Gillard Steve, Foster Rhiannon, White Sarah, Barlow Sally, Bhattacharya Rahul, Binfield Paul, Eborall Rachel, Faulkner Alison, Gibson Sarah, Goldsmith Lucy P, Simpson Alan, Lucock Mike, Marks Jacqui, Morshead Rosaleen, Patel Shalini, Priebe Stefan, Repper Julie, Rinaldi Miles, Ussher Michael, Worner Jessica
City, University of London, London, UK.
St George's, University of London, London, UK.
BMC Psychiatry. 2022 Jun 1;22(1):373. doi: 10.1186/s12888-022-03999-9.
Peer workers are increasingly employed in mental health services to use their own experiences of mental distress in supporting others with similar experiences. While evidence is emerging of the benefits of peer support for people using services, the impact on peer workers is less clear. There is a lack of research that takes a longitudinal approach to exploring impact on both employment outcomes for peer workers, and their experiences of working in the peer worker role.
In a longitudinal mixed methods study, 32 peer workers providing peer support for discharge from inpatient to community mental health care - as part of a randomised controlled trial - undertook in-depth qualitative interviews conducted by service user researchers, and completed measures of wellbeing, burnout, job satisfaction and multi-disciplinary team working after completing training, and four and 12 months into the role. Questionnaire data were summarised and compared to outcomes for relevant population norms, and changes in outcomes were analysed using paired t-tests. Thematic analysis and interpretive workshops involving service user researchers were used to analysis interview transcripts. A critical interpretive synthesis approach was used to synthesise analyses of both datasets.
For the duration of the study, all questionnaire outcomes were comparable with population norms for health professionals or for the general population. There were small-to-medium decreases in wellbeing and aspects of job satisfaction, and increase in burnout after 4 months, but these changes were largely not maintained at 12 months. Peer workers felt valued, empowered and connected in the role, but could find it challenging to adjust to the demands of the job after initial optimism. Supervision and being part of a standalone peer worker team was supportive, although communication with clinical teams could be improved.
Peer workers seem no more likely to experience negative impacts of working than other healthcare professionals but should be well supported as they settle into post, provided with in-work training and support around job insecurity. Research is needed to optimise working arrangements for peer workers alongside clinical teams.
同伴工作者越来越多地受雇于心理健康服务机构，利用他们自己的精神痛苦经历来支持有类似经历的其他人。虽然有证据表明同伴支持对服务使用者有益，但对同伴工作者的影响尚不清楚。缺乏采用纵向研究方法来探讨对同伴工作者就业成果及其担任同伴工作者角色的工作体验的影响的研究。
在一项纵向混合方法研究中，32名作为随机对照试验一部分为从住院治疗过渡到社区精神卫生保健提供同伴支持的同伴工作者，接受了服务使用者研究人员进行的深入定性访谈，并在完成培训后、担任该角色4个月和12个月时完成了幸福感、倦怠、工作满意度和多学科团队合作的测量。问卷数据进行了汇总，并与相关人群规范的结果进行了比较，使用配对t检验分析了结果的变化。使用主题分析和由服务使用者研究人员参与的解释性研讨会来分析访谈记录。采用批判性解释性综合方法来综合两个数据集的分析。
在研究期间，所有问卷结果与卫生专业人员或普通人群的人群规范相当。幸福感和工作满意度的某些方面在4个月后有小到中等程度的下降，倦怠感增加，但这些变化在12个月时基本没有持续。同伴工作者在这个角色中感到受到重视、有能力并建立了联系，但在最初的乐观情绪之后，可能会发现适应工作要求具有挑战性。监督以及作为独立的同伴工作者团队的一员是有帮助的，尽管与临床团队的沟通可以改进。
同伴工作者似乎并不比其他医疗保健专业人员更容易受到工作负面影响，但在他们适应工作岗位时应得到充分支持，提供在职培训以及围绕工作不安全感的支持。需要开展研究以优化同伴工作者与临床团队的工作安排。
