patient. Lack of routines and policy documents leads to the emergency nurse not wanting to be part of the forensic care. The feelings experienced by the emergency nurse affect the care meeting with the patient who has been subjected to violence. The emergency nurse needs to focus on creating a caring meeting and be present to reduce the patient's suffering. Through an open approach and the ability to show compassion, the emergency nurse can alleviate future but for the patient who has been subjected to violence.

Objective: to unveil experts’ experiences on traces not preserved by health and safety professionals. Methods: qualitative research developed with 27 criminal experts through telephone interview. Data were processed in IraMuTeQ and analyzed by the Descending Hierarchical Classification. Results: four thematic classes were obtained that evidenced the existence of a communication gap with the pre-hospital service experienced by experts, who believe that training of these professionals and police officers is necessary. In cases of differentiation between suicide and homicide, experts experience corpse mobilization, in addition to weapon removal from the original location. Health professionals mischaracterize the victim’s corpse and leave health care objects, such as gloves and syringes, in place, while police mischaracterize the scene, move objects and do not adequately isolate the scene. Conclusion: experts experience forensic traces not preserved by health and safety professionals in the position of objects and the victim’s corpse, feel a communication gap and point out the need for training and awareness of professionals. Contribution to practice: the findings can redirect the training of police officers and health professionals who work with crime situations., Objetivo: desvelar a vivência de peritos sobre vestígios não preservados por profissionais da saúde e segurança. Métodos: pesquisa qualitativa desenvolvida com 27 peritos criminais por meio de entrevista telefônica. Os dados foram processados no Software IraMuTeQ e analisados pela Classificação Hierárquica Descendente. Resultados: foram obtidas quatro classes temáticas que evidenciaram a existência de lacuna de comunicação com o serviço pré-hospitalar vivenciada pelos peritos, os quais acreditam ser necessário treinamento desses profissionais e dos policiais. Nos casos de diferenciação entre suicídio e homicídio, os peritos vivenciam a mobilização do cadáver, além da retirada de arma do local original. Os profissionais da saúde descaracterizam o corpo da vítima e deixam no local objetos do cuidado em saúde, como luvas e seringas, enquanto os policiais descaracterizam a cena, movimentam objetos e não isolam a cena adequadamente. Conclusão: os peritos vivenciam vestígios forenses não preservados pelos profissionais de saúde e segurança na posição dos objetos e do corpo da vítima, sentem lacuna de comunicação e apontam a necessidade de treinamento e sensibilização dos profissionais. Contribuição para a prática: os achados podem redirecionar o treinamento de policiais e profissionais de saúde que atuam com situações de crime.

Psykiskt trauma är vanligt hos patienter inom rättspsykiatrisk vård. Det finns idag effektiva metoder som traumamedveten omvårdnad för att vårda trauma. Det saknas forskning om hur sjuksköterskor inom denna vårdkontext upplever arbetet med trauma. Huvudsyftet med studien var att utforska sjuksköterskans arbete med trauma inom rättspsykiatrisk vård. Sju semistrukturerade intervjuer genomfördes med sjuksköterskor som arbetade inom rättspsykiatrisk vård. Intervjuerna transkriberades och analyserades med konventionell innehållsanalys med induktiv ansats. Resultatet var tre huvudteman: Sjuksköterskans arbete med trauma, Hinder i att arbeta med patientens trauma och Utvecklingsmöjligheter inom vården. Sjuksköterskor använder olika sätt att identifiera trauma och önskar mer kunskap i ämnet. Sjuksköterskor erfar hinder såsom patientens egna svårigheter och organisatoriska brister. Som slutsats konstateras att sjuksköterskor beskriver svårigheter med att arbeta omvårdnadsmässigt med trauma hos patienter inom rättspsykiatrisk vård, som bristande kunskap, bristande rutiner och bristande avdelningskulturer. Sjuksköterskorna har en vilja att upptäcka, förebygga och vårda trauma genom att förändra rutiner och lära sig mer om evidensbaserade behandlingsmetoder i vårdandet av trauma. Vidare beskrivs att den finns en medvetenhet om att delar av den rättspsykiatriska vården kan vara potentiellt traumatiserande eller retraumatiserande. Sjuksköterskorna beskriver att de har metoder för att förebygga denna risk genom att till exempel arbeta med tydlig information och lugn., Mental trauma is common among patients in forensic psychiatric care. Today, there are such as Trauma-informed Care to There is a lack ofresearch on how nurses within forensic psychiatry experience their work with trauma. The main purpose of the study was to explore how nurses describe their work with trauma in forensic psychiatric care. Seven semi-structured interviews were conducted with nurses working in forensic psychiatric care. The interviews were transcribed and analyzed with a conventional content analysis with inductive approach. The result ended up in three main themes: How the nurse works with trauma, The difficulties in working with the patients’ trauma and Opportunities for Development in Care. Nurses use different ways to identify effective methods nurture trauma. trauma and want more knowledge of the subject. Nurses experience obstacles such as the patient's own difficulties and organizational shortcomings. In conclusion, it is stated that nurses describe difficulties in working with nursing the trauma of patients in forensic psychiatric care, such as lack of knowledge, lack of routines and lack of ward cultures. Nurses have a desire to detect, prevent and nurture trauma by changing routines and learning more about evidence-based treatment methods in the care of trauma. It is further described that there is an awareness that parts of forensic psychiatric care can be potentially traumatic or retraumatizing. The nurses describe that they have methods for preventing this risk by, for example, working with clear information and being calm.

Background: Forensic psychiatric care (FPC) encompasses involuntary care and treatment of those who have committed a crime. On the one hand, FPC is constructed regarding the respect for the individual’s freedom and autonomy, and on the other hand, it is constructed on societal protection. Being a carer in FPC is intertwined with being faced with a distinct ethical dimension of care, as it involves caring for patients who are deprived of their freedom, meaning dealing with the tension of care and custody. Caring means often finding oneself in encounters with individuals with inevitable elements of rules, coercion, threats, and violence. In this complex environment, a caring relationship is to be established, which is intended to be built on trust, as a forensic nurse’s main purpose is creating wellbeing and care, based on the patient’s perspective. It is in the everyday encounters that occur often spontaneously that the carer–patient relationship should be established. It is in these encounters that the carer is given the opportunity to relive suffering. The encounter becomes the focal point where the lifeworlds of the carer and patient meet. Dealing with the duality of FPC and contradictory emotions requires a deeper understanding, which encourages to self reflect the meaning of these encounters and oneself as a carer. Aim: The overarching purpose of the thesis was to obtain a deeper understanding of carers’ lived experience of encounters with patients with mental illness in forensic inpatient care. Method: The thesis consists of four studies (I, II, III, IV) with qualitative design, based on ontological and epistemological reasonings of phenomenology and hermeneutics. The studies illuminated the lived experience and are conducted with phenomenological hermeneutics (I, III), hermeneutics (II), and reflective lifeworld research (IV). Findings: Encounters with patients are characterised with the duality of acting upon the patients’ needs and managing rules and norms s, Bakgrund: Rättspsykiatri (FPC) omfattar tvångsvård, behandling och omvårdnad av individer som begått brott. FPC är konstruerat ur avseende för respekten för individens frihet och autonomi, å andra sidan om samhällsskydd. Att vara vårdare i FPC är sammanflätad med att ställas inför en distinkt etisk dimension av vården, eftersom det handlar om att ta hand om patienter som är berövade sin frihet, det vill säga att hantera spänningen mellan omsorg och samhällsskydd. Omsorg innebär ofta att befinna sig i möten med individer med oundvikliga inslag av regler, tvång, hot och våld. I denna komplexa miljö ska en omtänksam relation etableras, som är tänkt att bygga på förtroende, då rättspsykiatrins huvudsakliga syfte är att skapa välbefinnande och utgå från patientens perspektiv. Det är i de vardagliga möten som ofta uppstår spontant, vård- och patientrelationen ska etableras. Det är i dessa möten vårdaren ges möjlighet att lindra lidande. Mötet blir samlingspunkten där vårdarens och patientens livsvärldar kan mötas. Att hantera dualiteten av FPC och motsägelsefulla känslor kräver en djupare förståelse som uppmuntrar till självreflektion angående innebörden av dessa möten och därmed sig själv som vårdare. Syfte: Det övergripande syftet med avhandlingen var att få en djupare förståelse av vårdares levda erfarenhet av mötet med patienter med psykisk ohälsa inom rättspsykiatrisk slutenvård ur vårdarnas perspektiv. Metod: Avhandlingen består av fyra studier (I, II, III, IV) med kvalitativ design, baserad på ontologiska och epistemologiska resonemang inom fenomenologi och hermeneutik. Studierna belyser den levda erfarenheten och är bedriven enligt fenomenologisk hermeneutik (I, III), hermeneutik (II) och reflekterande livsvärldsforskning (IV). Resultat: Mötet med patienter kännetecknas av dualiteten att agera utifrån patienternas behov och hantera regler och normer som fastställs i lagar och förordni

Background: Forensic psychiatric care (FPC) encompasses involuntary care and treatment of those who have committed a crime. On the one hand, FPC is constructed regarding the respect for the individual’s freedom and autonomy, and on the other hand, it is constructed on societal protection. Being a carer in FPC is intertwined with being faced with a distinct ethical dimension of care, as it involves caring for patients who are deprived of their freedom, meaning dealing with the tension of care and custody. Caring means often finding oneself in encounters with individuals with inevitable elements of rules, coercion, threats, and violence. In this complex environment, a caring relationship is to be established, which is intended to be built on trust, as a forensic nurse’s main purpose is creating wellbeing and care, based on the patient’s perspective. It is in the everyday encounters that occur often spontaneously that the carer–patient relationship should be established. It is in these encounters that the carer is given the opportunity to relive suffering. The encounter becomes the focal point where the lifeworlds of the carer and patient meet. Dealing with the duality of FPC and contradictory emotions requires a deeper understanding, which encourages to self reflect the meaning of these encounters and oneself as a carer. Aim: The overarching purpose of the thesis was to obtain a deeper understanding of carers’ lived experience of encounters with patients with mental illness in forensic inpatient care. Method: The thesis consists of four studies (I, II, III, IV) with qualitative design, based on ontological and epistemological reasonings of phenomenology and hermeneutics. The studies illuminated the lived experience and are conducted with phenomenological hermeneutics (I, III), hermeneutics (II), and reflective lifeworld research (IV). Findings: Encounters with patients are characterised with the duality of acting upon the patients’ needs and managing rules and norms s, Bakgrund: Rättspsykiatri (FPC) omfattar tvångsvård, behandling och omvårdnad av individer som begått brott. FPC är konstruerat ur avseende för respekten för individens frihet och autonomi, å andra sidan om samhällsskydd. Att vara vårdare i FPC är sammanflätad med att ställas inför en distinkt etisk dimension av vården, eftersom det handlar om att ta hand om patienter som är berövade sin frihet, det vill säga att hantera spänningen mellan omsorg och samhällsskydd. Omsorg innebär ofta att befinna sig i möten med individer med oundvikliga inslag av regler, tvång, hot och våld. I denna komplexa miljö ska en omtänksam relation etableras, som är tänkt att bygga på förtroende, då rättspsykiatrins huvudsakliga syfte är att skapa välbefinnande och utgå från patientens perspektiv. Det är i de vardagliga möten som ofta uppstår spontant, vård- och patientrelationen ska etableras. Det är i dessa möten vårdaren ges möjlighet att lindra lidande. Mötet blir samlingspunkten där vårdarens och patientens livsvärldar kan mötas. Att hantera dualiteten av FPC och motsägelsefulla känslor kräver en djupare förståelse som uppmuntrar till självreflektion angående innebörden av dessa möten och därmed sig själv som vårdare. Syfte: Det övergripande syftet med avhandlingen var att få en djupare förståelse av vårdares levda erfarenhet av mötet med patienter med psykisk ohälsa inom rättspsykiatrisk slutenvård ur vårdarnas perspektiv. Metod: Avhandlingen består av fyra studier (I, II, III, IV) med kvalitativ design, baserad på ontologiska och epistemologiska resonemang inom fenomenologi och hermeneutik. Studierna belyser den levda erfarenheten och är bedriven enligt fenomenologisk hermeneutik (I, III), hermeneutik (II) och reflekterande livsvärldsforskning (IV). Resultat: Mötet med patienter kännetecknas av dualiteten att agera utifrån patienternas behov och hantera regler och normer som fastställs i lagar och förordni

Background: Forensic psychiatric care (FPC) encompasses involuntary care and treatment of those who have committed a crime. On the one hand, FPC is constructed regarding the respect for the individual’s freedom and autonomy, and on the other hand, it is constructed on societal protection. Being a carer in FPC is intertwined with being faced with a distinct ethical dimension of care, as it involves caring for patients who are deprived of their freedom, meaning dealing with the tension of care and custody. Caring means often finding oneself in encounters with individuals with inevitable elements of rules, coercion, threats, and violence. In this complex environment, a caring relationship is to be established, which is intended to be built on trust, as a forensic nurse’s main purpose is creating wellbeing and care, based on the patient’s perspective. It is in the everyday encounters that occur often spontaneously that the carer–patient relationship should be established. It is in these encounters that the carer is given the opportunity to relive suffering. The encounter becomes the focal point where the lifeworlds of the carer and patient meet. Dealing with the duality of FPC and contradictory emotions requires a deeper understanding, which encourages to self reflect the meaning of these encounters and oneself as a carer. Aim: The overarching purpose of the thesis was to obtain a deeper understanding of carers’ lived experience of encounters with patients with mental illness in forensic inpatient care. Method: The thesis consists of four studies (I, II, III, IV) with qualitative design, based on ontological and epistemological reasonings of phenomenology and hermeneutics. The studies illuminated the lived experience and are conducted with phenomenological hermeneutics (I, III), hermeneutics (II), and reflective lifeworld research (IV). Findings: Encounters with patients are characterised with the duality of acting upon the patients’ needs and managing rules and norms s, Bakgrund: Rättspsykiatri (FPC) omfattar tvångsvård, behandling och omvårdnad av individer som begått brott. FPC är konstruerat ur avseende för respekten för individens frihet och autonomi, å andra sidan om samhällsskydd. Att vara vårdare i FPC är sammanflätad med att ställas inför en distinkt etisk dimension av vården, eftersom det handlar om att ta hand om patienter som är berövade sin frihet, det vill säga att hantera spänningen mellan omsorg och samhällsskydd. Omsorg innebär ofta att befinna sig i möten med individer med oundvikliga inslag av regler, tvång, hot och våld. I denna komplexa miljö ska en omtänksam relation etableras, som är tänkt att bygga på förtroende, då rättspsykiatrins huvudsakliga syfte är att skapa välbefinnande och utgå från patientens perspektiv. Det är i de vardagliga möten som ofta uppstår spontant, vård- och patientrelationen ska etableras. Det är i dessa möten vårdaren ges möjlighet att lindra lidande. Mötet blir samlingspunkten där vårdarens och patientens livsvärldar kan mötas. Att hantera dualiteten av FPC och motsägelsefulla känslor kräver en djupare förståelse som uppmuntrar till självreflektion angående innebörden av dessa möten och därmed sig själv som vårdare. Syfte: Det övergripande syftet med avhandlingen var att få en djupare förståelse av vårdares levda erfarenhet av mötet med patienter med psykisk ohälsa inom rättspsykiatrisk slutenvård ur vårdarnas perspektiv. Metod: Avhandlingen består av fyra studier (I, II, III, IV) med kvalitativ design, baserad på ontologiska och epistemologiska resonemang inom fenomenologi och hermeneutik. Studierna belyser den levda erfarenheten och är bedriven enligt fenomenologisk hermeneutik (I, III), hermeneutik (II) och reflekterande livsvärldsforskning (IV). Resultat: Mötet med patienter kännetecknas av dualiteten att agera utifrån patienternas behov och hantera regler och normer som fastställs i lagar och förordni

Sexual assault is an irrefutable trauma; an insult to the autonomy of the person forced into sexual acts. Sexual assault sequelae range from physical injury and acute traumatic stress, to pregnancy and sexually transmitted infections, including human immunodeficiency virus (HIV). HIV post-exposure prophylaxis (HIV PEP) following sexual assault may decrease the likelihood of HIV transmission. Many patients seeking healthcare post-sexual assault either do not initiate HIV PEP or do not complete the 28-day medication regimen. In this qualitative interpretive description, we interviewed sexual assault patients (N=11) about HIV PEP discussions/reactions, attitudes and understanding related to HIV and PEP, and barriers and facilitators of HIV PEP acceptance and adherence. Participants described a process of losing and reclaiming control throughout post-assault care and follow-up; and how this affected HIV PEP-related decision-making. Most HIV PEP decisions were described as a process of reclaiming control over one outcome while simultaneously losing control of another.

Sexual assault is an irrefutable trauma; an insult to the autonomy of the person forced into sexual acts. Sexual assault sequelae range from physical injury and acute traumatic stress, to pregnancy and sexually transmitted infections, including human immunodeficiency virus (HIV). HIV post-exposure prophylaxis (HIV PEP) following sexual assault may decrease the likelihood of HIV transmission. Many patients seeking healthcare post-sexual assault either do not initiate HIV PEP or do not complete the 28-day medication regimen. In this qualitative interpretive description, we interviewed sexual assault patients (N=11) about HIV PEP discussions/reactions, attitudes and understanding related to HIV and PEP, and barriers and facilitators of HIV PEP acceptance and adherence. Participants described a process of losing and reclaiming control throughout post-assault care and follow-up; and how this affected HIV PEP-related decision-making. Most HIV PEP decisions were described as a process of reclaiming control over one outcome while simultaneously losing control of another.

Introduction: Cases of violence and trauma are constantly increasing in Portugal. The knowledge empowerment of the nursing teams is essential for the implementation of good practices in the forensic area so as to provide the person, whether victim, suspect or aggressor, with the necessary health, medico-legal and legal care, as well as the legal safety of nurses. Objective: To assess the practices and knowledge of Portuguese nurses about forensic nursing. Methods: Quantitative, descriptive-correlational, and cross-sectional study carried out with Portuguese nurses. Data were collected using the General Forensic Nursing Questionnaire by Cunha & Libório (Libório, 2012). The study obtained a favorable approval by the Ethics Committee of the Ethics Committee of the Polytechnic Institute of Viseu, no. 10/ SUB/ 2021, and by the Ordem dos Enfermeiros, whose collaboration in the disclosure took place between May 6, 2021 and May 31, 2021. Results: 403 nurses were included, representing 0.55% of the universe of nurses registered in the Ordem dos Enfermeiros. Most of them were female (81.1%) and had a mean age of 41.18 years (±9.71). They consider that they have low knowledge even though they perform adequate practices in the field of forensic nursing. The available training is insufficient even though they consider it very important (90.6%). It was found that the frequency of training and the existence of protocols have an impact on the level of knowledge and quality of forensic practices (p<0.05). Conclusion: Health services lack forensic experts, and their absence jeopardizes rigorous procedures, the chain of custody and consequently the medico-legal rights of the victim. The adoption of academic curricula that include forensic content, training and team building may improve the forensic nursing care provided to the community., Introdução: Os casos de violência e trauma estão em constante crescimento em Portugal. A capacitação em conhecimentos das equipas de enfermagem é fulcral para a concretização de boas práticas no âmbito forense de modo a proporcionar à pessoa, seja ela vítima, suspeita ou agressora os devidos cuidados de saúde, médico-legais e em prol da segurança jurídica do enfermeiro. Objetivo: Avaliar as práticas e os conhecimentos dos enfermeiros portugueses sobre enfermagem forense. Métodos: Estudo quantitativo, descritivo-correlacional de matriz transversal realizado com os enfermeiros portugueses. A recolha de dados teve por base o Questionário Geral Enfermagem Forense (QGEF) de Cunha & Libório (Libório, 2012). O estudo obteve parecer favorável da Comissão de Ética do Instituto Politécnico de Viseu nº. 10/ SUB/ 2021 e da Ordem dos Enfermeiros cuja colaboração na divulgação decorreu de 6/05/2021 a 31/05/2021. Resultados: Foram incluídos 403 enfermeiros, representando 0,55% do universo do corpo de enfermagem inscrito na OE de Portugal, maioritariamente do género feminino (81,1%) e com uma idade média de 41,18 anos (±9,71). Estes consideram que possuem baixos conhecimentos ainda que executem práticas adequadas no domínio da enfermagem forense. A formação disponível é insuficiente ainda que a considerem muito importante (90,6%). Apurou-se que a frequência de formação e a existência de protocolos são impactantes no nível de conhecimentos e na qualidade das práticas forenses (p<0,05). Conclusão: Os serviços de saúde carecem de experts forenses e a sua inexistência põe em risco procedimentos rigorosos, a cadeia de custódia e por consequência direitos médico-legais da vítima. A adoção de programas curriculares académicos com inclusão de conteúdos forenses, o treino e a formação de equipas poderão melhorar os cuidados de enfermagem forenses prestados à comunidade., Introducción: Los casos de violencia y traumatismo aumentan constantemente en Portugal. La potenciación de los conocimientos de los equipos de enfermería es esencial para la implementación de buenas prácticas en el área forense, con el fin de proporcionar a la persona, ya sea víctima, sospechosa o agresora, los cuidados sanitarios, médico-legales y jurídicos necesarios, así como la seguridad jurídica de las enfermeras. Objetivo: Evaluar las prácticas y los conocimientos de las enfermeras portuguesas sobre la enfermería forense. Métodos: Estudio cuantitativo, descriptivo-correlacional de matriz transversal realizado con los enfermeros portugueses. Los datos se recogieron mediante el Cuestionario General de Enfermería Forense de Cunha & Libório (Libório, 2012). El estudio obtuvo el dictamen favorable del Comité de Ética del Instituto Politécnico de Viseu nº 10/ SUB/ 2021 y de la Orden de los Enfermeros cuya colaboración en la divulgación tuvo lugar entre el 6/05/2021 y el 31/05/2021. Resultados: Se incluyeron 403 enfermeros, que representaban el 0,55% del universo de enfermeros registrados en la Orden de los Enfermeros. La mayoría eran mujeres (81,1%) y tenían una edad media de 41,18 años (±9,71). Consideran que tienen pocos conocimientos, aunque realizan prácticas adecuadas en el ámbito de la enfermería forense. La formación disponible es insuficiente, aunque la consideran muy importante (90,6%). Se comprobó que la frecuencia de la formación y la existencia de protocolos influyen en el nivel de conocimientos y la calidad de las prácticas forenses (p<0,05). Conclusión: Los servicios de salud carecen de expertos forenses y su ausencia pone en riesgo los procedimientos rigurosos, la cadena de custodia y, en consecuencia, los derechos médico-legales de la víctima. La adopción de planes de estudios académicos, que incluyan contenidos forenses, formación y creación de equipos puede mejorar los cuidados de enfermería forense prestados a la comunidad.

Background: Forensic psychiatry is characterised by compulsory care and long hospital stays, where nurses care for patients with severe mental illness, who often have committed crimes. The main objective is to rehabilitate the patient to once again become a part of society by improving mental health and decreasing the risk of criminal relapse. This is mainly achieved through encounters with the patients. Encountering patients in forensic psychiatry means coming face to face with suffering and the duality of caring, doing what is best for the patient and protecting society. Aim: The purpose of the study was to obtain a deeper understanding of encounters with patients with mental illness in forensic inpatient care as experienced by nurses. Method: This licentiate thesis consists of two studies (I, II), both conducted with a qualitative design. A total of 13 nurses working at a forensic psychiatric hospital in Sweden were recruited through a purposive sample to participate in the studies through narrative interviews. Study I was analysed with phenomenological hermeneutics in line with Lindseth and Norbergh (2004) in order to illuminate the lived experience of nurses’ encounters. Study II was a secondary supplementary analysis, which applied hermeneutics in line with Fleming, Gaidys, and Robb (2003) to gain a deeper understanding of nurses’ compassion in forensic psychiatry. The two studies were merged to provide a comprehensive understanding in this licentiate thesis. Findings: Study I illuminated the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care, that is the nurses’ desire to do good despite being confronted with their own emotions as fear, humiliation, and disappointment. Encounters were also occasionally perceived as positive, awakening emotions of compassion, competence, pride, trust, satisfaction, and gratification regarding the patient’s recovery. However, a source of conflict was the struggle be

We aimed to deepen our understanding of the concept of compassion in caring for patients with mental illness in forensic psychiatric inpatient care settings. Qualitative analysis was used to illuminate themes from interviews conducted with 13 nurses in a prior study. The audiotaped interviews, which had been transcribed verbatim, were analyzed following a hermeneutic approach. Results revealed the main theme of “being compassionate in forensic psychiatry is an emotional journey” and three themes. Overall, compassion was seen as a changeable asset, but also an obstacle when absent; sensitivity to one's own vulnerability is necessary to overcome that obstacle.

We aimed to deepen our understanding of the concept of compassion in caring for patients with mental illness in forensic psychiatric inpatient care settings. Qualitative analysis was used to illuminate themes from interviews conducted with 13 nurses in a prior study. The audiotaped interviews, which had been transcribed verbatim, were analyzed following a hermeneutic approach. Results revealed the main theme of “being compassionate in forensic psychiatry is an emotional journey” and three themes. Overall, compassion was seen as a changeable asset, but also an obstacle when absent; sensitivity to one's own vulnerability is necessary to overcome that obstacle.

Objective: to construct and validate a questionnaire for tracking disciplines and content of Forensic Nursing and similar disciplines in undergraduate courses. Methods: methodological study for the construction and validation of content and semantics. The items were constructed and categorized using content analysis, based on the national and international theoretical framework of Forensic Nursing, structured in three sections with dichotomous and subjective questions. Content and semantics were validated using the brainstorming technique and an 80% concordance index among the judges. Results: the sections were: identification of courses, of disciplines of Forensic Nursing and Violence, and contents of Forensic Nursing discipline. Conclusion: the Forensic Nursing Discipline and Content Supervision Questionnaire for Graduation Nursing Courses was considered easy to use and dynamic to assess the situation of Forensic Nursing and Violence-related subjects in Nursing courses at college Institutions., Objetivo: construir e validar um questionário de rastreamento de disciplinas e conteúdos de Enfermagem Forense e similares em cursos de graduação. Métodos: estudo metodológico de construção e validação de conteúdo e de semântica.Os itens foram construídos e categorizados por meio da análise de conteúdo, com base no referencial teórico nacional e internacional de Enfermagem Forense, estruturado em três seções com perguntas dicotômicas e abertas. Realizaram-se validações de conteúdo e de semântica adotando Índice de Concordância de 80% entre os juízes, com a técnica brainstorming. Resultados: as seções referem-se a: identificação dos cursos, das disciplinas de Enfermagem Forense e de Violência, e dos conteúdos de Enfermagem Forense. Conclusão: o Questionário de Rastreamento de Disciplinas e Conteúdos de Enfermagem Forense nos Cursos de Graduação em Enfermagem foi considerado viável e amplo para avaliar a situação das disciplinas de Enfermagem Forense e de Violência nos cursos de Enfermagem das Instituições de Ensino Superior.

Background: Forensic psychiatry is characterised by compulsory care and long hospital stays, where nurses care for patients with severe mental illness, who often have committed crimes. The main objective is to rehabilitate the patient to once again become a part of society by improving mental health and decreasing the risk of criminal relapse. This is mainly achieved through encounters with the patients. Encountering patients in forensic psychiatry means coming face to face with suffering and the duality of caring, doing what is best for the patient and protecting society. Aim: The purpose of the study was to obtain a deeper understanding of encounters with patients with mental illness in forensic inpatient care as experienced by nurses. Method: This licentiate thesis consists of two studies (I, II), both conducted with a qualitative design. A total of 13 nurses working at a forensic psychiatric hospital in Sweden were recruited through a purposive sample to participate in the studies through narrative interviews. Study I was analysed with phenomenological hermeneutics in line with Lindseth and Norbergh (2004) in order to illuminate the lived experience of nurses’ encounters. Study II was a secondary supplementary analysis, which applied hermeneutics in line with Fleming, Gaidys, and Robb (2003) to gain a deeper understanding of nurses’ compassion in forensic psychiatry. The two studies were merged to provide a comprehensive understanding in this licentiate thesis. Findings: Study I illuminated the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care, that is the nurses’ desire to do good despite being confronted with their own emotions as fear, humiliation, and disappointment. Encounters were also occasionally perceived as positive, awakening emotions of compassion, competence, pride, trust, satisfaction, and gratification regarding the patient’s recovery. However, a source of conflict was the struggle be

We aimed to deepen our understanding of the concept of compassion in caring for patients with mental illness in forensic psychiatric inpatient care settings. Qualitative analysis was used to illuminate themes from interviews conducted with 13 nurses in a prior study. The audiotaped interviews, which had been transcribed verbatim, were analyzed following a hermeneutic approach. Results revealed the main theme of “being compassionate in forensic psychiatry is an emotional journey” and three themes. Overall, compassion was seen as a changeable asset, but also an obstacle when absent; sensitivity to one's own vulnerability is necessary to overcome that obstacle.

Background: Forensic psychiatry is characterised by compulsory care and long hospital stays, where nurses care for patients with severe mental illness, who often have committed crimes. The main objective is to rehabilitate the patient to once again become a part of society by improving mental health and decreasing the risk of criminal relapse. This is mainly achieved through encounters with the patients. Encountering patients in forensic psychiatry means coming face to face with suffering and the duality of caring, doing what is best for the patient and protecting society. Aim: The purpose of the study was to obtain a deeper understanding of encounters with patients with mental illness in forensic inpatient care as experienced by nurses. Method: This licentiate thesis consists of two studies (I, II), both conducted with a qualitative design. A total of 13 nurses working at a forensic psychiatric hospital in Sweden were recruited through a purposive sample to participate in the studies through narrative interviews. Study I was analysed with phenomenological hermeneutics in line with Lindseth and Norbergh (2004) in order to illuminate the lived experience of nurses’ encounters. Study II was a secondary supplementary analysis, which applied hermeneutics in line with Fleming, Gaidys, and Robb (2003) to gain a deeper understanding of nurses’ compassion in forensic psychiatry. The two studies were merged to provide a comprehensive understanding in this licentiate thesis. Findings: Study I illuminated the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care, that is the nurses’ desire to do good despite being confronted with their own emotions as fear, humiliation, and disappointment. Encounters were also occasionally perceived as positive, awakening emotions of compassion, competence, pride, trust, satisfaction, and gratification regarding the patient’s recovery. However, a source of conflict was the struggle be

We aimed to deepen our understanding of the concept of compassion in caring for patients with mental illness in forensic psychiatric inpatient care settings. Qualitative analysis was used to illuminate themes from interviews conducted with 13 nurses in a prior study. The audiotaped interviews, which had been transcribed verbatim, were analyzed following a hermeneutic approach. Results revealed the main theme of “being compassionate in forensic psychiatry is an emotional journey” and three themes. Overall, compassion was seen as a changeable asset, but also an obstacle when absent; sensitivity to one's own vulnerability is necessary to overcome that obstacle.

Background: Forensic psychiatry is characterised by compulsory care and long hospital stays, where nurses care for patients with severe mental illness, who often have committed crimes. The main objective is to rehabilitate the patient to once again become a part of society by improving mental health and decreasing the risk of criminal relapse. This is mainly achieved through encounters with the patients. Encountering patients in forensic psychiatry means coming face to face with suffering and the duality of caring, doing what is best for the patient and protecting society. Aim: The purpose of the study was to obtain a deeper understanding of encounters with patients with mental illness in forensic inpatient care as experienced by nurses. Method: This licentiate thesis consists of two studies (I, II), both conducted with a qualitative design. A total of 13 nurses working at a forensic psychiatric hospital in Sweden were recruited through a purposive sample to participate in the studies through narrative interviews. Study I was analysed with phenomenological hermeneutics in line with Lindseth and Norbergh (2004) in order to illuminate the lived experience of nurses’ encounters. Study II was a secondary supplementary analysis, which applied hermeneutics in line with Fleming, Gaidys, and Robb (2003) to gain a deeper understanding of nurses’ compassion in forensic psychiatry. The two studies were merged to provide a comprehensive understanding in this licentiate thesis. Findings: Study I illuminated the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care, that is the nurses’ desire to do good despite being confronted with their own emotions as fear, humiliation, and disappointment. Encounters were also occasionally perceived as positive, awakening emotions of compassion, competence, pride, trust, satisfaction, and gratification regarding the patient’s recovery. However, a source of conflict was the struggle be

We aimed to deepen our understanding of the concept of compassion in caring for patients with mental illness in forensic psychiatric inpatient care settings. Qualitative analysis was used to illuminate themes from interviews conducted with 13 nurses in a prior study. The audiotaped interviews, which had been transcribed verbatim, were analyzed following a hermeneutic approach. Results revealed the main theme of “being compassionate in forensic psychiatry is an emotional journey” and three themes. Overall, compassion was seen as a changeable asset, but also an obstacle when absent; sensitivity to one's own vulnerability is necessary to overcome that obstacle.

Background: Forensic psychiatry is characterised by compulsory care and long hospital stays, where nurses care for patients with severe mental illness, who often have committed crimes. The main objective is to rehabilitate the patient to once again become a part of society by improving mental health and decreasing the risk of criminal relapse. This is mainly achieved through encounters with the patients. Encountering patients in forensic psychiatry means coming face to face with suffering and the duality of caring, doing what is best for the patient and protecting society. Aim: The purpose of the study was to obtain a deeper understanding of encounters with patients with mental illness in forensic inpatient care as experienced by nurses. Method: This licentiate thesis consists of two studies (I, II), both conducted with a qualitative design. A total of 13 nurses working at a forensic psychiatric hospital in Sweden were recruited through a purposive sample to participate in the studies through narrative interviews. Study I was analysed with phenomenological hermeneutics in line with Lindseth and Norbergh (2004) in order to illuminate the lived experience of nurses’ encounters. Study II was a secondary supplementary analysis, which applied hermeneutics in line with Fleming, Gaidys, and Robb (2003) to gain a deeper understanding of nurses’ compassion in forensic psychiatry. The two studies were merged to provide a comprehensive understanding in this licentiate thesis. Findings: Study I illuminated the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care, that is the nurses’ desire to do good despite being confronted with their own emotions as fear, humiliation, and disappointment. Encounters were also occasionally perceived as positive, awakening emotions of compassion, competence, pride, trust, satisfaction, and gratification regarding the patient’s recovery. However, a source of conflict was the struggle be

Purpose: Nurses working in forensic psychiatry often encounter offenders who have a severe mental illness, which may cause ethical challenges and influence nurses’ daily work. This study was conducted to illuminate the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care. Methods: This qualitative study employed narrative interviews with 13 nurses. Interviews were audiotaped and transcribed verbatim and analysed following a phenomenological-hermeneutic approach. Results: Four key themes were revealed: “Being frustrated” (subthemes included “Fighting resignation” and “Being disappointed”), “Protecting oneself” (subthemes included “To shy away,” “Being on your guard,” and “Being disclosed”), “Being open-minded” (subthemes included “Being confirmed,” “Developing trust,” and “Developing compassion”), and “Striving for control” (subthemes included “Sensing mutual vulnerability” and “Regulating oneself”). Further, working in forensic psychiatry challenged nurses’ identity as healthcare professionals because of being in a stressful context. Conclusions: Dealing with aggressive patients with severe mental illnesses threatens nurses’ professional identity. Nurses must attempt to empathize with patients’ experiences and respond accordingly. Utilizing strategies rooted in compassion such as self-reflection, emotional regulation, and distancing themselves when necessary may enable nurses to more effectively respond to patients’ needs. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Purpose: Nurses working in forensic psychiatry often encounter offenders who have a severe mental illness, which may cause ethical challenges and influence nurses’ daily work. This study was conducted to illuminate the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care. Methods: This qualitative study employed narrative interviews with 13 nurses. Interviews were audiotaped and transcribed verbatim and analysed following a phenomenological-hermeneutic approach. Results: Four key themes were revealed: “Being frustrated” (subthemes included “Fighting resignation” and “Being disappointed”), “Protecting oneself” (subthemes included “To shy away,” “Being on your guard,” and “Being disclosed”), “Being open-minded” (subthemes included “Being confirmed,” “Developing trust,” and “Developing compassion”), and “Striving for control” (subthemes included “Sensing mutual vulnerability” and “Regulating oneself”). Further, working in forensic psychiatry challenged nurses’ identity as healthcare professionals because of being in a stressful context. Conclusions: Dealing with aggressive patients with severe mental illnesses threatens nurses’ professional identity. Nurses must attempt to empathize with patients’ experiences and respond accordingly. Utilizing strategies rooted in compassion such as self-reflection, emotional regulation, and distancing themselves when necessary may enable nurses to more effectively respond to patients’ needs. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

The practice of trauma-informed care (TIC) allows nurses in any setting to identify and intervene with traumatized individuals and to create a continuum of care when forensic nursing services are needed. The purpose of this article is to suggest ways to incorporate TIC content into baccalaureate nursing programs. We begin with an overview of baccalaureate nursing curricula and common types of traumatic experience important for students to understand. We then propose specific strategies for inclusion of TIC content in baccalaureate nursing education, using the American Association of Colleges of Nursing Essentials of Baccalaureate Education for Professional Nursing Practice. With a solid foundation in TIC, baccalaureate-prepared nursing students can provide effective patient care and better support forensic nursing practice. This will increase the capacity of the nursing profession in general to meet the needs of those affected by trauma, violence, and abuse.

Although forensic psychiatric care is located at the intersection of health care and the Swedish legal system, nursing research has not yet evaluated how language is context bound or its consequences for understanding patient care. The aim of this study was to explore how nursing staff talk about patient care in Swedish forensic psychiatric care and the implications for the care given to patients. The theoretical framework is based on social constructionism and sheds light on how language use can be understood as a social action. Twelve interviews were conducted with nursing staff working in forensic psychiatric settings. The questions focused on patient care in relation to activities, security, relationships with patients, and rules and routines. The results show that nursing staff assignments are encouraging them to use various interpretative repertoires to make meaning about their practice. The three interpretative repertoires were "taking responsibility for correcting patients' behavior," "justifying patient care as contradictory practice," and "patients as unpredictable." However, although forensic psychiatric care emphasizes both security and care, nursing staff's use of these interpretative repertoires provided multiple interpretations that lead to contradictory ways of understanding patient care. These findings show that talk itself can be understood as problematic in various situations. A possible implication for clinical forensic nursing practice might be that the nurse-patient relationship does not support patients' best interests. For example, when language endows the patient with certain characteristics, this talk is justified and given meaning by its context and thus has an influence on a patient's individual need for care.

Purpose: Nurses working in forensic psychiatry often encounter offenders who have a severe mental illness, which may cause ethical challenges and influence nurses’ daily work. This study was conducted to illuminate the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care. Methods: This qualitative study employed narrative interviews with 13 nurses. Interviews were audiotaped and transcribed verbatim and analysed following a phenomenological-hermeneutic approach. Results: Four key themes were revealed: “Being frustrated” (subthemes included “Fighting resignation” and “Being disappointed”), “Protecting oneself” (subthemes included “To shy away,” “Being on your guard,” and “Being disclosed”), “Being open-minded” (subthemes included “Being confirmed,” “Developing trust,” and “Developing compassion”), and “Striving for control” (subthemes included “Sensing mutual vulnerability” and “Regulating oneself”). Further, working in forensic psychiatry challenged nurses’ identity as healthcare professionals because of being in a stressful context. Conclusions: Dealing with aggressive patients with severe mental illnesses threatens nurses’ professional identity. Nurses must attempt to empathize with patients’ experiences and respond accordingly. Utilizing strategies rooted in compassion such as self-reflection, emotional regulation, and distancing themselves when necessary may enable nurses to more effectively respond to patients’ needs. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Purpose: Nurses working in forensic psychiatry often encounter offenders who have a severe mental illness, which may cause ethical challenges and influence nurses’ daily work. This study was conducted to illuminate the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care. Methods: This qualitative study employed narrative interviews with 13 nurses. Interviews were audiotaped and transcribed verbatim and analysed following a phenomenological-hermeneutic approach. Results: Four key themes were revealed: “Being frustrated” (subthemes included “Fighting resignation” and “Being disappointed”), “Protecting oneself” (subthemes included “To shy away,” “Being on your guard,” and “Being disclosed”), “Being open-minded” (subthemes included “Being confirmed,” “Developing trust,” and “Developing compassion”), and “Striving for control” (subthemes included “Sensing mutual vulnerability” and “Regulating oneself”). Further, working in forensic psychiatry challenged nurses’ identity as healthcare professionals because of being in a stressful context. Conclusions: Dealing with aggressive patients with severe mental illnesses threatens nurses’ professional identity. Nurses must attempt to empathize with patients’ experiences and respond accordingly. Utilizing strategies rooted in compassion such as self-reflection, emotional regulation, and distancing themselves when necessary may enable nurses to more effectively respond to patients’ needs. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Purpose: Nurses working in forensic psychiatry often encounter offenders who have a severe mental illness, which may cause ethical challenges and influence nurses’ daily work. This study was conducted to illuminate the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care. Methods: This qualitative study employed narrative interviews with 13 nurses. Interviews were audiotaped and transcribed verbatim and analysed following a phenomenological-hermeneutic approach. Results: Four key themes were revealed: “Being frustrated” (subthemes included “Fighting resignation” and “Being disappointed”), “Protecting oneself” (subthemes included “To shy away,” “Being on your guard,” and “Being disclosed”), “Being open-minded” (subthemes included “Being confirmed,” “Developing trust,” and “Developing compassion”), and “Striving for control” (subthemes included “Sensing mutual vulnerability” and “Regulating oneself”). Further, working in forensic psychiatry challenged nurses’ identity as healthcare professionals because of being in a stressful context. Conclusions: Dealing with aggressive patients with severe mental illnesses threatens nurses’ professional identity. Nurses must attempt to empathize with patients’ experiences and respond accordingly. Utilizing strategies rooted in compassion such as self-reflection, emotional regulation, and distancing themselves when necessary may enable nurses to more effectively respond to patients’ needs. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Background: Systematic efforts to improve the quality, safety and value of health care have increased over the last decades. Even so, it is hard to choose priorities and to know when the desired results are reached, especially in forensic psychiatric care where there can be a discrepancy between patient and staff expectations of what good quality of care is and how it should be reached. The aim of the present study was to describe and compare patient and staff experiences of quality of care in two forensic psychiatric clinics over a period of 4years. Methods: A quantitative design was used and yearly between 2011 and 2014, a total of 105 questionnaires were answered by patients and 598 by staff. Results: The sample consisted of four different groups; patient and staff in Clinic A and Clinic B respectively. The repeated measurements showed that quality of care, as described by the patients, varied over time, with significant changes over the 4years. The staff evaluations of the quality of care were more stable over time in both clinics compared with the patients. Generally, the staff rated the quality as being better than the patients but these differences tended to decrease when efforts were made to improve the care. Conclusions: It is important to highlight both what staff and patients perceive as both high and low quality care. With regular measurements and sufficient resources, training, support and leadership, the chances of successful improvement work increase. This knowledge is important in forensic nursing practice, for teaching and for management and decision makers in the constant work of improving forensic psychiatric care.

Burnout in nursing staff is a major cause for turnover and absenteeism. Identifying risk and protective factors may be helpful in decreasing burnout symptoms. Moreover, research indicates that ambulatory assessments of the autonomic nervous system might be helpful in detecting long‐term stress and burnout symptoms. One hundred and ten forensic nursing staff members completed questionnaires measuring experiences with aggressive behaviour, emotional intelligence, personality, and job stress during four waves of data collection across a 2‐year period. Multilevel analyses were used to test the predicted associations and moderation effects with (the development of) burnout symptoms. Burnout was predicted by a combination of emotional intelligence, job stress, aggression, personality factors, and skin conductance, but no moderation effects over time were found. Over a period of 2 years, the model approximately predicts a change in one burnout category on the Maslach Burnout Inventory. The amount of burnout symptoms in nurses might be used as an indicator to predict turnover and absenteeism considering the increase in symptoms over time. Nursing staff who experience severe aggression and who have relatively low levels of emotional intelligence and altruism and high levels of neuroticism and job stress should be monitored and supported to decrease the risk of burnout. Staff members can be trained to increase their emotional intelligence and relieve stress to decrease their burnout symptoms and turnover and absenteeism on the long term. Ambulatory assessment might be helpful as a nonintrusive way to detect increasing levels of burnout.

BackgroundNonoccupational postexposure prophylaxis (nPEP) for HIV following sexual assault may decrease the likelihood of HIV transmission.ObjectiveThe purpose of this exploratory chart review study was to examine factors associated with patients accepting post-sexual assault nPEP at three forensic nurse examiner programs in urban settings.MethodsForensic nursing charts of patients presenting for acute sexual assault care were reviewed as part of a mixed-methods study.ResultsPatients assaulted by more than one or an unknown number of assailants were over 12 times more likely to accept the offer of nPEP (adjusted odds ratio [aOR] = 12.66, 95% CI [2.77, 57.82]). In cases where no condom was used (aOR = 8.57, 95% CI [1.59, 46.10]) or when any injury to the anus or genitalia was noted (aOR = 4.10, 95% CI [1.57, 10.75]), patients were more likely to accept nPEP. Patients with any injury to the face or head were less likely to initiate nPEP (aOR = 0.32, 95% CI [0.11, 0.97]).DiscussionThis study is an important first step in understanding factors associated with nPEP acceptance after sexual assault.

BackgroundNonoccupational postexposure prophylaxis (nPEP) for HIV following sexual assault may decrease the likelihood of HIV transmission.ObjectiveThe purpose of this exploratory chart review study was to examine factors associated with patients accepting post-sexual assault nPEP at three forensic nurse examiner programs in urban settings.MethodsForensic nursing charts of patients presenting for acute sexual assault care were reviewed as part of a mixed-methods study.ResultsPatients assaulted by more than one or an unknown number of assailants were over 12 times more likely to accept the offer of nPEP (adjusted odds ratio [aOR] = 12.66, 95% CI [2.77, 57.82]). In cases where no condom was used (aOR = 8.57, 95% CI [1.59, 46.10]) or when any injury to the anus or genitalia was noted (aOR = 4.10, 95% CI [1.57, 10.75]), patients were more likely to accept nPEP. Patients with any injury to the face or head were less likely to initiate nPEP (aOR = 0.32, 95% CI [0.11, 0.97]).DiscussionThis study is an important first step in understanding factors associated with nPEP acceptance after sexual assault.

BackgroundTransitioning into society after release from incarceration presents real challenges for male offenders; in California, up to 60% return to prison within 3 years after release. The risk for ongoing drug use and having sex with multiple partners is a significant challenge for ex-offenders preparing to enter the community.ObjectivesThe aims are to describe drug use and sexual behavior (sex with multiple partners) prior to incarceration and 6 and 12 months after study enrollment using data obtained as part of a randomized controlled trial.MethodsThis is a planned secondary analysis of data obtained as part of a randomized controlled trial designed to study the effects of intensive peer coaching and nurse case management, intensive peer coaching, and brief nurse counseling on hepatitis A and B vaccination adherence compared to a usual care control treatment that also included brief peer coaching and brief nurse counseling. Self-report data from subjects enrolled at one residential drug treatment facility in Los Angeles were captured at three time points: baseline and 6- and 12-month follow-up.ResultsFindings showed substantive and significant reductions in drug use and engaging in sex with multiple partners 6 months after enrollment into the study compared to the baseline data, but results did not differ by study condition. At 12-month follow-up, drug use and sex with multiple partners increased but remained less than at baseline levels.DiscussionSustaining reductions in drug use and engaging in sex with multiple partners remains a challenge after incarceration.

BACKGROUND: Nonoccupational postexposure prophylaxis (nPEP) for HIV following sexual assault may decrease the likelihood of HIV transmission. OBJECTIVE: The purpose of this exploratory chart review study was to examine factors associated with patients accepting post-sexual assault nPEP at three forensic nurse examiner programs in urban settings. METHODS: Forensic nursing charts of patients presenting for acute sexual assault care were reviewed as part of a mixed-methods study. RESULTS: Patients assaulted by more than one or an unknown number of assailants were over 12 times more likely to accept the offer of nPEP (adjusted odds ratio [aOR] = 12.66, 95% CI [2.77, 57.82]). In cases where no condom was used (aOR = 8.57, 95% CI [1.59, 46.10]) or when any injury to the anus or genitalia was noted (aOR = 4.10, 95% CI [1.57, 10.75]), patients were more likely to accept nPEP. Patients with any injury to the face or head were less likely to initiate nPEP (aOR = 0.32, 95% CI [0.11, 0.97]). DISCUSSION: This study is an important first step in understanding factors associated with nPEP acceptance after sexual assault.

Nonoccupational, postexposure prophylaxis (nPEP) for human immunodeficiency virus (HIV) is offered inconsistently to patients who have been sexually assaulted. This may be due to Forensic Nurse Examiner (FNE) programs utilizing diverse nPEP protocols and HIV risk assessment algorithms. This study examines factors associated with FNEs offering nPEP to patients following sexual assault at two FNE programs in urban settings. Offering nPEP is mostly driven by site-specific protocol. At Site 1, in addition to open anal or open genital wounds, the presence of injury to the head or face was associated with FNEs offering nPEP (adjusted odds ratio [AOR] 64.15, 95% confidence interval [CI] = [2.12, 1942.37]). At Site 2, patients assaulted by someone of Other race/ethnicity (non-White, non-African American) were 86% less likely to be offered nPEP (AOR 0.14, 95% CI = [.03, .72]) than patients assaulted by Whites. In addition to following site-specific protocols, future research should further explore the mechanisms influencing clinician decision making.

Nonoccupational, postexposure prophylaxis (nPEP) for human immunodeficiency virus (HIV) is offered inconsistently to patients who have been sexually assaulted. This may be due to Forensic Nurse Examiner (FNE) programs utilizing diverse nPEP protocols and HIV risk assessment algorithms. This study examines factors associated with FNEs offering nPEP to patients following sexual assault at two FNE programs in urban settings. Offering nPEP is mostly driven by site-specific protocol. At Site 1, in addition to open anal or open genital wounds, the presence of injury to the head or face was associated with FNEs offering nPEP (adjusted odds ratio [AOR] 64.15, 95% confidence interval [CI] = [2.12, 1942.37]). At Site 2, patients assaulted by someone of Other race/ethnicity (non-White, non-African American) were 86% less likely to be offered nPEP (AOR 0.14, 95% CI = [.03, .72]) than patients assaulted by Whites. In addition to following site-specific protocols, future research should further explore the mechanisms influencing clinician decision making.

Nonoccupational, postexposure prophylaxis (nPEP) for human immunodeficiency virus (HIV) is offered inconsistently to patients who have been sexually assaulted. This may be due to Forensic Nurse Examiner (FNE) programs utilizing diverse nPEP protocols and HIV risk assessment algorithms. This study examines factors associated with FNEs offering nPEP to patients following sexual assault at two FNE programs in urban settings. Offering nPEP is mostly driven by site-specific protocol. At Site 1, in addition to open anal or open genital wounds, the presence of injury to the head or face was associated with FNEs offering nPEP (adjusted odds ratio [AOR] 64.15, 95% confidence interval [CI] = [2.12, 1942.37]). At Site 2, patients assaulted by someone of Other race/ethnicity (non-White, non-African American) were 86% less likely to be offered nPEP (AOR 0.14, 95% CI = [.03, .72]) than patients assaulted by Whites. In addition to following site-specific protocols, future research should further explore the mechanisms influencing clinician decision making.

Managing aggression in mental health hospitals is an important and challenging task for clinical nursing staff. A majority of studies focus on the perspective of clinicians, and research mainly depicts aggression by referring to patient-related factors. This qualitative study investigates how aggression is communicated in forensic mental health nursing records. The aim of the study was to gain insight into the discursive practices used by forensic mental health nursing staff when they record observed aggressive incidents. Textual accounts were extracted from the Staff Observation Aggression Scale-Revised (SOAS-R), and Fairclough's critical discourse analysis was used to identify short narrative entries depicting patients and staffs in typical ways. The narratives contained descriptions of complex interactions between patient and staff that were linked to specific circumstances surrounding the patient. These antecedents, combined with the aggression incident itself, created stereotyping representations of forensic psychiatric patients as deviant, unpredictable and dangerous. Patient and staff identities were continually (re)produced by an automatic response from the staff that was solely focused on the patient's behavior. Such response might impede implementation of new strategies for managing aggression.

Aims and objectives. To describe nurses' views of forensic care provided for victims of violence and their families in EDs, to identify factors associated with nurses' attitudes towards families in care and to investigate if these attitudes were associated with the involvement of patients' families in care. Background. Interpersonal violence has serious health consequences for individuals and family members. Emergency departments provide care for victims of violence, and nurses play a key role in forensic care. However, there is limited knowledge of their views and their involvement of family members. Design. A cross-sectional design was used with a sample of all registered nurses (n = 867) in 28 emergency departments in Sweden. Methods. A self-report questionnaire, including the instrument Families' Importance in Nursing Care Nurses' Attitudes, was used to collect data. Descriptive statistics, multiple linear regression and ordinal regression were used to analyse data. Results. Four hundred and fifty-seven nurses completed the questionnaire (53%). Most nurses provided forensic care, but few had specific education for this task. Policy documents and routines existed for specific patient groups. Most nurses involved family members in care although education and policy documents rarely included them. Being a woman, policy documents and own experience of a critically ill family member were associated with a positive attitude towards family. A positive attitude towards family members was associated with involving patients' families in care. Conclusion. Many emergency department nurses provided forensic care without having specific education, and policy documents only concerned women and children. Nurses' positive attitude to family members was not reflected in policies or education. Relevance to clinical practice. These results can inspire clinical forensic care interventions in emergency departments. Educational efforts for nurses and policies for all groups of victims

High levels of hostility present a formidable challenge among homeless ex-offenders. This cross-sectional study assessed correlates of high levels of hostility using baseline data collected on recently-released male parolees (N=472; age 18-60) participating in a randomized trial focused on prevention of illicit drug use and recidivism. Predictors of high levels of hostility included greater depressive symptomatology, lower self-esteem, having a mother who was treated for alcohol/drugs, belonging to a gang, more tangible support, having used methamphetamine and having a history of cognitive difficulties. These findings highlight the need to understand predictors of hostility among recently released homeless men and how these predictors may relate to recidivism. Research implications are discussed as these findings will shape future nurse-led harm reduction and community-based interventions.

Purpose: The purpose of this study was to explore the experiences of forensic nurses when providing care to victims of sexual assault in selected public hospitals of Limpopo province. Methods: A qualitative, explorative, descriptive and contextual research design was employed in this study. A sample of 7 registered nurses was purposively selected to partake in in-depth unstructured interviews. Results: Four themes associated with the experience of providing care to victims of sexual assaults emerged during data analysis. These included (1) psychological experiences of nursing victims of sexual assault, (2) physical challenges associated with implementing the forensic nursing specialty in a clinical setting, (3) psychological coping strategies to deal with challenges experienced, and (4) the experience of managerial support. Conclusion: Participants reported negative psychological and physical experiences of providing care to victims of sexual assault, which resulted to occupational stress. Recommendations of forensic nurses support guidelines and further research were made.