Date of Award
Spring 4-27-2026
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
First Advisor
Kristin Haglund
Second Advisor
Amy Newman
Third Advisor
Jessica Zemlak
Fourth Advisor
Melinda Hughes
Abstract
Trauma is recognized as a universal human experience. Well-established evidence demonstrates the negative impact of trauma on health outcomes. In 2014, following a recommendation from SAMHSA, trauma-informed care (TIC) was implemented across human service sectors, including healthcare. While TIC has been in use for the past decade, adults’ experiences of receiving TIC in outpatient healthcare remain largely unknown. The purposes of this study were (a) to explore and describe how adults’ healthcare experiences aligned with the principles of TIC being implemented in outpatient healthcare settings and (b) to understand the perceived usefulness and meaning of TIC for adult patients. A qualitative interpretative description design was utilized. Participants were English-speaking adults (age > 18) who had at least two outpatient healthcare visits in the U.S. since 2014. Data were collected with a demographic survey and individual, semi-structured interviews and analyzed using content analysis. Among participants (N = 25), 14 identified as female, 10 male, and 1 non-binary. Participants reported healthcare visits in primary care (96%), emergency department (88%), and mental health services (64%). Participants identified care consistent with TIC in their healthcare visits, especially the principles of safety, trust, and collaboration and reported that care reflective of TIC improved their healthcare. Thematic results were presented in three parts. Part One includes participants’ descriptions of their healthcare experiences in general since 2014 characterized by the theme Professionals Deliver a Spectrum of Care. Part Two includes participants’ descriptions of healthcare that specifically reflects TIC characterized by the theme Personalized Human Connection. Part Three includes participants’ perspectives on TIC and how it is implemented into healthcare by the theme Universal Trauma Awareness is Beneficial. This study provides support that adult patients have noticed and appreciated the incorporation of TIC in outpatient healthcare settings. Findings from this study can guide current TIC delivery strategies and inform future research on patient-oriented outcomes of TIC in healthcare.