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Evidence and best practices for trauma-informed care in gynecologic oncology patients
  1. Jessica Fulton1,
  2. Haverly Snyder2,
  3. Julia Chalif1,
  4. Katelyn Delwiche1 and
  5. Laura M Chambers1
    1. 1 Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
    2. 2 Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
    1. Correspondence to Dr Laura M Chambers, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA; laura.chambers{at}osumc.edu

    Abstract

    Diagnosing, treating, and managing gynecologic cancer can lead to significant physical and emotional stress, which may have lasting effects on a patient’s overall health and quality of life. The physical symptoms of gynecologic cancer, such as pain, discomfort, and loss of function, may also contribute to emotional distress and anxiety. Further, the diagnosis, treatment, and surveillance of gynecologic cancer may be traumatic due to the need for invasive exams and procedures, especially in women with a history of sexual assault or other traumatic experiences.

    Women with gynecologic cancer may experience various emotional and psychological symptoms, including anxiety, depression, post-traumatic stress disorder, and fear of recurrence. Trauma-informed care is an approach to healthcare that emphasizes the recognition and response to the impact of trauma on a patient’s life. Further, trauma-informed care acknowledges that prior traumatic experiences may affect a patient’s mental and physical health and that the healthcare system may unintentionally re-traumatize patients.

    Implementation of trauma-informed care can improve patient outcomes, increase patient satisfaction with care, and reduce the risk of re-traumatization during cancer treatment and follow-up care. Therefore, gynecologic oncology providers should become familiar with the principles and practices of trauma-informed care and implement trauma-informed screening tools to identify patients who may benefit from additional support or referrals to mental health services. This review will explore the importance of trauma-informed care in patients with gynecologic cancer and its impact on outcomes. Further, we discuss principles and evidence-based practices of trauma-informed care and strategies to implement trauma-informed screening tools to identify patients who may benefit from additional support or referrals to mental health services.

    • Gynecology
    • Quality of Life (PRO)/Palliative Care
    • Cancer Pain
    • Gynecologic Surgical Procedures
    • Palliative Care

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    Footnotes

    • X @laurajmoulton

    • Contributors JF: conceptualization, investigation, writing - original draft, writing - review and editing. HS: conceptualization, investigation, writing - original draft, writing - review and editing. JC: conceptualization, investigation, writing - review and editing. KD: writing - review and editing. LMC: conceptualization, investigation, writing - original draft, writing - review and editing, project administration, project supervision.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.