Understanding the meaning of trauma-informed care for burns health care professionals in a pediatric hospital: A qualitative study using interpretive phenomenological analysis.

Abstract

Trauma-informed care includes a range of practices that build a culture of safety, empowerment, and healing. Limited information is available regarding the lived experience of trauma-informed care by healthcare professionals treating burns in a multidisciplinary setting. The primary aim of this study was to understand what 'trauma-informed care' means to staff and students working in burns at a tertiary pediatric hospital. Semi-structured interviews and focus group were conducted with healthcare professionals (medical, nursing, allied health, pre-graduate students) working in paediatric burn care (or their line manager). Analysis of the dataset was undertaken using qualitative methods (interpretive phenomenological approach and qualitative content analysis). Eleven interviews and one focus group were completed and transcribed verbatim. Three superordinate themes were applicable across the five cohorts: 'what does trauma-informed care mean?', 'being able to deliver trauma-informed care' (agency) and 'impact of the setting'. Eleven components of trauma-informed care practice (for example, everyday interactions with patients and colleagues, screening and assessment) and service-level approaches (for example, service provider training) were described by participants. Healthcare professionals' experiences of delivering trauma-informed care in a burns centre highlighted the need to clarify the concept of 'trauma-informed care' as a first step. Enabling the workforce to understand trauma-informed care and apply it in everyday interactions with patients and colleagues, and a strategic commitment to practice change needs to be actioned more systematically to support implementation of a trauma-informed care approach in pediatric health services.