Brooke Kesic, Anna Tickle, Nima Moghaddam, Mike Rennoldson, Joanna Levene, Hannah Harris
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.