Traumatic events (including sexual abuse, domestic violence, elder abuse, and combat trauma) are associated with long-term physical and psychological effects. These events may influence patients' health care experiences and engagement in preventative care. Although the term trauma-informed care (TIC) is widely used, it is not well understood how to apply this concept in daily health care practice. On the basis of a synthesis of a review of the literature, the TIC pyramid is a conceptual and operational framework that can help physicians translate TIC principles into interactions with patients. Implications for clinical practice and future research are discussed in this article.
Dentists are likely to treat patients who have experienced a wide range of traumatic life events, including child abuse and neglect, domestic violence, sexual assault, elder abuse, and exposure to combat. In order to effectively treat survivors of traumatic events, dentists must understand how these patients may present in oral health settings, the basic mandated reporting requirements related to abuse and neglect, and communication strategies to help engage trauma survivors in dental treatment. A traditional lecture-format educational module on trauma-informed care was developed and implemented for second-year dental students (N=92) at one U.S. dental school, after which a needs assessment was performed (all 92 students participated). This assessment then informed development of an enhanced module for the subsequent group of second-year dental students (N=102) at the same school. The revised (inal) module was more interactive in nature, expanded to multiple sessions, and included more discussion of mandated reporting and appropriate dentist-patient communication in relation to traumatic events. All 102 students participated in assessments of the revised module. Comparison of pre and post tests and needs assessments between the initial and inal modules indicated that the extended, more interactive inal module was more effective in meeting the educational objectives. Results showed that the inal module increased the students' knowledge in the health-related manifestations of traumatic events and slightly improved their conidence levels in treating survivors of trauma. Dentists who are prepared to deliver traumainformed care may help individual patients feel more at ease and increase engagement in regular preventive care. Suggestions for future educational efforts in this area are discussed.
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