Trauma-informed care in the primary care setting: An evolutionary analysis

Abstract

Background: The high prevalence of trauma in the United States and its adverse effects on patient wellbeing has led to the adoption of trauma-informed care (TIC) in some specialized health care services. However, the implementation of TIC in primary care, where many nurse practitioners (NPs) provide services, is relatively uncommon and the concept not well-defined. Trauma includes physically and emotionally devastating experiences that have a lasting impact on individuals.Objectives: To synthesize a definition of TIC in the primary care setting for NPs to guide future practice and research.Data Sources: We searched CINAHL, PsycINFO, Social Work Abstracts, Scopus, and PubMed for articles published 2010-2020 that described the use of TIC in primary care. Rodgers' evolutionary method and the framework method of analysis were used to identify attributes and contexts of TIC in primary care and synthesize a definition. Thirty-one articles from nursing, medical, and social work sources were selected, including data-based studies (n = 15) and thought pieces (n = 16). Attributes, antecedents, and consequences were combined to provide a definition grounded in the literature. Conclusion:Trauma-informed care in primary care is a strengths-based approach in which trained, trauma-aware health care professionals provide services that prioritize safety, empowerment, and support, resulting in improved patient satisfaction and health care engagement in individuals who have experienced trauma.Implications for practice: A clearly defined concept provides a starting point for developing strategies to help NPs recognize and respond more effectively to the needs of patients who have experienced trauma.