How Do We Move Forward With Trauma-Informed Care?

Schimmels, JoEllen; Cunningham, L

doi:10.1016/j.nurpra.2020.12.005

Cited by 14 publications

(16 citation statements)

References 33 publications

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“…Incorporating trauma-informed care core values into daily nursing care may positively influence patient outcomes, resulting in reduced complications and increased adherence to treatment plans, factors that guide trauma survivors along a path to healing (Cochran, 2019; Isobel & Edwards, 2017). In addition, ensuring that the patient is an active participant in their health care journey will positively affect satisfaction with their care and foster an empowering environment (Schimmels & Cunningham, 2021).…”

Section: Discussionmentioning

confidence: 99%

Impact of Trauma-Informed Care Training on Attitudes Among Emergency Department Personnel, Staff Advocates, and Nursing Students

Wholeben,

Castro,

Salazar

et al. 2023

Journal of Trauma Nursing

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BACKGROUND: Health care providers may risk retraumatizing patients and intensifying patient distress unless they practice trauma-informed care. As the first line of defense in assisting trauma survivors' physical and emotional recovery, health care providers must use a strengths-based framework that promotes resilience and expands on the trauma survivor's existing resources. OBJECTIVE: This study aimed to compare the effect of trauma-informed care training on the attitudes of emergency department personnel, staff advocates, and nursing students toward trauma-informed care. METHODS: This study used a pretest–posttest design. Assessment of attitudes toward trauma-informed care was done before and after trauma-informed care training. Data collection occurred from February 2021 through August 2021. Participants included three cohorts of emergency department staff, advocates for trauma survivors, and nursing students. Attitudes toward trauma-informed care were measured using the Attitudes Related to Trauma-Informed Care (ARTIC) Scale. RESULTS: A total of 433 participants were studied, including 88 emergency department staff, 123 staff advocates, and 222 nursing students. All three cohorts significantly increased ARTIC Scale scores posttraining (p < .001). At preintervention, all three cohorts significantly differed from each other on ARTIC Scale scores (p < .01). In contrast, postintervention, ARTIC Scale scores did not significantly differ between nursing students and advocates (p = .99). Nursing students showed a significant increase in scores from pre- to postintervention compared with either advocates or emergency department staff. CONCLUSION: The results strongly suggest that health care providers can improve attitudes toward trauma-informed care after completing training on the principles and application of trauma-informed care.

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Section: Discussionmentioning

confidence: 99%

Impact of Trauma-Informed Care Training on Attitudes Among Emergency Department Personnel, Staff Advocates, and Nursing Students

Wholeben,

Castro,

Salazar

et al. 2023

Journal of Trauma Nursing

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“…Trauma-informed approaches require regular and ongoing training as well as quality improvement and preparation of the entire multidisciplinary team to incorporate trauma-informed responses into daily practice . Continuous quality improvement encourages all health care team members to continuously ask, “How are we doing?” and “What can we do?” This improvement could be achieved in several different ways.…”

Section: Discussionmentioning

confidence: 99%

Perspectives on Racism in Health Care Among Black Veterans With Chronic Kidney Disease

et al. 2022

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IMPORTANCEThe burden of chronic kidney disease (CKD) and end-stage kidney disease falls disproportionately on Black individuals in the US, with Black veterans experiencing substantial consequences, and only a portion of the disparities in health conditions and health care can be explained by nonbiological factors. Among Black individuals, racism is likely one of those factors, suggesting the need to examine the consequences of racism and the resulting social structures that establish and perpetuate these racial disparities. OBJECTIVE To investigate the health care experiences of Black veterans with CKD and identify and explore the racial discrimination encountered by this vulnerable population. DESIGN, SETTING, AND PARTICIPANTSThis qualitative study used semistructured interview guides to investigate the health care experiences of 36 Black veterans with CKD who received care at the Corporal Michael Crescenz Veterans Affairs Medical Center in Philadelphia, Pennsylvania, from October 2018 to September 2019. Interview transcripts were analyzed using applied thematic analysis. RESULTSAmong 36 Black veterans with CKD who characterized racism in the context of their care at a Veterans Affairs medical center, the mean (SD) age was 66.0 (7.8) years; 35 participants (97.2%) were male, 1 participant (2.8%) was female, and 19 participants (52.8%) were married. The mean (SD) duration of military service was 8.0 (7.0) years. Overall, 15 participants (41.7%) were not dependent on dialysis, and hypertension was the most common comorbidity (9 participants [25.0%]). Veterans described the ways in which racism produced emotional and physical stress, including psychological symptoms (eg, anger and hurt) and physiological symptoms (eg, headaches).Veterans described a strong sense of distrust in the health care system coupled with a need to be hypervigilant during clinical encounters. When encountering racism, veterans described bottling up their feelings, which sometimes led to maladaptive behavior (eg, substance use). Veterans also described individual and collective positive strategies (eg, faith) for coping with the stress of racism. CONCLUSIONS AND RELEVANCEIn this study, Black veterans with CKD experienced racism in the clinical setting that produced physical and emotional stress and a strong sense of distrust in the health care system. These findings highlight an important opportunity for education and training of health care professionals in the implementation of trauma-informed approaches to care as a means of addressing race-based stress and trauma.

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“…Trauma-informed care is so crucial to quality patient care several authors have described it uniquely. Schimmels and Cunningham33 call TIC a form of cardiopulmonary resuscitation based on its potential to promote purposeful wellness. Others25,26 have called TIC part of universal precautions promoting optimal blending of mental health into medical/physical health 27…”

Section: Methodsmentioning

confidence: 99%