Informal Peer Support Research Articles

Health care workers as second victims of medical errors

"Second victims" are health care providers who are involved with patient adverse events and who subsequently have difficulty coping with their emotions. Growing attention is being paid to making system improvements to create safer health care and to the appropriate handling of patients and families harmed during the provision of medical care. In contrast, there has been little attention to helping health care workers cope with adverse events. The aim of the study was to emphasize the importance of support structures for second victims in the handling of patient adverse events and in building a culture of safety within hospitals. A survey was administered to health care workers who participated in a patient safety meeting. The total number of registered participants was 350 individuals from various professions and different institutions within Johns Hopkins Medicine. The first part of the survey was paper-based and the second was administered online. The survey results reflected a need in "second victim" support strategies within health care organizations. Overall, informal emotional support and peer support were among the most requested and most useful strategies. When there is a serious patient adverse event, there are always second victims who are health care workers. The Johns Hopkins Hospital has established a "Second Victims" Work Group that will develop support strategies, particularly a peer-support program, for health care professionals within the system.

Twittering on about social networking and babyfeeding matters

The aim of this pilot study was to investigate whether or not social networking increases traffic to a website offering support and advice on infant feeding and whether or not this technology is potentially more useful than the existing online forum. Profile accounts were set up on Bebo, Facebook and Twitter and people who might be interested in infant feeding were contacted through the search facility on each of these sites over a 6-week period. If interest was expressed, they were invited to complete an online evaluation on www.babyfeedingmatters.co.uk. A total of 250 invitations were issued and 136 surveys were completed. The study found that www.babyfeedingmatters.co.uk is meeting its aims and is both easy to navigate and understand. However, the current forum may be outdated and would benefit from being incorporated into a social networking platform to provide informal peer support. Overall, social networking increased web traffic and responder feedback from the ‘wisdom of the crowd’ and has led to further refinement of the website.

Experiences of new physiotherapy lecturers making the shift from clinical practice into academia

Objectives To explore the experiences of physiotherapists making the transition from practising physiotherapist to physiotherapy lecturer in higher education, and to understand these experiences in order to inform an explanation of ways of managing this transition. Design A qualitative, interpretive research design using semi-structured interviews. The interviews were transcribed, read and thematically analysed. Participants Using purposive sampling, eight physiotherapy lecturers within their first 4 years of teaching in higher education at one North West university were interviewed. Findings Despite having previous successful clinical careers, participants initially struggled to make the transition, characterised by initial feelings of uncertainty and inadequacy. Participants took between 1.5 and 3 years to socialise into their new academic role, adopting a new professional identity as a physiotherapy academic. Informal learning and peer support were the most valued mechanisms of support, more so than a formally structured mentoring process. Challenges of dual professionalism and tensions emerged regarding the expected academic roles of a lecturer. Confidence in developing a pedagogy for higher education and contributing to established communities of practice were key indicators of successfully making the shift to becoming an academic. Conclusions To meet the new physiotherapy lecturers’ needs and build up confidence in higher education, more effective induction strategies are worthy of endeavour. More formal training designed to specifically address those aspects of transition particular to clinicians making the shift from clinical practice into academia is suggested.

Firefighter preferences regarding post-incident intervention

The effectiveness of Critical Incident Stress Debriefing (CISD) as a tool remains, at best, inconclusive. Yet in many locales CISD is mandatory for emergency services workers, including firefighters. To our knowledge, to date no study has investigated firefighters’ preferences for psychological intervention following traumatic events. To examine this, a survey was conducted with 142 members (54%) of an urban fire and rescue service in south-western Ontario, Canada. Firefighters were provided with five scenarios of varying traumatic intensity, for which they rated desirability of four voluntary post-incident interventions: CISD, individual debriefing, informal discussion, and no intervention. Firefighters expressed interest in working with post-event reactions within their peer group for all events, and an increasing interest in formal intervention as event severity increased. Individual debriefing was preferred to CISD in scenarios of low to moderate intensity. For scenarios of high intensity, ratings for all interventions were high. Expected relationships with prior CISD experience and years of service were not upheld. The essential role of informal peer-support, and the desire for meaningful intervention in severe situations, are discussed.

Can Informal e-learning and Peer Support Help Bridge the Digital Divide?

The project that we report here provided free home computers and a one-year broadband subscription to a sample of 108 older people diagnosed with coronary heart disease. The sample was divided at random and the experimental group had ‘facilitated learning’, based on access to a dedicated website, while controls did not. The results suggest that many participants needed to overcome their fear of new technology before they could learn how to use it effectively. Significant differences in computer skills were found between the experimental and control groups after six months of being involved in the project.

Best Practices: A Program to Support Shared Decision Making in an Outpatient Psychiatric Medication Clinic

This column presents preliminary findings of an intervention to support shared decision making in psychopharmacology consultation. The waiting area in an urban psychiatric medication clinic was transformed into a peer-run Decision Support Center featuring a user-friendly, Internet-based software program with which clients could create a one-page computer-generated report for use in the medication consultation. The Decision Support Center was used 662 times by 189 unique users from a young-adult and general adult case management team from October 2006 to September 2007. All clients had severe mental disorders. Only ten clients refused to use the intervention at some point during the pilot study. Focus groups with medical staff (N=4), clients (N=16), case managers (N=14), and peer-specialist staff (N=3) reported that the intervention helped to create efficiencies in the consultation and empower clients to become more involved in treatment-related decision making. A randomized controlled trial is currently in process.

Friends United: An Evaluation of an Innovative Residential Self-Management Programme in Adolescent Rheumatology

Independence in activities of daily living, self-advocacy and peer support are important aspects of adolescent development. These skills are potentially affected by chronic rheumatic diseases and are worthy of attention by occupational therapists and other members of the multidisciplinary team. An innovative 4-day residential programme for young people diagnosed with chronic rheumatic disease, known as the ‘Independence Break’, was evaluated in order to determine its perceived benefits. The participants were invited to complete a brief evaluation form immediately after the trip to determine the benefits of participation in the programme. The levels of continuing social contact within the group were established 4 months later during a subsequent telephone call. Thirty young people (median age 14 years) attended the 4-day programme and reported friendship and improved performance in activities of daily living as the major benefits. The majority stayed in touch with at least one other person, with more girls staying in touch than boys. The preferred method of communication was text messaging. Overall, the programme was perceived to be a valuable experience and offered the young people an opportunity to develop informal peer support networks. The potential of text messaging within adolescent rheumatology is also highlighted.

Use and Perceived Effectiveness of Student Support Services in a First‐Year Dental Student Population

The purpose of this study was to determine the severity of problems common to the first year of dental school and to assess the use and perceived effectiveness of formal and informal peer and professional support programs in addressing those problems. First-year students at one California dental school were surveyed on the severity of problems encountered, support services used, and perceived effectiveness of services. Results indicated that the problems perceived as most serious by students in this sample were of an emotional nature relating to academic performance. Findings showed that students relied heavily on themselves and on informal advice from peers to handle problems and that they perceived these resources to be very effective. Findings also showed that low-ranking students used both formal and informal resources to resolve problems and that females used resources outside of the school more than males did. Results of the study offer some evidence to support providing both formal and informal peer and faculty support programs for first-year dental students. Results also provide insight into the use of peers and "self" to resolve problems common to the first year of dental education.

Informal peer support: a key to success for nurse prescribers.

A study was conducted in Leicestershire and Rutland (NHS) Healthcare Trust to determine the continuing professional development needs of nurse prescribers. Qualitative and quantitative approaches were applied to the sample frame of 350 nurse prescribers to elicit the most significant factors which have influenced the development of nurse prescribing. The majority of nurse prescribers considered prescribing to be a skill, which is now an essential part of core practice. The study indicated that informal peer support seems to have compensated for the absence of formal clinical supervision. Any development such as nurse prescribing has the added benefit of examining practice from new perspectives. Reflection on how this was achieved highlights important issues as to how the next stage can be even more successful.

Indigenous nurses and professional education: friends or foes?

While the importance of cultural issues in nursing practices has been recognized, little attention has been directed to evaluating to what extent nursing education respects the cultural norms and values of students from diverse populations. A survey was used to explore the educational experiences of 40 Native American nurses. Respondents indicated that cultural content in their education was quite limited, they wanted more cultural content, and sometimes they obtained it from other sources. Many respondents found no support for their cultural identity during their nursing education. Those who did find support found it mainly through student groups, tribal or Native-specific programs, and through informal peer support. Many respondents identified struggles with culture shock and cultural differences, stereotypes and racist attitudes, isolation, and assumptions about their own cultural identity. This study makes an important contribution by bringing voices of indigenous nurses to the attention of the profession and by moving beyond practice wisdom to join with the growing body of research that is adding an empirical dimension to transcultural nursing literature.

The Nifty Nine

Social support has often been viewed as a therapeutic intervention for clients, but its potential for personal benefit to professionals who serve in stressful roles has not been adequately addressed. The author was for a number of years part of an informal peer support group for executives of residential child caring agencies called the "Nifty Nine." Organized in 1971, it continues as an informal yet important support network for its members. A qualitative study of the members revealed how their support group helped them (and ultimately their agencies) to be more effective.

The oncology nurse

Stress-producing factors in oncology nursing are described with special attention to the differences between the stresses inherent in the patient-oncology nurse relationship and the patient-oncologist (physician) relationship. Danger signals which signify emotional decompensation in oncology work are discussed. Personal characteristics are described which have proven valuable criteria in selecting nurses who will be capable of adapting to the oncology setting. A formal support mechanism which can be provided by the oncology unit and development of an informal peer support network are discussed. A professional maturing process which evolves from development of a philosophy compatible with oncology nursing is described.