The Effects of Trauma-informed Care Organization on Birth Professionals and Women's Experiences of Trauma.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 345
- 试验地点
- 1
- 主要终点
- Birth-related post-traumatic stress symptoms
研究概览
简要总结
This study aims to evaluate the effects of integrating trauma-informed care (TIC) into the organizational structure of maternity services on women giving birth and healthcare professionals involved in perinatal care. The study will be conducted at Tarsus State Hospital and will implement a systematic, organization-wide TIC approach designed to improve the quality and psychological safety of maternity care.
Trauma-informed care recognizes the potential impact of previous and birth-related trauma and seeks to prevent re-traumatization through respectful communication, emotional safety, informed consent, empowerment, collaborative decision-making, and support for women's autonomy and dignity. In maternity services, these principles may contribute to more positive childbirth experiences while also supporting healthcare professionals who may experience secondary traumatic stress through repeated exposure to traumatic events.
The intervention will involve multiple groups within the hospital, including organizational leaders, healthcare professionals, and support personnel. Organizational leaders will receive training on institutional implementation of TIC and the development of sustainable organizational strategies. Healthcare professionals, including midwives, nurses, obstetricians, psychologists, psychiatrists, and social workers, will receive training on recognizing trauma, trauma-sensitive communication, and integrating TIC principles into routine maternity care. Support personnel will receive training focused on respectful communication and awareness of trauma-related sensitivities.
Educational activities will include case discussions, group exercises, role-playing, and problem-solving sessions. The study will evaluate whether this organization-wide approach contributes to improved trauma-informed practices among healthcare professionals and more positive experiences among women receiving maternity care.
详细描述
Childbirth is generally considered a positive and meaningful life event; however, it may also be experienced as psychologically distressing or traumatic. Traumatic birth experiences may be associated with post-traumatic stress symptoms, including intrusive memories, avoidance, emotional distress, and heightened physiological arousal. Such experiences may affect maternal mental health, maternal-infant bonding, breastfeeding, and future reproductive decisions. Healthcare professionals who are repeatedly exposed to traumatic birth events may also experience secondary traumatic stress, burnout, and reduced job satisfaction.
Trauma-informed care (TIC) is an approach that recognizes the widespread and potentially long-lasting effects of trauma and seeks to minimize the risk of re-traumatization during healthcare interactions. Core principles include psychological and emotional safety, respectful and trauma-sensitive communication, informed consent, empowerment, collaboration, and support for individual autonomy and dignity. Within maternity care, a trauma-informed approach requires healthcare professionals to recognize that women may have previous or birth-related traumatic experiences, including experiences that have not been disclosed.
Effective implementation of TIC requires an organizational approach rather than isolated educational interventions. Women interact with multiple healthcare professionals and support personnel throughout maternity care, from admission to discharge. Therefore, communication practices, attitudes, institutional procedures, and the overall care environment may influence women's childbirth experiences. The present study will implement an organization-wide trauma-informed care model at Tarsus State Hospital involving organizational leaders, healthcare professionals, and support personnel.
The intervention will include educational programs specifically developed for different professional groups. Organizational leaders will receive training on institutional strategies for implementing trauma-informed care, recognizing secondary traumatic stress among staff, and developing sustainable action plans for integrating TIC principles into maternity services.
Healthcare professionals involved in maternity and perinatal care, including midwives, nurses, obstetricians, psychologists, psychiatrists, and social workers, will participate in a multi-module training program. Training will address recognition of psychological and birth-related trauma, trauma-sensitive communication, prevention of re-traumatization, informed consent, women's autonomy and dignity, and integration of trauma-informed principles into routine maternity care.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
盲法说明
Arm 1: Control cohort (women giving birth before implementation of trauma-informed care training)
Arm 2: Intervention cohort (women giving birth after implementation of trauma-informed care training)
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged 18 years or older.
- •Giving birth at Tarsus State Hospital during the study period.
- •Providing voluntary informed consent.
- •Healthcare professionals, organizational leaders, and support staff:
- •Aged 18 years or older.
- •Working in maternity or related services at Tarsus State Hospital.
- •Participating in the trauma-informed care intervention according to their professional role.
- •Providing voluntary informed consent.
排除标准
- •Severe postpartum complications preventing participation or completion of study assessments.
- •Incomplete study assessments.
- •Healthcare professionals, organizational leaders, and support staff:
- •Failure to complete the required training or study assessments. Incomplete study assessments.
研究组 & 干预措施
Control Group
Women giving birth during the pre-intervention period, before implementation of the organization-wide trauma-informed care program.
Trauma-Informed Care Intervention
Women giving birth during the post-intervention period, after implementation of the organization-wide trauma-informed care program for maternity service personnel.
干预措施: trauma-informed care training (Behavioral)
结局指标
主要结局
Birth-related post-traumatic stress symptoms
时间窗: 4-6 weeks postpartum
Birth-related post-traumatic stress symptoms will be assessed using the City Birth Trauma Scale (City BiTS). The scale assesses post-traumatic stress symptoms related to childbirth. The total score ranges from 0 to 60, with higher scores indicating greater severity of birth-related post-traumatic stress symptoms and therefore a worse outcome.
次要结局
- Trauma-related stress symptoms in maternity healthcare professionals(40-60 days after completion of the training program.)
研究者
Özlem KOÇ
Principal Investigator
Tarsus University
