Facilitators and barriers of implementing end-of-life care volunteering in a hospital in five European countries: the iLIVE study.

BACKGROUND: End-of-life (EoL) care volunteers in hospitals are a novel approach to support patients and their close ones. The iLIVE Volunteer Study supported hospital volunteer coordinators from five European countries to design and implement an EoL care volunteer service on general wards in their hospitals. This study aimed to identify and explore barriers and facilitators to the implementation of EoL care volunteer services in the five hospitals. METHODS: Volunteer coordinators (VCs) from the Netherlands (NL), Norway (NO), Slovenia (SI), Spain (ES) and United Kingdom (UK) participated in a focus group interview and subsequent in-depth one-to-one interviews. A theory-inspired framework based on the five domains of the Consolidated Framework for Implementation Research (CFIR) was used for data collection and analysis. Results from the focus group were depicted in radar charts per hospital. RESULTS: Barriers across all hospitals were the COVID-19 pandemic delaying the implementation process, and the lack of recognition of the added value of EoL care volunteers by hospital staff. Site-specific barriers were struggles with promoting the service in a highly structured setting with many stakeholders (NL), negative views among nurses on hospital volunteering (NL, NO), a lack of support from healthcare professionals and the management (SI, ES), and uncertainty about their role in implementation among VCs (ES). Site-specific facilitators were training of volunteers (NO, SI, NL), involving volunteers in promoting the service (NO), and education and awareness for healthcare professionals about the role and boundaries of volunteers (UK). CONCLUSION: Establishing a comprehensive EoL care volunteer service for patients in non-specialist palliative care wards involves multiple considerations including training, creating awareness and ensuring management support. Implementation requires involvement of stakeholders in a way that enables medical EoL care and volunteering to co-exist. Further research is needed to explore how trust and equal partnerships between volunteers and professional staff can be built and sustained. TRIAL REGISTRATION: NCT04678310. Registered 21/12/2020.

'It's not what they were expecting': A systematic review and narrative synthesis of the role and experience of the hospital palliative care volunteer.

BACKGROUND: Volunteers make a major contribution to palliative care but little is known specifically about hospital palliative care volunteers. AIM: The aim of this study was to understand the role and experience of hospital palliative care volunteers. DESIGN: Systematic review and narrative synthesis. DATA SOURCES: CINAHL, Embase, Medline, PsycINFO, PubMed and three dissertation databases were searched from inception to June 2019. A forward and backward search of included papers in key journals was also undertaken. Records were independently assessed against inclusion criteria by authors. Included papers were assessed for quality, but none were excluded. RESULTS: In total, 14 papers were included. Hospital palliative care volunteers were mostly female, aged above 40 years, and training varied considerably. Volunteers faced unique challenges in supporting dying patients due to the nature of hospital care, rapid patient turnover and the once-off nature of support. Volunteer roles were diverse, with some providing hands-on care, but most focused on 'being with' the dying patient. Volunteers were appreciated for providing psychosocial support, seen as complementary to, rather than replacing the work of health professionals. Given volunteers were often required to work across multiple wards, establishing positive work relationships with health professionals was challenging. Divergent views about whether the volunteer was part of or external to the team impacted volunteers' experience and perceptions of the value of their contribution. CONCLUSION: Hospital palliative care volunteers face unique challenges in supporting terminally ill patients. Volunteer support in hospital settings is possible and appropriate, if sufficient support is available to mitigate the challenges associated with complex, high-acuity care.

Evaluation of an Innovative, Hospital-Based Volunteer Doula Program.

OBJECTIVE: To evaluate program growth, doula characteristics, patient satisfaction, and characteristics and perceptions of labor and delivery nurses who work with volunteer doulas in a hospital-based volunteer doula program. DESIGN: Descriptive quantitative. SETTING: An academic health center in the southeastern United States with approximately 4,000 births per year. PARTICIPANTS: Participants (N = 519) included volunteer doulas (n = 80), labor and delivery nurses (n = 24), and women who were supported by doulas (n = 415). METHODS: We evaluated program growth by the number of doulas and women supported over time. We developed surveys to evaluate doula characteristics, patient satisfaction, and characteristics and perceptions of labor and delivery nurses who work with volunteer doulas. RESULTS: From 2012 to 2018, the number of Birth Partners doulas increased from 25 to 80. The annual number of women who received intrapartum care from doulas increased from 88 in 2012 to 477 in 2018. Doula characteristics included race, ethnicity, age, student or nonstudent status, and ability to speak Spanish. Of the 1,185 women who received doula support from 2015 to 2018, 415 (35%) responded to the patient satisfaction survey. Most were satisfied with the physical support (n = 379, 97.63%), emotional support (n = 384, 96.88%), doula care (n = 410, 96.34%), and support for family/friends (n = 346, 95.38%). All of the labor and delivery nurses who responded (n = 24, 100%) agreed or strongly agreed that doulas were important members of the maternity care team. CONCLUSION: In this evaluation, we highlight rapid program growth, expansion of services, and demographic characteristics of volunteer doulas; patient satisfaction with doula care; and acceptance of volunteer doulas among nursing staff. The data provided herein can be used to inform future development and guide the implementation of similar volunteer doula programs at other institutions.