Rewriting stories of trauma through peer‐to‐peer mentoring for and by at‐risk young people

Adverse childhood experiences are strongly associated with the development of mental health disorders during the life span. When mental health issues are not effectively dealt with during the adolescent period, young people can become long‐term consumers in the mental health system. A widely accepted method of intervention is the provision of mentoring. More recently, young people have been fulfilling the role of mentor to their peers and mentoring has played a large role in supporting young people who are considered at‐risk of not achieving the expected psychosocial, educational, and/or developmental goals. What is not known is why young people, previously identified as being at‐risk, are motivated to mentor their at‐risk peers. The study aim was to examine what motivates previously recognized at‐risk young people to provide mentoring to their at‐risk peers. Participants were twelve previously recognized at‐risk young people recruited through a formal peer‐to‐peer mentoring programme. Semi‐structured interviews were conducted, and the data analysed through narrative inquiry and reported in accordance with the consolidated criteria for reporting qualitative research guidelines (COREQ). Results indicate that young people are motivated by their own lived experiences of trauma(s) to provide at‐risk peer mentoring. The experience of mentoring afforded opportunities to rewrite individual personal journeys of trauma through mentoring their at‐risk peers, thus constructing a more positive self‐identity. Outcomes of developing positive peer relationships and prosocial behaviours could significantly assist mental health clinicians in providing more acceptable care to clients in an age group known to be reluctant to accept traditional mental health intervention.     

Peer‐led diabetes self‐management programme for community‐dwelling older people in China: study protocol for a quasi‐experimental design

Aim. A protocol for a new peer‐led self‐management programme for community‐dwelling older people with diabetes in Shanghai, China. Background. The increasing prevalence of type 2 diabetes poses major public health challenges. Appropriate education programmes could help people with diabetes to achieve self‐management and better health outcomes. Providing education programmes to the fast growing number of people with diabetes present a real challenge to Chinese healthcare system, which is strained for personnel and funding shortages. Empirical literature and expert opinions suggest that peer education programmes are promising. Design. Quasi‐experimental. Methods. This study is a non‐equivalent control group design (protocol approved in January, 2008). A total of 190 people, with 95 participants in each group, will be recruited from two different, but similar, communities. The programme, based on Social Cognitive Theory, will consist of basic diabetes instruction and social support and self‐efficacy enhancing group activities. Basic diabetes instruction sessions will be delivered by health professionals, whereas social support and self‐efficacy enhancing group activities will be led by peer leaders. Outcome variables include: self‐efficacy, social support, self‐management behaviours, depressive status, quality of life and healthcare utilization, which will be measured at baseline, 4 and 12 weeks. Discussion. This theory‐based programme tailored to Chinese patients has potential for improving diabetes self‐management and subsequent health outcomes. In addition, the delivery mode, through involvement of peer leaders and existing community networks, is especially promising considering healthcare resource shortage in China.     

Measurement properties of a peer‐teaching scale for nursing education

Teaching is a key role for nurses in contemporary clinical practice. Consequently, peer‐assisted learning continues to gather momentum in nursing education in tertiary and professional education settings. In this study, we investigated the factor structure of the Peer Teaching Experience Questionnaire when completed by a group of nursing undergraduates from a large Australian university. Data from the 14‐item Peer Teaching Experience Questionnaire completed by third year undergraduate nursing students were analyzed using factor analysis. A total of 257 final (third)‐year undergraduate nursing students participated in the study. Factor analysis of the 14 items revealed three factors with eigenvalues above 1, accounting for 47.3% of the total variance. Items with loadings greater than ± 0.40, with the factor in question, were used to characterize the factor solutions. Findings from the exploratory factor analysis provide preliminary results that the Peer Teaching Experience Questionnaire has adequate dimensionality and reliability.     

Applying the self‐determination theory to develop a school‐to‐work peer mentoring programme to promote social inclusion

Social inclusion of individuals with intellectual and developmental disabilities (IDD) is related to positive mental health and social outcomes; yet, individuals with IDD experience societal barriers that limit opportunities for community participation. Providing opportunities for interactions between individuals with and without IDD through peer mentoring may diminish barriers and improve community inclusion. Guided by the self‐determination theory, the current report describes the development of a peer mentoring programme to promote the natural process of building intrinsic motivation and personal growth through opportunities for individuals without disabilities to socialize with individuals with IDD on a large university campus and throughout the surrounding community. The theoretical framework that informed the development of the peer mentoring programme is described, as well as the participants, the setting in which the programme is situated, the structure of the programme, the initial impacts and improvement of the programme over time, including approaches to sustainability, and implications for future research and practice.     

‘Walking the tightrope’: The role of peer support workers in facilitating consumers’ participation in decision‐making

In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision‐making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers’ participation in decision‐making and recovery. Semi‐structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor‐centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision‐making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery‐oriented care.     

Outcomes of a co‐facilitation skills training programme for mental health service users,family members,and clinicians: the EOLAS project

Health policy is increasingly advocating for involvement of service users and family members in service development. In the present study, we evaluated the impact of a 4‐day education programme in co‐facilitation skills on clinician and peer (service users and family members) knowledge, confidence, and subsequent experience as co‐facilitators. The programme was designed to train peers and clinicians as co‐facilitators on a clinician and peer‐led information programme for people experiencing mental health problems. The study employed a mixed‐methods design involving a pre–post survey with 128 participants, and follow‐up qualitative interviews with a sample of 17 participants. To examine changes in levels of knowledge and confidence in facilitating from time 1 (T1) to time 2 (T2), paired sample t‐tests were conducted, and thematic analysis was conducted on the interviews. The programme had a statistically‐significant positive impact on participants’ knowledge, confidence, and skills, with no significant difference between the facilitator groups (i.e. service user, family member, and clinician) in terms of their improvement at the end of the training, indicating that all groups benefited equally from the training. A majority of participants reported a high level of preparedness as co‐facilitators and an open and respectful approach towards each other's expertise, and many continued to gain skills and develop their confidence as they co‐facilitated the 8‐week EOLAS programme (‘eolas’ is the Irish word for knowledge). The findings also provide evidence of the acceptability and feasibility of the programme, and appears to be the first detailed study reported on a programme of this nature.     

Introducing peer‐group clinical supervision: An action research project

Clinical supervision (CS) has been found to be beneficial in the role development of nurses and can contribute to increased job satisfaction and reduced burnout. However, implementing CS can be resource intensive, and there are few accounts of it being implemented in developing countries. Ten psychiatric nurses in Trinidad engaged in an action research project over a 5‐month period to develop, implement, and undertake an initial evaluation of a model of peer‐group CS for use in routine practice. The participants were involved in undertaking peer‐group CS and contributing to monthly focus groups to reflect on the practices and further refine the model. This inexpensive form of CS was perceived by participants to have positive effects on the way they viewed and practiced nursing. An outline of the model and initial evaluation is presented, but further research is necessary to establish the sustainability of the model in practice.     

Cross‐age peer mentoring approach to impact the health outcomes of children and families

Column Editor: Bonnie Gance‐Cleveland Family‐Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family‐to‐family support, and confidence building.     

‘Anyone can have a mental illness’: A qualitative inquiry of pre‐registration nursing students’ experiences of traditional mental health clinical placements

Nurses play a crucial role in mental healthcare provision. Like many countries, Australian nursing students are educated in comprehensive pre‐registration programmes which include mental health clinical placements. Placements play a vital role in students’ education, providing the opportunity to engage with consumers and develop mental health nursing knowledge and skills. There is limited knowledge of student perspectives on traditional placements in contemporary recovery‐oriented mental health services. This interpretive qualitative inquiry aimed to explore nursing students’ experience of traditional mental health clinical placement and how it influenced their practice and their understandings of recovery from mental illness. Data were collected from focus groups with n = 31 nursing students in a large metropolitan public mental health service. Thematic analysis resulted in three themes of experience: humanizing people with mental illness; learning about recovery; and shifting perspectives on mental health nursing. Through a positive placement experience where they felt supported and included by staff, students came to see consumers as people rather than diagnoses, developed greater understanding of mental health nursing work and were more likely to consider mental health nursing as a career choice. Peer‐support workers were an important influence on students’ understandings of recovery and have a key role to play in educating students on placement. Students need to be prepared and supported by university and clinical staff to deal with vicarious trauma that may occur on placement. Mental health placements play a crucial role in attracting students into the field, and it is imperative they remain part of comprehensive pre‐registration education.