MacLellan J, Dixon S, Toye F, McNiven A. Unpacking complexity in addressing the contribution of trauma to women's ill health: a qualitative study of perspectives from general practice.
Br J Gen Pract 2024;
74:e604-e609. [PMID:
38858098 PMCID:
PMC11325441 DOI:
10.3399/bjgp.2024.0024]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/09/2024] [Indexed: 06/12/2024] Open
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 healthcare 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.
METHOD
This was a secondary thematic analysis of 46 qualitative interviews conducted online/by telephone to explore primary care practitioners' 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 do not want to alienate people by saying the wrong thing; the system needs to support trauma-informed care; and delivering trauma-informed care takes work that can have an impact on practitioners.
CONCLUSION
Primary 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.
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