Nurses' perceptions of using volunteer support in health care settings: A systematic scoping review.

AIMS: To understand nurses' perceptions of volunteer support in health care settings. BACKGROUND: Increasingly, volunteers provide specialised support to health care service users, requiring volunteers and nurses to work closely together. However, little is known about nurses' perceptions of volunteer support. METHODS: A scoping review was conducted following the PRISMA-ScR checklist. A mixed-methods convergent integrative approach was taken guided by the JBI framework. Quantitative data were transformed into qualitative data for synthesis and descriptive thematic analysis. Six databases were searched (CINHAL+, EMBASE, PubMed, Scopus, PsycInfo, ProQuest Health and Medical Collection) on 24 January 2022 using terms related to nurses, perceptions, volunteers and care settings, followed by a manual search. The search was limited to English language articles published during 2000-2022. Studies were included if they reported nurses' perceptions of volunteers supporting care within any health care setting. RESULTS: Of the 943 records identified, 12 met the inclusion criteria. All 12 were included in the review following critical appraisal. Five themes were identified: perceived benefits for patients, volunteers providing support for nursing staff, nurses' valuing volunteer support, nurses' understanding of the volunteer role and nurses' understanding of recruitment and training of volunteers. CONCLUSION: Nurses generally viewed volunteer support positively and perceived that it benefitted patients and assisted nurses. Some nurses raised concerns about the burden of additional supervision of volunteers and lacked knowledge of the volunteer role, recruitment and training. Emerging innovative models of nurse-led volunteer support can maximise the contribution of volunteers and help overcome barriers to volunteer acceptance. IMPLICATIONS: These findings will inform volunteer policies and provide guidance in developing volunteer support programs.

A program for volunteers accompanying older patients with cognitive dysfunction to improve the quality of emergency department care: A pilot study.

Admission to an emergency department (ED) is challenging for older patients with cognitive dysfunction (PWCD). Targeted patient-oriented approaches to improve the care for PWCD are needed. The aim of this pilot study was to design and evaluate a program for volunteers to support PWCD in the ED. Volunteers (N = 9) first received a training and during the following six months (N = 90 shifts), they accompanied PWCD (N = 112) during their stay. Results showed that the training increased volunteers' knowledge and expertise, but not shift-related self-efficacy. The most frequent strategies applied were conversations, holding hands and touching, and providing food and drinks. After six months, volunteers reported a great sense of meaningfulness and felt that they were highly appreciated by the patients. ED nurses' sceptical attitudes towards the program decreased. The program is beneficial for PWCD, appears to be meaningful for volunteers and is appreciated by ED nurses.

Empathy development and volunteering for undergraduate healthcare students: A scoping review.

OBJECTIVES: Empathy in healthcare benefits patients and healthcare providers. However, empathy decline is a recent trend within healthcare education. There is a paucity of literature that investigates the impact of volunteering on the empathy levels of undergraduate healthcare students. This scoping review explores the literature regarding empathy and volunteering for healthcare students. DESIGN: The Joanna Briggs Institute methodology for scoping reviews guided this study. DATA SOURCES: The electronic databases MEDLINE, CINAHL, ProQuest, JBI, Cochrane, PubMed, PsychInfo, and PsychNurses were searched from January 2001 to August 2021. The original search was developed in MEDLINE and then adapted to the other databases. REVIEW METHODS: This scoping review used the Joanna Briggs Institute scoping review methodology. The search retrieved a total of 310 articles. Following deduplication, 271 articles were reviewed by title and abstract. Thirty articles were reviewed in full text with twelve articles meeting the criteria for inclusion. Included studies were assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Five qualitative, four quantitative and three mixed method studies were included. A variety of volunteering interventions for undergraduate healthcare students were identified from countries including the United States of America, Singapore, Australia, and Brazil. Thematic analysis identified that volunteer undergraduate healthcare students practiced and developed empathy, and experienced professional and personal development. CONCLUSIONS: Volunteering interventions were primarily in a service-learning modality within community health and palliative healthcare settings. Inconsistencies exist in empathy definitions and empirical empathy measurement. There is a need for more research that explores empathy development through volunteer activities in acute care settings.

Recognition of factors affecting the use of volunteer clinical forces in hospitals in Tehran: A qualitative study.

INTRODUCTION: Volunteers are valuable human resources for service-providing organizations. Health system requires their participation and cooperation in all sectors to achieve more success. The present study was conducted to recognize factors influencing the use of volunteer clinical forces (VCFs) in Tehran hospitals from 2018 to 2020. METHODS: This is a qualitative study, based on grounded theory approach, and was done through semi-structured interviews. The studied population included the experts, managers of hospitals, and high-ranking managers in the Ministry of Health, Iranian Red Crescent Organization, and health nongovernmental organizations (NGOs). Nineteen persons were selected by purposeful sampling method and interviewed. The achieved data were analyzed by content analysis method. RESULTS: The results showed that using VCFs in Tehran's hospitals was affected by eight following factors: organizational, legal, policy-making, economic, social, security, personal, and cultural dimensions. These findings illustrated the necessity of making changes in the structures, the rules, and the culture of health system to fit the bases with new approaches. CONCLUSION: VCFs amplify the quality and structure of service providing for patients in hospitals. The focus of policymakers and high-ranking managers in health system is on accelerating their use permanently and legally. Developing health-centered NGOs facilitates the access to VCF, lessens nonclinical loads of hospitals, and improves the organization of human forces. The experiences and knowledge of VCFs cause to develop hospitals' resilience, develop social participation, and improve social capitals in medical field.

Impact of volunteers in the emergency department.

BACKGROUND: Fundamental aspects of patient experience have been reported as substandard in emergency departments. Hospital volunteers can improve the patient experience in inpatient settings. However, evidence is limited on their impact in emergency departments. AIMS: To determine whether emergency department volunteers could enhance patient experience through assisting with the psychological aspect of patient care and patients' nutritional needs. METHODS: Patients attending an emergency department responded to a questionnaire as part of a cross-sectional study. Comparisons were made between when the volunteer scheme was running and when there were no volunteers. Outcomes included patient experience of emotional support from staff and access to food and drink. RESULTS: Patients present when the volunteer scheme was running reported obtaining food and drink more often (96/124 vs 20/39, % rate difference 26, 95% CI 10-42, P=0.002) and that a member of staff offered them something to eat and drink more frequently (96/146 vs 19/52, % rate difference 29, 95% CI 14-45, P<0.001). There was no difference between patient responses when the volunteer scheme was running and not for emotional support from staff (49/68 vs 14/21, % rate difference 5, 95% CI -17-28, P=0.63). CONCLUSIONS: Hospital volunteers made a substantial contribution to providing food and drink to patients in the emergency department. Emotional support from volunteers was limited.

Percepções de um grupo de voluntários frente ao trabalho com pacientes oncológicos / Perceptions of a group of volunteers of the work with oncological patients

Este estudo teve como objetivo analisar a percepção de um grupo de voluntários frente ao trabalho com pacientes oncológicos. Trata-se de uma pesquisa descritiva-exploratória, com abordagem qualitativa. A população do estudo foi constituída por voluntários do Expresso Alegria. Foram selecionados voluntários que vão frequentemente às visitas hospitalares, pelo menos uma vez ao mês e que não estejam em fase de treinamento. A coleta de dados ocorreu após a aprovação do Comitê de Ética em Pesquisa, por meio de um questionário aberto. A investigação foi realizada em três etapas: reunião com o responsável do Expresso Alegria; abordagem individual para formalização do convite e coleta de dados. Foram entrevistados nove participantes. Para interpretação, os dados foram submetidos à análise de conteúdo de Bardin. A partir dos resultados foram elaboradas três categorias empíricas. O estudo apresentou a importância do trabalho voluntário no tratamento dos pacientes oncológicos, levando alegria, conforto e humanização ao ambiente. (AU)

This study aimed to analyze the perception of a group of volunteers regarding the work with cancer patients. It is a descriptive-exploratory research, with a qualitative approach. The study population consisted of volunteers from Expresso Alegria. The volunteers selected were those who frequently go to hospital visits, at least once a month, and who are not undergoing training. Data collection took place after approval by the Research Ethics Committee, through an open questionnaire. The investigation was carried out in three stages: meeting with the head of Expresso Alegria; individual approach to formalize the invitation and collect data. Nine participants were interviewed. For interpretation, data were submitted to Bardin's content analysis. From the results, three empirical categories were elaborated. The study showed the importance of voluntary work in the treatment of cancer patients, as they bring joy, comfort and humanization to the environment. (AU)

"They take a lot of pressure off us": Volunteers reducing staff and family care burden and contributing to quality of care for older patients with cognitive impairment in rural hospitals.

OBJECTIVES: 1Explore the ability of trained volunteers to provide person-centred care focusing on nutrition/hydration support, hearing/visual aids and activities in rural hospitals for older patients with dementia and/or delirium. 2Explore the impacts and challenges of volunteer care for family carers and hospital staff. METHODS: Staff were surveyed about their confidence, stress and satisfaction at 6 months post-implementation. Focus groups with staff and interviews with families explored program successes, challenges and enabling factors. RESULTS: Volunteers integrated themselves into the care team, providing person-centred care, increased safety and quality of care for patients and a reduced burden for staff and families. Key enablers were clear processes for screening, training and supporting volunteers. Key challenges included initial role delineation, staff/volunteer trust and sustainability. CONCLUSION: The program is reported by families and staff as being effective in addressing the main barriers to providing person-centred care for older adults with cognitive impairment in rural acute hospitals.

Process of implementing and delivering the Prevention of Delirium system of care: a mixed method preliminary study.

BACKGROUND: Delirium is a frequent complication of hospital admission among older people. Multicomponent interventions which can reduce incident delirium by ≈one-third are recommended by the National Institute of Health and Care Excellence. Currently, a standardised delirium prevention system of care suitable for adoption in the UK National Health Service does not exist. The Prevention of Delirium (POD) system of care is a theory informed, multicomponent intervention and systematic implementation process which includes a role for hospital volunteers. We report POD implementation and delivery processes in NHS hospital wards, as part of a feasibility study. METHODS: A comparative case study design and participatory, multi-method evaluation was performed with sequential six month preparatory and six month delivery stages. Six wards in five hospitals in Northern England were recruited. Methods included: facilitated workshops; observation of POD preparatory activities; qualitative interviews with staff; collection of ward organisational and patient profiles; and structured observation of staff workload. RESULTS: POD implementation and delivery was fully accomplished in four wards. On these wards, implementation strategies informed by Normalization Process Theory operated synergistically and cumulatively. An interactive staff training programme on delirium and practices that might prevent it among those at risk, facilitated purposeful POD engagement. Observation of practice juxtaposed to action on delirium preventive interventions created tension for change, legitimating new ways of organising work around it. Establishing systems, processes and documentation to make POD workable in the ward setting, enhanced staff ownership. 'Negotiated experimentation' to involve staff in creating, appraising and modifying systems and practices, helped integrate the POD care system in ward routines. Activating these change mechanisms required a particular form of leadership: pro-active 'steer', and senior ward 'facilitator' to extend 'reach' to the staff group. Organisational discontinuity (i.e. ward re-location and re-modelling) disrupted and extended POD implementation; staff shortages adversely affected staff capacity to invest in POD. Findings resulted in the development of 'site readiness' criteria without which implementation of this complex intervention was unlikely to occur. CONCLUSIONS: POD implementation and delivery is feasible in NHS wards, but a necessary context for success is 'site readiness.'

'End of life could be on any ward really': A qualitative study of hospital volunteers' end-of-life care training needs and learning preferences.

BACKGROUND: Over half of all deaths in Europe occur in hospital, a location associated with many complaints. Initiatives to improve inpatient end-of-life care are therefore a priority. In England, over 78,000 volunteers provide a potentially cost-effective resource to hospitals. Many work with people who are dying and their families, yet little is known about their training in end-of-life care. AIMS: To explore hospital volunteers' end-of-life care training needs and learning preferences, and the acceptability of training evaluation methods. DESIGN: Qualitative focus groups. SETTING/PARTICIPANTS: Volunteers from a large teaching hospital were purposively sampled. RESULTS: Five focus groups were conducted with 25 hospital volunteers (aged 19-80 years). Four themes emerged as follows: preparation for the volunteering role, training needs, training preferences and evaluation preferences. Many described encounters with patients with life-threatening illness and their families. Perceived training needs in end-of-life care included communication skills, grief and bereavement, spiritual diversity, common symptoms, and self-care. Volunteers valued learning from peers and end-of-life care specialists using interactive teaching methods including real-case examples and role plays. A chance to 'refresh' training at a later date was suggested to enhance learning. Evaluation through self-reports or observations were acceptable, but ratings by patients, families and staff were thought to be pragmatically unsuitable owing to sporadic contact with each. CONCLUSION: Gaps in end-of-life care training for hospital volunteers indicate scope to maximise on this resource. This evidence will inform development of training and evaluations which could better enable volunteers to make positive, cost-effective contributions to end-of-life care in hospitals.

Motivation of Volunteers to Work in Palliative Care Setting: A Qualitative Study.

BACKGROUND: Volunteers are an integral part of the palliative care services in the Tata Memorial Hospital, Mumbai, Maharashtra, India. These volunteers are an important resource for the department. Thus, it is necessary for the department to determine what motivates these volunteers to continue to work in the setting, acknowledge them and direct efforts toward retaining them and giving them opportunities to serve to the best of their desire and abilities. AIMS: The current study aimed at understanding the motivation of volunteers to work in palliative care, to identify the challenges they face and also the effect of their work on their self and relationships. METHODOLOGY: In-depth interviews were conducted using semistructured interview guide to study above mentioned aspects. Themes were identified and coding was used to analyze the data. RESULTS: The results suggested that the basic motivation for all the volunteers to work in a palliative care setting is an inherent urge, a feeling of need to give back to the society by serving the sick and the suffering. Other motivating factors identified were team spirit, comfort shared, warm and respectful treatment by the team, satisfying nature of work, experience of cancer in the family, and aligned values and beliefs. Some intrinsic rewards mentioned by volunteers were joy of giving, personal growth, enriching experiences, and meaningful nature of work. CONCLUSION: The study attempted to improve opportunities of working for these volunteers. Although limited in scope, it offers insight for future research in the area of volunteerism in palliative care setup.

Implementation of a volunteer university student research assistant program in an emergency department: the nuts and bolts for success.

Prospective research studies often advance clinical practice in the emergency department (ED), but they can be costly and difficult to perform. In this report, we describe the implementation of a volunteer university student research assistant program that provides students exposure to medicine and clinical research while simultaneously increasing the capacity of an ED's research program. This type of program provides 15 hours per day of research assistant coverage for patient screening and enrolment for minimal risk research studies, and screening for higher risk studies. The latter is true without the added burden or costs of co-administering university course credit or pay for service, which are common features of most of these types of programs currently in operation. We have shown that our volunteer-based program is effective for an ED's research success as well as for its student participants. For other EDs interested in adopting similar programs, we provide the details on how to get such a program started and highlight the structure and non-monetary incentives that facilitate a program's ongoing success.

The effectiveness of a student volunteer program for research in a pediatric Emergency Department.

BACKGROUND: Emergency Department (ED) student-based research assistant programs have been shown to be effective in enrolling patients when the students receive university course credit or pay. However, the impact on research outcomes when university students act as volunteers in this role is relatively unknown. OBJECTIVES: The main objective of this study was to determine how often potentially eligible children were accurately identified by volunteer research assistants for enrollment into prospective research in the ED. We also examined the frequency of successful enrollments and the accuracy of data capture. METHODS: This was a prospective cross-sectional study of university student volunteer research assistant performance in a tertiary care pediatric ED between March 2011 and July 2013. The participant's primary role was to screen and facilitate enrollment of ED patients into clinical research. For each volunteer, we recorded demographics, number of screenings, enrollments, and data capture accuracy. RESULTS: Over five 6-month sessions, 151 student volunteers participated. Of these, 77.3% were female, 58.8% were undergraduate students, and 61.1% were interested in medical school. Student volunteers accurately screened 11,362/13,067 (87.0%) children, and they accurately identified 4407/4984 (88.4%) potentially eligible children for study enrollment. Of the 3805 eligible for enrollment exclusively by the students, 3228 (84.8%) families/children consented and completed all study procedures. Furthermore, students correctly entered 11,660/12,567 (92.8%) data points. CONCLUSIONS: Utilizing university student volunteers to facilitate research enrollment in the ED is effective and allows for the capture of a high percentage of potentially eligible patients into prospective clinical research studies.

The professional benefits for volunteer research assistants in a pediatric emergency department.

BACKGROUND: Emergency departments (EDs) have utilized university student volunteers to facilitate enrollment of patients into prospective studies; however, the impact of this experience on participant careers is relatively unknown. OBJECTIVES: We determined the proportion of successful postgraduate school/research job applications supported by our program reference letter. We also examined participant satisfaction. METHODS: This was a prospective cohort study of volunteer research assistants in a tertiary care pediatric ED from September 2011 to July 2013. Students volunteered one 5-h shift per week for at least 6 months. They completed three surveys: 1) Entrance - demographics and goals for entering the ED research assistant program; 2) Exit - program satisfaction, reasons for leaving the program, and future career goals; 3) Follow-up - survey and e-mails were sent to record positions secured since leaving the program. RESULTS: There were a total of 920 applicants over the study period, and 127 volunteers were selected to participate in the program. Response rates for entrance, exit, and follow-up surveys were 100%, 84.9%, and 96.2%, respectively. Of the participants who left and responded, 89/101 (88.9%) obtained school/research positions supported by our program reference letter. Further, 72.6% ranked their satisfaction with the program at least a 7 on a 10-point categorical scale, and 82.9% reported that they "agreed/strongly agreed" that the program helped with their career goals. CONCLUSIONS: A volunteer student program is in high demand for university students interested in health sciences/research and potentially has a beneficial career impact for its participants.

MadAlegria – Palhaços de hospital: proposta multidisciplinar de humanização em saúde / MadAlegria – Hospital clowns: multidisciplinary approach for health humanization

O objetivo deste artigo é descrever o projeto MadAlegria como uma proposta de humanização em saúde. O MadAlegria é um projeto de extensão universitária da Faculdade de Medicina da Universidade de São Paulo criado emagosto de 2010, com caráter multidisciplinar. Inclui alunos dos cursos de Enfermagem, Fisioterapia, Fonoaudiologia, Medicina, Nutrição e Terapia Ocupacional, os quais desenvolvem atividades culturais, científicas e educacionais relacionadas à humanização do relacionamento com opaciente e com a equipe de saúde. A linguagem utilizada para a comunicação é a lúdica; pela atuação como palhaçosde hospital e contadores de história. O projeto tem como finalidade amenizar o ambiente hospitalar e os diferentescenários de saúde, para os pacientes e para a equipe de trabalho, e influenciar na formação dos alunos da área da saúde com intuito de obter profissionais diferenciados, que possam exercer sua profissão de maneira humanizada einterdisciplinar. Durante os dois anos de existência, foram formados 78 palhaços de hospital, sendo que a formação tem um ano de treinamento, e o curso de contação de histórias foi oferecido para 35 pessoas. A população alvo do projeto é adulto e em dois anos foram realizados 2.020 atendimentos como palhaços no hospital. Os relatórios elaborados pelos alunos após os atendimentos demonstram que há uma mudança positiva na qualidade do contato entre o aluno e o paciente e que o aluno tende a dedicar ao paciente um olhar mais compreensivo e afetivo. Os pacientes referem satisfação e raramente rejeitam a presença dopalhaço. É uma oportunidade do aluno da área de saúde se aproximar do paciente sem a obrigação de desempenhar o papel de profissional, mas com a liberdade de ouvir, se sensibilizar com a dor do outro e atuar naquele momento para minimizar a tristeza ou dor ou simplesmente compartilhar aquela experiência de internação hospitalar. O ProgramaMadAlegria colabora para a discussão da importância de estratégias de humanização...

The objective of this article is to describe the project MadAlegria as a multi-disciplinary proposal of humanization in healthcare. MadAlegria is a multidisciplinary extension project of the School of Medicine of Universityof São Paulo initiated in August 2010. The project includes students of Nursing, Physical Therapy, Speech Therapy, Medicine, Nutrition and Occupational Therapy, who developcultural, scientific and educational activities related with the humanization of the relationship with the patient and with the health professionals. The students act as hospital clowns and storytellers as a vehicle for the engagement.The project aims to tendering the hospital environment for patients and for the health professionals and to influencing the education of heath care students, seeking to shape differentiatedprofessionals that can work in an interdisciplinary and humanized way. In two years of existence 78 people were trained as hospital clowns and 35 underwent a storytelling course. In this period the students made 2020 visits as hospital clowns, targeting a population of adult patients. The post visit reports indicate a positive change in the quality of the student-patient contact, as well as a more affectiveand understanding approach by the student. Patients refer satisfaction and rarely reject the clown’s presence. These contacts offer the students the opportunity to get closer to patients with no professional expectations, but with freedom to listen and to empathize with the other’s pain and sorrow and eventually help minimizing it. The MadAlegria program supports the discussion on the importance of humanization strategies during hospital care activities as well as in the education of health professionals...