Low provider and staff self-care in a large safety-net HIV clinic in the Southern United States: Implications for the adoption of trauma-informed care

Objective: This mixed-methods needs assessment study examined self-care practices among providers, staff, and administrators at an HIV clinic and identified barriers and facilitators to strengthening self-care services in this setting. Methods: Surveys (n = 31) and qualitative interviews (n = 23) were conducted with staff, providers, and administrators at a large, safety-net HIV clinic. Results: Surveys indicated an overall absence of formal self-care services including resources to manage stress, opportunities to debrief, and formal mechanisms to voice concerns. Based on interviews with staff and providers, deficiencies in self-care services included support for dealing with complex patients, formal mechanisms for feedback, and time for self-care. Administrators recognized the need for more support, acknowledged that opportunities for employees to voice concerns were lacking, and felt that implementing multi-disciplinary team meetings could improve morale and reduce stress and burnout. Conclusion: This assessment revealed a need to enhance self-care in safety-net HIV services. Adoption of trauma-informed care, which includes activities to strengthen self-care, could reduce workplace burnout.

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Use of a Health Advocacy Model for Survivors of Interpersonal Violence

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238966 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8966

Author(s):

Jessica Grace ◽

Scott T. Walters ◽

Irene Gallegos ◽

Erika L. Thompson ◽

Emily E. Spence

Keyword(s):

Interpersonal Violence ◽

Goal Attainment ◽

Health And Safety ◽

Self Care ◽

Health Advocacy ◽

Trauma Informed Care ◽

Service Delivery Systems ◽

Trauma Informed ◽

Solution Focused ◽

Solution Focused Therapy

This article examines the implementation of a health advocacy model designed for survivors of interpersonal violence (IPV) in a metropolitan area of North Texas. Using a framework influenced by motivational interviewing, solution-focused therapy, and trauma-informed care, this program engaged IPV survivors in creating health and safety goals. Goal attainment scaling was used to track progress after each health advocacy encounter. Clients could set their own goals for healthcare, self-care, and safety. The program served 419 clients and 648 goals were set by clients at the first visit. Among all goals, 89% selected goals focused on healthcare, with 47% of those selecting obtaining health insurance or coverage as a need. These results demonstrate the need for an enhanced healthcare response for this population. The remaining goals selected were self-care (7%) and safety (3%). The design of the health advocacy intervention shows promise towards filling the gaps between IPV and healthcare service delivery systems.

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A Review of Social Cognitive Theory and Self-care for Type 2 Diabetes Mellitus Patients

Business Management and Strategy ◽

10.5296/bms.v11i1.16961 ◽

2020 ◽

Vol 11 (1) ◽

pp. 148

Author(s):

Nomahaza Mahadi ◽

Siti Nurani Abdullah ◽

Shathees Baskaran

Keyword(s):

Diabetes Mellitus ◽

Chronic Disease ◽

Social Cognitive Theory ◽

Social Cognitive ◽

Cognitive Theory ◽

Self Care ◽

Daily Lives ◽

Care Services ◽

Care Practices ◽

Diabetes Mellitus Treatment

Diabetes could be very challenging to manage due to its high complication that could give negative impacts to patient’s quality of life. Diabetes mellitus is a non-communicable chronic disease that has caused significant morbidity since ten years ago. Diabetes Mellitus treatment is essential to reduce disease complication. Adapting self-care behaviour based on theory can, therefore, be implemented as one of the effective ways of managing diabetes. Social Cognitive Theory has been one of the most common theories that used in many studies as to improve behaviours in-patient with chronic disease such as diabetes mellitus. Furthermore, managing good self-care is very important in order to reduce the morbidity and mortality of diabetes patients, however diabetes self-care became a challenge to many people living with diabetes, as they need to adapt and learn self-care practices in their daily lives. Thus this paper would provide an understanding of the health care professional in delivering their self-care services, also helping oneself to stay healthy and control their disease by good self-care practices.

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Training Pediatric Primary Care Residents in Trauma-Informed Care: A Feasibility Trial

Clinical Pediatrics ◽

10.1177/0009922819859868 ◽

2019 ◽

Vol 58 (11-12) ◽

pp. 1239-1249

Author(s):

Aubrey R. Dueweke ◽

Rochelle F. Hanson ◽

Elizabeth Wallis ◽

Emily Fanguy ◽

Carla Newman

Keyword(s):

Primary Care ◽

Perceived Competence ◽

Perceived Barriers ◽

Feasibility Trial ◽

Pediatric Residents ◽

Paired Samples ◽

Trauma Informed Care ◽

Trauma Informed ◽

Care Practices ◽

Residents Attitudes

This study examined the feasibility and outcomes of a training designed to enhance pediatric residents’ trauma-informed practices in primary care. Paired samples t tests examined changes in 33 residents’ attitudes, perceived competence, and perceived barriers toward trauma-informed care after a 2-hour training. Fisher’s exact tests measured changes in residents’ screening and referral behaviors. A subsample (n = 9) of residents were interviewed about the training. Residents reported increases in favorable attitudes ( P = .065) and perceived competence ( P < .001) and decreases in perceived barriers ( P = .001 to .521) to implementing trauma-informed care practices. Chart reviews revealed a significant increase in completed trauma screens (0% to 8.0%, P < .001) but no difference in referrals for psychology/psychiatry services (1.9% to 4.2%, P = .200). Residents reported finding the training helpful. Although residents were willing and understood the utility of assessing for trauma, they faced substantial barriers.

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A Randomized Pilot Study of improving Foot Care in Home Health Patients With Diabetes

The Diabetes Educator ◽

10.1177/014572170302900218 ◽

2003 ◽

Vol 29 (2) ◽

pp. 273-282 ◽

Cited By ~ 41

Author(s):

Cynthia F. Corbett

Keyword(s):

Home Care ◽

Educational Intervention ◽

Self Efficacy ◽

Self Care ◽

Home Care Services ◽

Home Health ◽

Study Entry ◽

Foot Care ◽

Care Services ◽

Care Practices

PURPOSE the purpose of this study was to test the effectiveness of an educational intervention to improve patients' foot care knowledge, self-efficacy, and self-care practices. METHODS A prospective, randomized, single center, 2-group design was used with a convenience sample of 40 home care patients from a Medicare-certified home health agency. Baseline measures of foot care knowledge, self-efficacy, and reported self-care practices were obtained at study entry and 6 weeks later to control for foot care interventions provided during routine home care services. After obtaining the 6-week baseline measures, patients who were randomized to the intervention group received individualized education about proper foot care. All patients were interviewed a third time 3 months after study entry to determine the effectiveness of the intervention. RESULTS The educational intervention improved patients' knowledge, confidence, and reported foot care behaviors. CONCLUSIONS A brief, individualized educational intervention about standard foot care topics improved patients' foot care knowledge and self-efficacy as well as reported self-care practices. Incorporating such interventions into routine home care services may enhance the quality of care and decrease the incidence of lower-extremity complications.

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Trauma-Informed Self-Care for Child and Youth Care Workers

Journal of Child and Youth Care Work ◽

10.5195/jcycw.2015.78 ◽

2020 ◽

Vol 25 ◽

pp. 157-175

Author(s):

Vaughan Bowie

Keyword(s):

Self Care ◽

Youth Care ◽

Care Plan ◽

Short Article ◽

Childhood Experiences ◽

Child And Youth Care ◽

Trauma Informed Care ◽

Adverse Childhood ◽

Care Workers ◽

Trauma Informed

This article presents a framework for understanding, developing, and applying a trauma-informed approach to staff, team, and organizational self-care in youth serving organizations. The article draws on current research in the areas of Adverse Childhood Experiences (ACE), Trauma-Informed Care (TIC), Trauma Stewardship, resilience, and The Sanctuary Model. This approach will help child and youth care workers to develop a long lasting, effective trauma-informed self, team, and organizational care plan. The first article focuses on worker trauma-informed self-care, and the second on team and organizational approaches. Since there are limits as to what can be comprehensively covered in a short article, I will supply an extensive list of key references and resources relevant to self, team, and organizational care. Many of these are directly downloadable from the Internet. Thus, I do not attempt to answer all the issues but encourage readers to explore the various resources and ideas and apply them where relevant to the readers, their team, and organizations.

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