如果没有相同的健康或社会条件,你能成为同伴吗?关于初级保健中同伴融合的定性研究

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Émilie Lessard, Nadia O’Brien, Andreea-Catalina Panaite, Marie Leclaire, Geneviève Castonguay, Ghislaine Rouly, Antoine Boivin
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引用次数: 0

摘要

在社区初级保健的特定领域,如精神健康、药物使用、艾滋病、无家可归者和原住民健康等领域,对同伴支持进行了广泛的研究。这些计划通常建立在这样的假设之上,即同伴必须具有相似的社会身份或疾病生活经历才会有效。然而,如何将同龄人融入到为不同健康状况和社会背景的人提供服务的普通初级保健环境中,目前仍不清楚。我们在 2020 年至 2022 年期间开展了一项参与式定性研究,以探讨在加拿大蒙特利尔的初级医疗机构中整合同伴支持工作者的可行性、可接受性和感知效果。根据对患者、亲属、临床医生和一名同伴支持工作者的半结构式访谈(n = 18)进行了主题分析。研究结果表明,同伴通过分享自己的困难以及如何克服困难与患者建立联系,而不是分享类似的健康或社会状况。同伴在护理轨迹之外提供社会支持和指导,并将已确定的需求与社区中的可用资源联系起来,从而在医疗和社会护理之间架起一座桥梁。初级保健临床医生从同伴支持工作中获益匪浅,因为它有助于克服治疗上的障碍,促进患者需求的沟通。然而,由于临床医生对同伴支持工作性质和局限性的理解、经济补偿以及在医疗保健系统中缺乏正式地位等原因,将同伴融入初级保健团队可能具有挑战性。我们的研究结果表明,要建立信任关系,同伴并不需要拥有相似的健康或社会状况。相反,他们可以利用自己的经验知识、优势和能力来建立有意义的关系和可靠的联系,从而在医疗和社会关怀之间架起一座桥梁。这反过来又给患者带来了对美好生活的希望,增强了他们在自身护理中发挥积极作用的能力,并帮助他们实现医疗保健之外的人生目标。最后,将同伴纳入初级保健有助于克服预防和护理方面的障碍,减少对机构的不信任,确定需求的优先次序,并帮助患者应对复杂的医疗保健服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can you be a peer if you don’t share the same health or social conditions? A qualitative study on peer integration in a primary care setting
Peer support has been extensively studied in specific areas of community-based primary care such as mental health, substance use, HIV, homelessness, and Indigenous health. These programs are often built on the assumption that peers must share similar social identities or lived experiences of disease to be effective. However, it remains unclear how peers can be integrated in general primary care setting that serves people with a diversity of health conditions and social backgrounds. A participatory qualitative study was conducted between 2020 and 2022 to explore the feasibility, acceptability, and perceived effects of the integration of a peer support worker in a primary care setting in Montreal, Canada. A thematic analysis was performed based on semi-structured interviews (n = 18) with patients, relatives, clinicians, and a peer support worker. Findings show that peers connect with patients through sharing their own hardships and how they overcame them, rather than sharing similar health or social conditions. Peers provide social support and coaching beyond the care trajectory and link identified needs with available resources in the community, bridging the gap between health and social care. Primary care clinicians benefit from peer support work, as it helps overcome therapeutic impasses and facilitates communication of patient needs. However, integrating a peer into a primary care team can be challenging due to clinicians’ understanding of the nature and limits of peer support work, financial compensation, and the absence of a formal status within healthcare system. Our results show that to establish a relationship of trust, a peer does not need to share similar health or social conditions. Instead, they leverage their experiential knowledge, strengths, and abilities to create meaningful relationships and reliable connections that bridge the gap between health and social care. This, in turn, instills patients with hope for a better life, empowers them to take an active role in their own care, and helps them achieve life goals beyond healthcare. Finally, integrating peers in primary care contributes in overcoming obstacles to prevention and care, reduce distrust of institutions, prioritize needs, and help patients navigate the complexities of healthcare services.
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来源期刊
BMC Family Practice
BMC Family Practice 医学-医学:内科
CiteScore
3.20
自引率
0.00%
发文量
0
审稿时长
4-8 weeks
期刊介绍: BMC Family Practice is an open access, peer-reviewed journal that considers articles on all aspects of primary health care research. The journal has a special focus on clinical decision making and management, continuing professional education, service utilization, needs and demand, and the organization and delivery of primary care and care in the community.
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