The goal of this study was to examine the impact of hospice palliative care work on volunteers' lives. In-depth interviews were conducted with 23 direct-patient care volunteers. More than half of the volunteers became involved in hospice palliative care because of their own experiences with family members and/or friends who have died. Most of the volunteers reported that they were different now or had changed in some way since they have been volunteering (e.g., they had grown in some way, have learned how to keep things in perspective). In addition, most of the volunteers felt that their outlook on life had changed since they started volunteering (e.g., they were more accepting of death, and they learned the importance of living one day at a time). Volunteers reported doing a number of different things to prevent compassion fatigue or burnout (e.g., reading a book, listening to music, talking to others, and taking time off from volunteering). Most of the volunteers said that they would tell anyone who might be thinking of volunteering in hospice palliative care that it is a very rewarding activity and/or that they should try it. Finally, many of the volunteers offered suggestions for doing things differently in their programs.

Given the essential role of volunteers in hospice palliative care, it would be beneficial to have a recruitment and retention tool that is reliable and valid. To address this gap, the current investigation sought to adapt and extend the Inventory of Motivations for Palliative Care Volunteerism (IMPCV) of Claxton-Oldfield, Jefferies, Fawcett, Wasylkiw, and Claxton-Oldfield.(1) The purpose of study 1 was to address methodological concerns of the IMPCV using 141 undergraduate students. After conceptually relevant items were added to the IMPCV, participants indicated the degree of influence each of the motivations would have on their, and another person's, decision to become a hospice palliative care volunteer. In both cases, 5 internally consistent subscales were identified through principal components analysis: altruism, civic responsibility, self-promotion, leisure, and personal gain. Convergent and discriminant validity were demonstrated using an established measure of empathy. In study 2, 141 hospice palliative care volunteers completed the revised and renamed Inventory of Motivations for Hospice Palliative Care Volunteerism (IMHPCV). Confirmatory factor analysis provided support for the 5-factor structure of the IMHPCV. The authors encourage other researchers to use the IMHPCV as a measurement tool in studying the motivations of hospice palliative care volunteers.

Before and immediately after the 2 most recent offerings of a local palliative care volunteer training program, 17 participants completed the Collett-Lester Fear of Death Scale and Bugen's Coping with Death Scale. The training program consisted of approximately 27 hours of training presented in 3-hour blocks during a 9-week period. Topics included the philosophy and goals of palliative care, spiritual issues from a multi-cultural and multifaith perspective, communication, the dying process, grief and bereavement, and the role of the volunteer. The results showed no differences in participants' pretraining and posttraining scores on the 4 subscales of the Fear of Death Scale. However, participants felt significantly more able to cope with death and dying after the training program than before. With proper training, volunteers will feel more prepared to handle situations involving terminal illness and death. In short, they will be more effective in their work with dying patients and their families.

A total of 50 nurses (hospital and home care) responded to a survey designed to measure: (1) their attitudes toward, and knowledge of, hospice palliative care volunteers; (2) the types of tasks they felt it was appropriate for volunteers to perform; and (3) how valuable they felt different members of the hospice palliative care team are. In addition, they were asked to respond to some open-ended questions (eg, "Do you feel that it is appropriate for hospice palliative care volunteers to know patient medical information?"). The nurses' responses to the "Attitude/Knowledge" part of the survey revealed that they generally held positive attitudes toward volunteers. The majority of the nurses felt that it was appropriate for volunteers to perform most of the tasks listed, except for hands-on patient care. Nurses rated the value of nurses, family members, doctors, and pharmacists significantly higher than volunteers. Fifty-three percent of the nurses felt that volunteers should know patient medical information, and 77% thought that volunteers should have the opportunity to provide input regarding patient care. Also, 75% of the nurses felt that volunteers made their jobs easier, and 56% felt that volunteers should be included in team meetings. When asked to list the topics covered in a hospice palliative care volunteer training program, 73% of the nurses indicated that they were not sure or did not know what topics were covered, indicating a lack of knowledge regarding volunteer training.

This paper examines 4 common problems that many hospice palliative care volunteers in Canada (and the United States) encounter, namely, being underutilized, being placed with a patient too late in the patient's illness, feeling undervalued by some members of the medical staff, and not being able to do more to help patients and their families. The implications of each of these problems are discussed along with suggestions for overcoming them. Finally, some ideas for future research are proposed.