Ross Dana C, Farhat Kaniz Fatema, Sayrafizadeh Negar, Truuvert Annie K, Waliji Louloua Ashikhusein, Musheer Mahum, Blair Julie, Hughes Lesley, MacRae Sue, Vigod Simone N, Soklaridis Sophie, McCallum Nancy
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Women's College Hospital, 76 Grenville Street, 7th floor, Toronto, ON, M5S 1B2, Canada.
BMC Health Serv Res. 2025 Mar 24;25(1):426. doi: 10.1186/s12913-025-12568-1.
Trauma-informed care (TIC) is a framework that recognizes the pervasive impact of trauma, aiming to enhance both patient outcomes and provider well-being. Given the high prevalence of trauma among individuals seeking healthcare, it is essential for healthcare providers (HCPs) to be trauma informed. However, standardized TIC curricula for training healthcare staff are lacking. This study assessed perceptions towards TIC among multidisciplinary HCPs, patients, and leadership staff at two urban hospitals in Canada.
This mixed-methods prospective cross-sectional study employed Kern's six-step approach for curriculum development. A needs assessment was conducted via an online questionnaire for HCPs and semi-structed interviews with individuals from the three participant groups: HCPs, patients, and leadership staff. The questionnaire assessed knowledge, skills, and attitudes regarding TIC. Semi-structured interviews explored perspectives on TIC, including curriculum priorities and potential implementation barriers. Findings informed the development of a virtual TIC curriculum, with iterative feedback collected to refine and assess its acceptability.
Among 106 HCP questionnaire respondents including Medical Doctors, Social Workers and Registered Nurses, 96 (90.6%) identified as women, and 97 (91.5%) as providers of direct patient care. Despite 93 (87.7%) having prior TIC education, 77 (72.6%) reported low confidence in applying TIC knowledge in clinical practice. Key perceived challenges to TIC training implementation included time constraints and lack of standardization across disciplines. A multimedia, self-paced course was the preferred solution. Thematic analysis of interviews with 28 participants (10 HCPs, 10 patients, 8 leadership staff) revealed six major themes: healthcare interactions, TIC implementation, training needs, system level barriers, curriculum preferences, and systems level improvements. Participants underscored the risk of re-traumatization to patients in healthcare settings without TIC and emphasized the need for universal TIC training for all staff.
This study revealed a strong interest in a TIC course for multidisciplinary HCPs, supports the translation of knowledge into practice and incorporates a focus on cultural humility. Integrating insights from key stakeholders in this needs assessment phase resulted in the development of a TIC curriculum inclusive of diverse voices and viewpoints and strengthened the understanding of contextual factors that will support effective TIC implementation.
创伤知情护理（TIC）是一种认识到创伤普遍影响的框架，旨在改善患者结局并提升医护人员的福祉。鉴于在寻求医疗保健的人群中创伤的高发生率，医护人员了解创伤情况至关重要。然而，缺乏用于培训医护人员的标准化TIC课程。本研究评估了加拿大两家城市医院的多学科医护人员、患者及领导人员对TIC的看法。
这项混合方法的前瞻性横断面研究采用克恩课程开发六步法。通过在线问卷对医护人员进行需求评估，并对三个参与组（医护人员、患者和领导人员）的个体进行半结构化访谈。问卷评估了关于TIC的知识、技能和态度。半结构化访谈探讨了对TIC的看法，包括课程重点和潜在实施障碍。研究结果为虚拟TIC课程的开发提供了依据，并收集迭代反馈以完善和评估其可接受性。
在106名医护人员问卷受访者中，包括医生、社会工作者和注册护士，96名（90.6%）为女性，97名（91.5%）为直接护理患者的人员。尽管93名（87.7%）曾接受过TIC教育，但77名（72.6%）表示在临床实践中应用TIC知识的信心较低。TIC培训实施的主要感知挑战包括时间限制和各学科缺乏标准化。多媒体、自主学习课程是首选解决方案。对28名参与者（10名医护人员、10名患者、8名领导人员）的访谈进行主题分析，揭示了六个主要主题：医疗互动、TIC实施、培训需求、系统层面障碍、课程偏好和系统层面改进。参与者强调在没有TIC的医疗环境中患者再次受创伤的风险，并强调所有工作人员都需要接受普遍的TIC培训。
本研究表明多学科医护人员对TIC课程有浓厚兴趣，支持将知识转化为实践，并注重文化谦逊。在这个需求评估阶段整合关键利益相关者的见解，促成了一个包含不同声音和观点的TIC课程的开发，并加强了对支持有效实施TIC的背景因素的理解。
