Using the ARTIC-35 to Measure Nurses' Attitudes Related to Trauma-Informed Care

Exploring clinicians' knowledge and attitudes toward the care needs of complex adult users of an Emergency Department: A descriptive mixed methods study

BACKGROUND

Adults who frequently present (FPAs) to emergency departments (EDs) often have a history of adverse childhood experiences (ACEs) and related adult health sequelae. Implications for ED care of this group remains poorly understood. This study explored clinicians' knowledge and attitudes toward the care needs of FPAs who have an ACEs history, providing preliminary evidence to inform further research and interventions.

METHODS

A purposive sample of ED clinicians completed an investigator developed mixed-methods survey. Descriptive statistics and content analysis were applied.

RESULTS

Forty-three ED clinicians completed the survey. Most perceived that ACEs were common among FPAs and influenced their ED presentations. Clinicians were more aware of the psychosocial impacts of ACEs than the risks to physical health. While most clinicians agreed that FPAs should be asked about ACEs for management planning, most never asked, describing multiple barriers to doing so. Consumer's healthcare needs were often described as unmet by clinicians who desired additional support to provide care for this group.

CONCLUSIONS

This study highlights clinicians' perceptions of gaps in healthcare for this patient group and introduces requirements for appropriate knowledge and resources to partner with consumers to provide patient-centred and trauma-informed health care responses.

Trauma-informed climate scale-10 and attitudes related to trauma-informed care-10: An examination of scale psychometrics using data from disability service providers

BACKGROUND

Assessment is fundamental to the implementation of trauma-informed care. As trauma-informed care advances among organizations supporting people with intellectual and developmental disabilities (IDD), it is critical that they have access to validated assessment tools.

OBJECTIVE

This is the first study to examine the psychometric properties of two brief measures associated with trauma-informed care, Trauma-Informed Climate Scale (TICS-10) and Attitudes Related to Trauma-Informed Care (ARTIC-10), using data from the IDD service industry.

METHODS

We employed structural equation modeling to examine the factor structure, reliability of TICS-10 and ARTIC-10, and construct validity with the ProQOL using secondary data from 374 service providers.

RESULTS

We confirmed the factorial validity of TICS-10 and ARTIC-10 with single factor solutions; however, modifications were necessary to achieve adequate model fit.

CONCLUSIONS

The current study provides initial evidence of the validity and reliability of TICS-10 and ARTIC-10 when used within organizations supporting people with IDD. Recommendations for subsequent improvements and future research of the scales are provided.

Trauma-Informed Care Education Initiative Explores Impact on Perinatal Nurse Secondary Traumatic Stress and Workforce Challenges

BACKGROUND

Psychological trauma refers to long-lasting adverse effects on well-being precipitated by the experience of a distressing event or a combination of events. High rates of psychological birth trauma in patients contribute to secondary traumatic stress (STS) in perinatal nurses, creating workplace challenges and resulting in dissatisfaction, apathy, and attrition. Perinatal nurses experience high rates of STS, and researchers have called for a universal standard of trauma-informed care (TIC). However, there is a lack of published results on effectively creating TIC education in this nurse population.

METHODS

A pre/posttest design evaluated an online pilot evidence-based practice project addressing a perinatal nurse education initiative on STS and its correlation with nurse attitudes toward TIC. Participants include perinatal nurses in the United States (n = 29). Two scales measured the program's effect on nurses: the Secondary Traumatic Stress Scale (STSS) and the Attitudes Related to Trauma-Informed Care (ARTIC) scale.

RESULTS

A paired t test evaluating pre- and postprogram levels of the STSS showed a decrease in STS (t28 = -3.28, P = .003, Cohen's d = 0.609), the ARTIC scale results showed an increased receptiveness to TIC (t28 = 3.8, P < .001, Cohen's d = 0.706], and a not significant correlation was found between pretest STS and ARTIC scores (Spearman' ρ = -0.248, P = .194).

CONCLUSION

This program supported a significant reduction in nurses' identification of STS. Future perinatal nurse education can expand to build a standard of TIC that is patient-centered and reduces nurse STS.

Development of a Questionnaire for Measuring Trauma-Informed Care of Nurses Working with Traumatically Injured Patients

Purpose

To develop a new questionnaire for assessing nurses' current situation of knowledge, attitude and practice related to trauma-informed care (TIC) for patients with traumatic injury.

Methods

By literature review, qualitative interview and Delphi consultation, the 46 preliminary items about trauma-informed care of nurses working with traumatically injured patients were selected. After that, the preliminary questionnaire was distributed to 293 Chinese nurses in relevant departments. The collected data were analyzed by internal reliability, split-half reliability, structural validity and content validity.

Results

The questionnaire was developed with a total of 30 items in 3 dimensions: 8 items in the TIC knowledge dimension, 10 items in the TIC attitude dimension and 12 items in the TIC practice dimension. The Cronbach's alpha coefficient was 0.939, and the content validity was 0.971.

Conclusion

This designed questionnaire shews receptable reliability and validity, which could be used to assess the knowledge, attitude and practice of nurses in application of trauma-informed care for traumatically injured patients.

Exploring School Professionals' Definitions of Childhood Trauma

PURPOSE

Little is known about school professionals' definitions of trauma outside of the context of trauma-informed school trainings.

METHODS

The present study used thematic analysis to explore school professionals' open-ended definitions of childhood trauma (N = 1271). Follow-up chi-square tests of independence were used to investigate differences in professionals' definitions based on their professional role and education.

RESULTS

Five themes were identified: effects of trauma, events of trauma, solutions to trauma, emotional responses, and no knowledge. Effects of trauma and events of trauma contained ten and five subthemes, respectively. School professionals who identified long-term effects of trauma on students most commonly listed general negative effects (e.g., "An experience or event that can negatively impact that child") instead of effects on specific domains such as behavior or emotions (e.g., "An experience that negatively impacted a child emotionally"). School professionals who identified an event of trauma most commonly provided examples of trauma (e.g., child maltreatment) or a general definition of trauma. School professionals' roles and education were somewhat related to their definitions of childhood trauma. Findings suggest that childcare providers and professionals without a bachelor's degree have gaps in their knowledge of child trauma.

CONCLUSIONS

These results suggest school professionals have some foundational knowledge about trauma, but it is not universal. To best serve school professionals working with this vulnerable population of students, researchers and practitioners should design future trauma-informed professional development opportunities around school professionals' prior knowledge and understanding of trauma as well as their potential misunderstandings of trauma.

Expanding the Trauma-Informed Care Measurement Toolkit: An Evaluation of the Attitudes Related to Trauma-Informed Care (ARTIC-45) Scale with SUD Workers in PIMH

Human service organizations (HSO) have increasingly recognized the value of employing trauma-informed care (TIC) in a variety of practice settings. Evidence suggests that effectively adopting TIC has shown client improvements. Organizational barriers to TIC implementation, however, exist. To improve TIC practice, the attitudes related to trauma-informed care (ARTIC) scale was developed to measure staff attitudes and beliefs towards TIC. The ARTIC has been widely adopted by researchers without evaluating its psychometric performance in diverse practice settings. The purpose of this study was to independently validate the ARTIC scale drawn from a sample of staff (n = 373) who provide services to substance-using parents. Psychometric tests were conducted to evaluate how the ARTIC performs with our HSO population. Results from a confirmatory factor analysis showed poor fit (X² = 2761.62, df = 2.96; RMSEA = 0.07 [0.07, 0.08]; CFI = 0.72). An exploratory factor analysis was conducted to analyze how the data fit with our specific population, yielding 10 factors. Finally, a qualitative inter-item analysis of these factors was conducted, resulting in nine factors. Our findings suggest that measuring TIC attitudes and beliefs may vary according to field of practice and ethno-racially diverse workers. Further refinement of the ARTIC may be necessary for various services domains.