Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships
Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships
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DOI：
10.1186/s12954-017-0202-x
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发表时间：
2017-11-28
影响因子：
4.4
通讯作者：
Mannell, Jenevieve
中科院分区：
文献类型：
--
作者：
MacLellan, Jennifer;Surey, Julian;Mannell, Jenevieve
背景：同伴支持计划利用具有特定经验的个人来提高新客户的参与度和成果。然而，用于实现这种参与的技能和技术尚未绘制出来。这可能会限制成功的同伴倡导护理模式的发展和复制。这项研究探讨了一群有过无家可归、酗酒和滥用毒品经历的同伴倡导者如何与他们的客户群体建立并维持关系。出于本项目的目的，客户群体属于丙型肝炎阳性人群，他们有注射吸毒和无家可归的历史。方法：五名自选倡导者进行了持续 40-90 分钟的叙述性访谈。这些访谈使用主题分析和叙述分析进行双重转录，以便对数据进行三角测量，并提供一系列关于同伴倡导者在与难以接触到的人群的客户建立和维持关系方面的独特技能的可靠调查结果。结果：同伴倡导者通过披露有关客户生活的个人详细信息与客户建立融洽的关系。虽然这与需要在客户与患者关系中保持距离的假设背道而驰，但治疗益处似乎超过了这种接触的潜在成本。结论：我们得出的结论是，同伴倡导者与其客户之间自我披露的治疗益处为自我披露作为与关键难以接触人群建立关系的一种手段提供了道德基础。
Background: Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness.Methods: Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations.Results: Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement.Conclusion: We conclude the therapeutic benefits of self- disclosure between peer advocates and their clients offer a moral grounding for self- disclosure as a means of building relationships with key hard-to-reach populations.