Trauma-Related Shame: An Evolutionary Concept Analysis.

BACKGROUND

Feelings of shame after interpersonal assault directly impact survivor well-being. Although the concept of trauma-related shame has been well defined and applied in psychology, the direct application to nursing care for victims of sexual assault is unclear.

OBJECTIVE

The aim of this study was to perform an interdisciplinary concept analysis to clarify and synthesize the concept of trauma-related shame as it relates to interpersonal assault.

METHOD

A multidisciplinary literature search was conducted using the term "trauma-related shame." Article titles and abstracts were reviewed for significance to interpersonal assault. Rodgers' evolutionary method of concept analysis was used to identify attributes and related concepts and also clarify the contextual basis of trauma-related shame.

RESULTS

The search resulted in 150 articles, 15 of which met the specified inclusion criteria. Fourteen of the selected articles were research studies, and one was a systematic review. A thematic analysis was used, and two attributes were identified: self-devaluation and self-isolation. An experience of trauma, fear, multivictimization, preexisting shame, low self-esteem, stigmatized events, and negative reactions from others were identified as antecedents. Finally, when reviewing for consequences, anxiety, depression, posttraumatic stress disorder, acute stress disorder, distress, poor health outcomes, social withdrawal, and suicidal tendencies were identified as common themes.

CONCLUSION

This concept analysis is a first step in the further development and implementation of trauma-related shame in nursing. It will be vital to the provision of holistic care for the profession to conduct research and publish literature related to shame for survivors of interpersonal traumatic events.