Peer support experiences and needs across the continuum of trauma care: A qualitative study of traumatic injury survivor, caregiver, and provider perspectives.

Background: Traumatic injuries significantly impact individuals' physical and mental health and are a leading cause of disability worldwide. Trauma recovery is complex and entails patients interacting with multiple places of care before returning to the community. Despite trauma recovery being optimized when patients' psychosocial needs are addressed early on and throughout recovery, care remains overwhelmingly focused on physical and functional improvement. Peer support is a cost-effective way of providing emotionally and experientially-driven psychosocial support that complements usual patient care. Thus, we aimed to explore the experiences of trauma survivors, family caregivers, and healthcare providers (HCPs) with engaging in and facilitating peer support and to identify their priorities for a future peer support program.

Methods: Qualitative descriptive approach. Trauma survivors, caregivers and HCPs were recruited from three major trauma centres in Ontario. We conducted one-one-one interviews with participants which were recorded and transcribed. Data was thematically analyzed by multiple analysts to reduce bias and enhance data reliability.

Results: We interviewed n=16 trauma survivors, n=4 caregivers, and n=16 HCPs. We identified four themes: (1) "It's a major change": Navigating life after injury is challenging and characterized by uncertainty; "I just needed somebody just to talk to:" Peer support helps trauma survivors feel like they're not alone; (3) "You can learn off each other": Peer support is multi-faceted and facilitates recovery in ways that other supports cannot; and (4) "If other people say negative things…that makes things worse": Tensions exist between the benefits of peer support and the risk of unintended negative consequences. Overall, to meet trauma survivors' socialization needs and enhance the efficacy of interventions, it is recommended that peer support to be offered via a range of modalities.

Conclusions: Our study demonstrates that peer support is valued across stakeholders and has the potential to positively impact the psychosocial health of trauma survivors throughout recovery. Future development of a cross-continuum peer support program will consider how to connect peers early on after injury and sustain these relationships into community recovery.