Youth, caregiver and healthcare professional perspectives on planning the implementation of a trauma‐informed care programme: A qualitative study

Author:

Stokes Yehudis123ORCID,Cloutier Paula4,Aggarwal Dhiraj124,Jacob Jean Daniel1,Hambrick Erin5,Tricco Andrea C.678,Ward Michelle K.124,Kennedy Allison24,Greenham Stephanie124ORCID,Robb Marjorie124,Sheppard Roxanna2,Murphy David2,Boggett Jennifer2,Graham Ian D.19,Lewis Krystina B.1910

Affiliation:

1. University of Ottawa Ottawa Ontario Canada

2. Children's Hospital of Eastern Ontario (CHEO) Ottawa Ontario Canada

3. Princess Margaret Cancer Centre Toronto Ontario Canada

4. CHEO Research Institute Ottawa Ontario Canada

5. University of Missouri‐Kansas City Kansas City Missouri USA

6. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto Toronto Ontario Canada

7. Epidemiology Division and Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada

8. Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, School of Nursing Queen's University Kingston Kingston Ontario Canada

9. Ottawa Hospital Research Institute Ottawa Ontario Canada

10. University of Ottawa Heart Institute Ottawa Ontario Canada

Abstract

AbstractAimsTo explore youth, caregiver and staff perspectives on their vision of trauma‐informed care, and to identify and understand potential considerations for the implementation of a trauma‐informed care programme in an inpatient mental health unit within a paediatric hospital.Design and MethodsWe applied the Interpretive Description approach, guided by complexity theory and the Implementation Roadmap, and used Applied Thematic Analysis methods.FindingsTwenty‐five individuals participated in individual or group interviews between March and June 2022, including 21 healthcare professionals, 3 youth and 1 caregiver. We identified two overarching themes. The first theme, ‘Understanding and addressing the underlying reasons for distress’, related to participants’ understanding and vision of TIC in the current setting comprising: (a) ‘Participants’ understanding of TIC’; (b) ‘Trauma screening and trauma processing within TIC’; (c) ‘Taking “a more individualized approach”’; (d) ‘Unit programming’; and (e) “Connecting to the community”. The second theme, ‘Factors that support or limit successful TIC implementation’ comprises: (a) ‘The need for a broad “cultural shift”’; (b) ‘The physical environment on the unit’; and (c) ‘Factors that may limit successful implementation’.ConclusionWe identified five key domains to consider within trauma‐informed care implementation: (a) the centrality of engagement with youth, caregivers and staff in trauma‐informed care delivery and implementation, (b) trauma‐informed care core programme components, (c) factors that may support or limit success in implementing trauma‐informed care within the mental health unit and (d) hospital‐wide and (e) the importance of intersectoral collaboration (partnering with external organizations and sectors).Impact When implementing TIC, there is an ongoing need to increase clarity regarding TIC interventions and implementation initiatives. Youth, caregiver and healthcare professional participants shared considerations important for planning the delivery and implementation of trauma‐informed care in their setting. We identified five key domains to consider within trauma‐informed care implementation: (a) the centrality of relational engagement, (b) trauma‐informed care programme components, (c) factors that may support or limit successful implementation of trauma‐informed care within the mental health unit and (d) hospital‐wide and (e) the importance of intersectoral collaboration. Organizations wishing to implement trauma‐informed care should consider ongoing engagement with all relevant knowledge user groups throughout the process. Reporting MethodStandards for Reporting Qualitative Research (SRQR).Patient or Public ContributionThe local hospital research institute's Patient and Family Advisory Committee reviewed the draft study methods and provided feedback.

Publisher

Wiley

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