Exploring trauma-informed principles for empowering physical and psychological recovery in a multidisciplinary inpatient rehabilitation unit: a qualitative study.

Abstract

To describe the experiences of people admitted to inpatient rehabilitation related to the trauma-informed principles of safety, trustworthiness, choice, collaboration and empowerment, and to define the barriers and enablers to trauma-informed care from the perspective of clinicians. This qualitative study included semi-structured interviews with 14 people admitted to a sub-acute rehabilitation unit. Interviews were transcribed, coded and reflexive thematic analysis used to generate themes. Three focus groups with multidisciplinary health professionals (<i>n</i> = 14) were conducted, with barriers and enablers to trauma-informed care identified. Themes generated on trauma-informed principles included: human connection touches the heart; clear communication of expectations, and hope, facilitates safety and trust; pushing back to be heard; using the link between the mind and body to advantage; loss of independence and control; and wanting room to breathe. Nursing and allied health clinicians identified enablers to providing trauma-informed care: holistic, empathic and team approaches, and supporting clinician psychological safety. Barriers identified included: limited time and resources, increasing complexity, prioritisation of physical safety, organisational processes, and limitations of the environment. Building relationships with empathy, clear communication, and holistic approaches, facilitate interpersonal safety, trust and empowerment. System constraints, processes and resources are barriers to implementing trauma-informed care.