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

Berivan Yildiz; Agnes van der Heide; Misa Bakan; Grethe Skorpen Iversen; Dagny Faksvåg Haugen; Tamsin McGlinchey; Ruthmarijke Smeding; John Ellershaw; Claudia Fischer; Judit Simon; Eva Vibora-Martin; Inmaculada Ruiz-Torreras; Anne Goossensen; iLIVE consortium

doi:10.1186/s12904-024-01423-5

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

BMC Palliat Care. 2024 Apr 2;23(1):88. doi: 10.1186/s12904-024-01423-5.

Authors

Collaborators

iLIVE consortium:
Simon Allan, Pilar Barnestein-Fonseca, Mark Boughey, Andri Christen, Nora Lüthi, Martina Egloff, Steffen Eychmüller, Sofia C Zambrano, Gustavo G De Simone, Eline E C M Elsten, Eric C T Geijteman, Iris Pot, Carin C D van der Rijt, Carl Johan Fürst, Birgit H Rasmussen, Maria E C Schelin, Christel Hedman, Gabriel Goldraij, Svandis Iris Halfdanardottir, Valgerdur Sigurdardottir, Tanja Hoppe, Melanie Joshi, Julia Strupp, Raymond Voltz, Maria Luisa Martín-Roselló, Silvi Montilla, Verónica I Veloso, Vilma Tripodoro, Katrin Ruth Sigurdardottir, Hugo M van der Kuy, Lia van Zuylen, Michael Berger, Rosemary Hughes, Hana Kodba-Ceh, Ida J Korfage, Urska Lunder, Stephen Mason, Beth Morris, Kjersti Solvåg

Affiliations

¹ Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. b.yildiz@erasmusmc.nl.
² Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
³ Research Department, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
⁴ Regional Centre of Excellence for Palliative Care, Western Norway, Haukeland University Hospital, Bergen, Norway.
⁵ Department of Clinical Medicine K1, University of Bergen, Bergen, Norway.
⁶ Palliative Care Unit, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
⁷ Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria.
⁸ CUDECA Institute for Training and Research in Palliative Care, CUDECA Hospice Foundation, Malaga, Spain.
⁹ Informal Care and Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands.

Abstract

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.

Keywords: End of life care; Hospital volunteer; Implementation; Inpatient; Volunteering.

MeSH terms

Hospitals
Humans
Palliative Care
Pandemics*
Qualitative Research
Terminal Care* / methods
Volunteers

Associated data

ClinicalTrials.gov/NCT04678310