Emotional harm and the absence of trauma-informed care: A social work analysis of hospital complaint narratives

BACKGROUND: Negative events in hospitals can deeply impact people receiving healthcare and their carers. Trauma-Informed Care (TIC) aims to promote safety, choice, collaboration, and empowerment, but gaps remain between these principles and the lived experiences of patients. METHODS: This qualitative study, led by hospital social workers, analyzed written complaints to an Australian general hospital during two three-month periods in 2019 and 2021. Complaints were categorized using traditional and trauma-informed frameworks, and thematic analysis captured the emotional aspects of these experiences. RESULTS: Among 61 complaints, issues were categorized into clinical, organizational, and relational concerns. However, a lack of TIC principles was identified in a higher percentage of complaints compared to these traditional categories. Five key emotional themes were identified: feeling unheard, misunderstood, uninformed, disrespected, and powerless.