Trauma-Informed Care Instruments for Nursing in Natural Disaster-Prone Areas: A Systematic Review

Background: Nurses play a crucial role not only in clinical management but also in preventing
psychological trauma, especially in disaster-prone settings. Trauma-Informed Care (TIC) is a key
strategy, and its implementation requires the use of valid and reliable instruments. This systematic review
aims to identify TIC assessment tools and analyze their application across different disaster phases.
Methods: A systematic review was conducted following the PRISMA guidelines. Literature searches
were performed in five databases (PubMed, ScienceDirect, Emerald, ProQuest, and Sage Journals) using
keywords, covering publications from 2015 to 2024. Results: Nine TIC instruments were identified and
grouped into three categories: (1) Individual attitudes and competencies The Attitudes Related to Trauma
Informed Care (ARCTIC), Knowledge, Attitudes, and Practices related to Trauma-Informed care (KAP�TIC), Nurses’ Intention to Care for Patients with Infectious Disease Scale (NICPS), Measuring TIC�Nurses). (2) Organizational readiness and culture (TICO Meter, Organizational Trauma Resilience
Assessment (OTRA)), and (3) Specific clinical practices (TIC-PAT, Trauma-Informed Practice (TIP)
Scale). Instruments such as ARTIC and the Trauma-Informed Care Provider Assessment Tool (TIC-PAT)
are suitable for the initial phase of a disaster, allowing for the rapid assessment of healthcare workers.
Meanwhile, TICO Meter and OTRA are effective for evaluating organizational readiness and resilience
during response and rehabilitation. The TIP Scale is particularly relevant in the recovery phase to
empower survivors. Conclusion:Nine TIC instruments can be integrated into different phases of disaster
management: ARTIC and TIC-PAT for early assessment, TICO Meter and OTRA for organizational
readiness during response and rehabilitation, and the TIPScale for recovery. Training and systematic use
of these tools enable nurses to deliver compassionate, safe, and resilient care in disaster-prone settings.