Psychiatric hospital nurses' attitudes towards trauma‐informed care

Abstract

Introduction: Quantitative studies exploring trauma-informed care (TIC) attitudes have not used samples made up exclusively of mental health nurses (MHNs). Qualitative methods were sparingly used. Aim: To examine nurses' TIC attitudes at a psychiatric hospital. Method: A mixed-method design was used. One hundred and thirty-six MHNs completed the Attitudes Related to Trauma-Informed Care scale. Data were analysed using inferential statistics. A focus group interview among ten MHNs ensued. Thematic analysis was used. Results: MHNs demonstrated favourable TIC attitudes. Ambivalent attitudes for the subscale “Causes” were identified. MHNs employed for less than 5 years at the hospital and those in acute settings displayed more favourable attitudes on some subscales. Three themes “Awareness,” “Unhealthy boundaries” and “Inhibition” emerged from qualitative analysis. Discussion: Challenges uncovered in the provision of TIC include the unacknowledged impact of trauma on challenging behaviour among MHNS, the influence of blurred professional boundaries with long-term clients on the cycle of perpetuated trauma identified by previous research and MHNs work-related traumas. Implications for practice: Identified challenges to TIC integration among MHNs can facilitate the implementation of TIC in hospitals. TIC educational packages for MHNs should acknowledge traumatic histories in the aetiology of challenging behaviour and stress the importance of maintaining professional boundaries with clients.