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Table 1 Thematic Analysis

From: Experience of emergency department use among persons with a history of adverse childhood experiences

ThemeParticipant Quote (note: P18,M,ACE5 indicates participant no.18, male, with an ACE score of 5)
Positive Experiences of ED CareYou know, like he was like the kind of doctor that you’re looking for. He was very professional. He took responsibility even though it wasn’t his. And, you know, he was like, this is what’s going to happen. You know, I can’t give you any word on what’s going to happen them, but I can guarantee what’s going to happen to you. You know we got you booked for x-ray right now. You know and it was it was really nice because he addressed every problem basically that he could. (P20,M,ACE10)
A positive experience is that I walked out of there feeling confident that my concerns were heard and my specific concerns were addressed. Now were they treated or left untreated – it would have been explained as to what was going on, why and how and where. And what my role was in fostering a remediation – whatever it was that was bothering me. So I mean it wasn’t just, you know, from the point of view of positive – that’s very positive! (P10,M,ACE5)
I’ve had mostly positive experiences where they’ve actually figured out what’s wrong, when I went there. And I’ve found that they’ve listened. Like I’ve only had a couple instances where they haven’t listened. (P16,F,ACE6)
Stigmatization as a negative experience of ED careWhen she came in, she explained “there’s nothing we’re going to do for you today, and you might as well go home”. And I said “you’re not listening to me. I’m saying that there’s something wrong with my stomach right now, and I’m telling you that I’m not here seeking drugs”. That’s what really upset me. They looked at me and said “she’s a drug seeker, and we’re not going to do anything for her”. And that really upset me. (P15,F,ACE7)
So I’ve mentioned like some mental health stuff in the past. So there seems to be sort of like a stigma too for that. So like when I show up and I’m in like physically in pain or I’m having issues with my breathing – ok no problem - they can see that there’s something wrong. ( … ) But when I’ve gone before dealing with panic attacks, anxiety attacks—um, people look at you funny and they don’t always take you seriously. They just—I don’t know. Like you can just tell. Like the way they look at you or the way that they talk to you. Even if it is not intentional. I don’t know if they’re always aware that their behavior has that effect. (P3,F,ACE7)
So I think that because I am such a young parent - they look at me like I don’t know what I am talking about. They never listen to you. ( … ) Listen to what we say no matter what we look like! (P6,F,ACE5)
Like I don’t out and dress like your average person so I don’t get your regular looks. So they set that as a personality disorder and all of a sudden I’m a drug addict. I can tell – like I can tell by the look on their face and the questions they ask. (P20,M,ACE10)
I just wish there was maybe better or more training and not like necessarily on how to diagnose something like that but how to work with patients who present those issues. ( … ) Maybe like compassion training or something. Like I feel like that should be mandatory or, I don’t know. (P3,F,ACE7)
Difficulties at Registration and TriageWhen you go into one of the emerg department, when you’re not in a good state mentally, ah, it’s almost like a house on fire. Like it’s very tight and closed in and so you’re very anxious and you’re in a vulnerable state and it gets amplified by the environment. And the, the staff, some of them seem to have an issue working with patients with mental health. (P3,F,ACE7)
Not so much the nurses or the doctors but the triage people always make me feel like I’m wasting their time. (P1,F,ACE5)
And then it’s like – what’s your concern. And it’s obviously a low concern as far as who’s in the Emerg that day. Um I don’t know, it doesn’t feel good and you’re not sure whether you’re going to be taken seriously (P23,F,ACE7)
Rationale for Seeking Emergency CareUm really it just comes down to speed. Um like if I want thoroughness, I go see my family doctor. (P20M,ACE10)
Generally I will go to, like, I will call my family doctor but if it’s not something I think she can handle there because she doesn’t have all the things and resources that the hospital does, then I will go to KGH (P25,F,ACE7)
Generally it’s new problems. Um yeah it’s generally new but if it’s something that’s happened before and I could never get an answer as to why and it reoccurs and sometimes I go to the Emerg – but generally it’s for new things that are scaring me. (P1,F,ACE5)
Like if I can’t get in to see my doctor. I pick up the phone and they say no he’s busy he really can’t see you or can it wait until tonight. There’s an Emergency Clinic tonight between 5 and 8. If it can’t wait then then I’m going into the Emergency. (P10,M,ACE5)