{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:14:49Z","timestamp":1789679689867,"version":"4.0.1"},"reference-count":24,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T00:00:00Z","timestamp":1568246400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Deepwater Horizon Medical Benefits Class Action Settlement"},{"DOI":"10.13039\/100006108","name":"national center for advancing translational sciences","doi-asserted-by":"publisher","award":["UL1 TR001417"],"award-info":[{"award-number":["UL1 TR001417"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nurs Sci Q"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>Nurses need a pragmatic theory to understand and respond to the impact of vulnerable patients\u2019 previous healthcare experiences, as these are likely to influence response and adherence to treatment plans. The authors of this paper present the new BITTEN (Betrayal history by health-related institutions, Indicator for healthcare engagement, Traumas related to healthcare, Trust in healthcare providers, patient Expectations and Needs) Model of Trauma-Informed Healthcare. BITTEN identifies patients\u2019 current healthcare expectations and needs as a function of their previous betrayal by healthcare systems, which operates in conjunction with their current health indicators to potentially trigger trauma symptoms and impact trust in healthcare providers.<\/jats:p>","DOI":"10.1177\/0894318419864344","type":"journal-article","created":{"date-parts":[[2019,9,13]],"date-time":"2019-09-13T01:50:00Z","timestamp":1568339400000},"page":"291-298","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Once BITTEN, Twice Shy: An Applied Trauma-Informed Healthcare Model"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3301-9608","authenticated-orcid":false,"given":"Chrystal L.","family":"Lewis","sequence":"first","affiliation":[{"name":"Assistant Professor, College of Nursing, University of South Alabama, Mobile, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Langhinrichsen-Rohling","sequence":"additional","affiliation":[{"name":"Professor of Psychology, University of South Alabama, Mobile, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candice N.","family":"Selwyn","sequence":"additional","affiliation":[{"name":"Research Assistant Professor, College of Nursing, University of South Alabama, Mobile, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma C.","family":"Lathan","sequence":"additional","affiliation":[{"name":"Clinical and Counseling Psychology Doctoral Candidate, University of South Alabama, Mobile, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,9,12]]},"reference":[{"key":"bibr1-0894318419864344","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31822c997c"},{"key":"bibr2-0894318419864344","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. 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