Culturally competent care for psychiatric clients who have a history of sexual abuse.

Canadian psychiatric nurses (N = 1,701) participated in a survey in which they-assessed their ability to nurse clients with a history of sexual abuse when cultural differences are present. Thirty-nine percent worked at a facility having a significant number of clients from a different culture. Only 4.6% rated themselves as "very competent." Four themes emerged from nurses' assessment of their ability: culture is not the problem, culture is not an issue, culture influences perspective and responses, and culturally specific competence. Only one cultural group, First Nations, was identified by sufficient numbers of nurses to generate themes concerning the challenge of working with clients from a particular culture. These themes (abuse as a cultural norm, concurrent and related health and social problems, reluctance to talk about problems, a need to learn about First Nations culture, and developing culturally competent caregivers), critical areas of concern, and possible solutions suggested by the nurses are discussed.

Forbidden love: sexual exploitation in the forensic milieu.

Strategies must be developed within forensic psychiatric nursing practice that deal with issues surrounding forbidden love before, during, and after they arise. Unfortunately, nurses are generally ill prepared to deal with the sexual dilemmas that can occur in clinical practice. Sexual dilemmas must be recognized as an occupational hazard and not a professional taboo. Open acknowledgement that the potential for abuse exists in all nurse-client relationships is the key to avoiding the pitfalls that lead to sexual impropriety.

Sexual abuse comfort scale: a scale to measure nurses' comfort to respond to sexual abuse in psychiatric populations.

The purpose of the present study was to further contribute to the psychometric evaluation of the Sexual Abuse Comfort Scale (SACS) in order to provide a standardized measure that would assess the impact of educational programmes on nurses' comfort to intervene with psychiatric clients regarding sexual abuse. This study was part of a larger multisite study conducted in four Canadian provinces, designed to assess the attitudes, beliefs, competencies and educational needs of psychiatric nurses who may work with clients who have been sexually abused. As part of the larger study, a self-administered survey was sent to 3532 psychiatric nurses employed in Alberta, Saskatchewan, Ontario and Nova Scotia. The SACS, the Sexual Attitudes Scale (SAS), the Questionnaire Measure of Emotional Empathy (QMEE) and the Marlowe-Crowne Social Desirability Scale (M-CDS) were included in the survey. The SACS was submitted for item analysis, factor analysis, hypothesis testing regarding construct validity and assessment of concurrent validity. Item analysis of the SACS resulted in a 30-item scale with a coefficient of 0.91, indicating an excellent level of reliability. Empirical evidence indicates that the SACS is a reliable and valid instrument that may be used for the effective evaluation of intervention programmes directed towards increasing clinical knowledge and competence related to sexual abuse.

Nurses' views regarding False Memory Syndrome.

Knowledge concerning the storage and retrieval of traumatic memories and so-called False Memory Syndrome has not been widely available in nursing journals. Information in the popular media, however, means that nurses are learning about aspects of the memory debate from such sources. This article reports on 1,701 nurses' views of False Memory Syndrome (FMS). As background, this report reviews briefly current issues and research on traumatic memory retrieval. The majority of participants believed that FMS, although rare, could occur. For these nurses, FMS was a consequence of incompetent and unethical therapists. They worried that attention to FMS would silence or revictimize survivors of abuse.

Custody and caring: clinical placement of student nurses in a forensic setting.

TOPIC: Clinical placement of student nurses in a forensic setting during their psychiatric nursing course. SOURCE: Curriculum at the College of Nursing, University of Saskatchewan. GOAL: To describe a unique setting for learning psychiatric nursing. CONCLUSION: Forensic settings provide an opportunity for students nurses, educators, and clinicians to work together to learn and to provide excellent care.

Serving time: psychiatric mental health nursing in corrections.

1. The opposing philosophies of custody and caring result in direct implications for nurses working in the correctional environment. Nurses constantly "walk in line" between the requirement of security, health care, and client advocacy. 2. Deinstitutionalization, increased rates of incarceration for interpersonal violence, and substance abuse related crimes have resulted in a rapidly expanding prison population. Of all offenders, 10% to 15% have a major mental illness, leading to many treatment challenges for the nurse. 3. Therapy issues with this population are complicated. Correctional nurses must have a good understanding of the therapeutic nurse-client relationship, with particular attention to therapeutic impasses, transference, and countertransference. 4. Historically, role development for nurses working in corrections has been particularly difficult. Correctional nurses must grapple with issues surrounding professional identity, professional isolation, and territoriality.

Living with mental illness: professional/family collaboration.

What started as a pilot project in the spring of 1990 has matured into a successful ongoing enterprise between professionals and families that continues to meet the needs of families experiencing the impact of mental illness. According to self-administered evaluations completed by those in attendance, and a subjective review by the planning committee, the program was an immediate success. It attained its overall education and mutual support objectives, and fostered successful collaboration between professionals and families. One hundred percent of family participants indicated that they would recommend the workshop to others in similar situations. In managing mental illness through collaborative partnerships, the family must be an integral part of each phase of project development. Family members are the "thermometer," measuring how closely the project is mirroring their needs. Since its inception, 370 people have participated in this dynamic project. This program demonstrates that through understanding, respect, and positive regard, families, friends, and professionals can work collaboratively to enhance the quality of life for all who are victimized by mental illness.

The effects of patient weight and sex on nurses' perceptions: a proposed model of nurse withdrawal.

This investigation challenged the premise that nurses adhere to affective neutrality in their practice of nursing, and examined the effect of patient weight and sex on evaluations, attributions and care delivery decisions formed by nurses. The phenomenon of mutual withdrawal originally identified by Tudor in psychiatric nursing was adapted to the general nursing milieu and served as the conceptual framework. Emphasis in this study was given to the phenomenon of nurse withdrawal. A volunteer sample of 100 senior female baccalaureate students was randomly assigned to one of four conditions in a 2 X 2 factorial design with the following factors: (a) weight of the stimulus patient (normal versus obese); and (b) sex of the stimulus patient (male versus female). These independent variables were presented through descriptive vignettes and visual stimuli to participants completing a self-administered questionnaire. Dependent variables included evaluation, attribution and care delivery. Analysis of the questionnaire demonstrated that obese patients were evaluated more negatively than normal weight patients, F = 2.82, P less than 0.05, but were not held more responsible for an alleged transgression, nor did nurses indicate withdrawal. The phenomenon of social attractiveness was identified as an intervening variable lending support to the proposed model of nurse withdrawal. This finding is examined within the context of affective neutrality in the nurse-patient relationship. Implications for nursing practice, theory and research are discussed.