Peer support for CKD patients and carers: overcoming barriers and facilitating access

Abstract

BackgroundPeer support is valued by its users. Nevertheless, there is initial low take‐up of formal peer support programmes among patients with chronic kidney disease (CKD), with fewer patients participating than expressing an interest. There is little evidence on reasons for low participation levels. Few studies have examined the perspectives of carers.ObjectiveTo explore with CKD patients and carers their needs, wants and expectations from formal peer support and examine how barriers to participation may be overcome.MethodsQualitative interviews with a sample of 26 CKD stage five patients and carers. Principles of Grounded Theory were applied to data coding and analysis.SettingSix NHS Hospital Trusts.ResultsWhilst informal peer support might occur naturally and is welcomed, a range of emotional and practical barriers inhibit take‐up of more formalized support. Receptivity varies across time and the disease trajectory and is associated with emotional readiness; patients and carers needing to overcome complex psychological hurdles such as acknowledging support needs. Practical barriers include limited understanding of peer support. An attractive peer relationship is felt to involve reciprocity based on sharing experiences and both giving and receiving support. Establishing rapport is linked with development of reciprocity.ConclusionsThere is potential to facilitate active uptake of formal peer support by addressing the identified barriers. Our study suggests several facilitation methods, brought together in a conceptual model, including clinician promotion of peer support as an intervention suitable for anyone with CKD and their carers, and opportunity for choice of peer supporter.

Patient‐to‐patient peer mentor support in dialysis: Improving the patient experience

“…The timing of these conversations can be when a person is first diagnosed with ESKD, when dialysis is imminent, or when the discussion of transplant is considered. These shorter conversations have shown benefit in the ESKD population, particularly when experiences are shared with both mentor and mentee providing support for each other …”

“…Mentor programs can be coordinated by a local dialysis or outpatient center or can be run from a renal network or region . The National Kidney Foundation (NKF) has developed this to a national basis through their NKF Peers program .…”

“…Knowledge relating to confidentiality, sharing experiences without sharing medical information, when to refer to health professionals and self‐management is commonly presented . Other processes that are undertaken may be confidentiality agreements and background checks . The ultimate aim of the training is to ensure the mentor is well prepared to facilitate an optimal mentor/mentee experience.…”

“…The patient‐to‐patient peer relationship is one that is nonhierarchical and reciprocal with peers sharing similar experiences and knowledge with others who have undergone similar challenges . Thus, the strategy of peer mentor programs is based on this premise that people who have gone through these experiences are best placed to assist others . Peers can develop relationships and provide additional emotional support and informational assistance to address common health‐related issues .…”

Effect of peer support on health outcomes in patients with cardiac pacemaker implantation: A randomized, controlled trial

“…Patients are not the only beneficiaries of peer support, and nurses or other caregivers can benefit from it (Charlesworth et al, ; Taylor, Gutteridge, & Willis, ). At the end of the program, three nurses were asked what impact peer support had on them.…”