South Riverdale Community Health Centre, 955 Queen St East, Toronto, ON, M4M 3P3, Canada.
Department of Medicine, Division of Infectious Diseases, Schulich School of Medicine and Dentistry, Western University. St. Joseph's Health Care, 268 Grosvenor Street, London, ON, N6A 4V2, Canada.
Harm Reduct J. 2018 Aug 14;15(1):41. doi: 10.1186/s12954-018-0245-7.
Despite the integration of peer workers into harm reduction services, there is little documentation regarding the experience of this integration or of models in which peers are fully integrated as members of health care teams. The purpose of this study was to gain an in-depth understanding of the transition from client to support worker from the perspective of two individuals who received treatment for hepatitis C at a multi-disciplinary, community-based program, grounded in a harm reduction approach to substance use.
A participatory case study design was selected. Interviews were conducted with two current peer workers who were also involved in the study design, analysis and writing. Data was coded and analyzed using an inductive approach to identify emergent themes.
Five primary themes emerged during our analysis of the facilitators and challenges of the transition from client to support worker: (1) the role of prior experience, (2) changes in substance use practices, (3) shifts in relationships with community members and friends, (4) supportive organizational and structural factors, and (5) role transition as a journey. In some cases, themes overlapped and contained elements that were both facilitating and challenging.
The transition from client to co-worker is a gradual process and one that is supported by, and in turn helps to support, a number of other personal transitions. The cases examined here suggest that a model of peer employment with broad qualification criteria, sufficient transition timelines, flexible job responsibilities, a solid investment in the inclusion of people with lived experience, and a harm reduction framework will support successful integration of current and/or former clients into health care teams.
尽管同伴工作人员已经融入到减少伤害服务中，但对于这种融合的经验或同伴作为医疗保健团队成员完全融入的模式，几乎没有文献记录。本研究的目的是从在一个以减少伤害为基础的方法来处理物质使用的多学科社区为基础的项目中接受丙型肝炎治疗的两个人的角度深入了解从客户到支持工作者的过渡。
选择了参与式案例研究设计。对两名目前正在从事同伴工作的人员进行了访谈，他们也参与了研究设计、分析和写作。使用归纳法对数据进行编码和分析，以确定出现的主题。
在分析从客户到支持工作者过渡的促进因素和挑战时，出现了五个主要主题：（1）先前经验的作用，（2）物质使用实践的变化，（3）与社区成员和朋友关系的转变，（4）支持性的组织和结构因素，以及（5）作为旅程的角色转变。在某些情况下，主题重叠，并包含促进和挑战的元素。
从客户到同事的过渡是一个渐进的过程，它得到了许多其他个人过渡的支持，并反过来有助于支持这些过渡。这里检查的案例表明，具有广泛资格标准、足够过渡时间表、灵活工作责任、对纳入有生活经验的人的大力投资以及减少伤害框架的同伴就业模式将支持将现有和/或以前的客户成功融入医疗保健团队。
