Peer support workers as a bridge: a qualitative study exploring the role of peer support workers in the care of people who use drugs during and after hospitalization

Harm Reduction Journal - Tập 18 Số 1 - 2021
Robin Lennox1, Larkin Lamarche1, Tim O’Shea2
1Department of Family Medicine, McMaster University, Hamilton, Canada
2Division of Infectious Diseases, Department of Medicine, McMaster University, Hamilton, Canada

Tóm tắt

Abstract Background To describe the key qualities and unique roles of peer support workers in the care of people who inject drugs during and after hospitalization. Methods We conducted a qualitative study. Key stakeholders were recruited including: people who use drugs who had been hospitalized, healthcare team members, peer support workers, and employers of peer support workers. Data were collected from 2019 to 2020 using semi-structured interviews that were audio-recorded, transcribed, and analyzed thematically. Results Fourteen participants were interviewed: 6 people who use drugs who had been hospitalized, 5 healthcare team members, 2 peer support workers, and 1 employer of peer support workers. At the core of the data was the notion of peer workers acting as a bridge. We found four themes that related to functions of this bridge: overcoming system barriers, advocacy, navigating transitions within the healthcare system, and restoring trust between HCPs and PWUD. We found two themes for building a strong bridge and making the role of a peer support worker function effectively (training and mentorship, and establishing boundaries). We found three themes involving characteristics of an effective peer worker (intrinsic qualities, contributions of shared experiences, and personal stability). Conclusion Peer support workers are highly valued by both people who use drugs and members of the healthcare team. Peer support workers act as a bridge between patients and healthcare providers and are critical in establishing trust, easing transitions in care, and providing unique supports to people who use drugs during and after hospitalization.

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Tài liệu tham khảo

Kerr T, Wood E, Grafstein E, Ishida T, Shannon K, Lai C, et al. High rates of primary care and emergency department use among injection drug users in Vancouver. J Public Health. 2005;27(1):62–6.

Palepu A, Tyndall MW, Leon H, Muller J, O’Shaughnessy MV, Schechter MT, et al. Hospital utilization and costs in a cohort of injection drug users. CMAJ. 2001;6:415–20.

Kendall CE, Boucher LM, Mark AE, Martin A, Marshall Z, Boyd R, et al. A cohort study examining emergency department visits and hospital admissions among people who use drugs in Ottawa, Canada. Harm Reduct J. 2017;14:16. https://doi.org/10.1186/s12954-017-0143-4.

McNeil R, Small W, Wood E, Kerr T. Hospitals as a “risk environment”: an ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs. Soc Sci Med. 2014;105:59–66. https://doi.org/10.1016/j.socscimed.2014.01.010.

Chan Carusone S, Guta A, Robinson S, Tan TH, Cooper C, O’Leary B, et al. “Maybe if I stop the drugs, then maybe they’d care?”—hospital care experiences of people who use drugs. Harm Reduct J. 2019;16:16. https://doi.org/10.1186/s12954-019-0285-7.

Ti L, Ti L. Leaving the hospital against medical advice among people who use illicit drugs: a systematic review. Am J Public Health. 2015;105(12):e53–9.

Sharma M, Lamba W, Cauderella A, Guimond TH, Bayoumi A. Harm reduction in hospitals. Harm Reduct J. 2017;14(1):32.

Collins D, Alla J, Nicolaidis C, Gregg J, Gullickson DJ, Patten A, et al. “If it wasn’t for him, I wouldn’t have talked to them”: qualitative study of addiction peer mentorship in the hospital. J Gen Intern Med. 2019. https://doi.org/10.1007/s11606-019-05311-0.

van Boekel LC, Brouwers EP, van Weeghel J, Garretsen HF. Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. Drug Alcohol Depend. 2013;131(1–2):23–35. https://doi.org/10.1016/j.drugalcdep.2013.02.018.

Merrill JO, Rhodes LA, Deyo RA, Marlatt GA, Bradley KA. Mutual mistrust in the medical care of drug users: the keys to the “narc” cabinet. J Gen Intern Med. 2002;17(5):327–33. https://doi.org/10.1046/j.1525-1497.2002.10625.x.

Wright-Berryman JL, McGuire AB, Salyers MP. A review of consumer-provided services on assertive community treatment and intensive case management teams: implications for future research and practice. J Am Psychiatric Nurses Assoc. 2011;17(1):37–44. https://doi.org/10.1177/1078390310393283.

Davidson L, Bellamy C, Guy K, Miller R. Peer support among persons with severe mental illnesses: a review of evidence and experience. World Psychiatry. 2012;11(2):123–8. https://doi.org/10.1016/j.wpsyc.2012.05.009.

Sledge WH, Lawless M, Sells D, Wieland M, O’Connell MJ, Davidson L. Effectiveness of peer support in reducing readmissions of persons with multiple psychiatric hospitalizations. Psychiatr Serv. 2011;62(5):541–4. https://doi.org/10.1176/ps.62.5.pss6205_0541.

Englander H, Gregg J, Gullickson J, Cochran-Dumas O, Colasurdo C, Alla J, et al. Recommendations for integrating peer mentors in hospital-based addiction care. Subst Abus. 2019. https://doi.org/10.1080/08897077.2019.1635968.

Bassuk EL, Hanson J, Greene RN, Richard M, Laudet A. Peer-delivered recovery support services for addictions in the United States: a systematic review. J Subst Abuse Treat. 2016;63:1–9. https://doi.org/10.1016/j.jsat.2016.01.003.

Reif S, Braude L, Lyman DR, Dougherty RH, Daniels AS, Ghose SS, et al. Peer recovery support for individuals with substance use disorders: assessing the evidence. Psychiatr Serv. 2014;65(7):853–61. https://doi.org/10.1176/appi.ps.201400047.

Liamputtong P. Qualitative research methods. Chapter 1, Methodological frameworks and sampling in qualitative research. Oxford: Oxford University Press; 2013. p. 5–22.

McGuire AB, Powell KG, Treitler PC, Wagner KD, Smith KP, Cooperman N, et al. Emergency department-based peer support for opioid use disorder: Emergent functions and forms. J Subst Abuse Treat. 2020;108:82–7. https://doi.org/10.1016/j.jsat.2019.06.013.

Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage; 2002.

Braun V, Clarke V. To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qual Res Sport Exerc Health. 2019;17:1–16.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa.

Morgan DL. Pragmatism as a paradigm for social research. Qual Inquiry. 2014;20:1045–53. https://doi.org/10.1177/1077800413513733.

Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Dir Program Eval. 1986;1986(30):73–84.

Tracy SJ. Qualitative quality: Eight “big-tent” criteria for excellent qualitative research. Qual Inquiry. 2010;16(10):837–51. https://doi.org/10.1177/1077800410383121.

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Harm Reduction Journal

Tập 18 Số 1

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