Journal of palliative medicine · 2026
Participant Perceptions of a Trauma-Informed Advanced Care Planning Intervention: A Qualitative Study.
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Kimpel Christine C, Finamore Victoria, Clouse Kate
Аннотация
BACKGROUND: Low-income communities are at higher risk for adverse childhood experiences and have low rates of advance care planning.
OBJECTIVES: This study explored subsidized housing residents' perceptions of the trauma-informed components of an advance care planning intervention to address these inequities.
DESIGN: We used a qualitative descriptive design to analyze the post-intervention qualitative interviews.
SETTING/SUBJECTS: In a Southeast Nashville subsidized housing community, we recruited adult (aged 18+) residents who had not completed an advance directive to participate in an intervention study. Interviews were conducted in an on-site apartment reserved for community service and research.
MEASUREMENTS: An expert-informed and Substance Abuse and Mental Health Services Administration trauma-informed care model-informed semi-structured guide was used to conduct face-to-face, audio-recorded, and one-time post-intervention debrief interviews. Using thematic analysis, two trained coders coded transcripts, resulting in a hierarchical codebook. Codes were individually reapplied as coding evolved. The final themes were inductively informed by participant quote patterns and deductively informed by the trauma-informed care model.
RESULTS: Most interview participants (n = 29) identified as male (n = 15), Black or African American (n = 18), and Christian (n = 26) (median age: 60). Three themes emerged: Meet me where I am, I don't want anyone in my business, and this was an eye-opener.
CONCLUSIONS: This study expanded the advance care planning literature by using a trauma-informed lens, suggesting a strong need for privacy with aging adults across socioeconomic levels. Research, policy, and practice recommendations are discussed to spread trauma-informed processes at the organizational and community levels.
OBJECTIVES: This study explored subsidized housing residents' perceptions of the trauma-informed components of an advance care planning intervention to address these inequities.
DESIGN: We used a qualitative descriptive design to analyze the post-intervention qualitative interviews.
SETTING/SUBJECTS: In a Southeast Nashville subsidized housing community, we recruited adult (aged 18+) residents who had not completed an advance directive to participate in an intervention study. Interviews were conducted in an on-site apartment reserved for community service and research.
MEASUREMENTS: An expert-informed and Substance Abuse and Mental Health Services Administration trauma-informed care model-informed semi-structured guide was used to conduct face-to-face, audio-recorded, and one-time post-intervention debrief interviews. Using thematic analysis, two trained coders coded transcripts, resulting in a hierarchical codebook. Codes were individually reapplied as coding evolved. The final themes were inductively informed by participant quote patterns and deductively informed by the trauma-informed care model.
RESULTS: Most interview participants (n = 29) identified as male (n = 15), Black or African American (n = 18), and Christian (n = 26) (median age: 60). Three themes emerged: Meet me where I am, I don't want anyone in my business, and this was an eye-opener.
CONCLUSIONS: This study expanded the advance care planning literature by using a trauma-informed lens, suggesting a strong need for privacy with aging adults across socioeconomic levels. Research, policy, and practice recommendations are discussed to spread trauma-informed processes at the organizational and community levels.