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Jun 23, 2022 · Vulnerability and trauma-informed practice: what nurses need to know. The impacts of vulnerability and associated trauma endure from childhood into adulthood and affect an individual's health and wellbeing in ways that are not always visible to others ( Felitti et al, 1998 ).
Dec 20, 2021 · Trauma, whether physical or psychosocial, has profound effects on health, and influences how people engage with their healthcare services. Healthcare providers and anchor systems are beginning to explore trauma through a more inclusive lens.
- 10.1136/tsaco-2021-000815
- 2021
Aug 22, 2024 · Trauma-informed care (TIC) is an approach to the delivery of health care that recognises the prevalence and pervasiveness of trauma and provides care in such a way as to enhance engagement and avoid re-traumatisation (Dowdell and Speck 2022; Isobel 2021; Portman-Thompson 2020; Sansbury, Graves, and Scott 2015; Wilson, Hutchinson, and Hurley 2017).
- Policy Documents
- Qualitative Interviews
- How Ti Approaches Are Represented in UK Health Policies
- How Ti Approaches Are Understood
- How Ti Approaches Are Implemented
We identified 50 documents and selected 24 policy documents at national, local, and organizational levels. The remaining 26 documents provided context and a background on TI approaches. The documents included were published over nine years (2012–2021) and considered all UK nations, multiple sectors, government policy and service-user voices. The do...
In total, 21 professionals expressed interest, 2 did not have direct experience of TI approach at the system level, 8 did not respond by the deadline, 11 provided consent and were interviewed. Interviews lasted between 32 and 68 min (mean 52 min). We achieved a maximum variation sample representing diversity of gender (4 men, 7 women), organization...
We found that the TI approach is referenced in government initiatives and included in policies at a national level, as well as in NHS and non-NHS organizations, local authorities, and devolved nations; however, there was no dedicated strategy or a position statement, nor was there an agreed terminology and framework, or a robust evidence base in th...
TI care as different from other practices
We found divergent interpretations of a TI approach versus other concepts related to trauma, such as ACEs, psychologically informed environments and standard good clinical practice. One participant unified concepts such as TI care, ACEs and psychologically informed environments in recognising past traumatic experiences. Another participant detached the terms ACEs and TI care, reflecting that ACEs have become well known in research whereas a TI approach is a pragmatic way of supporting those w...
TI care as a contextually tailored organizational approach
In line with the SAMHSA guidance , document and interview data showed that the framework of a TI approach needs to be tailored to the organizational and wider context. Policy documents advised organizations to clarify what TI care means for them, and that application of the framework should depend on the needs of service users and organisations [25, 28, 52, 54, 59, 60]. Several documents suggested that this organizational tailoring should be informed by service-users through co-production...
TI care as a remedy to challenges
In all policy documents and in nine interviews, TI approaches were presented as a remedy to a variety of problems within health systems. Sixteen of twenty-five documents justified a TI approach as a way for addressing the high prevalence and negative impact of violence and trauma on patients, with eleven documents considering its impact on staff. The growing international evidence base for the impact of psychological trauma and the need for service response was used in documents and interview...
Piecemeal implementation and a need for a shared vision
Interviewees confirmed the piecemeal implementation of TI approaches in the UK and felt that a shared national vision would be beneficial. Participants agreed that the implementation of TI approaches varied across the UK, with Scotland having more strategic coordinated implementation (additional file 2, quote 1). We found that different regions and organizations reinvented the TI approach wheel, with interviewees expressing a need for national coordination. Participants expressed the need for...
Factors that facilitated or hindered implementation
At the organization level, some participants felt high level leadership support was needed, and if lacking is a barrier to implementing a TI approach. To achieve effective implementation leaders with power and those with passion were felt to be important. The concept of organizational champions garnered support when “champions act as influencers and their credibility within services adds to the potential for buy-in from other staff”, fostering sustainable change . One participant warned a...
The evidence-policy gap
UK policies on implementation of TI approaches were not supported by UK-specific, methodologically robust, evidence for effectiveness, cost effectiveness and acceptability. Participants explained the policy-evidence gap by citing methodological challenges of evaluating system-level transformation and a need for commitment from commissioners and funders (additional file 2, quote 11). In addition, participants who developed and implemented TI approaches in their organizations and regions did no...
Nov 2, 2022 · Trauma-informed practice is an approach to health and care interventions which is grounded in the understanding that trauma exposure can impact an individual’s neurological, biological,...
- Trauma-informed approaches have become increasingly cited in policy and adopted in practice as a means for reducing the negative impact of trauma e...
- Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as harmful or life threatening. While...
- There are 6 principles of trauma-informed practice: safety, trust, choice, collaboration, empowerment and cultural consideration.SafetyThe physical...
- See: Office of Health Improvement and Disparities’ Vulnerabilities: applying All Our Health e-learning for healthcare: All Our Health: Vulnerabilit...
Trauma-informed care (TIC) is a skill underutilized by health care providers and organizations, yet nurse ethics and respect for human rights require us to care for all patients equally without judgment, including those living with the stress of complex trauma.
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Apr 13, 2019 · Trauma-informed nursing care is important for patients in all healthcare settings. Trauma-exposed patients are commonly seen in primary care for a wide range of issues from chronic disease management to routine health promotion.
