The patients' opinions about their treatment are seldom solicited in psychiatry. We studied the opinions of 225 patients about curative factors in their treatment in a maximum security hospital: 90% answered the questions, which evaluated 38 forms of treatment. The patients received help from free walking in the hospital area in 98% of the patients, holidays in 93%, a personal psychiatric nurse in 91%, trips in 91%, communication in 88%, personnel's support in 87% and a psychiatrist in 86%. Medication was considered helpful in 77% and even restriction or isolation in 36% of the patients. If the patient experienced help from the psychiatrist, the cross-tabulation revealed that she or he also received help from many other treatment forms, even from the isolation. Help from the personal psychiatric nurse and medication depended on many other treatment forms. The most helpful treatment factors experienced were liberties and interactive treatment forms.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Accessible summary• Forensic nurses in Finland work in the two state-maintained forensic hospitals.The main function of these hospitals is to perform forensic psychiatric evaluation and provide treatment for two groups of patients: violent offenders found not guilty by reason of insanity, and those too dangerous or difficult to be treated in regional hospitals. Although the forensic nurses work with the most challenging psychiatric patients, they do not have any preparatory special education for the work.• This paper describes the development of nurses who participated in a 1-year further education programme that was tailored to them.• The nurses experienced that the 1-year education had a significant impact on their overall competence level. They found that their skills for observing, helping, teaching and caring for their patients had increased during the education.• Conversely, it was found that the nurses collaborated little with their patients' family members. They were also not familiar with utilizing research findings in improving their care of patients. AbstractForensic nursing is a global and relatively young profession that combines nursing care and juridical processes. There are, however, significant differences in the qualifications of forensic nurses internationally. The aim of the study was to describe the professional competence profile of practising forensic nurses in Finland and to explore the effects of a 1-year further education programme on that competence profile. The data were collected in 2011-2012 using the Nurse Competence Scale comprising seven competence categories, and analysed using the software package SPSS version 19.0 (SPSS, Inc., Armonk, NY, USA). The participants were 19 forensic nurses and their 15 head nurses. The assessed overall scores from both informant groups indicated a high level of competence across the seven categories. The nurses felt that the overall competence level had increased during the education programme. The increase seen by the head nurses was smaller. The less frequent competence items included utilization of research and involvement of family in care. It can be stated that the 1-year further education programme was effective in developing the nurses' competence profile and, in particular, affected their professional self-confidence. It will, however, be essential to strengthen their skills for working with families and their awareness of evidence-based forensic nursing.

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