Abstract
Objectives
This research aimed to explore whether Adverse Childhood Experiences (ACEs) shape adults’ engagement with cancer services, including satisfaction with care and whether services reflect trauma-informed principles.
Design
Mixed-method sequential explanatory design. Stage one used a cross-sectional online survey; stage two comprised semi-structured interviews informed by the survey findings.
Methods
Survey responses (N = 266) were analysed using descriptive statistics, correlations and mediation analysis. Qualitative data used inductive-deductive reflexive thematic analysis, guided by the Substance Abuse and Mental Health Services Administration trauma-informed care (TIC) framework.
Results
Childhood trauma was moderately negatively correlated with patient satisfaction (r = −.40), with illness perceptions mediating this relationship. Thematic analysis yielded four themes relating to experiences of cancer care: (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.
Conclusions
Findings suggest ACEs may influence cancer care satisfaction through illness perceptions, supporting the clinical relevance of trauma-informed approaches 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 TIC for the UK cancer population.