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Pink DM. Providing trauma-informed care in the acute care setting. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:766-771. [PMID: 39250455 DOI: 10.12968/bjon.2022.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
Events such as the COVID-19 pandemic and the war in Ukraine have increased people's awareness of mental health issues. Psychological trauma impacts patients in the acute care setting through physical and mental health presentations. Trauma is a public health issue crossing all socioeconomic groups and is related to social determinants of health. Trauma-informed care (TIC) is an evidence-based approach to providing care. TIC is within the scope of nursing practice and improves outcomes for patients. However, there is a lack of standard terms or practices within healthcare. Additionally, there is superficial acknowledgment of the need for TIC at the local or national level regarding policy. Nurses need to adopt TIC into practice and advocate for policy change to improve the health and lives of those seeking care.
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Affiliation(s)
- Donna M Pink
- Education Specialist, University Hospital, Newark, New Jersey, USA
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Berring LL, Holm T, Hansen JP, Delcomyn CL, Søndergaard R, Hvidhjelm J. Implementing Trauma-Informed Care-Settings, Definitions, Interventions, Measures, and Implementation across Settings: A Scoping Review. Healthcare (Basel) 2024; 12:908. [PMID: 38727465 PMCID: PMC11083630 DOI: 10.3390/healthcare12090908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/16/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Traumatic experiences can have long-lasting negative effects on individuals, organizations, and societies. If trauma is not addressed, it can create unsafe cultures with constant arousal, untrusting relationships, and the use of coercive measures. Trauma-informed care (TIC) can play a central role in mitigating these negative consequences, but it is unknown how and in which way(s) TIC should be implemented. Our objective was to conduct a scoping review that systematically explored and mapped research conducted in this area and to identify existing knowledge about the implementation of TIC. The search was conducted on the CINAHL, Cochrane, Embase, ERIC, Medline, PsycINFO, and Web of Science databases, and more than 3000 empirical papers, published between 2000 and 2022, were identified. Following further screening, we included 157 papers in our review, which were mainly from the USA, Australia, New Zealand, and Canada, focusing on study settings, methodologies, and definitions of TIC, as well as the types of interventions and measures used. This review shows that TIC is a complex and multifaceted framework, with no overarching structure or clear theoretical underpinnings that can guide practical implementations. TIC has been defined and adapted in varied ways across different settings and populations, making it difficult to synthesize knowledge. A higher level of agreement on how to operationalize and implement TIC in international research could be important in order to better examine its impact and broaden the approach.
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Affiliation(s)
- Lene Lauge Berring
- Psychiatric Research Unit, Region Zealand Psychiatry, Faelledvej 6, 4200 Slagelse, Denmark; (C.L.D.); (R.S.)
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
| | - Tine Holm
- Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus, Denmark;
| | - Jens Peter Hansen
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
- Retspsykiatrisk Forskningsenhed, Østre Hougvej 70, 5500 Middelfart, Denmark
| | - Christian Lie Delcomyn
- Psychiatric Research Unit, Region Zealand Psychiatry, Faelledvej 6, 4200 Slagelse, Denmark; (C.L.D.); (R.S.)
- Department for Forensic Psychiatry, Region Zealand Psychiatry, Faelledvej 6, 4200 Slagelse, Denmark
| | - Rikke Søndergaard
- Psychiatric Research Unit, Region Zealand Psychiatry, Faelledvej 6, 4200 Slagelse, Denmark; (C.L.D.); (R.S.)
| | - Jacob Hvidhjelm
- Clinical Mental Health and Nursing Research Unit, Mental Health Center Sct Hans, Copenhagen University Hospital—Mental Health Services CPH, 2400 Copenhagen, Denmark;
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Isobel S, Wilson A, Gill K, Howe D. 'What would a trauma-informed mental health service look like?' Perspectives of people who access services. Int J Ment Health Nurs 2021; 30:495-505. [PMID: 33219725 DOI: 10.1111/inm.12813] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/07/2020] [Accepted: 10/21/2020] [Indexed: 01/08/2023]
Abstract
Trauma-informed care is an approach to the delivery of mental health care based on an awareness of the high prevalence of trauma in the lives of people accessing mental health services, the effects of trauma experiences and the potential for trauma or re-traumatization to occur in the context of care. Across Australia, inquiries and reports have increasingly indicated an urgent need for mental health services to become trauma-informed. However, how Australian mental health services should deliver trauma-informed care is not well documented. Efforts towards trauma-informed care in any setting require engagement with those who receive care. This qualitative study used an experience-based co-design methodology to explore the perspectives of consumers of mental health services in Australia and their family members, in relation to the question 'what would a trauma-informed mental health service look like?' Focus groups were held with consumers (n = 10) and carers (n = 10). Thematic analysis of transcripts identified that consumers and carers consider that trauma-informed care requires increased awareness of trauma amongst mental health staff, opportunities to collaborate in care, active efforts by services to build trust and create safety, the provision of a diversity of models and consistency and continuation of care. The findings provide important new information about the experiences of Australian service users and have implications for the implementation of trauma-informed care across settings.
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Affiliation(s)
- Sophie Isobel
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Allyson Wilson
- Mental Health Services, Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia
| | - Katherine Gill
- Consumer Led Research Network, University of Sydney, Sydney, New South Wales, Australia
| | - Deborah Howe
- NSW Agency for Clinical Innovation, St Leonards, New South Wales, Australia
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