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Table 2 TVIC Framework directed content analysis

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

Principles of Trauma and Violence Informed CareParticipant Quotes (note: P18,M,ACE5 indicates participant no.18, male, with an ACE score of 5)
Trauma awareness and acknowledgementHeard – no – actually not, never. Absolutely not. (laughter)
That’s how I feel when I get in there. They know, they think they know everything about my life. Meanwhile not one doctor has ever asked me what I eat or how my bowels work. Not one – ever. (P24,F,ACE7)
I have some unfortunate traumatic experiences having to go to
Emerg so even personally going there ah it can be triggering to that particular time in my life. I try to avoid that. If I can I’d much rather not do that to myself. (P14,F,ACE7)
Safety and trustworthinessScared [..] Lonely [..] As if nobody else has ever been in this position (P19,F,ACE9)
Um well when you’re sitting – I don’t – like one of the big issues I find is that you go to triage and then you sit in the waiting room. And sure they may call you in an hour, or whatever to go into the back, but then you sit there for hours sometimes before you see anybody. [ … ] And kind of not see anybody for like an hour, you know, just to check in to say like how’s your pain. Like there’s – I don’t know – there’s no checking in. That’s what really bothers me with Emerg. [ … ] it’s just frustrating as a patient yourself, sitting there waiting and wondering. Is anyone ever going to come and see me? (P15,F,ACE7)
Very tense (P2,M,ACE4)
Choice, control and collaborationBecause sometimes doctors will be like yeah shut up you don’t know as much as I do. And they’ll be like, yeah you’re clearly not giving me all the information. Or they’ll try to read around what you’re saying (P20,M,ACE10)
I: Do you ever tell people that you feel they’re not listening to you?
P: Oh, yes. All the time. I’ll be like “K, well I don’t agree with you, but I guess we have no choice” and they’ll just be like “yup, you’re right. Bye” (P25,F,ACE7)
Like I’m not a doctor and I’m not going to understand your technical terms. But when they break it down to like ok they’re going to do a test. This is kind of what we’re looking for. It will be about 20 minutes. I like that because like it feels like you still have a bit of control as to what’s going on with your health. (P14,F,ACE7)
I think just to basically um to inform patients what’s happening because when you’ve got chest pain and you actually don’t know what’s happening, it’s if someone had come in and said this, this and this is going on. I might have felt better. (P5,F,ACE6)
Strengths based and skills buildingA 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. (P10,M,ACE5)
I could see it being a benefit from having some sort of program that would educate or inform when it would be appropriate to go to Emerg or when it would be appropriate to go to a Walk In. When do you feel you need to call 911? I think something along those lines. (P17,M,ACE5)
Um more so confident ah more so like ah just at least knowing that it was most likely to do with my acid reflux. So obviously not medically better until I had the medication in me but I felt I felt better mentally. (P7,M,ACE5)
Respect for culture, gender and historyUm mostly just to be respected [ … ] taken seriously, not like um looked down on. Like I don’t out and out dress like your average person so I don’t get your regular looks. [ … ] So every time I go in they’re like – oh you’re an intravenous drug user. I’m like wow that is super fucking insulting. (P20,M,ACE10)
Ahh it’s just that whole non-judgemental, open minded aspect. Um like I said earlier like I don’t need your opinion on my life choices. I don’t need you to tell me that, you know, that people shouldn’t be doing this, this and this. It doesn’t matter because I’ve already done it probably. So either help me or or move on. I don’t – it’s like degrading almost. (P14,F,ACE7)
Like I’ve been to Emerg a lot of time and they’ve given me a prescription for medicine. And they haven’t maybe checked my chart or asked me what my insurance plan was. [ … ] But they’ve given me something that I then could not obtain [ … ]or could not afford. So it’s like – yeah here’s the care you need. And I’ll sit 7 hours to find out I can’t afford this medicine. (P20,M,ACE10)