Abstract：
The challenges faced by caregivers of people living with serious mental illness in Canada are well documented in the literature including emotional distress, financial strain, social isolation, and concerns about their physical health following the impact of caregiving. Peer support programs (including peer support groups) emerged as a promising method to attempt to address these challenges. While there is evidence on the positive impacts of peer support groups in providing support for caregivers, the mechanisms by which peer support groups operate and influence support for caregivers of people living with serious mental illness are less understood. This qualitative study took on a co-designed participatory research approach. Fifteen adult caregivers of people living with serious mental illness across Canada were engaged through key informant interviews that lasted for 45 - 60 min each. A thematic analysis was carried out to help understand the operational mechanisms of peer support groups in influencing support for caregivers. The key informant interviews allowed for the identification and description of the following operational mechanisms that influenced the support caregivers received from peer support groups: (1) Group dynamics; (2) Messaging/content; (3) Equity and inclusion, (4) Group philosophy; and (5) Privacy concerns. Findings from this study showed that caregivers identified a number of operational mechanisms of peer support groups that explained how they felt supported when they participated in peer support groups. Among other operational mechanisms, group dynamics in terms of the gathering of caregivers of different age brackets and varying caregiving experience negatively influenced the peer support experience of caregivers. This pointed to the need for group dynamics that consider close age ranges and similar caregiving experience during group meetings to enhance support for caregivers. Caregivers also identified a gap in equity and inclusion in peer support groups that could have otherwise enriched their experience and enhanced the support they looked to receive from the group. Practical examples to enhance equity and inclusion include promoting active listening, using inclusive language, encouraging diverse representation and asking for feedback from peer support group members. While peer support groups in Canada exist independently of one another, it may help to consolidate evidence-based recommendations in the operational mechanisms of these groups, for the benefit of caregivers who turn to these groups for support, having been left on their own by an otherwise fractured mental health system.
摘要：
在加拿大，患有严重精神疾病的人的照顾者所面临的挑战在文献中有很好的记录，包括情绪困扰，财务压力，社会孤立,以及护理影响后对他们身体健康的担忧。对等支持计划（包括对等支持小组）成为尝试解决这些挑战的一种有希望的方法。虽然有证据表明同伴支持小组在为照顾者提供支持方面的积极影响，同伴支持小组的运作和影响对患有严重精神疾病的人的照顾者的支持的机制知之甚少。这项定性研究采用了共同设计的参与式研究方法。加拿大各地15名患有严重精神疾病的成年人的照顾者通过关键的线人访谈进行了采访，每次持续45-60分钟。进行了主题分析，以帮助了解同伴支持小组在影响对护理人员的支持方面的运作机制。关键的线人访谈允许识别和描述以下影响从同伴支持小组获得的支持护理人员的运作机制:(1)小组动态；(2)消息传递/内容；(3)公平和包容，(4)集团理念；(5)隐私问题。这项研究的结果表明，护理人员确定了同伴支持小组的许多运作机制，这些机制解释了当他们参加同伴支持小组时他们的感受。在其他运作机制中，不同年龄段的护理人员的聚集和不同的护理经验对护理人员的同伴支持体验产生了负面影响。这表明需要在小组会议期间考虑紧密的年龄范围和类似的护理经验的小组动态，以加强对护理人员的支持。照顾者还发现，在平等和包容方面存在差距，同行支持小组本来可以丰富他们的经验，并增强他们希望从小组获得的支持。加强公平和包容的实际例子包括促进积极倾听，使用包容性语言，鼓励多样化的代表，并要求同行支持小组成员提供反馈。虽然加拿大的同行支持团体彼此独立存在，它可能有助于在这些团体的运作机制中巩固基于证据的建议，为了向这些团体寻求支持的护理人员的利益，被一个原本支离破碎的心理健康系统独自留下。
