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- Title
Implementing the NCTSN Trauma-Informed Organizational Assessment (TIOA) for Improving Trauma-Informed Care in Inpatient Child Psychiatry.
- Authors
Choi, Kristen; Ayala, Leilanie; Lierly, Rebecca; Bustamante, Daniela; Cioppa-Fong, Benjamin; Mead, Meredith; Mkroyan, Hagop J.; Morris, Elizabeth; Babajanyan, Irina; Maryanov, Daniel
- Abstract
Introduction: Children and adolescents receiving inpatient psychiatric services have disproportionately high levels of exposure to trauma and adversity. The National Child Traumatic Stress Network Trauma-Informed Organizational Assessment (TIOA) is a comprehensive tool intended to guide implementation of trauma-informed care, but it has not yet been applied in inpatient settings. Aims: The purpose of this quality improvement project was to describe trauma-informed care in inpatient child/adolescent psychiatry with the TIOA, examine relatedness among trauma-informed care domains, and explore barriers or facilitators to applying trauma-informed care. Methods: This quality improvement project used mixed methods. We conducted a web-based survey in Summer 2022 with staff members (clinical and administrative) at two inpatient child/adolescent psychiatric units in California to assess trauma-informed care practices with the TIOA (87 items). Qualitative follow-up interviews were offered to interested participants. A correlation matrix and cluster analyses were used to examine relationships among TIOA domains; qualitative data were analyzed thematically. Results: There were 69 survey respondents and seven qualitative interviews. TIOA domain scores ranged from a low of 2.3 to a high of 3.2, indicating that practices were occurring only "rarely" to "sometimes." There were two major themes identified from qualitive interviews: (a) barriers to trauma-informed care in an inpatient context that can be resource-constrained or coercive; and (b) discovering strategies to provide trauma-informed care despite structural barriers. Conclusion: Organizational interventions targeting any domains of trauma-informed care are needed in inpatient settings given limited uptake of trauma-informed care.
- Subjects
TREATMENT of post-traumatic stress disorder; TREATMENT of emotional trauma; HEALTH services accessibility; PEARSON correlation (Statistics); STATISTICAL correlation; ADOLESCENT psychiatry; HUMAN services programs; CLUSTER analysis (Statistics); T-test (Statistics); STATISTICAL significance; RESEARCH funding; CHILD psychiatry; HOSPITAL care; DESCRIPTIVE statistics; THEMATIC analysis; ATTITUDES of medical personnel; RESEARCH methodology; QUALITY assurance; PSYCHOLOGICAL tests; DATA analysis software
- Publication
Journal of the American Psychiatric Nurses Association, 2024, Vol 30, Issue 3, p722
- ISSN
1078-3903
- Publication type
Article
- DOI
10.1177/10783903231171590