The following is a recommended intervention identified by the TP-CKD programme for implementation with both staff and patients, to test the following question:
Can the use of intervention tools help to improve the knowledge, skills and confidence of patients with kidney disease to enable fuller participation in the management of their own health?
To explore other interventions identified by the programme, visit our Interventions Toolkit Home Page
Peer Support
Peer Support occurs when patients are put in touch with each other for the specific purpose of giving and receiving assistance with issues related to their common goals (Dennis 2003).
Patients share their experiences all the time e.g. in clinic waiting rooms, when sharing a ward bay, whilst receiving treatment. However, formal peer support offers individuals contact with other patients who have been trained to provide such support, and has been shown to be more positively viewed than unplanned/untrained support (McCarthy 2014).
Here’s a couple of examples of where peer support has been put into practice:
Implementing peer support as an intervention: Click here to read about the peer support service offered at King’s College Hospital renal department.
Learning, sharing and helping others: Click here to read renal patient Geoff’s personal experience in his role as Volunteer Patient Liaison Officer.
What are the benefits?
Peer support has the potential to improve experience, psycho-social outcomes, behaviour, health outcomes and service use among people with long-term physical and mental health conditions and their carers’. Experience and evidence suggest that peer support is valued by those who take part and that it can improve how people feel and what they do. It may improve self-confidence (“you are not alone”) and motivation.
I know the staff, and the nurses know about that sort of thing but it’s different when it’s the truth from a patient about how it’s affected them
It may also enhance self-esteem in the supporter.
How can it be used?
The top three most useful types of initiatives for improving emotional and physical wellbeing may be:
- Face-to-face groups run by trained peers which focus on emotional support, sharing experiences, education and specific activities such as exercise or social activities
- One-to-one support offered face-to-face or by telephone. This may include information provision, emotional support, befriending and conversation. This type of one-to-one support may result in reciprocal benefits for supporters and may involve volunteers rather than paid peer support facilitators
- Online platforms such as discussion forums. These have been found to be useful for improving knowledge and reducing anxiety, though people may use them only for a limited time
For patients
Talking to another patient who has had the same or similar experience may give a patient a better understanding of living with their condition and help them make decisions. In a unit with a peer-support service, a member of staff will be able to arrange a conversation with an appropriate peer supporter. Conversations can take place face-to-face, by phone or even email. Peer supporters are trained to listen, maintain confidentiality and share what they know. They don’t provide education as this is too individualised and needs to be provided by a healthcare professional. Many units do not have a formal peer support service. However, even in these circumstances healthcare professionals may well be able to arrange a conversation with an appropriate person.
For staff
Trained peer supporters can offer patients a level of understanding and shared experience that healthcare professionals are unable to do. Sharing common experience has been shown to improve experience, psycho-social outcomes, behaviour, and both physical and mental health outcomes.
Though inexpensive to set-up and manage peer support does need organising and time investing in it. A training package has been developed and evaluated and is available free of charge (see resources section) (Wood 2014a 2014b, 2015). The package provides the training syllabus and resources needed. It is recommended that peer supporters are registered as hospital volunteers (ensuring a criminal record check) and, more importantly, that they are recognised for the support they are providing. Volunteer services may also cover the cost of transport and parking when peer support is being delivered.
Peer support does have its challenges; it takes staff time and effort to identify and train peer supporters. Maintaining the peer support service and getting healthcare professionals to refer patients requires regular reminders to the wider service. There will be a turnover of peer supporters due to changing life circumstances so we recommend only training a few supporters at a time, but training regularly. Ideally, having a wide range of patient experience, ages and ethnicity in your peer supporters makes it likely that people can be matched with someone they are able to relate to (McCarthy 2016).
Useful Links and Resources
The Health Foundation. Patient centred Care. 2014
Nesta UK. People helping people: peer support that changes lives. 2014
National Voices. Peer support: what is it and does it work? 2015
Dennis CL. Peer support within a health care context: a concept analysis. Int J Nurs Stud, Vol 40 (3): 321-332
Wood E. Patient to patient peer support in renal care: what, why and how. Journal of renal nursing: 2014a Vol 6 (5) 239-243
Wood E. Patient to patient peer support in renal care: examining the role and attitudes of renal clinicians. Journal of renal nursing: 2014b Vol 6 (6) 293-297
Wood E. Peer support: increasing participation through clinician engagement. Journal of renal nursing: 2015 Vol 7 (4) 189-193