Communities as 'renewable energy' for healthcare services? a multimethods study into the form, scale and role of voluntary support for community hospitals in England.

OBJECTIVE: To examine the forms, scale and role of community and voluntary support for community hospitals in England. DESIGN: A multimethods study. Quantitative analysis of Charity Commission data on levels of volunteering and voluntary income for charities supporting community hospitals. Nine qualitative case studies of community hospitals and their surrounding communities, including interviews and focus groups. SETTING: Community hospitals in England and their surrounding communities. PARTICIPANTS: Charity Commission data for 245 community hospital Leagues of Friends. Interviews with staff (89), patients (60), carers (28), volunteers (35), community representatives (20), managers and commissioners (9). Focus groups with multidisciplinary teams (8 groups across nine sites, involving 43 respondents), volunteers (6 groups, 33 respondents) and community stakeholders (8 groups, 54 respondents). RESULTS: Communities support community hospitals through: human resources (average=24 volunteers a year per hospital); financial resources (median voluntary income = £15 632); practical resources through services and activities provided by voluntary and community groups; and intellectual resources (eg, consultation and coproduction). Communities provide valuable supplementary resources to the National Health Service, enhancing community hospital services, patient experience, staff morale and volunteer well-being. Such resources, however, vary in level and form from hospital to hospital and over time: voluntary income is on the decline, as is membership of League of Friends, and it can be hard to recruit regular, active volunteers. CONCLUSIONS: Communities can be a significant resource for healthcare services, in ways which can enhance patient experience and service quality. Harnessing that resource, however, is not straight forward and there is a perception that it might be becoming more difficult questioning the extent to which it can be considered sustainable or 'renewable'.

Translation and Validation of the Volunteer Functions Inventory (VFI) among the General Dutch Older Population.

Improvement of volunteering rates in the Netherlands is important because increased productivity among older adults would contribute to societal sustainability in the light of population aging. Therefore, a better understanding of volunteer motivations of Dutch older adults is needed. The Volunteer Functions Inventory (VFI) for assessing volunteer motivations has good psychometric properties and is adapted to several languages, but no validated Dutch translation yet exists. The aim of the current study is to validate the VFI for use in the Dutch older population (60 years and over). The Dutch-translated VFI (6 scales, 30 items) is included in the Lifelines 'Daily Activities and Leisure Activities add-on Study', which was distributed among participants aged 60 to 80. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) are performed to assess the validity of the translated VFI. Internal consistency is assessed by computing Cronbach's α's. Results of the EFA (N = 4208) point towards a six-factor solution with a nearly perfectly clean structure. Deletion of three problematic items results in a clean factor structure. CFA results indicate moderate model fit (RMSEA = 0.06, CFI = 0.90, TLI = 0.89). Cronbach's α's (0.78 to 0.85) indicate good internal consistency. Goodness-of-fit indices are sufficient and comparable to those obtained in the validation of the original VFI. The current study provides support for use of the Dutch-translation of the VFI (6 scales, 27 items) to assess volunteer motivations among Dutch volunteers aged 60 years and over.

Is unwilling volunteering protective for functional decline? The interactive effects of volunteer willingness and engagement on health in a 3-year longitudinal study of Japanese older adults.

AIM: The present study explored the interactive effects of willingness to volunteer and actual volunteer engagement on the maintenance of functional health among older Japanese adults, using data from a 3-year longitudinal study. METHODS: We used data from the 3-year longitudinal Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging (1997). We examined 676 older adults aged >65 years from the rural Nangai District who were independent in their basic activities of daily living (BADL). A follow-up study was carried out in 2000. We categorized participants into four groups: "willing volunteers," "unwilling volunteers," "willing non-volunteers" and "unwilling non-volunteers." Logistic regression analyses were carried out to evaluate the interactive effects of willingness to volunteer and actual engagement in volunteering at baseline on BADL decline over a 3-year period. RESULTS: During the follow-up period, 6.6% of willing volunteers, 17.4% of unwilling volunteers, 16.3% of willing non-volunteers and 21.0% of unwilling non-volunteers experienced a decline in BADL. Unwilling volunteers (odds ratio [OR] 2.88, 95% confidence interval [CI] 1.29-6.43) and both non-volunteer groups (willing: OR 2.70, 95% CI 1.28-5.72; unwilling: OR 2.48, 95% CI 1.32-4.64) had significantly higher odds of BADL decline than did willing volunteers. When unwilling non-volunteer was set as the reference, the OR of unwilling volunteers became 1.16 (95% CI 0.55-2.49), suggesting that unwilling volunteers had a similar odds of BADL decline as non-volunteers. CONCLUSION: Volunteer activity is effective for preventing BADL decline only for those who willingly engage. Geriatr Gerontol Int 2019; 19: 673-678.

Motivations for Volunteering and Its Associations with Time Perspectives and Life Satisfaction: A Latent Profile Approach.

This study aims to examine motivation for volunteering and its association with time perspective and life satisfaction among volunteers ( N = 221). Latent profile analysis was used to profile individuals based on their time perspectives and then to compare group differences in life satisfaction and volunteering motivation. Three profiles were identified. Profile 1 ( n = 32; 14.5%) was a "balanced time perspective group," Profile 2 ( n = 102; 46.2%) was a "maladaptive group," and Profile 3 ( n = 87; 39.3%) was a "nonchalant group." Profile 1 showed the highest life satisfaction compared to the two remaining groups. Significant group differences in volunteering motivation between this group and the other two were also reported. These findings suggest that time perspective may be appropriate for understanding motivation for voluntarism and life satisfaction.

Who is a community health worker? - a systematic review of definitions.

BACKGROUND: Community health workers (CHWs) can play vital roles in increasing coverage of basic health services. However, there is a need for a systematic categorisation of CHWs that will aid common understanding among policy makers, programme planners, and researchers. OBJECTIVE: To identify the common themes in the definitions and descriptions of CHWs that will aid delineation within this cadre and distinguish CHWs from other healthcare providers. DESIGN: A systematic review of peer-reviewed papers and grey literature. RESULTS: We identified 119 papers that provided definitions of CHWs in 25 countries across 7 regions. The review shows CHWs as paraprofessionals or lay individuals with an in-depth understanding of the community culture and language, have received standardised job-related training of a shorter duration than health professionals, and their primary goal is to provide culturally appropriate health services to the community. CHWs can be categorised into three groups by education and pre-service training. These are lay health workers (individuals with little or no formal education who undergo a few days to a few weeks of informal training), level 1 paraprofessionals (individuals with some form of secondary education and subsequent informal training), and level 2 paraprofessionals (individuals with some form of secondary education and subsequent formal training lasting a few months to more than a year). Lay health workers tend to provide basic health services as unpaid volunteers while level 1 paraprofessionals often receive an allowance and level 2 paraprofessionals tend to be salaried. CONCLUSIONS: This review provides a categorisation of CHWs that may be useful for health policy formulation, programme planning, and research.

Average bioequivalence of single 500 mg doses of two oral formulations of levofloxacin: a randomized, open-label, two-period crossover study in healthy adult Brazilian volunteers

Average bioequivalence of two 500 mg levofloxacin formulations available in Brazil, Tavanic(c) (Sanofi-Aventis Farmacêutica Ltda, Brazil, reference product) and Levaquin(c) (Janssen-Cilag Farmacêutica Ltda, Brazil, test product) was evaluated by means of a randomized, open-label, 2-way crossover study performed in 26 healthy Brazilian volunteers under fasting conditions. A single dose of 500 mg levofloxacin tablets was orally administered, and blood samples were collected over a period of 48 hours. Levofloxacin plasmatic concentrations were determined using a validated HPLC method. Pharmacokinetic parameters Cmax, Tmax, Kel, T1/2el, AUC0-t and AUC0-inf were calculated using noncompartmental analysis. Bioequivalence was determined by calculating 90% confidence intervals (90% CI) for the ratio of Cmax, AUC0-t and AUC0-inf values for test and reference products, using logarithmic transformed data. Tolerability was assessed by monitoring vital signs and laboratory analysis results, by subject interviews and by spontaneous report of adverse events. 90% CIs for Cmax, AUC0-t and AUC0-inf were 92.1% - 108.2%, 90.7% - 98.0%, and 94.8% - 100.0%, respectively. Observed adverse events were nausea and headache. It was concluded that Tavanic(c) and Levaquin(c) are bioequivalent, since 90% CIs are within the 80% - 125% interval proposed by regulatory agencies.

A bioequivalência média de duas formulações de levofloxacino disponíveis no Brasil, Tavanic(c) (Sanofi-Aventis Farmacêutica Ltda, Brasil, produto referência) e Levaquin(c) (Janssen-Cilag Farmacêutica Ltda, Brasil, produto teste) foi determinada por meio da realização de ensaio aleatório, aberto, cruzado, com dois períodos e duas sequências, em 26 voluntários sadios em condições de jejum. Amostras de sangue dos voluntários foram obtidas ao longo de um período de 48 horas após administração de dose única de 500 mg de levofloxacino. As concentrações plasmáticas do fármaco foram determinadas por método cromatográfico validado. Os parâmetros farmacocinéticos Cmax, Tmax, Kel, T1/2el, AUC0-t e AUC0-inf foram calculados por análise não compartimental. A bioequivalência foi determinada pelo cálculo de intervalos de confiança 90% (IC 90%) para as razões entre os valores de Cmax, AUC0-t e AUC0-inf obtidos para os produtos teste e referência, usando dados transformados logaritmicamente. A tolerabilidade foi avaliada pelo acompanhamento dos sinais vitais e resultados de exames laboratoriais, por consultas e por relato espontâneo dos voluntários. ICs 90% para Cmax, AUC0-t e AUC0-inf foram 92.1% - 108.2%, 90.7% - 98.0%, e 94.8% - 100.0%, respectivamente. Os eventos adversos observados foram náusea e cefaleia. Concluiu-se que os produtos Tavanic(c) e Levaquin(c) são bioequivalentes, uma vez que os ICs 90% estão dentro da faixa de 80%-125% proposta pelas agências reguladoras.

Volunteers in specialist palliative care: a survey of adult services in the United Kingdom.

BACKGROUND: Worldwide, the demand for specialist palliative care is increasing but funding is limited. The role of volunteers is underresearched, although their contribution reduces costs significantly. Understanding what volunteers do is vital to ensure services develop appropriately to meet the challenges faced by providers of palliative care. OBJECTIVE: The study's objective is to describe current involvement of volunteers with direct patient/family contact in U.K. specialist palliative care. DESIGN: An online survey was sent to 290 U.K. adult hospices and specialist palliative care services involving volunteers covering service characteristics, involvement and numbers of volunteers, settings in which they are involved, extent of involvement in care services, specific activities undertaken in each setting, and use of professional skills. RESULTS: The survey had a 67% response rate. Volunteers were most commonly involved in day care and bereavement services. They entirely ran some complementary therapy, beauty therapy/hairdressing, and pastoral/faith-based care services, and were involved in a wide range of activities, including sitting with dying patients. CONCLUSIONS: This comprehensive survey of volunteer activity in U.K. specialist palliative care provides an up-to-date picture of volunteer involvement in direct contact with patients and their families, such as providing emotional care, and the extent of their involvement in day and bereavement services. Further research could focus on exploring their involvement in bereavement care.

[Voluntary work in social and health care: a critical review of assessment instruments]. / Freiwilligenengagement im Gesundheits- und Pflegebereich: Ein Critical Review über Assessmentinstrumente.

BACKGROUND: Due to an increasing need for voluntary workers in the provision of care for care-dependent people, sustainable recruiting, retention, and quality management strategies are required. In this regard, assessment instruments (AI) are helpful as a basis for obtaining information and planning. The aims of this critical review are to identify AIs in voluntary work and to analyze and critically appraise their domains, target groups, and psychometric properties. METHODS: A systematic search with an interdisciplinary emphasis was conducted in Medline, CINAHL, PsycINFO and other socioscientific databases. After the selection of identified articles, 12 research papers remained for analysis and were summarized in a critical review. RESULTS: In total, 15 AIs, 13 domains (e.g., motivation, satisfaction), and 4 target groups could be identified. The domain "motivation" and the target group "voluntary workers in hospice/palliative care" were most frequently represented. Currently, there are no instruments available which cover a broad range of domains and target groups. CONCLUSION: To support sustainability and quality of care in volunteerism, the development of new AIs is necessary.

Volunteer transitions and physical and psychological health among older adults in Taiwan.

OBJECTIVES: This study examines the relationship between transitions in volunteering activity and physical and psychological health outcomes among older adults in Taiwan. METHOD: We used 3 waves of a longitudinal survey from Taiwan (1999, 2003, and 2007) including 1,847 older adults aged 58-74. We categorized volunteer activity over time into 5 categories and used generalized estimating equations to examine the relationship between volunteer transition group membership and health outcomes. RESULTS: Approximately, 3% of older volunteers kept volunteering and 7% stopped or started their volunteering over time. Engaging in any volunteering, including continuous volunteering, discrete volunteering, active-to-inactive volunteering, and inactive-to-active volunteering, was significantly associated with better self-rated health and higher life satisfaction when compared with the nonvolunteering group. Only those in the continuous volunteer group and those who shifted from inactive-to-active volunteering showed a positive association with better physical function and less depression, compared with the nonvolunteering group. DISCUSSION: The results suggest that the positive relationship between volunteering and health may decline when older adults discontinue or withdraw from volunteering. More research is needed to explore the mechanism behind older people's desistance from, persistence in, and resumption of volunteer engagement.

Volunteering and depression: the role of psychological and social resources in different age groups.

There are a number of reasons why volunteering might yield mental health benefits, especially to older people. Volunteer work improves access to social and psychological resources, which are known to counter negative moods such as depression and anxiety. Analysis of three waves of data from the Americans' Changing Lives data set (1986, 1989, 1994) reveals that volunteering does lower depression levels for those over 65, while prolonged exposure to volunteering benefits both populations. Some of the effect of volunteering on depression among the elderly is attributable to the social integration it encourages, but the mediating effect of psychological resources is very small. Volunteering for religious causes is more beneficial for mental health than volunteering for secular causes but, again, the effect is confined to the elderly.

Predictors of volunteer status in a retirement community.

In the present study, actual volunteers, latent volunteers, conditional volunteers, and definite nonvolunteers living in a retirement community are compared on social-structural, role, environmental, resource, lifestyle, and individual difference variables. Three functions emerged from the discriminant analysis. Actual volunteers attend church frequently, are free of activity limitations due to health, have volunteered previously, and belong to several clubs and organizations. Latent volunteers engage in informal religious behaviors, attend church about once a month, are about seventy years old (i.e., they are younger than the other groups), and are very satisfied with their neighborhood. Conditional volunteers engage infrequently informal religious behavior, have no instrumental activity limitations due to health, did not attend college, have very high neighborhood satisfaction, and are seventy-four years old (i.e., older than latent volunteers and actual volunteers). Implications for recruiting latent and conditional volunteers are discussed.

A comparison of office and adult day care center older volunteers: social-psychological and demographic differences.

Numerous researchers have compared older adults who volunteer with those who do not volunteer on several demographic variables. In contrast, in the present study we compared older adults (minimum age = 55 years old) who volunteered to work for a community organization at an office or in a day care center on social-psychological and demographic predictors. It was hypothesized that day care center volunteers would have higher scores than office volunteers on sympathy, role taking, and self-based salience of volunteer role (i.e., personal identity). In addition, office volunteers were expected to have higher scores than day care center volunteers on other-based salience of volunteer role (i.e., social identity). Discriminant function analysis indicated that day care center volunteers were higher than office volunteers on sympathy whereas office volunteers were higher than day care center volunteers on educational attainment, involvement in clubs and organizations, and role taking.