Trauma-informed care: recognizing and resisting re-traumatization in health care

Grossman, Samara; Cooper, Zara; Buxton, Heather; Hendrickson, Sarah; Lewis‐O’Connor, Annie; Stevens, Jane; Wong, Lye-Yeng; Bonne, Stephanie

doi:10.1136/tsaco-2021-000815

Cited by 48 publications

(46 citation statements)

References 28 publications

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“…Similarly, trauma-informed care (TIC) has emerged as an important over-arching approach to trauma care delivery. The concept of TIC is the systematic consideration of past physical and emotional trauma experienced by patients and how that context affects their experience of the current care event [ 40 ]. Since many trauma victims present with numerous lifetime adverse events, the importance of TIC to overall trauma outcome will continue to garner interest and warrants further investigation.…”

Section: For Our Patientsmentioning

confidence: 99%

History of Equity, Diversity, and Inclusion in Trauma Surgery: for Our Patients, for Our Profession, and for Ourselves

et al. 2022

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Purpose of Review Disparities exist in outcome after injury, particularly related to race, ethnicity, socioeconomics, geography, and age. The mechanisms for this outcome disparity continue to be investigated. As trauma care providers, we are challenged to be mindful of and mitigate the impact of these disparities so that all patients realize the same opportunities for recovery. As surgeons, we also have varied professional experiences and opportunities for achievement and advancement depending upon our gender, ethnicity, race, religion, and sexual orientation. Even within a profession associated with relative affluence, socioeconomic status conveys different professional opportunities for surgeons. Recent Findings Fortunately, the profession of trauma surgery has undergone significant progress in raising awareness of patient and professional inequity among trauma patients and surgeons and has implemented systematic changes to diminish these inequities. Herein we will discuss the history of equity and inclusion in trauma surgery as it has affected our patients, our profession, and our individual selves. Summary Our goal is to provide a historical context, a status report, and a list of key initiatives or objectives on which all of us must focus. In doing so, the best possible clinical outcomes can be achieved for patients and the best professional and personal “outcomes” can be achieved for practicing and future trauma surgeons.

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Section: For Our Patientsmentioning

confidence: 99%

History of Equity, Diversity, and Inclusion in Trauma Surgery: for Our Patients, for Our Profession, and for Ourselves

et al. 2022

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“…The idea that "trauma" not only encompasses an acute event or injury to a patient but also represents a summation of childhood and adulthood adverse experiences through their life has gained momentum in past decades. Trauma has both individual and interpersonal, as well as collective and structural, 24 components and to better care for our patients, we need to understand the impact of each component. Individual trauma describes an event or series of events experienced by an individual, whereas interpersonal trauma may represent a series of adverse childhood events (ACEs) or maltreatment.…”

Section: Trauma-informed Carementioning

confidence: 99%

“…In a recent article, 3 examples of trauma-informed organizations and their outcomes have been highlighted. 24 The first example is the “Center for Health Resilience at MetroHealth” in Cleveland, OH, which promotes recovery-focused services through a “Recovery Coaching Model.” This model is composed of 3 main elements, including needs assessment, resource navigation, and care coordination. With this approach, they reported higher overall patient-reported care ratings, lower rates of emergency department misuse, higher rates of patient-perceived ability to recover, and higher rates of patient perception of physician competence and responsiveness.…”

Section: Introductionmentioning

confidence: 99%

“…26 Furthermore, collective trauma is defined as the cultural, historical, or structural trauma that can impact not only an individual but also the community. 24 As we gain better understanding of these potential traumas in our patients, the health care community can take a collective trauma-informed approach to caring for our patients. This approach was summarized by the Substance Abuse and Mental Health Administration to consist of the “4 Rs”, which are (1) realize, (2) recognize, (3) respond, and (4) resist.…”

Section: Introductionmentioning

confidence: 99%

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Resources for Patient Mental Health and Well-being after Orthopaedic Trauma

Obey

Miller

2022

Journal of Orthopaedic Trauma

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Orthopaedic trauma is an unanticipated life-altering experience for patients. Additionally, the prevalence of psychiatric disorders has been found to be higher in patients with trauma than in the general adult population. Symptoms of depression, anxiety, or posttraumatic stress disorder have been reported in up to 56% of patients throughout their postoperative course. Furthermore, symptoms of any one of these illnesses have been consistently associated with worse patient outcomes after treatment of traumatic orthopaedic injuries. This includes increased levels of pain and disability, postoperative complications, and, in some cases, higher rates of hospital readmission. For most patients with trauma, focus is placed on physical therapy and rehabilitation in the acute postoperative setting to help patients regain function and strength; however, more recent studies have demonstrated equal importance of the social and psychological factors involved with trauma and their impact on outcomes. Therefore, it is essential for orthopaedic surgeons and other members of the care team to be adept in the screening and treatment of psychiatric disorders. For patients struggling with these conditions, several treatment resources exist, which can be used both during their admission and after discharge. Thus, earlier recognition and intervention with appropriate treatment and referrals should be emphasized to improve outcomes. This review discusses the social and psychological impacts of orthopaedic trauma on patients' mental health and well-being and outlines numerous resources available to patients as they recover from their injuries.

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“…Routine medical procedures may invoke memories that lead to discomfort or traumatic stress (Hornor et al, 2019). Accordingly, physicians and practitioners often support trauma-informed care to address the unique needs of patients and promote positive outcomes (Grossman et al, 2021; Raja et al, 2021).…”

mentioning

confidence: 99%

Exploring Collaborative Care Effects on the Mental and Physical Health of Patients With and Without Violent Victimization Histories

Hullenaar

Rivara

Wang

et al. 2022

J Interpers Violence

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Collaborative care is a multicomponent intervention delivered by frontline social work, nursing, and physician providers to address patients’ physical, emotional, and social needs. We argued that collaborative care may particularly benefit patients with a violent victimization history because it practices three principles of trauma-informed care: patient–provider collaboration, preventing repeat trauma in clinical and community settings, and delivering comprehensive mental and physical healthcare. We conducted an exploratory secondary data analysis of a collaborative care randomized clinical trial involving patients who presented with traumatic physical injury at a Level I trauma center in Washington state between 2006 and 2009. We used random-effect linear regression models to estimate how histories of multiple violent traumas moderated the effects of the collaborative care intervention on Short Form-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) T-scores over time. Collaborative care significantly improved follow-up MCS scores among patients who experienced three to four types of violent victimization in their lifetime. Additionally, intervention effects on MCS scores at the 3- and 6-month follow-up were clinically stronger for patients who reported three to four types of violent victimization (3-month = 7.5, 95% confidence level [CI] = 5.1 to 18.7; 6-month = 11.9, 95% CI = 5.1 to 18.7) than those without a history of violent victimization (3-month = 0.8, 95% CI = −5.1, 6.6; 6-month = 5.6, −2.4 to 13.5). We did not find that intervention effects on PCS scores differed between these groups at any wave. Collaborative care may be a promising approach to delivering trauma-informed mental healthcare to patients with histories of multiple types of violent victimization.

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Trauma-informed care: recognizing and resisting re-traumatization in health care

Cited by 48 publications

References 28 publications

History of Equity, Diversity, and Inclusion in Trauma Surgery: for Our Patients, for Our Profession, and for Ourselves

History of Equity, Diversity, and Inclusion in Trauma Surgery: for Our Patients, for Our Profession, and for Ourselves

Resources for Patient Mental Health and Well-being after Orthopaedic Trauma

Exploring Collaborative Care Effects on the Mental and Physical Health of Patients With and Without Violent Victimization Histories

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