P. Kallepalli1,2, L. Hart2,3, M. White3, C. Castater1,2, J. Bliton5, R. Smith1,2,3,4 1Morehouse School of Medicine, Atlanta, GA, USA 2Grady Memorial Hospital, Trauma Surgery, Atlanta, GA, USA 3Emory University School of Medicine, Surgery, Atlanta, GA, USA 4Rollins School of Public Health at Emory University, Atlanta, GA, USA 5Jamaica Hospital Medical Center, Surgery, Queens, NY, USA
Introduction: Trauma Informed care (TIC) is a set of principles that can be used as a framework for healthcare professionals to mitigate traumatic stress or re-traumatization of injured patients. Importantly, trauma-informed language (TIL) is a key concept of TIC that provides safety, empathy, and autonomy to patients and avoids revictimization and re-traumatization. The language that clinicians use in treating traumatically-injured patients is integral in providing holistic, trauma-informed care. This study evaluates the literature on the education, guidance and outcomes associated with TIL to provide a current framework that will help practitioners provide better care for this population.
Methods: Cochrane CENTRAL, CINAHL, Embase, PubMed, and Web of Science were searched on July 2, 2024. Terms and controlled vocabulary associated with TIC, gun, gunshot, violent injury, residency (education) and emergency department were used. Results were limited to English language, published since 2004. Case reports, comments, commentary, editorials, letters, meta-analyses, reviews and systematic reviews were excluded.
Results: The searches yielded 3,960 records. The results were uploaded to Covidence©, an online tool used for systematic and scoping reviews. After 1,599 duplicates were removed by Covidence©, 2401 studies, including one study which was not discovered during the searches, were reviewed for the initial title/abstract screening. Of the 20 studies selected for further full text review, 3 studies were deemed eligible for this study.
Included studies suggest that TIL is infrequently taught and rarely utilized in managing traumatically injured patients. This leads to significant challenges in communication between trauma patients and providers. When taught, TIL improves trainee communication skills and confidence. When utilized in the healthcare setting, TIL improves patient satisfaction and may mitigate post-traumatic symptoms in patients and physicians alike.
Conclusion: Understanding the positive impact that trauma-informed, patient-centered language has on victims of firearm violence remains elusive due to the profound paucity of literature. Trainee education on TIL is essential to improve patient outcomes and promote health equity. Future studies should focus on evaluating pedagogical approaches to integrating TIL into trauma care with an end goal of increasing comprehensive empathy practices and enhancing patient outcomes.