Mental health outcomes of a peer support programme for prosthesis and orthosis users in Cambodia: An explanatory sequential mixed-methods study.

Abstract

People with physical disabilities in low- and middle-income countries experience elevated rates of psychological distress. This study explored the impact of a peer support intervention ('friendship group') for people with disabilities attending prosthetic and orthotic clinics in Cambodia. A total of 462 individuals were screened using the Kessler Psychological Distress Scale (K10), 47 met inclusion criteria (scores 20-29). Of these, 27 enrolled in the intervention, while 20 did not participate. Psychological distress was assessed across four domains of the K10 (nervousness, agitation, fatigue and negative affect). Intervention participants were measured at three time points (2 baseline measures and 1 follow-up), non-participants contributed baseline data only. Quantitative data were analysed using linear mixed-effects models, qualitative data from post-intervention focus groups (n = 21) were analysed thematically. Reductions in K10 scores were observed across all domains following the intervention (p < 0.001). Qualitative findings highlighted perceived benefits including restored family and community roles, emotional relief and improved self-regulation. Given the pre-post design without a full comparator group, findings should be interpreted cautiously. This exploratory study suggests that peer support may offer a feasible and culturally acceptable route to support people with disabilities in low-resource settings.