trauma experience

Home>Homework Answsers>Nursing homework helpa year ago11.09.202440Report issuefiles (3)FreeWriteAssignmentDescriptionandRubric.pdfChapter121.pptxFamily_Health_Care_Nursing_6e_Theory_Practice_a…_—-_UNIT_2_Families_Across_the_Health_Continuum.pdfFreeWriteAssignmentDescriptionandRubric.pdf10.24.23 LKN362 Family and Societal Nursing for RNsFamily Free Write Assignment DescriptionFamily Free WriteEarly in the course, each student will write a 2-page (minimum 250 words and no more than 500 words) openwrite on four topics. Each free write is worth 10 points (40 points total).1. Healthy Families—250-500 words (Module One)
2. Family during Acute Care Experience—250-500 words (Module Two)
3. Family in Crisis or Trauma—250-500 words (Module Three)
4. Chronic Illness Experience—250-500 words (Module Five)The free write is not an edited piece of work, but you must use at least two sources for each topic. The workwill be evaluated for its clarity, creativity, and relevance. Please write about your thoughts, insights, stories,cases, examples, experiences, for that particular topic. These papers may be used to complete the Family TheoryInterview Project later on in the course.This free write is meant to help you access your deepest and most powerful feelings about family, as well asbuilding on your past and your developing knowledge of family: academically, professionally, and personally.The 250-500 word free write on healthy families (for example, there are four categories), may include ideasgleaned from your text, stories from your childhood, something you read in the newspaper, a novel or poem, oran interaction you witnessed in the grocery story. The objective of the free write is to help you decide whatmost interests you in family health nursing and what literature you might use for your annotated bibliographyand your final research work with a family. Examination of the course topics will organize your thoughts andfocus your ideas on the desired outcomes of the learning you are doing.This is not an edited piece of work. This material is rich in image, story and insight. The free write is meant inpart to get in touch with this material. Thoughts from your readings may also be included and will spark newideas unique to you. Use at least two resources (do not need to be scholarly) in your initial post for fullpoints.Free Write RubricComponents:1. Initial post: Posted a free write on the given subject;2. of at least 250 words;3. incorporating at least two resources in correct APA format (do not need to be scholarly).4. Reply post: Replied to one person in the group;5. of at least 100 words (no resources required).10 pointsMissing 1 component 9 pointsMissing 2 components 8 pointsMissing 3 components 7 pointsMissing 4 components 6 pointsDid not participate 0 pointsChapter121.pptxFamily Health Care Nursing; Theory, Practice, and Research, Seventh Edition.Chapter 12Trauma and Family NursingCopyright ©2022 F.A. Davis CompanyCopyright ©2022 F.A. Davis Company1Critical ConceptsTrauma is a key experience affecting individuals and the family system.Trauma-informed care (TIC) is an important part of nursing care for all clients, including families, to improve outcomes, avoid biased and inaccurate assessments and interventions, and prevent unethical decision-making processes.Copyright ©2022 F.A. Davis Company2Critical Concepts (continued_1)Adaptive responses to trauma are more likely to become problematic when resiliency traits are underdeveloped.Post-traumatic stress disorder is based on a cluster of symptoms in response to trauma that can be acute or chronic and can occur months, or even years, after a disaster or traumatic event such as war.Copyright ©2022 F.A. Davis Company3Critical Concepts (continued_2)The Ecological Systems Model can guide nurses in applying TIC.When one or more family members are traumatized, all family members and family relationships can be affected.Perpetrators of trauma can experience trauma.Copyright ©2022 F.A. Davis Company4Critical Concepts (continued_3)Nurses who focus on TIC can address the dilemmas of caring for perpetrators through mandatory reporting and family-focused care.Secondary trauma can occur whenever a family member, or caring provider, is exposed to victims of trauma, and is affected by their response to the traumatic event(s).Copyright ©2022 F.A. Davis Company5Critical Concepts (continued_4)The family response to trauma of one or more of its members cannot be understood or treated by focusing on individual family members alone.Family members can provide key contextual information about past traumatic events and experiences that help explain current responses.Copyright ©2022 F.A. Davis CompanyCritical Concepts (continued_5)Community systems can prevent, treat, and measure negative outcomes to traumatic events.Larger political and social systems can influence and be influenced positively or negatively by individual, family, or community trauma.Copyright ©2022 F.A. Davis CompanyCritical Concepts (continued_6)Nursing focuses on the individual, family, community, and societal reactions to trauma in order to optimize positive outcomes and prevent or treat problematic stress responses.Nurses have an essential role in supporting health and resilience, rather than focusing on the pathology of trauma response.Copyright ©2022 F.A. Davis CompanyIntroductionThe care by nurses of families experiencing traumatic stress revolves around:Preventing trauma when possibleSupporting the development of resiliencyWhen not preventable, working toward positive outcomesNurses are among the professional group most likely to experience vicarious or secondary trauma due to their exposure to traumatized clients.Copyright ©2022 F.A. Davis Company(APA, 2013)9Post-Traumatic Stress DisorderDifferences in symptoms across developmental ages and stagesDifferent types of trauma have different rates of severity and incidences of PTSD symptomsSymptoms cross ethnic groups, ages, and timeNumber of individuals with PTSD affects communitiesCopyright ©2022 F.A. Davis CompanyPost-Traumatic Stress Disorder (continued_1)DSM-IV and DSM-IV-TR categorized PTSD under Anxiety Disorders with three categories of symptoms:Re-experiencing the traumaAvoidance and numbingIncreased arousalCopyright ©2022 F.A. Davis CompanyPost-Traumatic Stress Disorder (continued_2)DSM-5 developed a separate category, Trauma and Stressor Related Disorders, with four categories of symptoms:Intrusion of thoughts about the traumaAvoidance of discussion or other stimuli reminding the person of the traumaIncreased arousal or sensory sensitivityNegative cognitions and moodsCopyright ©2022 F.A. Davis CompanyTheories Applied to TraumaSubstance Abuse and Mental Health Services Administration’s (SAMHSA’s) Guide for TIC in Behavioral Health ServicesEcological Systems ModelFamily Systems TheoryCopyright ©2022 F.A. Davis Company13Trauma Informed Care (TIC)SAMHSA (2014) identified six key principles guiding TIC:SafetyTrustworthiness and transparencyPeer supportCollaboration and mutualityEmpowerment and choiceCultural, historical, and gender issuesCopyright ©2022 F.A. Davis CompanyEarly TraumaEarly childhood traumaA relationship between the number of adverse childhood experiences and the number of comorbid outcomes:Adulthood depressionPanic disorderSubstance abuseSexual promiscuityRelationship problemsDomestic violenceCopyright ©2022 F.A. Davis Company15Early Trauma (continued)Resilience refers to positive outcomes, adaptation, or the attainment of developmental milestones or competencies in the face of significant risk, adversity, or stress.Research has focused on identifying factors or characteristics that are consistently found in individuals who are resilient.Copyright ©2022 F.A. Davis Company16Family TraumaThe National Center for PTSD identified 10 key areas affecting family functioning when one or more members are diagnosed with PTSD:Increased sympathy is felt by family members.Increased negative feelings develop about the person with PTSD.Avoidance is a common reaction by individuals with PTSD and by family members.Copyright ©2022 F.A. Davis Company17Family Trauma (continued_1)The National Center for PTSD identified 10 key areas affecting family functioning when one or more members are diagnosed with PTSD (continued):Depression is common among individuals with PTSD and their family members.Anger is common among family members as they struggle to cope with changes in the person with PTSD.Copyright ©2022 F.A. Davis Company18Family Trauma (continued_2)Ten key areasGuilt and shame are common for family members.Health problems increase in individuals with PTSD and their family members.Fear and worry develop as their worldview changes given the intimate knowledge that terrible things can happen.Copyright ©2022 F.A. Davis Company19Family Trauma (continued_3)Ten key areas (continued)Drug and alcohol abuse occur as a way to escape their negative feelings.Sleep problems develop, especially when it is a problem for the trauma survivor.Copyright ©2022 F.A. Davis Company20Family Trauma (continued_4)Families affected by warUnidentified and untreated PTSD presents special risks for family reintegration and puts the veterans and their families at higher danger for maladaptive responses to stress.Risk for trauma-related symptoms in children from their parents’ traumatic experiences increases with prolonged separation from parent(s) and decreased time between recovery from one traumatic event and the onset of another.Copyright ©2022 F.A. Davis Company21Family Trauma (continued_5)Family violence and traumaFamily violence is often both a cause and an outcome of PTSD in family members.Generally divided into three categories:Physical violenceEmotional violenceSexual abuseCopyright ©2022 F.A. Davis Company22Family Trauma (continued_6)Families affected by disastersEvents that cause widespread destruction of property, dislocation of people, and immediate suffering through death or injuryEither natural or human causedInterrupt meeting basic daily needs for an extended periodSome of the many stressors that occur include loss of significant others, injuries to self or family, separation from family, or extensive loss of propertyCopyright ©2022 F.A. Davis Company(Norris, 2007).23Family Trauma (continued_7)Family functioning and post-traumatic stress disorderPTSD symptoms of avoidance and emotional numbing have deleterious effects on parent-child relationships.Trauma symptoms such as sleep problems, dissociation, and severe sexual problems predict lower marital satisfaction.Copyright ©2022 F.A. Davis Company24Family Trauma (continued_8)Secondary traumatizationOnly recently has been described and is not yet a diagnostic category in the DSM-VCan affect family and nonfamily members of traumatized victimsCopyright ©2022 F.A. Davis Company25Community and TraumaWar, terror, and natural disasters have resulted in disaster syndrome symptoms.Children are particularly at risk due to isolation and fear of losing loved ones.The community has a key role in the prevention and treatment of trauma.Agencies have a responsibility to become trained for their role in trauma care.Copyright ©2022 F.A. Davis Company26Systemic TraumaMany argue that the United States is suffering from PTSD because of repeated traumatic events such as wars, natural disasters, and economic traumas across time without resolution or intervention.This leads to toxic stress.Management of trauma symptoms should expand to include national and international traumas and the impact on the nation as a whole.Copyright ©2022 F.A. Davis Company27Nurses and TraumaNurses are key in helping with the diagnosis and treatment of PTSD in individuals and families.Trauma-informed nursing assessment and interventionCertain conditions must exist to be diagnosed with PTSDPrimary care PTSD screenCopyright ©2022 F.A. Davis Company28Nurses and Trauma (continued_1)Risks associated with traumaFor adults and childrenSuicide riskDanger to othersOngoing stressorsRisky behaviorsPersonal characteristicsLimited social supportComorbidityCopyright ©2022 F.A. Davis CompanyNurses and Trauma (continued_2)Risks associated with trauma (continued)For childrenDysregulationPoor connectionPoor cognitive developmentPoor attunement skillsInability to trustHyperarousalCopyright ©2022 F.A. Davis CompanyNurses and Trauma (continued_3)Secondary family traumatization assessment and interventionNurses should first realize that traumatized families rarely seek family-focused intervention.Nurses should learn the parallel processes of individual and systemic stress reactions that follow a traumatic event.Initial steps of treatmentCopyright ©2022 F.A. Davis Company31image3.pngimage2.pngimage4.tiffimage1.pngFamily_Health_Care_Nursing_6e_Theory_Practice_a…_—-_UNIT_2_Families_Across_the_Health_Continuum.pdfThis file is too large to display.View in new windowFamily_Health_Care_Nursing_6e_Theory_Practice_a…_—-_UNIT_2_Families_Across_the_Health_Continuum.pdfThis file is too large to display.View in new windowFreeWriteAssignmentDescriptionandRubric.pdf10.24.23 LKN362 Family and Societal Nursing for RNsFamily Free Write Assignment DescriptionFamily Free WriteEarly in the course, each student will write a 2-page (minimum 250 words and no more than 500 words) openwrite on four topics. Each free write is worth 10 points (40 points total).1. Healthy Families—250-500 words (Module One)
2. Family during Acute Care Experience—250-500 words (Module Two)
3. Family in Crisis or Trauma—250-500 words (Module Three)
4. Chronic Illness Experience—250-500 words (Module Five)The free write is not an edited piece of work, but you must use at least two sources for each topic. The workwill be evaluated for its clarity, creativity, and relevance. Please write about your thoughts, insights, stories,cases, examples, experiences, for that particular topic. These papers may be used to complete the Family TheoryInterview Project later on in the course.This free write is meant to help you access your deepest and most powerful feelings about family, as well asbuilding on your past and your developing knowledge of family: academically, professionally, and personally.The 250-500 word free write on healthy families (for example, there are four categories), may include ideasgleaned from your text, stories from your childhood, something you read in the newspaper, a novel or poem, oran interaction you witnessed in the grocery story. The objective of the free write is to help you decide whatmost interests you in family health nursing and what literature you might use for your annotated bibliographyand your final research work with a family. Examination of the course topics will organize your thoughts andfocus your ideas on the desired outcomes of the learning you are doing.This is not an edited piece of work. This material is rich in image, story and insight. The free write is meant inpart to get in touch with this material. Thoughts from your readings may also be included and will spark newideas unique to you. Use at least two resources (do not need to be scholarly) in your initial post for fullpoints.Free Write RubricComponents:1. Initial post: Posted a free write on the given subject;2. of at least 250 words;3. incorporating at least two resources in correct APA format (do not need to be scholarly).4. Reply post: Replied to one person in the group;5. of at least 100 words (no resources required).10 pointsMissing 1 component 9 pointsMissing 2 components 8 pointsMissing 3 components 7 pointsMissing 4 components 6 pointsDid not participate 0 pointsChapter121.pptxFamily Health Care Nursing; Theory, Practice, and Research, Seventh Edition.Chapter 12Trauma and Family NursingCopyright ©2022 F.A. Davis CompanyCopyright ©2022 F.A. Davis Company1Critical ConceptsTrauma is a key experience affecting individuals and the family system.Trauma-informed care (TIC) is an important part of nursing care for all clients, including families, to improve outcomes, avoid biased and inaccurate assessments and interventions, and prevent unethical decision-making processes.Copyright ©2022 F.A. Davis Company2Critical Concepts (continued_1)Adaptive responses to trauma are more likely to become problematic when resiliency traits are underdeveloped.Post-traumatic stress disorder is based on a cluster of symptoms in response to trauma that can be acute or chronic and can occur months, or even years, after a disaster or traumatic event such as war.Copyright ©2022 F.A. Davis Company3Critical Concepts (continued_2)The Ecological Systems Model can guide nurses in applying TIC.When one or more family members are traumatized, all family members and family relationships can be affected.Perpetrators of trauma can experience trauma.Copyright ©2022 F.A. Davis Company4Critical Concepts (continued_3)Nurses who focus on TIC can address the dilemmas of caring for perpetrators through mandatory reporting and family-focused care.Secondary trauma can occur whenever a family member, or caring provider, is exposed to victims of trauma, and is affected by their response to the traumatic event(s).Copyright ©2022 F.A. Davis Company5Critical Concepts (continued_4)The family response to trauma of one or more of its members cannot be understood or treated by focusing on individual family members alone.Family members can provide key contextual information about past traumatic events and experiences that help explain current responses.Copyright ©2022 F.A. Davis CompanyCritical Concepts (continued_5)Community systems can prevent, treat, and measure negative outcomes to traumatic events.Larger political and social systems can influence and be influenced positively or negatively by individual, family, or community trauma.Copyright ©2022 F.A. Davis CompanyCritical Concepts (continued_6)Nursing focuses on the individual, family, community, and societal reactions to trauma in order to optimize positive outcomes and prevent or treat problematic stress responses.Nurses have an essential role in supporting health and resilience, rather than focusing on the pathology of trauma response.Copyright ©2022 F.A. Davis CompanyIntroductionThe care by nurses of families experiencing traumatic stress revolves around:Preventing trauma when possibleSupporting the development of resiliencyWhen not preventable, working toward positive outcomesNurses are among the professional group most likely to experience vicarious or secondary trauma due to their exposure to traumatized clients.Copyright ©2022 F.A. Davis Company(APA, 2013)9Post-Traumatic Stress DisorderDifferences in symptoms across developmental ages and stagesDifferent types of trauma have different rates of severity and incidences of PTSD symptomsSymptoms cross ethnic groups, ages, and timeNumber of individuals with PTSD affects communitiesCopyright ©2022 F.A. Davis CompanyPost-Traumatic Stress Disorder (continued_1)DSM-IV and DSM-IV-TR categorized PTSD under Anxiety Disorders with three categories of symptoms:Re-experiencing the traumaAvoidance and numbingIncreased arousalCopyright ©2022 F.A. Davis CompanyPost-Traumatic Stress Disorder (continued_2)DSM-5 developed a separate category, Trauma and Stressor Related Disorders, with four categories of symptoms:Intrusion of thoughts about the traumaAvoidance of discussion or other stimuli reminding the person of the traumaIncreased arousal or sensory sensitivityNegative cognitions and moodsCopyright ©2022 F.A. Davis CompanyTheories Applied to TraumaSubstance Abuse and Mental Health Services Administration’s (SAMHSA’s) Guide for TIC in Behavioral Health ServicesEcological Systems ModelFamily Systems TheoryCopyright ©2022 F.A. Davis Company13Trauma Informed Care (TIC)SAMHSA (2014) identified six key principles guiding TIC:SafetyTrustworthiness and transparencyPeer supportCollaboration and mutualityEmpowerment and choiceCultural, historical, and gender issuesCopyright ©2022 F.A. Davis CompanyEarly TraumaEarly childhood traumaA relationship between the number of adverse childhood experiences and the number of comorbid outcomes:Adulthood depressionPanic disorderSubstance abuseSexual promiscuityRelationship problemsDomestic violenceCopyright ©2022 F.A. Davis Company15Early Trauma (continued)Resilience refers to positive outcomes, adaptation, or the attainment of developmental milestones or competencies in the face of significant risk, adversity, or stress.Research has focused on identifying factors or characteristics that are consistently found in individuals who are resilient.Copyright ©2022 F.A. Davis Company16Family TraumaThe National Center for PTSD identified 10 key areas affecting family functioning when one or more members are diagnosed with PTSD:Increased sympathy is felt by family members.Increased negative feelings develop about the person with PTSD.Avoidance is a common reaction by individuals with PTSD and by family members.Copyright ©2022 F.A. Davis Company17Family Trauma (continued_1)The National Center for PTSD identified 10 key areas affecting family functioning when one or more members are diagnosed with PTSD (continued):Depression is common among individuals with PTSD and their family members.Anger is common among family members as they struggle to cope with changes in the person with PTSD.Copyright ©2022 F.A. Davis Company18Family Trauma (continued_2)Ten key areasGuilt and shame are common for family members.Health problems increase in individuals with PTSD and their family members.Fear and worry develop as their worldview changes given the intimate knowledge that terrible things can happen.Copyright ©2022 F.A. Davis Company19Family Trauma (continued_3)Ten key areas (continued)Drug and alcohol abuse occur as a way to escape their negative feelings.Sleep problems develop, especially when it is a problem for the trauma survivor.Copyright ©2022 F.A. Davis Company20Family Trauma (continued_4)Families affected by warUnidentified and untreated PTSD presents special risks for family reintegration and puts the veterans and their families at higher danger for maladaptive responses to stress.Risk for trauma-related symptoms in children from their parents’ traumatic experiences increases with prolonged separation from parent(s) and decreased time between recovery from one traumatic event and the onset of another.Copyright ©2022 F.A. Davis Company21Family Trauma (continued_5)Family violence and traumaFamily violence is often both a cause and an outcome of PTSD in family members.Generally divided into three categories:Physical violenceEmotional violenceSexual abuseCopyright ©2022 F.A. Davis Company22Family Trauma (continued_6)Families affected by disastersEvents that cause widespread destruction of property, dislocation of people, and immediate suffering through death or injuryEither natural or human causedInterrupt meeting basic daily needs for an extended periodSome of the many stressors that occur include loss of significant others, injuries to self or family, separation from family, or extensive loss of propertyCopyright ©2022 F.A. Davis Company(Norris, 2007).23Family Trauma (continued_7)Family functioning and post-traumatic stress disorderPTSD symptoms of avoidance and emotional numbing have deleterious effects on parent-child relationships.Trauma symptoms such as sleep problems, dissociation, and severe sexual problems predict lower marital satisfaction.Copyright ©2022 F.A. Davis Company24Family Trauma (continued_8)Secondary traumatizationOnly recently has been described and is not yet a diagnostic category in the DSM-VCan affect family and nonfamily members of traumatized victimsCopyright ©2022 F.A. Davis Company25Community and TraumaWar, terror, and natural disasters have resulted in disaster syndrome symptoms.Children are particularly at risk due to isolation and fear of losing loved ones.The community has a key role in the prevention and treatment of trauma.Agencies have a responsibility to become trained for their role in trauma care.Copyright ©2022 F.A. Davis Company26Systemic TraumaMany argue that the United States is suffering from PTSD because of repeated traumatic events such as wars, natural disasters, and economic traumas across time without resolution or intervention.This leads to toxic stress.Management of trauma symptoms should expand to include national and international traumas and the impact on the nation as a whole.Copyright ©2022 F.A. Davis Company27Nurses and TraumaNurses are key in helping with the diagnosis and treatment of PTSD in individuals and families.Trauma-informed nursing assessment and interventionCertain conditions must exist to be diagnosed with PTSDPrimary care PTSD screenCopyright ©2022 F.A. Davis Company28Nurses and Trauma (continued_1)Risks associated with traumaFor adults and childrenSuicide riskDanger to othersOngoing stressorsRisky behaviorsPersonal characteristicsLimited social supportComorbidityCopyright ©2022 F.A. Davis CompanyNurses and Trauma (continued_2)Risks associated with trauma (continued)For childrenDysregulationPoor connectionPoor cognitive developmentPoor attunement skillsInability to trustHyperarousalCopyright ©2022 F.A. Davis CompanyNurses and Trauma (continued_3)Secondary family traumatization assessment and interventionNurses should first realize that traumatized families rarely seek family-focused intervention.Nurses should learn the parallel processes of individual and systemic stress reactions that follow a traumatic event.Initial steps of treatmentCopyright ©2022 F.A. Davis Company31image3.pngimage2.pngimage4.tiffimage1.pngFamily_Health_Care_Nursing_6e_Theory_Practice_a…_—-_UNIT_2_Families_Across_the_Health_Continuum.pdfThis file is too large to display.View in new windowFreeWriteAssignmentDescriptionandRubric.pdf10.24.23 LKN362 Family and Societal Nursing for RNsFamily Free Write Assignment DescriptionFamily Free WriteEarly in the course, each student will write a 2-page (minimum 250 words and no more than 500 words) openwrite on four topics. Each free write is worth 10 points (40 points total).1. Healthy Families—250-500 words (Module One)
2. Family during Acute Care Experience—250-500 words (Module Two)
3. Family in Crisis or Trauma—250-500 words (Module Three)
4. Chronic Illness Experience—250-500 words (Module Five)The free write is not an edited piece of work, but you must use at least two sources for each topic. The workwill be evaluated for its clarity, creativity, and relevance. Please write about your thoughts, insights, stories,cases, examples, experiences, for that particular topic. These papers may be used to complete the Family TheoryInterview Project later on in the course.This free write is meant to help you access your deepest and most powerful feelings about family, as well asbuilding on your past and your developing knowledge of family: academically, professionally, and personally.The 250-500 word free write on healthy families (for example, there are four categories), may include ideasgleaned from your text, stories from your childhood, something you read in the newspaper, a novel or poem, oran interaction you witnessed in the grocery story. The objective of the free write is to help you decide whatmost interests you in family health nursing and what literature you might use for your annotated bibliographyand your final research work with a family. Examination of the course topics will organize your thoughts andfocus your ideas on the desired outcomes of the learning you are doing.This is not an edited piece of work. This material is rich in image, story and insight. The free write is meant inpart to get in touch with this material. Thoughts from your readings may also be included and will spark newideas unique to you. Use at least two resources (do not need to be scholarly) in your initial post for fullpoints.Free Write RubricComponents:1. Initial post: Posted a free write on the given subject;2. of at least 250 words;3. incorporating at least two resources in correct APA format (do not need to be scholarly).4. Reply post: Replied to one person in the group;5. of at least 100 words (no resources required).10 pointsMissing 1 component 9 pointsMissing 2 components 8 pointsMissing 3 components 7 pointsMissing 4 components 6 pointsDid not participate 0 pointsChapter121.pptxFamily Health Care Nursing; Theory, Practice, and Research, Seventh Edition.Chapter 12Trauma and Family NursingCopyright ©2022 F.A. Davis CompanyCopyright ©2022 F.A. Davis Company1Critical ConceptsTrauma is a key experience affecting individuals and the family system.Trauma-informed care (TIC) is an important part of nursing care for all clients, including families, to improve outcomes, avoid biased and inaccurate assessments and interventions, and prevent unethical decision-making processes.Copyright ©2022 F.A. Davis Company2Critical Concepts (continued_1)Adaptive responses to trauma are more likely to become problematic when resiliency traits are underdeveloped.Post-traumatic stress disorder is based on a cluster of symptoms in response to trauma that can be acute or chronic and can occur months, or even years, after a disaster or traumatic event such as war.Copyright ©2022 F.A. Davis Company3Critical Concepts (continued_2)The Ecological Systems Model can guide nurses in applying TIC.When one or more family members are traumatized, all family members and family relationships can be affected.Perpetrators of trauma can experience trauma.Copyright ©2022 F.A. Davis Company4Critical Concepts (continued_3)Nurses who focus on TIC can address the dilemmas of caring for perpetrators through mandatory reporting and family-focused care.Secondary trauma can occur whenever a family member, or caring provider, is exposed to victims of trauma, and is affected by their response to the traumatic event(s).Copyright ©2022 F.A. Davis Company5Critical Concepts (continued_4)The family response to trauma of one or more of its members cannot be understood or treated by focusing on individual family members alone.Family members can provide key contextual information about past traumatic events and experiences that help explain current responses.Copyright ©2022 F.A. Davis CompanyCritical Concepts (continued_5)Community systems can prevent, treat, and measure negative outcomes to traumatic events.Larger political and social systems can influence and be influenced positively or negatively by individual, family, or community trauma.Copyright ©2022 F.A. Davis CompanyCritical Concepts (continued_6)Nursing focuses on the individual, family, community, and societal reactions to trauma in order to optimize positive outcomes and prevent or treat problematic stress responses.Nurses have an essential role in supporting health and resilience, rather than focusing on the pathology of trauma response.Copyright ©2022 F.A. Davis CompanyIntroductionThe care by nurses of families experiencing traumatic stress revolves around:Preventing trauma when possibleSupporting the development of resiliencyWhen not preventable, working toward positive outcomesNurses are among the professional group most likely to experience vicarious or secondary trauma due to their exposure to traumatized clients.Copyright ©2022 F.A. Davis Company(APA, 2013)9Post-Traumatic Stress DisorderDifferences in symptoms across developmental ages and stagesDifferent types of trauma have different rates of severity and incidences of PTSD symptomsSymptoms cross ethnic groups, ages, and timeNumber of individuals with PTSD affects communitiesCopyright ©2022 F.A. Davis CompanyPost-Traumatic Stress Disorder (continued_1)DSM-IV and DSM-IV-TR categorized PTSD under Anxiety Disorders with three categories of symptoms:Re-experiencing the traumaAvoidance and numbingIncreased arousalCopyright ©2022 F.A. Davis CompanyPost-Traumatic Stress Disorder (continued_2)DSM-5 developed a separate category, Trauma and Stressor Related Disorders, with four categories of symptoms:Intrusion of thoughts about the traumaAvoidance of discussion or other stimuli reminding the person of the traumaIncreased arousal or sensory sensitivityNegative cognitions and moodsCopyright ©2022 F.A. Davis CompanyTheories Applied to TraumaSubstance Abuse and Mental Health Services Administration’s (SAMHSA’s) Guide for TIC in Behavioral Health ServicesEcological Systems ModelFamily Systems TheoryCopyright ©2022 F.A. Davis Company13Trauma Informed Care (TIC)SAMHSA (2014) identified six key principles guiding TIC:SafetyTrustworthiness and transparencyPeer supportCollaboration and mutualityEmpowerment and choiceCultural, historical, and gender issuesCopyright ©2022 F.A. Davis CompanyEarly TraumaEarly childhood traumaA relationship between the number of adverse childhood experiences and the number of comorbid outcomes:Adulthood depressionPanic disorderSubstance abuseSexual promiscuityRelationship problemsDomestic violenceCopyright ©2022 F.A. Davis Company15Early Trauma (continued)Resilience refers to positive outcomes, adaptation, or the attainment of developmental milestones or competencies in the face of significant risk, adversity, or stress.Research has focused on identifying factors or characteristics that are consistently found in individuals who are resilient.Copyright ©2022 F.A. Davis Company16Family TraumaThe National Center for PTSD identified 10 key areas affecting family functioning when one or more members are diagnosed with PTSD:Increased sympathy is felt by family members.Increased negative feelings develop about the person with PTSD.Avoidance is a common reaction by individuals with PTSD and by family members.Copyright ©2022 F.A. Davis Company17Family Trauma (continued_1)The National Center for PTSD identified 10 key areas affecting family functioning when one or more members are diagnosed with PTSD (continued):Depression is common among individuals with PTSD and their family members.Anger is common among family members as they struggle to cope with changes in the person with PTSD.Copyright ©2022 F.A. Davis Company18Family Trauma (continued_2)Ten key areasGuilt and shame are common for family members.Health problems increase in individuals with PTSD and their family members.Fear and worry develop as their worldview changes given the intimate knowledge that terrible things can happen.Copyright ©2022 F.A. Davis Company19Family Trauma (continued_3)Ten key areas (continued)Drug and alcohol abuse occur as a way to escape their negative feelings.Sleep problems develop, especially when it is a problem for the trauma survivor.Copyright ©2022 F.A. Davis Company20Family Trauma (continued_4)Families affected by warUnidentified and untreated PTSD presents special risks for family reintegration and puts the veterans and their families at higher danger for maladaptive responses to stress.Risk for trauma-related symptoms in children from their parents’ traumatic experiences increases with prolonged separation from parent(s) and decreased time between recovery from one traumatic event and the onset of another.Copyright ©2022 F.A. Davis Company21Family Trauma (continued_5)Family violence and traumaFamily violence is often both a cause and an outcome of PTSD in family members.Generally divided into three categories:Physical violenceEmotional violenceSexual abuseCopyright ©2022 F.A. Davis Company22Family Trauma (continued_6)Families affected by disastersEvents that cause widespread destruction of property, dislocation of people, and immediate suffering through death or injuryEither natural or human causedInterrupt meeting basic daily needs for an extended periodSome of the many stressors that occur include loss of significant others, injuries to self or family, separation from family, or extensive loss of propertyCopyright ©2022 F.A. Davis Company(Norris, 2007).23Family Trauma (continued_7)Family functioning and post-traumatic stress disorderPTSD symptoms of avoidance and emotional numbing have deleterious effects on parent-child relationships.Trauma symptoms such as sleep problems, dissociation, and severe sexual problems predict lower marital satisfaction.Copyright ©2022 F.A. Davis Company24Family Trauma (continued_8)Secondary traumatizationOnly recently has been described and is not yet a diagnostic category in the DSM-VCan affect family and nonfamily members of traumatized victimsCopyright ©2022 F.A. Davis Company25Community and TraumaWar, terror, and natural disasters have resulted in disaster syndrome symptoms.Children are particularly at risk due to isolation and fear of losing loved ones.The community has a key role in the prevention and treatment of trauma.Agencies have a responsibility to become trained for their role in trauma care.Copyright ©2022 F.A. Davis Company26Systemic TraumaMany argue that the United States is suffering from PTSD because of repeated traumatic events such as wars, natural disasters, and economic traumas across time without resolution or intervention.This leads to toxic stress.Management of trauma symptoms should expand to include national and international traumas and the impact on the nation as a whole.Copyright ©2022 F.A. Davis Company27Nurses and TraumaNurses are key in helping with the diagnosis and treatment of PTSD in individuals and families.Trauma-informed nursing assessment and interventionCertain conditions must exist to be diagnosed with PTSDPrimary care PTSD screenCopyright ©2022 F.A. Davis Company28Nurses and Trauma (continued_1)Risks associated with traumaFor adults and childrenSuicide riskDanger to othersOngoing stressorsRisky behaviorsPersonal characteristicsLimited social supportComorbidityCopyright ©2022 F.A. Davis CompanyNurses and Trauma (continued_2)Risks associated with trauma (continued)For childrenDysregulationPoor connectionPoor cognitive developmentPoor attunement skillsInability to trustHyperarousalCopyright ©2022 F.A. Davis CompanyNurses and Trauma (continued_3)Secondary family traumatization assessment and interventionNurses should first realize that traumatized families rarely seek family-focused intervention.Nurses should learn the parallel processes of individual and systemic stress reactions that follow a traumatic event.Initial steps of treatmentCopyright ©2022 F.A. Davis Company31image3.pngimage2.pngimage4.tiffimage1.pngFamily_Health_Care_Nursing_6e_Theory_Practice_a…_—-_UNIT_2_Families_Across_the_Health_Continuum.pdfThis file is too large to display.View in new window123Bids(59)PROVEN STERLINGMiss DeannaDr. Ellen RMEmily ClareDr. Aylin JMDr. Sarah BlakeMISS HILLARY A+abdul_rehman_STELLAR GEEK A+Young NyanyaProWritingGuruProf. TOPGRADEgrA+de plusSheryl HoganDr. Adeline ZoeDr M. 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