The value of peer support for self-management of diabetes among veterans in the Empowering Patients In Chronic care intervention
The value of peer support for self-management of diabetes among veterans in the Empowering Patients In Chronic care intervention
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DOI：
10.1111/dme.14220
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发表时间：
2020-01-28
影响因子：
3.5
通讯作者：
Woodard, L. D.
中科院分区：
文献类型：
--
作者：
Arney, J. B.;Odom, E.;Woodard, L. D.
目的探讨同伴支持在综合医疗系统中退伍军人糖尿病自我管理中的价值。方法我们对退伍军人和临床医生进行了半结构化的深度访谈，在他们参加了慢性护理中的患者赋权(EPIC)6个月后，EPIC是一种带有同伴支持成分的小组糖尿病干预措施。访谈引出了临床医生对同辈支持如何在小组中展开的叙述，以及退伍军人给予和接受同龄人支持的经历。数据分析以海斯勒同伴支持模型的框架分析原则为指导。结果研究结果支持海斯勒的同伴支持模式，并为专业带队的同伴交流小组访问提供了证据。临床医生和退伍军人认可在史诗团体中得到的信息和情感支持。临床医生经常将EPIC称为一个公开论坛或支持小组，退伍军人可以在其中给予和接受帮助。退伍军人注意到了共同解决问题的好处和他们得到的支持。临床医生和退伍军人认为EPIC的同伴支持部分有助于在自我效能方面增强赋权，增加感受到的社会支持，并增加对自我护理的理解。最终，许多退伍军人承认，他们参与EPIC有助于提高与健康相关的生活质量，改善健康行为，并改善慢性病控制。结论研究结果强调了同伴支持在慢性病管理中的价值。同伴支持方案可以解决退伍军人的独特挑战，并有可能改善身心健康。
Aim To examine the value of peer support in the self-management of diabetes among veterans in an integrated health care system. Methods We conducted semi-structured in-depth interviews with veterans and clinicians 6 months after their participation in Empowering Patients in Chronic Care (EPIC), a group-based diabetes intervention with a peer-support component. Interviews elicited clinicians' narratives of how peer support unfolded in the groups and veterans' experiences of giving and receiving support from their peers. Data analysis was guided by principles of framework analysis using Heisler's peer-support model. Results Findings support Heisler's peer-support model and provide evidence supporting professional-led group visits with peer exchange. Clinicians and veterans endorsed informational and emotional support received in EPIC groups. Clinicians often referred to EPIC as an open forum or a support group where veterans could both give and receive help. Veterans noted the benefits of shared problem-solving and the support they received. Clinicians and veterans perceived the peer-support component of EPIC as facilitating increased empowerment in terms of self-efficacy, increased perceived social support and increased understanding of self-care. Ultimately, many veterans acknowledged that their participation in EPIC facilitated improved health-related quality of life, improved health behaviours and improved chronic disease control. Conclusions Findings emphasize the value of peer support in managing chronic illness. Peer-support programmes may address veterans' unique challenges and have the potential to improve physical and mental health.