AIM:To evaluate the impact of forum theater on nursing students' attitudes towards forensic psychiatric patients. METHODS:Using a quasi-experimental, single-group, pretest/posttest design, twenty-five nursing students enrolled during the 2025-2026 academic year participated. Data were collected using a personal information form and an attitude scale for health care professionals towards forensic psychiatric patients. As part of the intervention, a three-hour forum theater-based educational programme was implemented. Pretest and posttest scores were analysed using the Wilcoxon signed-rank test. RESULTS:After the forum theater intervention, a statistically significant increase was observed in participants' total attitude scores (p < 0.001). While significant increases were found in the Social Distance and Dangerousness subscale scores (p < 0.05), no significant changes were observed in the Willingness to Provide Care and Trust subscales (p > 0.05). DISCUSSION:Forum theater is an effective educational method for reducing stigmatising attitudes towards forensic psychiatric patients among nursing students, and for promoting more accepting attitudes. From a public health nursing perspective, such experiential and participatory educational approaches are considered to be a significant means of combatting stigma within community-based mental health services.
BACKGROUND:Although Sunflower Centers in South Korea facilitates access to care through an integrated support model, the specific survivor and incident characteristics associated with requests for mental health services remain poorly understood. AIM:To identify factors associated with requests for mental health services among sexual violence survivors at a SunFlower Center in South Korea. METHODS:Retrospective cohort study of 269 cases from the Sunflower Center between July 2020 and December 2022. RESULTS:Overall, 41.3% of survivors requested mental health services. Among minor survivors, intact memory of the incident was associated with a higher likelihood of requesting mental health services [odds ratio (OR): 6.44, 95% CI: 1.05-39.54]. Among adult survivors, assault by a socially acquainted person (OR: 4.13, 95% CI: 1.17-14.55) or a chat partner (OR: 4.10, 95% CI: 1.13-14.93) was associated with a higher likelihood of requesting therapy. Conversely, genital penetration was associated with a lower likelihood of requesting psychotherapy (OR: 0.33, 95% CI: .14-.79). CONCLUSION:These findings highlight the importance of age-sensitive, trauma-informed care. Forensic nurses play a key role in coordinating mental health referrals based on survivor and assault characteristics.
Background Telehealth technology has been used to increase access to SANE care as many patients have limited or no access to a SANE. Aim To map current literature on telehealth-based Sexual Assault Nurse Examiner (teleSANE) services. Methods We searched databases for articles published through May 2025 and identified 13 articles from 371 initial records. Eligible studies discussed telehealth SANE services and included feedback from stakeholders. Results Most teleSANE services used a hub-and-spoke model with SANEs providing real-time guidance to remote-site clinicians. Implementation rationales focused on ensuring quality care, increasing access, and improving provider confidence. Stakeholder feedback was predominantly positive, although rarely gathered from patients. Significant sustainability challenges were evident. Discussion TeleSANE shows promise in ensuring access to SANE care while creating new practice opportunities for forensic nurses. Future research should focus on patient outcomes, cost-effectiveness, experiences of diverse populations, and implementation in specialized settings.
Background Incarceration is a critical life transition that may affect prisoners’ health perceptions and access to care. Understanding these experiences is essential to address health vulnerabilities in detention settings. Aim To explore prisoners’ perceptions of health, the impact of incarceration, and challenges in accessing health care during early detention. Methods A qualitative descriptive study was conducted using semi-structured interviews with 10 prisoners in a French remand center. Data were analyzed using deductive thematic content analysis informed by Meleis’ Transition Theory. Results Incarceration was experienced as a situational transition frequently associated with psychological vulnerability. Although some participants perceived detention as an opportunity to improve their health, others reported negative health impacts. Barriers to care included overcrowding, low health literacy, and mistrust of the health care system. Adaptive responses involved positive reframing, establishment of new routines, engagement with health professionals, and reliance on social support. Discussion Incarceration emerged as a health paradox in which structural vulnerability coexists with perceived health stabilization. These findings underscore the importance of trust-building, health literacy promotion, and person-centered nursing interventions to support health engagement among incarcerated individuals.
BACKGROUND:Natural disasters are increasing in severity and frequency, whereas women's increased risk for sexual violence (SV) during disasters is largely ignored by disaster management. AIMS:To assess what is known in the literature about SV towards adult women immediately before, during, and after natural disasters to inform forensic nursing practice. METHODS:Following the Joanna Briggs Institute (JBI) framework, primary literature was searched in CINAHL, PubMed, and PsycINFO. Twenty-two sources met inclusion criteria. RESULTS:Few theoretically based high-level studies, and multiple terms to describe similar phenomena limiting comparison between studies. Despite searching in CINAHL, no authors were nurses, and no sources came from nursing journals. DISCUSSION:Quality research addressing sexual violence against women during disasters is needed. Forensic nurses are well poised to bring awareness and collaborate with emergency management agencies to lead regulation and policy change, advancing gender-sensitive disaster management.
Buprenorphine/naloxone is widely used in correctional settings to treat opioid use disorder and reduce post-release overdose risk. However, diversion and nonprescribed use of opioid agonist therapy within custody have been documented. This case report describes a 29-year-old man without a prior history of opioid use disorder who developed opioid dependence during incarceration through repeated illicit use of diverted buprenorphine/naloxone. Given the link between incarceration and elevated post-release overdose mortality, newly acquired opioid dependence may increase vulnerability during community re-entry. This case highlights an iatrogenic opioid use disorder pathway arising within correctional environments and underscores the importance of screening upon admission, diagnostic measures, and consideration of abuse-resistant formulations when implementing opioid agonist therapy. Addressing co-occurring trauma, substance use, and mental health disorders may be integral to prevention. Further research is needed to better characterize potential iatrogenic pathways to opioid dependence and inform harm-reduction strategies across correctional and community settings.
Pediatric fatalities present multifaceted clinical and forensic complexities requiring both clinical acumen and trauma-informed vigilance. This case study examines a school-aged child who arrived at a Level I trauma center following a reported accidental drowning. Despite prompt resuscitative efforts, the child was pronounced deceased. While no external trauma was noted, scattered nonblanching petechiae on the face, eyelids, and conjunctiva raised concerns. Toxicology results were negative, and no forensic nursing consultation was initiated. The child's death was classified as accidental without autopsy findings to substantiate or challenge that conclusion. Forensic pathology literature identifies isolated conjunctival petechiae as a potential indicator of asphyxial death, including strangulation, suggesting a missed opportunity for forensic assessment. This case highlights the essential role of forensic nurses in identifying subtle signs of violence. Furthermore, it emphasizes the importance of interdisciplinary forensic awareness and early forensic consultation in pediatric deaths to ensure comprehensive evaluation and safeguard medicolegal integrity.
BACKGROUND:Strangulation by assault is high-risk and survivors have specific medical and forensic needs. There is no standardized protocol for the evaluation of pediatric victims of acute, abusive, nonfatal strangulation. AIM:To develop a pathway and supporting documentation templates, forensic interview questions, and a pediatric-specific kit for children with assault by strangulation. METHODS:A multidisciplinary team at a large pediatric hospital created a protocol for forensic interviews and evidence collection in the emergency department for patients below 18 years old disclosing assault by strangulation within 24 hr by a dating partner or caregiver in the home. RESULTS:The team was implemented on October 31, 2024, and finalized evidence-collection materials in August 2025. From October 31, 2024 to June 23, 2026, 66 patients with strangulation were assessed. CONCLUSION:We implemented an emergency department pathway for acute pediatric, nonfatal strangulation by assault, providing valuable insight for institutions caring for these vulnerable patients.
BACKGROUND:Several states have amended their laws relating to a minor's ability to consent to medical forensic exams after sexual assault. AIM:To identify state-by-state legal differences of who may provide informed consent for forensic medical exams with adolescent patients following sexual assault. METHODS:A search of all 50 states using the legal database Westlaw for state statutes pertaining to who may provide consent for sexual assault medical forensic exams on minors. RESULTS:Unless stated as an exception, parental consent remains a prerequisite for minors to undergo medical forensic exams and medical treatment following a sexual assault. Fourteen states have an exception that allows minors to obtain sexual assault medical forensic exams without parental consent, while twenty-eight states do not have an exception (require parental consent). DISCUSSION:Legislative divergence across states highlights the importance of health care providers to remain current on their state's requirements.
BACKGROUND:Nonfatal strangulation (NFS) is a high-lethality act commonly associated with intimate partner violence and sexual assault. Strangulation-specific knowledge among U.S. health care professionals outside of forensic settings is not well characterized. AIM:To examine NFS knowledge and clinical decision-making across health care roles and assess whether licensure type or clinical experience was associated with knowledge scores. METHODS:A cross-sectional survey was administered to 131 U.S. health care professionals. A 10-item composite knowledge score was analyzed using ANCOVA, controlling for years of experience. RESULTS:Mean composite score was 5.68 (SD=1.576, range=2-9). Licensure type was significantly associated with scores (P=0.001, partial η²=0.120). Nursing professionals scored highest (M=6.22), significantly outperforming providers (M=5.42), prehospital (M=4.85), and allied health providers (M=4.43). Years of experience were not significant (P=0.412). DISCUSSION:Nursing professionals had a significantly higher level of comfort than other healthcare roles, suggesting that education and experience are not uniformly distributed during schooling and on-the-job training. This may suggest that healthcare education would benefit from more broadly applied education, although the size of the study limits the generalizability of conclusions. CONCLUSION:Strangulation knowledge varied by professional role and was not associated with clinical experience, highlighting the need for standardized, cross-disciplinary education.
ABSTRACT: AIM:To examine occupational challenges faced by nurses providing cardiac care to incarcerated individuals with cardiovascular disease in a high-security environment. METHODS:This study used Graneheim and Lundman's conventional content analysis. We conducted in-depth, semistructured interviews with nine purposively selected nurses from cardiology departments at Razi Hospital, Birjand, Iran (November 2023-May 2024). MAXQDA software was used for analysis, and Guba and Lincoln's criteria ensured the credibility and trustworthiness of the data. RESULTS:Four main themes were identified: (1) conflict between custody and care, (2) relational challenges and mutual distrust, (3) prisoner-specific care issues, and (4) psychological pressures and increased workload for nurses. DISCUSSION:Nurses providing specialized care to prisoners with cardiovascular disease face numerous challenges, necessitating multilevel interventions such as enhanced training, improved organizational protocols, and policy collaboration between health care and correctional facilities to address the core custody-versus-care tension and develop effective strategies for equitable care.
BACKGROUND/AIM:Conduct a descriptive synthesis of case reports on nurse and physician suicide. METHODS:The literature was searched using CINAHL, PsycINFO, PubMed, and Google Scholar. RESULTS:Collectively, 47 case reports on nurse suicide and 95 case reports on physician suicide were examined. Most case reports did not differentiate between working and non-working nurse and physician suicide decedents. Case reports suggested nurse and physician suicide decedents maintained specialties that provided knowledge of and/or easier access to lethal means of suicide. Case reports frequently included nurse and physician suicide decedents from high-income countries with higher provider per population ratios. Male nurse suicide decedents were overrepresented across case reports, and there were also more case reports on male physician suicide decedents. Nurse and physician suicide decedents in their 40s and 30s were the subject of numerous case reports. Nurses and physicians were frequently found deceased in their homes, followed by the workplace. Across case reports, self-poisoning represented the leading method of suicide among nurses and physicians. Ethanol represented a common nonfatal substance among nurse and physician suicide decedents. Across case reports, leading overlapping contextual factors among nurse and physician suicide decedents included mental health concerns, physical health concerns, and job problems. DISCUSSION:Taken together, additional research is important in corroborating evidence from case reports, building and expanding the evidence base, and informing prevention and intervention.
BACKGROUND:Despite growing awareness among health care practitioners of youth sex trafficking in the United States, little is known from the perspective of the survivors about their experiences communicating with such professionals. AIM:To provide insight into how nurses and other health care practitioners, who often encounter survivors, can better intervene to assist them. METHODS:We conducted a qualitative thematic analysis of interviews with eight 18-26-year-old adults who had survived sex trafficking as a youth; we inquired bout their interactions with nurses and health care first responders while being trafficked. RESULTS:Three major communication themes emerged in participants' descriptions: victim/survivor-focused, practitioner-focused, and disclosure-focused themes. Each reflected a different pattern of verbal and nonverbal communication in survivors' perceptions of how their interactions unfolded. DISCUSSION:Results highlight important directions for education and training for health care practitioners to enhance identification of and support and service provisions for youth victims of exploitation and trafficking, an important, overlooked, and underserved youth population that regularly seeks services in clinic and emergency health care settings.
BackgroundHealth professionals frequently care for individuals who have been trafficked, yet many go unrecognized. Trainings that reinforce narrow stereotypes may contribute to these missed opportunities by shaping provider perceptions and deepening bias.PurposeTo assess whether introductory online trainings about human trafficking reflect representational biases.MethodsThirteen publicly available trainings were analyzed for sensationalism, racial representation, gender identity expression, and trafficking type.ResultsAll trainings showed bias in at least one domain; the greatest bias was toward feminine gender expression (92%). Sensationalized imagery appeared in 46%. White-presenting survivors were overrepresented in 38%. About half lacked any transgender/nonbinary (46%) or LGBTQ+ (54%) identities. Sex trafficking was emphasized over labor trafficking in 85% of trainings.ConclusionsEven brief trainings can shape perceptions and perpetuate bias. Educators should critically examine representation and their own positionality to support trauma-informed skills-building that helps clinicians recognize and support all survivors in clinical care.
BACKGROUND:Forensic nursing is emerging in France following the 2010 forensic medicine reform, establishing Medico-Judicial Units. This field lacks standardized training and formal recognition compared with international standards. AIM:To describe the current practices and future professional perspectives of forensic nurses in France. METHODS:Cross-sectional survey with attendees of first French forensic nursing symposium, assessing demographics, forensic nursing activities, and professional interests. RESULTS:Forty nurses participated, revealing forensic nursing as a mid-career transition with substantial general nursing experience but limited forensic experience. Current practices emphasized collaborative clinical examinations, photography participation, and comprehensive victim follow-up. However, only half had received specific forensic training. Primary difficulties were insufficient training and a lack of supervision. Future aspirations favored technical activities and academic pursuits over independent examinations. CONCLUSIONS:Forensic nursing is a collaborative specialty with training gaps; study findings inform recommendations for standardized education, supervision, and formal recognition through a new national association.
BACKGROUND:Telehealth technology has been used to increase access to SANE care as many patients have limited or no access to a SANE. AIM:To map current literature on telehealth-based Sexual Assault Nurse Examiner (teleSANE) services. METHODS:We searched databases for articles published through May 2025 and identified 13 articles from 371 initial records. Eligible studies discussed telehealth SANE services and included feedback from stakeholders. RESULTS:Most teleSANE services used a hub-and-spoke model with SANEs providing real-time guidance to remote-site clinicians. Implementation rationales focused on ensuring quality care, increasing access, and improving provider confidence. Stakeholder feedback was predominantly positive, although rarely gathered from patients. Significant sustainability challenges were evident. DISCUSSION:TeleSANE shows promise in ensuring access to SANE care while creating new practice opportunities for forensic nurses. Future research should focus on patient outcomes, cost-effectiveness, experiences of diverse populations, and implementation in specialized settings.
