Skip to main content
Top
Published in: BMC Nephrology 1/2022

Open Access 01-12-2022 | Care | Research

Healthcare provider perspectives on integrating peer support in non-dialysis-dependent chronic kidney disease care: a mixed methods study

Authors: Shannan Love, Tyrone G. Harrison, Danielle E. Fox, Maoliosa Donald, Nancy Verdin, Brenda R. Hemmelgarn, Meghan J. Elliott

Published in: BMC Nephrology | Issue 1/2022

Login to get access

Abstract

Background

Peer support complements traditional models of chronic kidney disease (CKD) care through sharing of peer experiences, pragmatic advice, and resources to enhance chronic kidney disease self-management and decision-making. As peer support is variably offered and integrated into multi-disciplinary CKD care, we aimed to characterize healthcare providers’ experiences and views on peer support provision for people with non-dialysis-dependent CKD within Canada.

Methods

In this concurrent mixed methods study, we used a self-administered online survey to collect information from multi-disciplinary CKD clinic providers (e.g., nurses, nephrologists, allied health professionals) on peer support awareness, program characteristics and processes, perceived value, and barriers and facilitators to offering peer support in CKD clinics. Results were analyzed descriptively. We undertook semi-structured interviews with a sample of survey respondents to elaborate on perspectives about peer support in CKD care, which we analyzed using inductive, content analysis.

Results

We surveyed 113 providers from 49 clinics. Two thirds (66%) were aware of formal peer support programs, of whom 19% offered in-house peer support through their clinic. Peer support awareness differed by role and region, and most referrals were made by social workers. Likert scale responses suggested a high perceived need of peer support for people with CKD. Top cited barriers to offering peer support included lack of peer support access and workload demands, while facilitators included systematic clinic processes for peer support integration and alignment with external programs. Across 18 interviews, we identified themes related to peer support awareness, logistics, and accessibility and highlighted a need for integrated support pathways.

Conclusions

Our findings suggest variability in awareness and availability of peer support among Canadian multi-disciplinary CKD clinics. An understanding of the factors influencing peer support delivery will inform strategies to optimize its uptake for people with advanced CKD.
Appendix
Available only for authorised users
Literature
1.
go back to reference Collaboration GBDCKD. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–33.CrossRef Collaboration GBDCKD. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–33.CrossRef
2.
go back to reference Donald M, Beanlands H, Straus S, Ronksley P, Tam-Tham H, Finlay J, et al. Identifying Needs for Self-management Interventions for Adults With CKD and Their Caregivers: A Qualitative Study. Am J Kidney Dis. 2019;74(4):474–82.CrossRefPubMed Donald M, Beanlands H, Straus S, Ronksley P, Tam-Tham H, Finlay J, et al. Identifying Needs for Self-management Interventions for Adults With CKD and Their Caregivers: A Qualitative Study. Am J Kidney Dis. 2019;74(4):474–82.CrossRefPubMed
3.
go back to reference Chen SH, Tsai YF, Sun CY, Wu IW, Lee CC, Wu MS. The impact of self-management support on the progression of chronic kidney disease--a prospective randomized controlled trial. Nephrol Dial Transplant. 2011;26(11):3560–6.CrossRefPubMed Chen SH, Tsai YF, Sun CY, Wu IW, Lee CC, Wu MS. The impact of self-management support on the progression of chronic kidney disease--a prospective randomized controlled trial. Nephrol Dial Transplant. 2011;26(11):3560–6.CrossRefPubMed
4.
5.
go back to reference Ghahramani N, Chinchilli VM, Kraschnewski JL, Lengerich EJ, Sciamanna CN. Effect of Peer Mentoring on Quality of Life among CKD Patients: Randomized Controlled Trial. Kidney Dis (Basel). 2021;7(4):323–33.CrossRef Ghahramani N, Chinchilli VM, Kraschnewski JL, Lengerich EJ, Sciamanna CN. Effect of Peer Mentoring on Quality of Life among CKD Patients: Randomized Controlled Trial. Kidney Dis (Basel). 2021;7(4):323–33.CrossRef
6.
go back to reference Wood E. Patient-to-patient peer support in renal care: examining the role and attitudes of renal clinicians. J Renal Nurs. 2014;6:293–7.CrossRef Wood E. Patient-to-patient peer support in renal care: examining the role and attitudes of renal clinicians. J Renal Nurs. 2014;6:293–7.CrossRef
7.
go back to reference Taylor F, Gutteridge R, Willis C. Peer support for CKD patients and carers: overcoming barriers and facilitating access. Health Expect. 2016;19(3):617–30.CrossRefPubMed Taylor F, Gutteridge R, Willis C. Peer support for CKD patients and carers: overcoming barriers and facilitating access. Health Expect. 2016;19(3):617–30.CrossRefPubMed
8.
go back to reference Winterbottom AE, Bekker HL, Conner M, Mooney AF. Patient stories about their dialysis experience biases others’ choices regardless of doctor’s advice: an experimental study. Nephrol Dial Transplant. 2012;27(1):325–31.CrossRefPubMed Winterbottom AE, Bekker HL, Conner M, Mooney AF. Patient stories about their dialysis experience biases others’ choices regardless of doctor’s advice: an experimental study. Nephrol Dial Transplant. 2012;27(1):325–31.CrossRefPubMed
9.
go back to reference Yohanna S, Naylor KL, Mucsi I, McKenzie S, Belenko D, Blake PG, et al. A Quality Improvement Intervention to Enhance Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD) in Patients With Chronic Kidney Disease: Clinical Research Protocol of a Cluster-Randomized Clinical Trial. Can J Kidney Health Dis. 2021;8:1–18.CrossRef Yohanna S, Naylor KL, Mucsi I, McKenzie S, Belenko D, Blake PG, et al. A Quality Improvement Intervention to Enhance Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD) in Patients With Chronic Kidney Disease: Clinical Research Protocol of a Cluster-Randomized Clinical Trial. Can J Kidney Health Dis. 2021;8:1–18.CrossRef
10.
go back to reference Walker RC, Howard K, Morton RL, Palmer SC, Marshall MR, Tong A. Patient and caregiver values, beliefs and experiences when considering home dialysis as a treatment option: a semi-structured interview study. Nephrol Dial Transplant. 2016;31(1):133–41.CrossRefPubMed Walker RC, Howard K, Morton RL, Palmer SC, Marshall MR, Tong A. Patient and caregiver values, beliefs and experiences when considering home dialysis as a treatment option: a semi-structured interview study. Nephrol Dial Transplant. 2016;31(1):133–41.CrossRefPubMed
11.
go back to reference Sullivan C, Dolata J, Barnswell KV, Greenway K, Kamps CM, Marbury Q, et al. Experiences of Kidney Transplant Recipients as Patient Navigators. Transplant Proc. 2018;50(10):3346–50.CrossRefPubMedPubMedCentral Sullivan C, Dolata J, Barnswell KV, Greenway K, Kamps CM, Marbury Q, et al. Experiences of Kidney Transplant Recipients as Patient Navigators. Transplant Proc. 2018;50(10):3346–50.CrossRefPubMedPubMedCentral
12.
go back to reference St Clair Russell J, Southerland S, Huff ED, Thomson M, Meyer KB, Lynch JR. A Peer-to-Peer Mentoring Program for In-Center Hemodialysis: A Patient-Centered Quality Improvement Program. Nephrol Nurs J. 2017;44(6):481–96.PubMed St Clair Russell J, Southerland S, Huff ED, Thomson M, Meyer KB, Lynch JR. A Peer-to-Peer Mentoring Program for In-Center Hemodialysis: A Patient-Centered Quality Improvement Program. Nephrol Nurs J. 2017;44(6):481–96.PubMed
13.
go back to reference Tweed AE, Ceaser K. Renal replacement therapy choices for pre-dialysis renal patients. Br J Nurs. 2005;14(12):659–64.CrossRefPubMed Tweed AE, Ceaser K. Renal replacement therapy choices for pre-dialysis renal patients. Br J Nurs. 2005;14(12):659–64.CrossRefPubMed
16.
go back to reference Bennett PN, St Clair Russell J, Atwal J, Brown L, Schiller B. Patient-to-patient peer mentor support in dialysis: Improving the patient experience. Semin Dial. 2018;31(5):455–61.CrossRefPubMed Bennett PN, St Clair Russell J, Atwal J, Brown L, Schiller B. Patient-to-patient peer mentor support in dialysis: Improving the patient experience. Semin Dial. 2018;31(5):455–61.CrossRefPubMed
17.
go back to reference Elliott MJ, Goodarzi Z, Sale JEM, Wilhelm LA, Laupacis A, Hemmelgarn BR, et al. Perceived Significance of Engagement in Research Prioritization Among Chronic Kidney Disease Patients, Caregivers, and Health Care Professionals: A Qualitative Study. Can J Kidney Health Dis. 2018;5:1–9.CrossRef Elliott MJ, Goodarzi Z, Sale JEM, Wilhelm LA, Laupacis A, Hemmelgarn BR, et al. Perceived Significance of Engagement in Research Prioritization Among Chronic Kidney Disease Patients, Caregivers, and Health Care Professionals: A Qualitative Study. Can J Kidney Health Dis. 2018;5:1–9.CrossRef
19.
go back to reference Levin A, Steven S, Selina A, Flora A, Sarah G, Braden M. Canadian chronic kidney disease clinics: a national survey of structure, function and models of care. Can J Kidney Health Dis. 2014;1:29.CrossRefPubMedPubMedCentral Levin A, Steven S, Selina A, Flora A, Sarah G, Braden M. Canadian chronic kidney disease clinics: a national survey of structure, function and models of care. Can J Kidney Health Dis. 2014;1:29.CrossRefPubMedPubMedCentral
20.
go back to reference Beaulieu M, Levin A. Analysis of multidisciplinary care models and interface with primary care in management of chronic kidney disease. Semin Nephrol. 2009;29(5):467–74.CrossRefPubMed Beaulieu M, Levin A. Analysis of multidisciplinary care models and interface with primary care in management of chronic kidney disease. Semin Nephrol. 2009;29(5):467–74.CrossRefPubMed
21.
go back to reference Collister D, Pyne L, Cunningham J, Donald M, Molnar A, Beaulieu M, et al. Multidisciplinary Chronic Kidney Disease Clinic Practices: A Scoping Review. Can J Kidney Health Dis. 2019;6:1–11. Collister D, Pyne L, Cunningham J, Donald M, Molnar A, Beaulieu M, et al. Multidisciplinary Chronic Kidney Disease Clinic Practices: A Scoping Review. Can J Kidney Health Dis. 2019;6:1–11.
22.
go back to reference Saxena N, Rizk DV. The interdisciplinary team: the whole is larger than the parts. Adv Chronic Kidney Dis. 2014;21(4):333–7.CrossRefPubMed Saxena N, Rizk DV. The interdisciplinary team: the whole is larger than the parts. Adv Chronic Kidney Dis. 2014;21(4):333–7.CrossRefPubMed
23.
go back to reference Creswell JW, Clark VL. Chapter 3: Core mixed methods designs. 3rd ed. Thousand Oaks: SAGE Publications; 2018. Creswell JW, Clark VL. Chapter 3: Core mixed methods designs. 3rd ed. Thousand Oaks: SAGE Publications; 2018.
24.
go back to reference Levitt HM, Bamberg M, Creswell JW, Frost DM, Josselson R, Suarez-Orozco C. Journal article reporting standards for qualitative primary, qualitative meta-analytic, and mixed methods research in psychology: The APA Publications and Communications Board task force report. Am Psychol. 2018;73(1):26–46.CrossRefPubMed Levitt HM, Bamberg M, Creswell JW, Frost DM, Josselson R, Suarez-Orozco C. Journal article reporting standards for qualitative primary, qualitative meta-analytic, and mixed methods research in psychology: The APA Publications and Communications Board task force report. Am Psychol. 2018;73(1):26–46.CrossRefPubMed
25.
go back to reference Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRefPubMed Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRefPubMed
26.
go back to reference Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research. Admin Pol Ment Health. 2015;42(5):533–44.CrossRef Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research. Admin Pol Ment Health. 2015;42(5):533–44.CrossRef
27.
go back to reference Donald M, Gil S, Kahlon B, Beanlands H, Straus S, Herrington G, et al. Overview of Self-Management Resources Used by Canadian Chronic Kidney Disease Clinics: A National Survey. Can J Kidney Health Dis. 2018;5:1–8.CrossRef Donald M, Gil S, Kahlon B, Beanlands H, Straus S, Herrington G, et al. Overview of Self-Management Resources Used by Canadian Chronic Kidney Disease Clinics: A National Survey. Can J Kidney Health Dis. 2018;5:1–8.CrossRef
28.
go back to reference Hennink MM, Kaiser BN, Marconi VC. Code Saturation Versus Meaning Saturation: How Many Interviews Are Enough? Qual Health Res. 2017;27(4):591–608.CrossRefPubMed Hennink MM, Kaiser BN, Marconi VC. Code Saturation Versus Meaning Saturation: How Many Interviews Are Enough? Qual Health Res. 2017;27(4):591–608.CrossRefPubMed
29.
go back to reference Stata Statistical Software: Release 17. College Station, TX: StataCorp LLC; 2021. Stata Statistical Software: Release 17. College Station, TX: StataCorp LLC; 2021.
30.
go back to reference Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRefPubMed Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRefPubMed
31.
go back to reference NVivo 12 qualitative data analysis software. Victoria, Australia: Quantitative Solutions and Research Pty Ltd; 2020. NVivo 12 qualitative data analysis software. Victoria, Australia: Quantitative Solutions and Research Pty Ltd; 2020.
32.
go back to reference Dennis CL. Peer support within a health care context: a concept analysis. Int J Nurs Stud. 2003;40(3):321–32.CrossRefPubMed Dennis CL. Peer support within a health care context: a concept analysis. Int J Nurs Stud. 2003;40(3):321–32.CrossRefPubMed
34.
go back to reference Wood E. Peer support: Increasing participation through clinician engagement. J Renal Nurs. 2015;7:189–93.CrossRef Wood E. Peer support: Increasing participation through clinician engagement. J Renal Nurs. 2015;7:189–93.CrossRef
35.
go back to reference Cassidy BP, Harwood L, Getchell LE, Smith M, Sibbald SL, Moist LM. Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study. Can J Kidney Health Dis. 2018;5:1–9. Cassidy BP, Harwood L, Getchell LE, Smith M, Sibbald SL, Moist LM. Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study. Can J Kidney Health Dis. 2018;5:1–9.
36.
go back to reference Heisler M. Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. Fam Pract. 2010;27(Suppl 1):i23–32.CrossRefPubMed Heisler M. Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. Fam Pract. 2010;27(Suppl 1):i23–32.CrossRefPubMed
37.
go back to reference Hemmelgarn BR, Pannu N, Ahmed SB, Elliott MJ, Tam-Tham H, Lillie E, et al. Determining the research priorities for patients with chronic kidney disease not on dialysis. Nephrol Dial Transplant. 2017;32(5):847–54.PubMed Hemmelgarn BR, Pannu N, Ahmed SB, Elliott MJ, Tam-Tham H, Lillie E, et al. Determining the research priorities for patients with chronic kidney disease not on dialysis. Nephrol Dial Transplant. 2017;32(5):847–54.PubMed
Metadata
Title
Healthcare provider perspectives on integrating peer support in non-dialysis-dependent chronic kidney disease care: a mixed methods study
Authors
Shannan Love
Tyrone G. Harrison
Danielle E. Fox
Maoliosa Donald
Nancy Verdin
Brenda R. Hemmelgarn
Meghan J. Elliott
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2022
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-022-02776-w

Other articles of this Issue 1/2022

BMC Nephrology 1/2022 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.