Vulnerability and trauma-informed practice: what nurses need to know
The impacts of vulnerability and associated trauma endure from childhood into adulthood and affect an individual's health and wellbeing in ways that are not always visible to others (Felitti et al, 1998). Nurses and midwives must understand the research and literature behind these concepts if they are to help affected people enhance their health and wellbeing.
Although the recognition and understanding of trauma has been developing for more than 50 years, appreciation of the enduring impact it has from infancy to adulthood is a relatively recent concept. Originally considered in terms of the mental health problems experienced by soldiers on their return from war, trauma was formally recognised as post-traumatic stress disorder (PTSD) in the 1970s. Since then our understanding of trauma has broadened to include many other types of traumatic experiences (Asmussen et al, 2022).
Trauma may be an event, a series of events, or a set of circumstances that a person experiences as physically or emotionally harmful or life-threatening. Usually unexpected, it overwhelms an individual's coping resources and causes them to feel frightened, vulnerable, and helpless. While specific to the individual, generally the experience of trauma in the absence of protective factors will cause lasting adverse effects, limiting the ability to function and achieve mental, physical, social, emotional, or spiritual health and wellbeing. Conversely, the presence of strong protective factors can change the outcomes considerably, making any impact temporary and allowing the individual to benefit from education, employment, and friendships (Substance Abuse and Mental Health Services Administration (SAMHSA), 2012).
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