Unpacking complexity in addressing the contribution of trauma to women’s ill health: a qualitative study of perspectives from general practice

Abstract

Background: There is an intricate relationship between the mind and the body in experiences of health and wellbeing. This can result in complexity of both symptom presentation and experience. Although the contribution of life trauma to illness experience is well described, this is not always fully recognised or addressed in health care encounters. Negotiating effective and acceptable trauma informed conversations can be difficult for clinicians and patients. Aim: To explore the experience of primary care practitioners caring for women through a trauma informed care lens. Design and Setting: Qualitative study in the general practice setting of England, with reflections from representatives of a group with lived experience of trauma. Methods: A secondary thematic analysis of 46 qualitative interviews conducted online/by telephone to explore primary care practitioner’s experiences of supporting women’s health needs in general practice, alongside consultation with representatives of a lived experience group to contextualise the findings. Results: Four themes were constructed: you prioritise physical symptoms because you don’t want to miss something; you don’t want to alienate people by saying the wrong thing; the system needs to support trauma informed care; delivering trauma informed care takes work which can impact on practitioners. Conclusion: Health Care Practitioners are aware of the difficulties in discussing the interface between trauma and illness with patients, and request support and guidance in how to negotiate this supportively. Lack of support for practitioners moves the focus of trauma informed care from a whole systems approach towards individual clinician – patient interactions.