Health care providers' comfort caring for trauma-exposed patients in the primary care setting: A mixed methods approach.

ABSTRACT: Introduction: Patients seeking primary care often present with health concerns related to psychological trauma, highlighting the importance of health care providers' (HCPs) comfort discussing trauma in the primary care setting. This study used mixed methods, including qualitative content analysis, to (1) document HCPs' trauma-related comfort levels and factors contributing to discomfort and (2) examine the associations between provider-level factors and comfort. Materials and Methods: Direct patient care providers (74.6% physicians/residents; 68.7% women; 44.8% White; M_age = 36.7 years, SD_age = 9.8) were recruited from primary care clinics in an urban public hospital system in the United States to complete a survey assessing trauma-related comfort; responses to open-ended prompts were coded by independent raters. Results: Few HCPs endorsed comfort providing care to patients with known trauma histories (29.8%), most often citing limited knowledge and fear of exacerbating symptoms as contributors to discomfort. HCPs most often endorsed formal education and integrated behavioral health teams as having enhanced their comfort providing trauma-informed care; 59.2% indicated that receiving formal education would further increase comfort. HCPs' comfort was unrelated provider-level factors other than department, F (2,53) =6.56, P = 0.003, and race, F (2,52) =5.69, P = 0.006. Discussion: Findings provide critical context to HCPs' trauma-related discomfort as well as actionable next steps to increase trauma-related comfort during primary care encounters. [ABSTRACT FROM AUTHOR]