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Kesic, Brooke (2025) Trauma Informed Care within Oncology? Understanding the impact of childhood trauma on experiences of cancer and cancer services in adulthood. DClinPsy thesis, University of Nottingham.

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Abstract

Objectives: This research aimed to explore whether Adverse Childhood Experiences (ACEs) influence individuals’ experiences when accessing and engaging in cancer services as adults, including their satisfaction with cancer services, and whether cancer services are trauma-informed.

Design: An experimental study using a mixed-method sequential explanatory design. Stage one was an online quantitative survey that informed stage two, in which semi-structured interviews were completed after analysis of the survey data.

Methods: The online survey was completed by 266 participants. Descriptive statistics, correlation and mediation analysis was conducted (quantitative data), and an inductive-deductive reflexive thematic analysis was implemented (qualitative data). The deductive framework used was based on the Substance Abuse and Mental Health Services Administration (SAMHSA; 2014) trauma-informed care model (TIC), which addresses physical, relational and emotional challenges associated with trauma exposure (Sweeney et al., 2016). The overall study results integrated both the quantitative and qualitative data.

Results: Findings indicate a moderate negative correlation (r = -.40) between childhood trauma and patient satisfaction scores, suggesting that higher levels of childhood trauma are associated with lower levels of satisfaction with cancer services, mediated by an individual’s illness perceptions of their cancer. The thematic analysis generated four themes relating to experiences of cancer care and how these are informed within personal and historical contexts: 1) ‘Connecting the dots’: Resonance of childhood memories and current experiences. 2) ‘Nobody ever told me’: Powerlessness & cancer-related losses. 3) ‘I just wanted everyone else around me to be okay’: Distributed effects of cancer through the social network. 4) ‘It’s down to bedside manner’: Patient satisfaction is shaped by relational care. Patients only made connections back to their childhood trauma in Theme 1 and spoke about their cancer experiences more broadly.

Conclusions: The results offer preliminary insights into the potential importance of applying trauma-informed care to the cancer population. While the interview findings do not conclusively support this, it remains a significant clinical consideration that cancer services in the UK may benefit from adjustments to incorporate trauma-informed care for the UK cancer population.

Item Type:	Thesis (University of Nottingham only) (DClinPsy)
Supervisors:	Tickle, Anna Moghaddam, Nima Rennoldson, Michael Levene, Joanna Harris, Hannah
Keywords:	Adverse childhood experiences, cancer, childhood trauma, trauma-informed care, psychological distress
Subjects:	QS-QZ Preclinical sciences (NLM Classification) > QZ Pathology W Medicine and related subjects (NLM Classification) > WM Psychiatry
Faculties/Schools:	UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID:	81930
Depositing User:	Kesic, Brooke
Date Deposited:	31 Dec 2025 04:40
Last Modified:	31 Dec 2025 04:40
URI:	https://eprints.nottingham.ac.uk/id/eprint/81930

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