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Children's exposure to intimate partner violence (IPV) is a widespread phenomenon that can have detrimental consequences on their health and well-being. This study examined how clinical forensic consultation data of adult victims of IPV might provide information on the potential suffering of children exposed to IPV, the duration of exposure and the knowledge of the situation by the professionals with whom those children were in contact. Data were collected from the consultation files of 112 adult victims of IPV who consulted the Violence Medical Unit at the Lausanne University Hospital (Switzerland) in 2014, and who were parents of children aged 0 through 12. Descriptive quantitative and qualitative analyses were performed. Symptoms of suffering, such as dysregulation of instinctual functions and developmental, behavioral or emotional difficulties, were reported for nearly one-third of the victims' children. Children's exposure to IPV often started around their birth and about four in 10 children had been exposed for three years or more. Health and childhood professionals were unaware of the exposure for the vast majority of the children. Clinical forensic data can be useful in providing information on the suffering and care of children exposed to IPV. Their suffering took the form of a non-specific posttraumatic symptomatology and therefore might be difficult to detect. It is necessary to make professionals and parents aware of the fact that IPV can have a harmful impact on children's health and well-being, and to encourage health professionals to consider the possibility of IPV when facing such symptoms. [ABSTRACT FROM AUTHOR]

In Germany, the most frequently used legal section to order forensic mental health treatment is § 63 of the Penal Code (Strafgesetzbuch; StGB). This disposition is primarily aimed at individuals with major mental illnesses who are not fully responsible for a criminal act they committed. Despite evaluation and follow-up studies being conducted within individual hospitals or federal states we lack key epidemiological data on this patient group across the whole country. The present study aims to fill this gap by conducting an annual survey of all eligible forensic mental health hospitals to develop a database of basic clinical, legal and demographic data. Staff at participating hospitals will complete an online survey answering questions about individual patients using routinely collected hospital records. Over the duration of the study, eight-and-a-half years, we aim to collect data on approximately N = 6,450 patients. Alongside important clinical data, we will use official reconviction data at 3- and 6-year follow-ups to investigate the number and types of crimes committed by discharged patients. We aim to extend the scientific literature on factors associated with reconviction in the Risk-Needs-Responsivity model by also measuring the extent to which treatment engagement and programme completion during care predicts reconviction. This study protocol describes the background and theoretical framework for this study, its methods of data collection and analysis, and steps taken to ensure compliance with ethical and data protection principles. [ABSTRACT FROM AUTHOR]

Forensic mental health nursing (FMHN) is a specialized field, designed to meet the needs of people who have a serious mental illness across the criminal justice system, inpatient services and community. Frameworks can assist assessment, planning, intervention, documentation and evaluation of nursing care. However, there is no prior research investigating frameworks in FMHN. This study aimed to explore the Nursing Process (NP) and the Clinical Reasoning Cycle (CRC), with nurses, to determine a suitable framework for use service‐wide. A Nominal Group Technique was used to facilitate exploration of the two frameworks, where open‐ended verbal and written responses collected from a Nominal Group were thematically analysed, and the participants voted on their preferred framework. Seventeen nurses from a state‐wide forensic mental health (FMH) service participated. The four main themes were as follows: challenges to current practice, limitations of the NP, perceived benefits of the CRC and addressing implementation. Consensus was reached with the nurses selecting the CRC as the framework of choice. This is the first study to explore frameworks to guide practice in FMHN. Nurses in this study considered the CRC to be a suitable framework for novice through to expert, offering a contemporary framework to guide nursing care in complex FMH settings. Some adjustments to the existing cycle were suggested to emphasize recovery‐oriented practice, and inclusion of family and carers. Any changes to the cycle warrant exploration with the interdisciplinary team and consumer carer workforce. [ABSTRACT FROM AUTHOR]

There is growing evidence that culturally adapted, evidence-based, violence prevention programmes can have benefits for people in correctional and forensic mental health services. Adding to this evidence is crucial, given the over-representation of Indigenous people and ethnic minorities in such services. This qualitative descriptive study describes Tū Tahanga, which combines the ManAlive violence prevention programme, with Māori (Indigenous people of Aotearoa/New Zealand) cultural concepts. This was developed for Māori service users in a forensic mental health service. Content analysis was undertaken through interviews with participants in the group (N = 11). Core aspects of ManAlive were maintained. These aspects coexist with cultural concepts of a specific healing space, a holistic Māori model of health, and the creation of family like supportive relationships reinforced by living in the same facility. This description lays a platform for future evaluative research to determine the impact of the programme on reducing violent offending. [ABSTRACT FROM AUTHOR]

The Short-Term Assessment of Risk and Treatability (START) is a 20-item structured professional judgment instrument for assessing dynamic risk in mental health services. Much of the START research literature examines the relationship between Strengths and Vulnerabilities sub-scale total scores and various adverse outcomes including violence. This assumes that the two sub-scales have the psychometric property of unidimensionality i.e. all the items cluster together as a measure of a single construct. Such assumed unidimensionality is a necessary condition for any analyses based on scale "total score" and the widespread use of scores summated in this way in research studies may obscure more specific clusters of items within each sub-scale. This multinational study examined START assessments (n = 685) conducted in four forensic services in Scandinavia and the UK using principal component analysis. It was found that all but three Strengths items (Substance Use, Social Support and Material Resources) and all but four Vulnerabilities items (Substance Use, Social Support, Material Resources and Self care) loaded >0.5 on the expected component. This indicates a unidimensional structure underlying the START and provides empirical support from a large multinational sample for the widespread use of summated Strengths and Vulnerabilities scores in forensic psychiatric risk research. [ABSTRACT FROM AUTHOR]

Forensic evaluators conduct assessments of individuals with a wide range of sociocultural identities. Although recommendations regarding how to incorporate cultural considerations in forensic evaluations have been published over the past decade, there is no clear consensus on best practices nor is it clear how evaluators interpret and apply the available recommendations. The current survey represents a replication and extension of a previous survey regarding self-reported culturally-informed practices among forensic evaluators. Subjects were forensic mental health professionals (n = 258; 64.7% women, 69.4% PhD or PsyD) recruited through listservs and training events to complete a survey online or by hard copy. Evaluators reported significant challenges in conducting culturally-informed evaluations, including lack of appropriate tests for their examinees, lack of guidelines for their evaluations, lack of colleagues from diverse backgrounds, and lack of relevant research. Evaluators reported engaging in a wide range of culturally-informed practices across all domains, some being nearly universal (e.g., considered cultural context when forming diagnosis). In contrast, other practices were relatively uncommon (e.g., referred the evaluation to another professional with more knowledge/experience regarding examinees with particular identities). Results indicate a need for more research, more practice guidelines, and diversification of the forensic mental health workforce. [ABSTRACT FROM AUTHOR]

Introduction: Psychiatric rehabilitation is a set of interactions that are to lead to the proper functioning of the patient in society, in accordance with the adopted social and legal order. Includes elements of education, care, and therapy. Material and methods: The study was conducted among patients of forensic psychiatry departments in the period September – October 2019. It covered 100 people, both men and women. subjects of the so-called judicial detention. The study was carried out by the method of a diagnostic survey, using the questionnaire technique. The study did not require the approval of the Bioethics Committee. Results: Most of the patients (58% of the study group) correctly realized the reasons for staying in the forensic psychiatry ward and accepted the court’s decision to be placed in a psychiatric hospital. Most of the patients (73%) were satisfied with the treatment and willingly participated in rehabilitation activities (80%). The oldest patients less often participated in rehabilitation classes — 23% of people participated in the classes on their own initiative or because of their interests. The age of the patients was significantly related to the involvement of patients in the proposed forms of rehabilitation. The vast majority of patients (92%) were optimistic about their future after leaving the ward. Conclusions: The vast majority of patients willingly participated in psychiatric rehabilitation classes. Educational classes conducted by nurses in the form of educational lectures turned out to be the most popular form of rehabilitation classes at the forensic psychiatry department. They needed these activities in the pine trees of patients and constituted a valuable source of information about health. A large group of patients noticed the positive impact of rehabilitation activities on their personality or life and intend to use the acquired skills in the future. [ABSTRACT FROM AUTHOR]

Mentorship can be defined as the person-to- person transmission of knowledge in a domain where one person has more experience than the other. Formal mentorship programs and awards have recently been implemented in the field of forensic anthropology, but the attitudes of forensic anthropologists toward mentors, protégés, and mentorship experiences have not been systematically explored. This study surveyed a sample of 123 forensic anthropology practitioners and students via 23 multiple-choice and 12 open-answer questions regarding their demographic information, opinions about mentorship, and experiences as both mentors and protégés. Results indicated that forensic anthropologists value both traditional, “top-down” mentorship interactions and “horizontal” peer-to- peer relationships with multiple mentors. Respondents emphasized the career and professionalism advice they received from their mentors, though some wished for additional guidance in social interactions and social issues. Demographic data were consistent with recent research highlighting the problematic homogeneity of the field, particularly in terms of social race. Based on the survey responses, a proposed consensus definition of forensic anthropology mentorship involves professional and personal guidance by a mentor who imparts discipline-specific, experiential knowledge, advice, and support in a way that allows a protégé to develop both professionally and personally. To enable that development in both ourselves and our colleagues—and to increase diversity and retention within our field—we recommend participation in a formal mentorship program specific to the discipline of forensic anthropology. [ABSTRACT FROM AUTHOR]

Aim: To quantify and characterise sexual assaults occurring after 12–17‐year‐old children connect with an alleged offender online (technology‐facilitated sexual assault: TFSA) examined at a paediatric forensic medical service in Melbourne, Australia between 2014 and 2020. To compare these findings to a previous 7‐year audit (2007–2013) to determine if there has been an increase in TFSA over the last 14 years. Methods: A retrospective audit was undertaken of medical records of children aged 12–17 who underwent forensic medical examinations at the Victorian Forensic Paediatric Medical Service following an allegation of sexual assault, between 1 January 2014 and 31 December 2020. Cases identified as being technology facilitated were further analysed. Results from 2014 to 2020 7‐year cohort were then compared to an existing audit over the preceding 7‐year period (2007–2013). Results: Of 515 sexual assault cases between 2014 and 2020, 70 (14%) victims reported connecting with the offender on a technological platform, compared to 4% of cases between 2007 and 2013. In 2019 and 2020, TFSA comprised almost one‐fifth of caseload. Of the 70 TFSA cases, the majority occurred at the first face‐to‐face meeting following a variable period of online communication. Approximately one‐third of TFSA's occurred at the offender's residence, and another third in a public place (park, public toilets). Technological platforms used evolved over the 14‐year study period. Conclusions: The proportion of TFSA caseload seen at an Australian paediatric forensic medical service increased over the last 14 years, with common characteristics to these sexual assaults suggested. [ABSTRACT FROM AUTHOR]

The current study aimed to increase understanding of men's experiences of fatherhood in forensic inpatient care; a population overlooked in research and at risk of neglect in clinical practice. Eight participants recruited from forensic inpatient services were interviewed. Data was analyzed via social constructivist Grounded Theory. The central psychological concept developed was that of paternal connection, reflecting a transient sense of connection to the father-child relationship. Core categories included 1) Psychological Processes, 2) Interpersonal Relationships, and 3) Institutional Organization. Fathers in forensic inpatient care experience dynamic psychological connectivity to their paternal relationship, regardless of child contact. This multi-layered experience requires responsive intervention to support fathers in this context. Recommendations for research, practice, and policy are outlined. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Individuals with intellectual and developmental disabilities (IDD) are at high risk of co-occurring mental health conditions, including major depressive disorder, bipolar disorder, psychotic disorders, anxiety disorders, impulse control disorders, and others. Because of symptoms associated with these illnesses and with the disabilities themselves, these individuals are often served in a mental health service system framework. In this second of two articles on care for persons with IDD in the mental health system, the authors focus on policy and systems considerations to assist practitioners and administrators to provide high-quality mental health services for these individuals by recognizing existing infrastructures of support. The authors describe historical factors, including legislation and case law, that have led to greater inclusion of persons with IDD in mainstream settings; systemic barriers to integrating services for persons with IDD and Medicaid waivers and provisions of the Affordable Care Act designed to overcome such barriers; and considerations for treating persons with IDD in various settings, such as emergency departments and forensic settings. They propose approaches to developing the workforce, such as by training direct service professionals and utilizing the services of board-certified behavioral analysts. A robust continuum of care and service delivery system that is increasingly sophisticated in working with persons with IDD, with and without co-occurring mental illness, is critical to maximize the autonomy and community inclusion of these individuals. [ABSTRACT FROM AUTHOR]

Readmission from secure forensic services has significant implications for individuals and providers. Whilst there is research on readmission for forensic services internationally and for medium secure services in the UK, little is known about rates of readmission to low secure services, and there is no research examining predictors of readmission in low secure services specifically. This study aimed to examine rates and predictors of readmission of 94 individuals discharged from UK-based low secure services. A retrospective quantitative design was employed to assess the rate of readmission. Treatment, demographic, clinical and forensic factors were considered to compare readmitted and non-readmitted groups and examined as possible predictors of readmission. In total, 34% patients were readmitted with an average time to readmission of 524 days. Readmitted patients differed significantly from non-readmitted on prescribed antipsychotic medication, previous forensic admissions, psychology intervention and group psychology intervention. Previous secure forensic admissions, scoring present on HCR-20 historical problems with violence and employability were significantly associated with a shorter time to readmission. Deterioration in mental state was the most common reason for readmission. Time to readmission post-discharge from low secure services can be predicted by several factors that are readily available to clinical teams. This novel exploratory investigation is imperative in furthering understanding of factors associated with readmission to LSFS. [ABSTRACT FROM AUTHOR]

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.

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.

Background: The COVID-19 pandemic has had a substantial impact on forensic mental health service provision and implementation. This study aimed to provide an analysis of the impact of COVID-19 related restrictions on routine outcomes within a large forensic mental health service in London, UK. Method: We conducted a longitudinal cohort study using data collected routinely prior to the COVID-19 pandemic (April 2018–March 2020) and then stages thereafter (March 2020–March 2021; analyzed as March–May 2020, June–September 2020, October–December 2020, January–March 2021). We used causal impact models (Bayesian structural time-series) to examine the effect of COVID-19 related changes on routine outcomes related to service provision and implementation. Results: There was an overall increase in long-term segregation (LTS) hours during the pandemic; 140%, (95% Cl 107, 171%) during Lockdown 1; 113%, (159% Cl 127, 192%) during post-Lockdown 1; 45% (95% Cl 23, 68%) during Lockdown 2 and, finally, 90% (95% Cl 63, 113%) during Lockdown 3. The most negative outcomes were evident during Lockdown 3. Incidents of violence were significantly more frequent during Lockdown 3 than would have been predicted based on pre-pandemic data, including physical assaults to service users (206%, 95% CI 57%, 346%), non-physical assaults to service users (206%, 95% CI 53%, 339%), and self-harm (71%, 95% CI 0.4%, 135%). Use of enforced medication also increased during Lockdown 3 (317%, 95% CI 175%, 456%). Conclusion: The pandemic and its related restrictions negatively affected some service outcomes. This resulted in increased incidents of violence and increased use of restrictive interventions, beyond what would have been expected had the pandemic not occurred. [ABSTRACT FROM AUTHOR]

SUMMARY: Forensic psychiatry services have grown and become more complex in structures, processes and pathways. Legacy customs, practices and changing policy are now organised into formal models of care. These are written accounts of how a health service is delivered, outlining best practice and services for patients progressing through the stages of their condition and the care and treatment available. This article explores the four key elements of a model of care: goals; pathways and processes; treatment programmes; and systematic evaluation. It describes the most common model of care in forensic services, which builds on structures of stratified therapeutic security. It also considers variations on this basic or standard model matched to needs arising from the complex interrelationship with other parts of the mental health service for the population served and with criminal justice, primary care and physical health, housing and welfare agencies. [ABSTRACT FROM AUTHOR]

The use of structured risk assessment instruments (SRAIs) has increased significantly over the past decades, with research documenting variation between countries. The use of SRAIs, their perceived utility and potential for mitigating bias in forensic risk evaluations (FREs) was investigated in a survey of Dutch forensic mental health practitioners (N = 110) We found generally positive views regarding SRAI utility. Bias in FREs was of concern to respondents. We found no evidence of a bias blind spot (the belief that oneself is less prone to bias than peers/colleagues). SRAIs were rated as the most effective debiasing strategy, but respondents also endorsed introspection. There were few differences in beliefs about sources of bias or debiasing strategies between respondents who had bias training and those who had not, suggesting the need for development of effective strategies to mitigate bias and training related to bias in FREs. [ABSTRACT FROM AUTHOR]

Restrictive practices are often harmful and many academics, policy-makers and clinicians agree that their use should be reduced in care settings. Specific focus on secure mental health services is warranted because restrictive practices are often seen as an integral part of forensic psychiatry but have received limited research attention relative to other areas of psychiatric practice. The aim of this scoping review was to map and evaluate recent empirical research that examines the use of restrictive practices, the consequences of using them and efforts to reduce restrictive practices, in secure mental health settings published since June 2015. The purpose of this review was to identify limitations and gaps in the literature in order to inform further research. PsycINFO, Medline, Embase, CINAHL, Scopus and ASSIA databases were searched for studies published between 2015 and 2020. Following electronic and manual searches, 36 studies were included. The studies were grouped into four main areas: 1) Nature of the problem describing the type, incidence, prevalence and scope of restrictive practices in secure mental health services; 2) Service user perceptions and experiences of restrictive practices; 3) Staff experiences, views and decision making; and 4) Interventions designed to reduce the use of restrictive practices. Findings support the notion that restrictive practices have a detrimental impact on the wellbeing of most service users in adult secure services as well as the staff who use them. Continued efforts to reduce restrictive practices are needed and the importance of collaborative working cannot be understated. Implications for future research, clinical practice, policy and best practice guidelines are all discussed. [ABSTRACT FROM AUTHOR]

Objective: to map the scientific production on the preservation of forensic traces by Nursing professionals working in emergency services. Method: a scoping review, with searches for studies carried out in six databases, in the gray literature available in Google Scholar and in the references of the studies selected. For analysis, the data reduction method was adopted. Results: 26 studies were included, organized into five categories: 1) Nursing professionals' knowledge on the preservation of forensic traces; 2) Procedures performed by Nursing to preserve traces in the victim's body; 3) Procedures performed by Nursing to preserve traces in the victim's belongings/ objects; 4) Procedures performed by Nursing to document traces; and 5) Actions to maintain the chain of custody performed by Nursing. Conclusion: the studies showed situations in which the emergency nurse may act in the preservation of forensic traces present in the victim's body and in objects, as well as in the registration of traces, verifying the role of Nursing to ensure integrity of the chain of custody, especially in situations of aggression, firearm injury, sexual violence, child abuse and assistance to trauma victims. [ABSTRACT FROM AUTHOR]

BACKGROUND: Forensic nursing is a specialty deployed in patient care areas, including emergency departments, intensive care units, labor and delivery suites, and psychiatric units treating persons who have suffered trauma from a violent or criminal act. The recognition of violence-related injuries in patients presenting to health care facilities is critical to an appropriate care trajectory. These patients require specialized resources beyond the treatment of physical injuries to include psychosocial and legal care that supports patient recovery and pursuit of criminal justice. OBJECTIVE: The purpose of this study is to obtain a broad view of current forensic knowledge and training for emergency nurses working in U.S. emergency departments and to identify gaps in nursing skills and practice such that appropriate education can be developed for this nursing specialty. METHODS: The study was conducted using a quantitative exploratory, descriptive approach via an emailed cross-sectional survey sent to a convenience sample of U.S. emergency nurses. RESULTS: A total of 43,775 emails were sent out to members of the Emergency Nurses Association. Of that group, 2,493 recipients opened the email, and 1,824 completed the survey, resulting in a total response rate of 4% and a 73% response rate from those who opened the email. Few respondents self-reported competence in the care of patients who experienced child abuse (13.1%), elder abuse (12.4%), interpersonal violence (17.6%), sexual assault (19.2%), human trafficking (7.4%), developmental challenges (7.2%), strangulation (12.5%), or who were suspected of committing a violent crime (11.4%). CONCLUSIONS: There is a compelling need to expand forensic education to advance knowledge and skill acquisition in emergency nursing practice and provide staff with additional resources that support a holistic trauma-informed approach to patient care. [ABSTRACT FROM AUTHOR]

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rev Rene is the property of Rev Rene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Forensic nursing is a specialty in the nursing profession based on legal procedures. This study aimed to assess the effect of a forensic nursing virtual education course on knowledge and clinical decision-making among master's nursing students. Methods: In a quasi-experimental study with a pre- and post-test, 106 master's nursing students at Guilan (n=65) and Mazandaran (n=41) Universities of Medical Sciences, Iran were enrolled. Data were collected using census sampling from March to April 2021. Participants in the intervention group received a forensic nursing virtual education course in three 90-minute sessions for 2 days. Results: A total of 88 out of 106 master's nursing students were enrolled in this study. The mean post-education score for knowledge in the intervention group was significantly higher than in the control group (12.52 vs. 7.67, P<0.001). The mean post-education score for clinical decision-making in the intervention group was significantly higher than in the control group (16.96 vs. 13.64, P<0.001). Conclusion: The level of knowledge and clinical decision-making of master's nursing students regarding forensic evidence improved after the forensic nursing virtual education course in the intervention group compared to the control group. Nursing managers and policy-makers can develop appropriate strategies to improve the knowledge and clinical decision-making of nursing students by using forensic nursing education courses in the curricula of nursing programs, especially in postgraduate education as an elective or mandatory course. [ABSTRACT FROM AUTHOR]

Purpose: Health-care professionals working in inpatient forensic mental health settings are exposed to a range of traumatic and distressing incidents with impacts discussed variously as "burnout", "compassion fatigue", "secondary trauma stress" and "vicarious traumatisation". This study aims to explore the short- and long-term psychological and physical health effects of trauma exposure in the workplace for frontline staff in a forensic setting. Design/methodology/approach: Semi-structured interviews were conducted with 14 nursing staff members working in the male personality disorders care stream in a Medium Secure Hospital. Findings: Thematic analysis yielded five themes: categories of trauma; how well-being is impacted; ways of coping and managing; protective factors; and systemic factors, with sub-themes within each of the superordinate themes. Practical implications: The findings demonstrate that some staff members were affected both physically and psychologically as a result of trauma-focused work whereas other staff members were unaffected. The psychological and physical health effects were broadly short-term; however, long-term effects on staff member's social networks and desensitisation to working conditions were observed. A broad range of coping methods were identified that supported staff member's well-being, which included both individual and organisational factors. Staff member's health is impacted by exposure to workplace trauma either directly or indirectly through exposure to material, and there is a greater need to support staff members after routine organisational provisions are complete. Staff should receive education and training on the possible health effects associated with exposure to potentially traumatic material and events. Originality/value: This research has further contributed to understanding the staff needs of nursing staff members working with the forensic personality disorder patients within a secure hospital setting. This research has identified the following service developments: the need for ongoing support particularly after organisational provisions are complete; further prospects to engage in psychological formulations; greater opportunities for informal supervision forums; staff training to understand the potential health impact associated with trauma-focused work; supervisors being appropriately trained and supported to elicit impacts of trauma-focused work on staff members; and additional opportunities to discuss well-being or monitor well-being. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It is more likely than ever that healthcare staff of all grades and in all settings will encounter cases of sexual assault, so it is crucial that they know how to respond appropriately to support survivors. Health and social care workers engage with clients in a range of situations, which means that they are well placed for such disclosure. In some cases, particularly if the assault is a recent incident, time is of the essence to ensure that there is no loss of evidence that could be crucial in gaining a conviction. This article explores the role of a sexual assault referral centre (SARC), a service that few people know about or think they will ever need. The type of sexual activity that constitutes a criminal offence will be discussed and information presented that offers direction for those who want to involve the police, and for those who do not. Links to a range of organisations are also included that survivors of recent or historic sexual assault can access for support and advice. [ABSTRACT FROM AUTHOR]

In the Netherlands, two new approaches have been developed for acute and forensic psychiatry, called High and Intensive Care (HIC) and Forensic High and Intensive Care (FHIC). The models provide standards for temporary high-quality clinical care for patients in crisis and combine practices to reduce seclusion. To support the implementation of these approaches, Communities of Practice (CoPs) were created, including peer providers, mental health nurses, psychiatrists and managers. CoPs are increasingly used in healthcare. However, CoPs vary greatly in form and objective, and more insight is needed in the organisation and facilitation of CoPs. Therefore, the aim of this study is to gain insight into the lessons learned and perceived effects of the CoPs. A qualitative approach was used. Data were collected through focus groups (n = 3) with participants in the CoPs, feedback meetings with teams implementing HIC (n = 78) or FHIC (n = 23), and observations by the researchers. Data were analysed thematically. Lessons learned are: 1) create an ambassador role for CoP participants, 2) organize concrete activities, 3) take care of a multidisciplinary composition, and 4) foster shared responsibility and work on sustainability. Perceived effects of the CoPs were: 1) support of HIC and FHIC implementation, 2) creation of a national movement, and 3) further development of the HIC and FHIC approaches. The audits served as an important vehicle to activate the CoPs, and stimulated the implementation of HIC and FHIC. The findings may help others in creating a CoP when it comes to the implementation of best practices and improving healthcare. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: There are insufficient nurses to meet current demand for mental health care. This is an international concern. Within England, the impact of staff shortages on the quality of patient care in forensic high secure settings has been highlighted by the national regulatory body for hospitals.Forensic hospital nursing is a distinct specialism within mental health. Forensic nurses must negotiate the therapeutic, ethical and practical challenges of caring for high‐risk patients in a locked environment. What this paper adds to existing knowledge?: There has been no previous study to ask frontline high secure forensic nurses, union representatives, senior nurses and workforce leads about what factors may be affecting recruitment and retention in their setting.As well as the specialized and challenging nature of the work, participants identified that workforce sustainability was affected by unequal working terms and conditions, the hospital locations and wider national factors, such as changes to how nurse training was funded.They also identified that some strategies that were employed to address workforce shortages, such as day‐to‐day movement of staff within the hospital and incentive packages for new recruits could be demotivating for established staff. What are the implications for practice?: Forensic high secure nursing workforce strategies should include training, development and career pathways that are specific to the specialism and extend beyond preceptorship for newly qualified staff.There should be clear and equitable employment terms and conditions with remuneration packages that are consistent within and between organizations.Hospital managers should address the effect that movement of staff between wards may have on nurses' morale, therapeutic relationships and safety culture. Introduction: There has been no previous study of stakeholders' views on recruitment and retention concerns in high secure forensic settings. Aim: To identify factors affecting recruitment and retention in high secure hospitals, from the perspectives of stakeholders with experience in forensic mental health nursing. Method: Framework analysis of data from fifteen interviews and three focus groups with frontline nurses, nurse leaders, recruitment leads and union representatives from three high secure hospitals in England. Results: Six themes emerged from the data: (a) the unique nature of high secure nursing; (b) the impact of short staffing; (c) wider factors affecting the high secure nursing workforce; (d) the location; (e) staff being on different terms and conditions of work; (f) recruitment strategies. Discussion: Multiple factors are likely to simultaneously affect high secure hospital recruitment and retention. Findings on the unique nature of high secure work reflect previous qualitative research. The themes of location, working terms and condition and recruitment strategies have not been previously identified in forensic nursing research. Implications for practice: Employers should ensure that employment terms and conditions are equitable and consistent. Furthermore, hospital managers should address the effect that movement of staff between wards may have on morale and therapeutic relationships. [ABSTRACT FROM AUTHOR]

This evidence-based opinion piece explores the totalising risk averse nature of secure and forensic mental health services and associated iatrogenic harms in England and Wales. Drawing on the research literature I consider the various influences, both external and internal which impact on the provision of such services and how both the therapeutic alliance and recovery potential for patients may be improved. Especial attention is paid to the deployment of restrictive practise, practitioner attitudes, the potential for non-thinking, and how these may impact on decision-making and the care and treatment of mentally disordered offenders. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Young people moving from child and adolescent secure hospitals present with complex needs and vulnerabilities and are more likely to experience poor transition outcomes. Previous research has indicated the presence of several risk factors in periods of transition, such as poor liaison among services, lack of proper planning, shortage of beds in adult services, multiple transitions and lack of emotional readiness. However, little evidence exists about the processes and outcomes of transitions from adolescent secure services to adult settings. This study aims to bridge the gap in the existing literature by exploring the views and experiences of key professionals involved in the transition process from six adolescent medium secure units to nine adult secure and community services in England. Thirty-four key workers from 15 child and adolescent (N = 21) and adult (N = 13) forensic hospitals were interviewed to provide information about potential barriers and facilitators to transitions. Face-to-face semi-structured interviews were conducted between January 2016 and December 2017. Thematic analysis was used to identify challenges and facilitators to transitions. Three primary themes were identified: (1) transition processes and preparation; (2) transition barriers and challenges; (3) success factors to transition. Key differences in adult and adolescent service care-models and lack of emotional and developmental readiness to moving onto adult-oriented settings constitute major barriers to positive transition outcomes. Practice and policy implications are considered to address the need for service transformations. [ABSTRACT FROM AUTHOR]

National epidemiological data indicate that nearly 4 in 10 victims of recent sexual assaults have physical, cognitive/developmental, or mental health disabilities, which can make navigating postassault help seeking more challenging. To streamline services, many communities have created sexual assault nurse examiner (SANE) programs for comprehensive health care, crisis intervention, medical forensic evidence collection, victim advocacy, and legal referrals. SANE programs are recommended as the national best practice for postassault care, but there is virtually no U.S.-based research on whether survivors with disabilities seek these services. The present study sought to identify the disclosure and referral pathways that successfully connected sexual assault survivors with disabilities to SANE programs for postassault care. Forensic nurses in one midwestern state recorded information about all adult sexual assault patients (N = 755) who sought care during a 9-month window of data collection. Survivors with disabilities were significantly less likely than those who did not have disabilities to disclose to informal support providers (e.g., family, friends) and those individuals were unlikely to suggest to survivors with disabilities that they seek postassault health care. Survivors with disabilities were significantly more likely than survivors who did not have disabilities to disclose to formal help sources and to be referred to SANE programs by other formal community services, typically the police. A strong referral network from law enforcement to SANE programs is important, but survivors who do not wish to pursue criminal investigation need reliable pathways to postassault health care. Strategies for promoting community awareness of SANE services are discussed. Public Policy Relevance Statement: Sexual assault nurse examiner (SANE) programs are recommended as the national best practice for postassault health care, but survivors with disabilities face multiple barriers accessing these services. Strong interagency collaboration and referral networks can help connect survivors with disabilities to these critical health services. Promoting community awareness about SANE programs is necessary to ensure that survivors' family and friends can also help link victims with disabilities to high-quality health care. [ABSTRACT FROM AUTHOR]

COVID-19 outbreak has resulted in a substantial morbidity and mortality, and has put the health system under tremendous stress. A need for devising and adopting newer methods and techniques is being emphasized in the healthcare facilities to combat the effects of the SARS-CoV- 2. Besides patient care, focus needs to be laid on the effective and dignified management of the deceased and medico-legal services provided by the hospitals and medical institutions during the COVID-19 pandemic. Considering the likelihood of forensic experts and autopsy personnel being exposed to SARS-CoV-2 inadvertently during the autopsy, it is recommended to resort to safer and minimally invasive techniques of postmortem examination of the dead. In this regard, employing radiological techniques for postmortem examination appears to be a promising option during the COVID-19 pandemic. An inherent advantage of postmortem radiography over conventional autopsies is the minimization of the risk of transmission of infection to the health care workers. Our correspondence highlights on the possibility of using radiological facilities as an effective replacement of high-risk conventional autopsy procedures during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Forensic Nursing emerges as a new nursing practice, combining scientific and technical nursing knowledge with Forensic Science principles. Objectives: To evaluate the level of knowledge about the Forensic Nursing Practices in the 4th year students of the Nursing Degree. Methodology: A cross sectional analysis study conducted with a sample of 240 students. The Knowledge Questionnaire over Forensics Nursing Practices (KQFNP) was applied in a survey. Results: The level of knowledge of the students of the 4th year of the Degree in Nursing was good (52.1%), sufficient (21.3%) and insufficient (26.7%), according with scale scored defined, with the existence of deficits essentially at the level of crucial aspects of the preservation of vestiges. Conclusion: The evidence emphasizes the need of investment in the training of the students over forensic nursing practices. So, basic knowledge of forensic nursing is a critical concept to be included in core curriculum of a four-year nursing degree program.

Background: Nursing is a vital element in providing safe and effective care. Forensic nursing is one of the specialties in this discipline which, in addition to creating more satisfaction in nurses, is considered essential in holistic, quality, and safe care. This study aimed to describe the consequences of the presence of forensic nurses in the health system. Materials and Methods: This qualitative study was conducted between 2017 and 2018 in Iran. Semi-structured interviews were performed with 18 participant experts in the field of health and law. The interviews were analyzed using the inductive content analysis approach proposed by Graneheim and Lundman. Results: The consequences of the presence of nurses in the health system were summarized into two categories: positive and negative consequences. The positive consequences consisted of improved performance, better legality of nurses, the calmness of nurses, prevention of patients' rights violations, advancement comparable with developed countries, reduced costs, increased accuracy and speed in dealing with forensic cases, improved performance of Iranian Legal Medicine Organization and increased employment. On the other hand, the negative consequences were role conflict with other involved professionals and nursing shortage. Participants included nurses (with different specialties), nurse lawyers, forensic medicines, forensic midwives, a judge, and a medical lawyer. Conclusions: If planners and policymakers have a positive attitude toward the presence of forensic nurses, we can anticipate better forensic services for clients through the development of systematic educational programs, the formation of forensic teams, and the expertise of this profession can provide many benefits.

Abstract Objective: To identify the perceptions of Primary Health Care workers regarding Violence Against Women. Method: Qualitative, exploratory, descriptive study addressing 23 health professionals working in three Health Centers in Praia, Cape Verde, Africa. Semi-structured interviews were held via videoconference in November and December 2020. Data were treated according to thematic analysis. Results: Three categories emerged: violence against women restricted to physical aggression; violence as a phenomenon resulting from financial dependency; and victim blaming. Conclusion: The reductionist view of violence, as limited to physical harm, associated with financial dependency and victim blaming helps to unveil perceptions that ground the practice of health workers with women victims of violence and can support the planning of continuous education provided in Primary Health Care services.

Competing Interests: The authors declare no conflict of interest.

Background: To strengthen the nation's use of forensic science and advance professional practice, forensic practitioners and scientists in the Organization of Scientific Area Committees (OSAC) develop standards in forensic science. The Forensic Nursing Subcommittee was created by OSAC in 2021 to develop standards that improve patient outcomes through delivery of consistent practice guidelines, evidence-based techniques for preservation of evidence, and accurate representation of practice and examination findings., Purpose: The purpose of this article is to relate the history of forensic science standard development in the United States, discuss the rationale for forensic nursing standards, and describe the standards development process. In this article, we provide an overview of OSAC and the OSAC Forensic Nursing Subcommittee. We discuss how forensic nurses can be involved in the development and advancement of standards that define minimum requirements, best practices, and evidence-based protocols to ensure reliable and reproducible outcomes., Implications for Forensic Nurses: The development of forensic nursing standards is an important step in advancing the profession. It is critical that forensic nurses are actively involved in the standards development process, which includes volunteering to serve on the OSAC Forensic Nursing Subcommittee or a forensic nursing standards development organization, providing input into standards drafts during the public comment period, and implementing approved standards into practice., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 International Association of Forensic Nurses.)

Competing Interests: The author declares no conflict of interest.

Introduction: Sexual assault nurse examiners are crucial care providers in cases of sexual assault. However, it is not clear whether sexual assault nurse examiner availability differs throughout the 13 states that comprise the Appalachian region of the United States. Therefore, this cross-sectional analysis identified sexual assault nurse examiner availability in 13 states and determined differences in availability by both county-level Appalachian status and county-level rurality status., Methods: Data were downloaded from 2 public sexual assault nurse examiner registries for the included 13 states. Descriptive statistics of sexual assault nurse examiner certification type and availability by state were calculated. In addition, bivariate analyses of sexual assault nurse examiner availability by rurality and by Appalachian status were performed using 2-sample z-tests for equality of proportions., Results: State-level sexual assault nurse examiner availability ranged from 0.34 to 0.86 sexual assault nurse examiners per 100,000 residents. Sexual assault nurse examiner availability in these 13 states did not differ by Appalachian status. However, rural areas had significantly lower sexual assault nurse examiner availability than urban areas in these 13 states., Discussion: These data support previous literature on the need for stronger sexual assault nurse examiner programs in rural areas in the United States. Future research should take sexual assault prevalence into account to determine whether local sexual assault nurse examiner access needs, as well as appropriate support for sexual assault nurse examiners, are being met throughout Appalachian states., (Copyright © 2024 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.)