Copenhagen Research Unit for Recovery, Mental Health Centre Amager, Hans Bogbinders Allé 3, 3. Floor, Copenhagen S, 2300, Denmark.
BMC Psychiatry. 2024 Aug 13;24(1):555. doi: 10.1186/s12888-024-05992-w.
Worldwide, peers support has been shown to play a crucial role in supporting people with mental illness in their personal recovery process and return to everyday life. Qualitiative studies underpinning the mechanisms of change in peer support has been reviewed. However, the findings are primeraly based on the perspectives of peer support workers employed in mental health services. Thus, qualitiative studies elucidating the mechanisms of change from the recipient perspective in mental health service independent civil society settings are higly needed to further contribute to the evidence of peer support. The 'Paths to every day life' (PEER) is evaluated in a randomized trial and is substantiated by qualitative studies investigating the experiences of PEER from the perspectives of the recipients and the facilitators of peer support. The purpose of this qualitative study underpinned by critical realism was to substantiate the PEER intervention program theory by gaining deeper insight into the change mechanisms and elaborate how, when, and under what circumstances the peer support groups potentially had or did not have an impact on personal recovery from the perspectives of the recipients of peer support.
Eleven individuals were interviewed at the end of the ten-week group course. The semi-structured realist-inspired interviews were audio recorded and transcribed verbatim. The analysis was guided by reflective thematic analysis and through an abductive framework based on the program theory. Data were coded and analysed in Nvivo software.
Four overarching themes were identified that informed and nuanced the program theory: 1) Connectedness as a prerequisite for engagement; 2) A sense of hope by working out new paths to recovery; 3) Seeing new sides of oneself; and 4) Sprout for change.
This study substantiates the program theory and the quantitative results of the PEER trial by elaborating on mechanisms that were felt to be essential for the personal recovery process from the perspectives of the recipients of the group-based peer support. In addition, the study points out that the opportunities to act in everyday life depended on individual context and where the group participants were on their recovery journey.
ClinicalTrials.gov identifier: NCT04639167.
在全球范围内，同伴支持已被证明在支持患有精神疾病的人实现个人康复和重返日常生活方面发挥着至关重要的作用。已经对支持同伴支持的变化机制的基础质化研究进行了审查。然而，这些发现主要基于在精神卫生服务中受雇的同伴支持工作者的观点。因此，非常需要从精神卫生服务独立的民间社会环境中的接受者角度阐明变化机制的质化研究，以进一步为同伴支持提供证据。“通往日常生活之路”（PEER）在一项随机试验中进行了评估，并通过调查从接受者和同伴支持促进者的角度来看同伴支持的经验的质化研究来证实。本项由批判现实主义支撑的质化研究的目的是通过深入了解变化机制来证实 PEER 干预计划理论，并详细说明同伴支持小组如何、何时以及在何种情况下可能对个人从接受者的角度从精神疾病中康复产生影响或没有产生影响。
在为期十周的小组课程结束时，对 11 名个人进行了访谈。半结构化的基于现实主义的访谈进行了录音，并逐字记录下来。分析受到反映主题分析和基于计划理论的推断框架的指导。数据在 Nvivo 软件中进行编码和分析。
确定了四个总体主题，这些主题为计划理论提供了信息和细微差别：1）作为参与的前提条件的联系感；2）通过制定新的康复途径而产生的希望感；3）看到自己的新面貌；4）变化的萌芽。
这项研究从接受团体基于同伴支持的群体接受者的角度详细阐述了被认为对个人康复过程至关重要的机制，从而证实了计划理论和 PEER 试验的定量结果。此外，该研究指出，在日常生活中采取行动的机会取决于个人的背景和团体参与者在康复过程中的位置。
ClinicalTrials.gov 标识符：NCT04639167。
