Document Type

Capstone Experience

Graduation Date

12-2018

Degree Name

Master of Public Health

First Committee Member

Jungyoon Kim, Ph.D.

Second Committee Member

Jeanette Harder, Ph.D.

Third Committee Member

Charity Evans, M.D., M.H.C.M., F.A.C.S.

Fourth Committee Member

Ashley Farren, MSN, MBA, RN

Abstract

Background: Trauma-informed care (TIC) has recently become a popular topic in medical science. Many patients’ health conditions have been diagnosed and treated purely as medical issues, yet emerging research indicates that trauma is sometimes the source of many physical and mental conditions. Implementing TIC education in healthcare systems may lead to preventing the onset of symptomology related to undiagnosed, chronic trauma experience.

Objectives: The primary goal of this Capstone project was to implement TIC training developed by Trauma Matters Omaha Coalition and assess preliminary evidence for changes in participants’ confidence, clinical knowledge, professional knowledge, self-awareness, and assumptions and biases regarding TIC.

Methods: The Trauma Matters Omaha Coalition created a curriculum and evaluation tool to implement TIC education and measure the impacts. Collaborating partners included CHI Health and Project Harmony. This project used a train-the-trainer model; trainers completed the initial three-hour training and then deliver a one-hour training to their colleagues. Study participants (N = 164) included staff (N = 107) and students (N = 57) at Nebraska Medicine/UNMC and CHI Health. Training participants learned to define trauma and traumatic stress, to understand the impact of trauma on the brain and body, and to learn the foundations of TIC. This study used convenience sample. Investigators used pretest and posttest survey instruments, including the subscales of confidence, clinical knowledge, professional knowledge, self-awareness, and assumption/bias. Data were analyzed in SPSS using descriptive statistics, reliability tests, and paired samples t-tests.

Results: This Capstone project yielded an increased number of clinicians who are TIC trained and a preliminary analysis of the first 164 participants. Three areas of research were divulged from this study including (1) increasing the amount of information on reliable subscales to be included in future measurement tools, (2) the realization that this training has yielded both clinically and statistically significant results in the areas of confidence (mean score change = .836, p-value = .001) and clinical knowledge (mean score change = .178, p-value = .001), and (3) has proved to be feasible to implement as a one-hour training. Most participants strongly agreed that they would recommend this training to their colleagues (mean score = 4.52) and it will have a positive impact on the care they provide (mean score = 4.35).

Conclusion: We conducted a pilot study of participants who had completed a one-hour training session that was designed to increase confidence, clinical knowledge, professional knowledge, self-awareness, and assumption/bias regarding TIC. The study pilot tested an instrument for internal consistency and reliability of five subscales. The conclusions are that the training was well-received and provided many promising leads for further research on refining a valid and reliable instrument.

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