Implementing Trauma-Informed Care in a General Setting: A Qualitative Study of Community Health Nurse Perceptions.

aim(1) To explore community health nurses' experiences of implementing trauma-informed care in a general health context to individuals impacted by sexual assault or domestic violence; and (2) to identify essential components of implementing trauma-informed care in general health settings. DESIGN AND

methodA naturalistic inquiry approach was used, incorporating a focus group (n = 4) and a semi-structured interview (n = 1) with community health nurses who implement trauma-informed care in general health services in Victoria, Australia. Data were inductively analysed using reflexive thematic analysis.

resultsNurse descriptions of implementing trauma-informed care are described across four main themes demonstrating competence in translating theory into trauma-informed care. These nurses recognised what trauma can look like in patients. They were able to identify the essential components of trauma-informed care, determine when trauma-informed care is working, and describe the benefits to clinicians. Themes demonstrate that implementation of trauma-informed care enables recognition of trauma, can help reduce the risk of re-traumatisation (through anticipating and planning interventions to support the unique needs of trauma survivors), can strengthen patient-centred care for trauma survivors, and enhance the experiences of clinicians and survivors alike.

conclusionsImplementation of trauma-informed care into general health settings has the potential to enhance person-centred care with professionals trained to anticipate, recognise, and respond to trauma. Recommendations from this study include future research on building capacity for all healthcare providers to understand the importance of taking a trauma-informed approach to care, and large-scale evaluation of the impact of trauma-informed care approaches in mainstream health services on trauma responsiveness, patient satisfaction, and staff morale. IMPLICATIONS FOR PRACTICE: This study provides an understanding of the benefits associated with implementing trauma-informed care in generalist settings with important implications for training, practice and research. PATIENT OR PUBLIC CONTRIBUTION: There was no involvement of patients in this study; however, one of the authors is a lived-experience researcher in this topic area. REPORTING GUIDELINES: EQUATOR guidelines were followed, using the Standards for Reporting Qualitative Research (SRQR) checklist.