NHS Greater Glasgow and Clyde, Glasgow, United Kingdom.
University of Glasgow, Glasgow, United Kingdom.
Crit Care Med. 2019 Jan;47(1):e21-e27. doi: 10.1097/CCM.0000000000003497.
Patients and caregivers can experience a range of physical, psychologic, and cognitive problems following critical care discharge. The use of peer support has been proposed as an innovative support mechanism.
We sought to identify technical, safety, and procedural aspects of existing operational models of peer support, among the Society of Critical Care Medicine Thrive Peer Support Collaborative. We also sought to categorize key distinctions between these models and elucidate barriers and facilitators to implementation.
Seventeen Thrive sites from the United States, United Kingdom, and Australia were represented by a range of healthcare professionals.
Via an iterative process of in-person and email/conference calls, members of the Collaborative defined the key areas on which peer support models could be defined and compared, collected detailed self-reports from all sites, reviewed the information, and identified clusters of models. Barriers and challenges to implementation of peer support models were also documented. Within the Thrive Collaborative, six general models of peer support were identified: community based, psychologist-led outpatient, models-based within ICU follow-up clinics, online, groups based within ICU, and peer mentor models. The most common barriers to implementation were recruitment to groups, personnel input and training, sustainability and funding, risk management, and measuring success.
A number of different models of peer support are currently being developed to help patients and families recover and grow in the postcritical care setting.
患者和护理人员在重症监护出院后可能会经历一系列身体、心理和认知问题。同伴支持已被提议作为一种创新的支持机制。
我们试图在重症监护医学学会 Thrive 同伴支持协作组织中确定现有的同伴支持运营模式的技术、安全和程序方面。我们还试图对这些模型进行分类,并阐明实施的障碍和促进因素。
来自美国、英国和澳大利亚的 17 个 Thrive 站点由各种医疗保健专业人员代表。
通过协同成员之间的面对面和电子邮件/电话会议的迭代过程,确定了可以定义和比较同伴支持模型的关键领域,从所有站点收集详细的自我报告,审查信息,并确定模型集群。还记录了实施同伴支持模型的障碍和挑战。在 Thrive 协作组织中,确定了六种一般的同伴支持模式:基于社区、心理学家主导的门诊、基于 ICU 随访诊所的模式、在线、基于 ICU 的小组以及同伴导师模式。实施团体最常见的障碍包括团体招募、人员投入和培训、可持续性和资金、风险管理和衡量成功。
目前正在开发许多不同的同伴支持模式,以帮助患者和家属在重症监护后恢复和成长。