{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T09:14:52Z","timestamp":1788340492577,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"JSPS","doi-asserted-by":"publisher","award":["JP25K13895"],"award-info":[{"award-number":["JP25K13895"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"award":["JP25K13895"],"award-info":[{"award-number":["JP25K13895"]}],"id":[{"id":"https:\/\/ror.org\/00hhkn466","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nurs. Rep.","Nursing Reports"],"abstract":"<jats:p>Background\/Objectives: Nurses may support offense-related self-reflection through practices that extend beyond formal group programs and dedicated offense-focused interviews; however, the scope of such support remains unclear. In this study, we described the range of nursing practices that nurses in Japanese forensic psychiatric inpatient settings perceived as supporting offense-related self-reflection beyond these formal interventions. Methods: A qualitative descriptive study was conducted using individual semi-structured interviews with 13 nurses from six hospitals between May and November 2025. Japanese-language transcripts were analyzed using inductive qualitative content analysis. Meaning units were coded and iteratively organized into subcategories and categories. Credibility and dependability were strengthened through co-researcher review, reflexive discussion, audit trail, and peer debriefing. Results: Five categories and 15 subcategories were identified: (1) examining offenses, victim impact, and responsibility; (2) clinical and relational readiness for self-reflection; (3) applying reflective insights to recidivism-prevention actions; (4) extending reflective learning into post-discharge life planning; and (5) integrating offense-related understanding into inpatient\u2013community care planning. Conclusions: The categories describe functions that participants attributed to nursing practices surrounding formal interventions; therefore, they should not be interpreted as validated components of self-reflection or as evidence of effectiveness. The findings provide an initial, context-specific framework to guide nursing assessment, care planning, education, and further conceptual and empirical research that includes patients and community providers.<\/jats:p>","DOI":"10.3390\/nursrep16090313","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:53:11Z","timestamp":1788335591000},"page":"313","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurses\u2019 Perceptions of the Scope of Nursing Support for Offense-Related Self-Reflection Beyond Formal Programs and Dedicated Interviews in Japanese Forensic Psychiatric Care"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6109-4533","authenticated-orcid":false,"given":"Jun","family":"Okuda","sequence":"first","affiliation":[{"name":"Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, School of Medicine, Nara Medical University, Nara 634-0813, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7800-919X","authenticated-orcid":false,"given":"Yoshiyuki","family":"Takashima","sequence":"additional","affiliation":[{"name":"Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, School of Medicine, Nara Medical University, Nara 634-0813, Japan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jemep.2016.01.005","article-title":"Ethical issues of long-term forensic psychiatric care","volume":"2","author":"Bartlett","year":"2016","journal-title":"Ethics Med. Public Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1177\/0093854811406356","article-title":"The risk-need-responsivity (RNR) model: Does adding the good lives model contribute to effective crime prevention?","volume":"38","author":"Andrews","year":"2011","journal-title":"Crim. Justice Behav."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.eurpsy.2017.12.007","article-title":"European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders","volume":"51","author":"Clarke","year":"2018","journal-title":"Eur. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Askola, R., Soininen, P., and Sepp\u00e4nen, A. (2020). Offense-related issues in forensic psychiatric treatment: A thematic analysis. Front. Psychiatry, 10.","DOI":"10.3389\/fpsyt.2019.00925"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S1359-1789(01)00076-3","article-title":"Good lives and the rehabilitation of offenders: Promises and problems","volume":"7","author":"Ward","year":"2002","journal-title":"Aggress. Violent Behav."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.avb.2006.03.004","article-title":"The good lives model of offender rehabilitation: Clinical implications","volume":"12","author":"Ward","year":"2007","journal-title":"Aggress. Violent Behav."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1192\/bjp.bp.110.083733","article-title":"Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis","volume":"199","author":"Leamy","year":"2011","journal-title":"Br. J. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Lutz, M., Zani, D., Fritz, M., Dudeck, M., and Franke, I. (2022). A review and comparative analysis of the Risk\u2013Need\u2013Responsivity, Good Lives, and Recovery models in forensic psychiatric treatment. Front. Psychiatry, 13.","DOI":"10.3389\/fpsyt.2022.988905"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1080\/14999013.2019.1648344","article-title":"What is the evidence for offense-specific group treatment programs for forensic patients?","volume":"19","author":"Mallion","year":"2020","journal-title":"Int. J. Forensic Ment. Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1111\/ppc.12148","article-title":"The therapeutic approach to a patient\u2019s criminal offense in a forensic mental health nurse\u2013patient relationship: The nurses\u2019 perspectives","volume":"53","author":"Askola","year":"2017","journal-title":"Perspect. Psychiatr. Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1097\/JFN.0000000000000274","article-title":"Nurses\u2019 perspectives of factors that influence therapeutic relationships in secure inpatient forensic hospitals","volume":"16","author":"Stevenson","year":"2020","journal-title":"J. Forensic Nurs."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1111\/inm.13176","article-title":"Forensic mental health nurses\u2019 experiences of rebuilding the therapeutic relationship after an episode of physical restraint in forensic services in Ireland: A qualitative study","volume":"32","author":"Moyles","year":"2023","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e301678","DOI":"10.1136\/bmjment-2025-301678","article-title":"Patient engagement in forensic mental health care: A scoping review","volume":"28","author":"Zhao","year":"2025","journal-title":"BMJ Ment. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"102009","DOI":"10.1016\/j.avb.2024.102009","article-title":"Experiences of forensic mental health patients and professionals with shared violence risk assessment and management: A scoping review of qualitative studies","volume":"79","author":"Luigi","year":"2024","journal-title":"Aggress. Violent Behav."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1111\/inm.13096","article-title":"Exploring adaptations to the clinical reasoning cycle for forensic mental health nursing: A qualitative enquiry","volume":"32","author":"Maguire","year":"2023","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1192\/bjo.2021.1068","article-title":"Personal recovery and its challenges in forensic mental health: Systematic review and thematic synthesis of the qualitative literature","volume":"8","author":"Senneseth","year":"2022","journal-title":"BJPsych Open"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/JFN.0000000000000511","article-title":"\u201cGetting people back into the community\u201d: Forensic mental health nurses\u2019 perceptions and experiences of the recovery model within a high-secure hospital","volume":"21","author":"Roberts","year":"2025","journal-title":"J. Forensic Nurs."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1097\/JFN.0000000000000477","article-title":"Forensic psychiatric patients\u2019 experiences of personal recovery: A Wilsonian concept analysis","volume":"20","author":"Louheranta","year":"2024","journal-title":"J. Forensic Nurs."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1752-4458-8-21","article-title":"Development of forensic mental health services in Japan: Working towards the reintegration of offenders with mental disorders","volume":"8","author":"Fujii","year":"2014","journal-title":"Int. J. Ment. Health Syst."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/JFN.0000000000000367","article-title":"Strategies employed by forensic community mental health nurses to resolve difficulties in supporting offenders with mental disorders under the Medical Treatment and Supervision Act in Japan","volume":"18","author":"Okuda","year":"2022","journal-title":"J. Forensic Nurs."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"102074","DOI":"10.1016\/j.ijlp.2025.102074","article-title":"Overview of forensic outpatients on the Medical Treatment and Supervision Act in Japan","volume":"100","author":"Ando","year":"2025","journal-title":"Int. J. Law Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G","article-title":"Whatever happened to qualitative description?","volume":"23","author":"Sandelowski","year":"2000","journal-title":"Res. Nurs. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: A synthesis of recommendations","volume":"89","author":"Harris","year":"2014","journal-title":"Acad. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","article-title":"Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness","volume":"24","author":"Graneheim","year":"2004","journal-title":"Nurse Educ. Today"},{"key":"ref_25","unstructured":"Polit, D.F., and Beck, C.T. (2021). Nursing Research: Generating and Assessing Evidence for Nursing Practice, Wolters Kluwer. [11th ed.]."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"101780","DOI":"10.1016\/j.ijlp.2022.101780","article-title":"Privacy and safety: Issues of dual compliance in high-secure and other forensic psychiatric hospitals","volume":"82","author":"Cameron","year":"2022","journal-title":"Int. J. Law Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1046\/j.1365-2850.2001.00395.x","article-title":"Interventions in the nurse\u2013patient relationship in forensic psychiatric nursing care: A Swedish survey","volume":"8","author":"Rask","year":"2001","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1080\/10973430008408412","article-title":"Improving understanding and coping in people with schizophrenia by changing attitudes","volume":"4","author":"Turkington","year":"2000","journal-title":"Psychiatr. Rehabil. Ski."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1192\/pb.bp.116.055509","article-title":"Measuring relational security in forensic mental health services","volume":"41","author":"Chester","year":"2017","journal-title":"BJPsych Bull."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e100291","DOI":"10.1136\/gpsych-2020-100291","article-title":"Collaborative risk assessment in secure and forensic mental health settings in the UK","volume":"33","author":"Markham","year":"2020","journal-title":"Gen. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1177\/0306624X15570027","article-title":"Taking the good life to the institution: Forensic service users\u2019 perceptions of the Good Lives Model","volume":"60","author":"Barnao","year":"2016","journal-title":"Int. J. Offender Ther. Comp. Criminol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Schoppmann, S., Balensiefen, J., Lau, S., Graf, M., and Hachtel, H. (2021). Patients\u2019 views with regard to personal recovery in forensic psychiatry in German-speaking Switzerland: An explorative study. Front. Psychiatry, 12.","DOI":"10.3389\/fpsyt.2021.695096"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"M\u00f8llerh\u00f8j, J. (2021). Offender recovery: Forensic patient perspectives on long-term personal recovery processes. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18126260"}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/9\/313\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:23:38Z","timestamp":1788337418000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/9\/313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":33,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["nursrep16090313"],"URL":"https:\/\/doi.org\/10.3390\/nursrep16090313","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}