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Peer-support groups for stroke survivors are often organized and facilitated by health authorities and disability related organizations within rehabilitation programs. However, the benefits of peer-led, peer-support groups have not yet been evaluated. The purpose of this study was to explore participants’ experiences in a community-based, peer-led, peer-support group for stroke survivors.
Materials and Methods:
Semi-structured interviews were conducted and analyzed following constructivist grounded theory with 11 participants who attended a peer-led, peer-support group for people with stroke. The data were also complemented with one quantitative rating question regarding their experience attending the group.
Results:
Three themes were identified. Meeting unmet needs after stroke captured how the group was created by stroke survivors to address life in the community post-stroke. Buddies helping buddies highlighted that stroke recovery is a shared process at the group, where members help and encourage each other to contribute what they can. Creating authentic friendships revealed how people experienced social connection and developed relationships in the peer-led, peer-support group.
Conclusions:
Peer-led, peer-support groups may provide opportunities for stroke survivors to connect with like-minded people in their community to have fun while exploring their abilities.
Services providing treatment for drug and alcohol users have developed considerably in the last 30 years. They are now provided in all areas of the UK and there are clear standards which govern how they should be provided and what they should provide. Over that period of development the outcomes services have been trying to achieve have changed. Initially, it was harm reduction and prevention of blood-borne viruses, then prevention of crime and most recently abstinence. Services for substance misusers are different from other services in that they are subject to a considerable amount of control from politicians and policy makers. Furthermore, services have had to change as drug and alcohol problems have changed. They have ebbed and flowed as funding sources have changed. Despite that they have been able to provide effective evidence-based treatment to many. This chapter explores the history of service provision, how treatment models have been developed and why and what elements of service provision are considered best practice.
Adolescents living with HIV (ALHIV) experience a high burden of mental health disorder which is a barrier to antiretroviral therapy adherence. In Zimbabwe, trained, mentored peer supporters living with HIV (Community Adolescent Treatment Supporters – CATS) have been found to improve adherence, viral suppression and psychosocial well-being among ALHIV. The Friendship Bench is the largest integrated mental health programme in Africa. We hypothesise that combining the CATS programme and Friendship Bench will improve mental health and virological suppression among ALHIV compared with the CATS programme alone.
Methods
We will conduct a cluster-randomised controlled trial in 60 clinics randomised 1:1 in five provinces. ALHIV attending the control arm clinics will receive standard CATS support and clinic support following the Ministry of Health guidelines. Those attending the intervention arm clinics will receive Friendship Bench problem-solving therapy, delivered by trained CATS. Participants with the signs of psychological distress will be referred to the clinic for further assessment and management. The primary outcome is HIV virological failure (≥1000 copies/ml) or death at 48 weeks. Secondary outcomes include the proportion of adolescents with common mental disorder symptoms (defined as Shona Symptom Questionnaire (SSQ-14) score ≥8), proportion with depression symptoms (defined as Patient Health Questionnaire (PHQ-9) score ≥11), symptom severity (mean SSQ-14 and PHQ-9 scores) and EQ-5D score for health-related quality of life.
Conclusions
This trial evaluates the effectiveness of peer-delivery of mental health care on mental health and HIV viral load among ALHIV. If effective this intervention has the potential to be scaled-up to improve these outcomes.
Trial registration: PACTR201810756862405. 08 October 2018.
Psychiatric in-patients are often transferred to an emergency department for care of minor wounds, incurring significant distress to the patient and cost to the service.
Aims
To improve superficial wound management in psychiatric in-patients and reduce transfers to the emergency department.
Method
Thirty-four trainees attended two peer-led suturing and wound management teaching sessions, and a suturing kit box was compiled and stored at the Royal Edinburgh Hospital. Teaching was evaluated using Kirkpatrick's model, and patient transfer numbers were acquired by reviewing in-patient Datix reports and emergency department case notes for 6 months before and after teaching.
Results
The proportion of patients transferred to the emergency department decreased significantly from 90% 6 months before the workshop to 30% 6 months after (P < 0.05). Trainees engaged positively and there was a significant increase in self-confidence rating following the workshop (P < 0.05). The estimated cost saving per transfer was £183.76.
Conclusion
The combination of a peer-led workshop and on-site suturing kit box was effective in reducing transfers to the emergency department and provided a substantial cost saving.
Declaration of interest
None.
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