Perspectives on Volunteer-Professional Collaboration in Palliative Care: A Qualitative Study Among Volunteers, Patients, Family Carers, and Health Care Professionals

Abstract

Context. Governments intend to meet resource constraints in professional palliative care by stimulating informal care, including volunteerism. However, little is known about current volunteer-professional collaboration. Such insights are relevant for future policy development regarding volunteer efficiency, quality of care, and the capacity of volunteer care to support health care services and professionals.Objectives.To explore what constitutes volunteer-professional collaboration around palliative care. Methods. A qualitative study was conducted using semistructured focus groups with volunteers, nurses, psychologists, and family physicians and semistructured interviews with people with serious illnesses and with family carers. Participants were recruited from hospital, home-care, day-care, and live-in services in Flanders, Belgium. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed by using a phenomenological approach. Two researchers coded independently in NVIVO 11 and reached a definitive coding scheme by comparing their resulting conceptual schemes.Results. Seventy-nine people participated in the study. Volunteers collaborate mostly with nurses, less with psychologists but not with physicians. Volunteer-professional collaboration entails mutual information-sharing regarding patient conditions and coordination of care provision, whereas nurses and psychologists provide emotional and functional support for volunteers. Lack of access to nurses, of leadership, and of patient-information-sharing guidelines were the most prominent barriers to collaboration.Conclusion. Volunteers are at the front line of palliative care provision and therefore collaborate intensely with nurses, particularly in dedicated palliative care services. However, collaboration with other professionals is limited. The presence and availability of nurses was found to be crucial for volunteers, both for support and to achieve integration through collaboration.

The involvement of volunteers in palliative care and their collaboration with healthcare professionals: A cross‐sectional volunteer survey across the Flemish healthcare system (Belgium)

“…Lower response rates from certain types of volunteers, such as those in nursing homes and community home care, imply possible issues for statistical generalisation and, hence, that results for the particular organisational types should be interpreted with caution. Results nevertheless confirm the findings from a previous organisational study of palliative care volunteering (Vanderstichelen et al, ; Vanderstichelen, Houttekier, et al, ) and are contextualised by previous qualitative studies of volunteering in these settings (Vanderstichelen, Cohen, Van Wesemael, Deliens, & Chambaere, ; Vanderstichelen et al, ), indicating the validity of our current conclusions. Strongly involved volunteers may be overrepresented in these strata.…”

“…Across health services, volunteers collaborated mainly with fellow volunteers, volunteer coordinators, nurses and family caregivers. Dedicated palliative care volunteers collaborated most often and extensively with nurses, confirming previous studies that have shown the importance of nurses to palliative care volunteering (Vanderstichelen, Cohen, et al, ; Vanderstichelen et al, ). Inpatient care service volunteers collaborated more with nurses than extramural care volunteers, however, the latter collaborated more with family caregivers than other volunteers.…”

“…Considering that nursing homes have been shown to invest little into palliative care volunteering in terms of tasks, training, supervision and coordination (Vanderstichelen, Cohen, et al, ; Vanderstichelen et al, , ; Vanderstichelen, Houttekier, et al, ), this may signal an existing potential for nursing home volunteers to expand their role as palliative care volunteers currently not being realised. In the light of these findings and the important complementary value of volunteers to palliative care (Vanderstichelen, Cohen, et al, ; Vanderstichelen et al, ), we suggest that nursing homes should consider employing volunteers more for palliative care tasks, offer them the required autonomy for this work and invest in the necessary supervision and training and collaboration with professionals to fully integrate them into palliative care provision.…”

“…Inpatient care service volunteers collaborated more with nurses than extramural care volunteers, however, the latter collaborated more with family caregivers than other volunteers. The low collaboration with psychologists was surprising, however, given that a previous qualitative study suggested the importance of contact between volunteers and psychologists (Vanderstichelen et al, ). It may be that psychologists have an important role in supporting volunteers, but less frequently interact with them regarding care provision.…”

“…Several studies have explored volunteer task performance, training, motivation, economic value and turnover rates (Burbeck et al, 2014;Claxton-Oldfield & Claxton-Oldfield, 2012;Morris, Payne, Ockenden, & Hill, 2017;Morris et al, 2013;Vanderstichelen, Houttekier, et al, 2018). However, with exception of a few studies that consider volunteer involvement -conceptualised mainly as volunteer presence -in palliative care (Candy, France, Low, & Sampson, 2015;Vanderstichelen, Cohen, Van Wesemael, Deliens, & Chambaere, 2019c) and volunteerprofessional collaboration in palliative care (Meyer, Schmidt, Zernikow, & Wager, 2018;Vanderstichelen, Cohen, Van Wesemael, Deliens, & Chambaere, 2019a;Wittenberg-Lyles, Parker Oliver, Demiris, & Regehr, 2010), the literature hitherto lacks insights into the wide variation of volunteers active in palliative care and into how volunteers are integrated into health services and care provision. Most studies limit their focus to volunteers in dedicated palliative care services (Candy et al, 2015;Hotchkiss, Unruh, & Fottler, 2014;Mundle, Naylor, Weaks, & Buck, 2013;Pesut, Hooper, Lehbauer, & Dalhuisen, 2014;Wilson et al, 2005), while research has, for instance, suggested that home-care services, sitting services and -to a lesser extent -oncology wards and nursing homes have volunteers who perform several palliative care-related tasks (Vanderstichelen, Cohen, Van Wesemael, Deliens, & Chambaere, 2019b;Vanderstichelen et al, 2019c;Vanderstichelen, Houttekier, et al, 2018).…”