The Case for Trauma-Informed Chronic Disease Care: Exploring trauma among adults with obesity on dialysis

Abstract

This study describes how U.S. dialysis patients with obesity experience trauma and manage it and co-occurring chronic diseases. We interviewed 40 adult dialysis patients and 20 physicians and dietitians. Transcripts were inductively coded using trauma theory. Patients described trauma that impacted their ability to manage co-morbidities. Providers characterized patient trauma and their own vicarious trauma while working in dialysis. Ninety-five percent of patients reported trauma, with characteristics of chronic (97%), emotional (73%), medical (92%), trauma from systems (59%), and vicarious trauma across relationships (54%). Complex, intersecting trauma exacerbates chronic disease burdens and may impact treatment effectiveness, successful management of co-morbidities, and patients’ relationships. Results demonstrate the need for trauma interventions within chronic disease treatment and community settings.