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103 Attachment and trauma: a case study on the challenges of implementing family centred and trauma informed care on a paediatric patient

Abstract

Background ‘Mother is the whole world’ was an article written in 1952 by attachment theory pioneer, John Bowlby. How are we, as healthcare providers in 2023, influenced by the theory of attachment? How do we support one another and families in providing care that supports the emotional needs of the child, in particular children who have experienced trauma? Such questions are pertinent to the care of our Paediatric population, their families and our colleagues, post-pandemic.

Methods A qualitative case study of a patient exhibiting high levels of psychological distress within the hospital environment during the pre-operative phase was compiled. The case-specific factors analysed were: patient background and attachment style, their response to the hospital environment, concerns voiced by parents, supports utilised by the family, outstanding supports available and staff approach to care. The themes included in the research process were: attachment, family centred care, trauma informed care, principles and practical approaches, challenges in practice and staff engagement. This cross-sectional analysis was then summarised into a presentation, aiming to deepen the understanding of the practical approaches and challenges faced across a multidisciplinary team.

Results This study showed that family centred care is considered a practical and preferred approach to promoting bonding within the contemporary family unit. Furthermore, the study revealed an array of challenges to providing trauma informed care such as: a lack of education concerning attachment and trauma, breakdowns within the multidisciplinary team’s approach to care which aggravate these problems, an increase in adult professional anxiety and reduced resources.

Conclusion In conclusion, to rise to the challenges of implementing family centred and trauma informed care there is a need for targeted improvements in education, systemic approaches and the availability of key resources in order to adequately support our paediatric population, their families and our colleagues, post-pandemic.

Acknowledgements for funding or support I would like to express my appreciation and gratitude to Kevin Viviers-Hogreve, whose support and guidance aided me in completing this work.

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