Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia.
Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Aust J Rural Health. 2023 Feb;31(1):98-113. doi: 10.1111/ajr.12922. Epub 2022 Sep 9.
An important service system for rural parents experiencing complex trauma is primary health care.
To investigate workforce knowledge, attitudes and practices, and barriers and enablers to trauma-informed care in rural primary health care.
MATERIAL & METHODS: This study used a descriptive, cross-sectional design. It involved an on-line survey conducted in 2021 in rural Victoria, Australia. Participants were the primary health care workforce. The main outcome measures were study-developed and included, a 21-item Knowledge, Attitudes and Practices tool, a 16-item Barriers and Enablers to Trauma-Informed Care Implementation tool, and three open-ended questions.
The 63 respondents were from community health (n = 40, 63%) and child and family services (n = 23, 37%). Many (n = 43, 78%) reported undertaking trauma-informed care training at some point in their career; with 32% (n = 20) during higher education. Respondents self-rated their knowledge, attitudes and practices positively. Perceived enablers were mainly positioned within the service (e.g. workforce motivation and organisational supports) and perceived barriers were largely external structural factors (e.g. availability of universal referral pathways, therapeutic-specific services). Open-ended comments were grouped into four themes: (1) Recognition and understanding; (2) Access factors; (3) Multidisciplinary and collaborative approaches; and (4) Strengths-based and outcome-focused approaches.
DISCUSSION & CONCLUSION: Primary health care is an important driver of population health and well-being and critical in rural contexts. Our findings suggest this sector needs a rural trauma-informed care implementation strategy to address structural barriers. This also requires policy and system development. Long-term investment in the rural workforce and primary care service settings is essential to integrate trauma-informed care.
农村经历复杂创伤的父母的一个重要服务系统是基层医疗保健。
调查农村基层医疗保健中创伤知情护理的劳动力知识、态度和实践,以及障碍和促进因素。
本研究采用描述性、横断面设计。它涉及 2021 年在澳大利亚维多利亚州农村地区进行的在线调查。参与者是基层医疗保健劳动力。主要结果测量指标是研究制定的,包括 21 项知识、态度和实践工具、16 项创伤知情护理实施障碍和促进因素工具,以及三个开放式问题。
63 名受访者来自社区卫生(n=40,63%)和儿童和家庭服务(n=23,37%)。许多人(n=43,78%)报告在职业生涯的某个阶段接受过创伤知情护理培训;其中 32%(n=20)是在高等教育期间接受的。受访者自我评估他们的知识、态度和实践表现积极。感知到的促进因素主要位于服务内(例如,劳动力动机和组织支持),感知到的障碍主要是外部结构因素(例如,普遍转诊途径、治疗特定服务的可用性)。开放式评论被分为四个主题:(1)认识和理解;(2)获取因素;(3)多学科和协作方法;(4)基于优势和注重结果的方法。
基层医疗保健是人口健康和福祉的重要驱动因素,在农村地区至关重要。我们的研究结果表明,该部门需要制定农村创伤知情护理实施战略,以解决结构性障碍。这还需要政策和系统发展。对农村劳动力和基层医疗服务环境的长期投资对于整合创伤知情护理至关重要。