Healthcare in Secure Environments: Leading a Collaborative for Forensic Nursing Education.

Atlantic Canada hosts six federal and 18 provincial correctional facilities distributed across the four provinces. All employ nurses and offer significant career opportunities, yet minimal content related to forensic nursing is provided in nursing curricula. Furthermore, there is a paucity of continuing educational offerings for Canadian forensic nurses. This article describes the series of events that brought the practice of forensic nursing to the forefront of provincial news media. Actions taken by nurses in academia and practice addressed the lack of educational opportunities for forensic nurses in Atlantic Canada. One of these actions, a Knowledge Forum, was held to nurture partnerships between nurse leaders responsible for healthcare in correctional services in New Brunswick and nurse educators. The idea was to connect nurse leaders responsible for healthcare in federal and provincial jurisdictions, community liaison nurses and nurse managers working in hospital-based forensic mental health assessment units, and nurse educators, to explore nursing practice within secure environments and the current educational needs of forensic nurses.

The effects and expense of augmenting usual cancer clinic care with telephone problem-solving counseling.

This study was done to assess the effectiveness and efficiency of individualized, problem-solving counseling provided by baccalaureate nurses over the telephone to prevent the onset of depression in persons with breast, lung, or prostate cancer. Of 175 persons randomized, 149 completed the 8-month follow-up. The primary outcome measures were changes in the Jalowiec Coping Scale, the Centre for Epidemiologic Studies in Depression Scale, and the Derogotis Psychosocial Adjustment to Illness Scale. In addition, expenditures for people's use of all health and social services were computed at baseline and follow-up. Telephone counseling improved the use of more favorable coping behaviors, prevented a clinically important but not statistically significant decline into depression, and poor psychosocial adjustment in a group of people with mixed cancer. These results were associated with a greater total per person per annum expenditure for use of all other health and social services in the community compared with the control group. In a situation of limited resources and a service producing more effect for more costs, one needs either to examine what services to forgo to offer this service or to carefully target the new service to those most likely to benefit.

Incomplete and inconsistent information provided to men making decisions for treatment of early-stage prostate cancer.

OBJECTIVES: To determine whether there is a gap between what patients know about early-stage prostate cancer and what they need to know to make treatment decisions, and whether the information patients receive varies depending on their treating physician. METHODS: Needs assessment was performed using a questionnaire consisting of 41 statements about early-stage prostate cancer. Statements were divided into six thematic subsets. Participants used a 5-point Likert scale to rate statements in terms of knowledge of the information and importance to a treatment decision. Information gaps were defined as significant difference between the importance and knowledge of an item. Descriptive statistics were used to describe demographic subscale scores. The information gap was analyzed by a paired t test for each thematic subset. One-way analyses of variance were used to detect any differences on the basis of treating physician. RESULTS: Questionnaires were distributed to 270 men (135 treated by radical prostatectomy, 135 by external beam radiotherapy). The return rate was 51% (138 questionnaires). A statistically significant information gap was found among all six thematic subsets, with five of the six P values less than 0.0001. Statistically significant variation was observed in the amount of information patients received from their treating physicians among four of the thematic subsets. CONCLUSIONS: There is an information gap between what early-stage prostate cancer patients need to know and the information they receive. Additionally there is a difference in the amount of information provided by different physicians.

Women living with ovarian cancer: dealing with an early death.

Our intent to explore the emotion of anger in women living with ovarian cancer revealed a basic social concern of "dealing with an early death." The findings of this grounded theory study also identified the core variable of "finding meaning in life" as assisting the nine women in dealing with an early death. The categories of hope and physical wellness influenced the women's search for meaning after a diagnosis of ovarian cancer. Several action and interactional coping strategies were identified as positive coping behaviors. The consequences of finding meaning in life was a perception of well-being defined by the women as satisfaction with their lives. Conversely, an inability to find meaning in life resulted in feelings of despair. The women's perceptions of well-being were not static and could fluctuate as they lived with ovarian cancer. Implications for further research and practice are discussed.