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Bakelants H, Van Droogenbroeck F, Chambaere K, Vanderstichelen S, De Donder L, Deliens L, De Gieter S, De Moortel D, Cohen J, Dury S. A compassionate university for serious illness, death, and bereavement: Qualitative study of student and staff experiences and support needs. Death Stud 2024; 48:442-453. [PMID: 37432448 DOI: 10.1080/07481187.2023.2233495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Serious illness, death, and bereavement are common experiences within the work and study context. This study aims to explore the experiences and support needs of university students and staff confronted with serious illness, death, and bereavement. Semi-structured interviews and focus groups were conducted with 21 students and 26 staff. A thematic analysis resulted in three overarching themes: the university as a high-pressure environment; navigating the complex university information and support system; and disenfranchized grief. Four themes were identified in terms of what participants needed from the university: clear processes and procedures; flexibility in policy application; proactive support and recognition; and activities to enhance awareness and interpersonal communication skills. Findings from this study could enable higher education institutions to become more compassionate schools and workplaces.
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Affiliation(s)
- Hanne Bakelants
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Filip Van Droogenbroeck
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Data Analytics Lab & Tempus Omnia Revelat, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Kenneth Chambaere
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
| | - Steven Vanderstichelen
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
| | - Liesbeth De Donder
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Luc Deliens
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
| | - Sara De Gieter
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Work and Organizational Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Deborah De Moortel
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Interface Demography, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Joachim Cohen
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
| | - Sarah Dury
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Van Hove L, Baetens I, Vanderstichelen S. Conceptualizing Self-Harm through the Experiences of Psychogeriatric Experts. Psychopathology 2024:1-9. [PMID: 38599197 DOI: 10.1159/000537809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 02/11/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Fewer studies thus far have focused on self-harm and its specific forms among older adults. Moreover, the limited available literature applies varying terminology. The categorization of self-harm used in younger populations may not be as appropriate for this population. This means that less is known about this phenomenon in older adults. The current study aimed to reduce this gap. METHODS Nine Flemish psychogeriatric experts participated in a semi-structured interview. Transcripts were thematically analyzed. RESULTS Themes emerging from the interviews suggest that self-harm in older adults may also include distinct elements, such as the omission of certain behaviours and engagement in indirect self-harm to cause bodily harm. According to the experts, self-harm may be engaged in to cope with emotions, express life fatigue, hasten death, and communicate a cry for help. DISCUSSION Self-harm is prevalent in older adults, and some characteristics may be specific to self-harm in an older age group. These findings may enable clinicians to be more alert to self-harm in older adults and consequently prevent serious suicidal behaviour. More research is needed to further uncover this phenomenon.
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Affiliation(s)
- Lisa Van Hove
- Brussels University Consultation Center (BRUCC), Department of Clinical Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Imke Baetens
- Brussels University Consultation Center (BRUCC), Department of Clinical Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Steven Vanderstichelen
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels/Ghent University, Ghent, Belgium
- Compassionate Communities Centre of Expertise (COCO), Vrije Universiteit Brussel, Brussels/Ghent University, Ghent, Belgium
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Mertens F, Vanderstichelen S, Deveugele M, Deliens L, Pype P. Family carers' experiences regarding patient transfers between care settings in palliative care: an interview study. Ann Palliat Med 2023; 12:767-782. [PMID: 37431219 DOI: 10.21037/apm-23-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/23/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND To understand how family carers experienced the illness trajectory of their next of kin related to transfers taken place between care settings in palliative care, their experiences and attitude regarding the transfer decision and their experiences regarding patient transfers across settings. METHODS Semi-structured interviews were held with 21 family carers. A constant comparative approach was used to analyze data. RESULTS Three themes were identified after data analysis: (I) patient transfer dynamics, (II) experiences regarding the changed care environment and (III) impact of the transfer on the family carer. The dynamics of the patient's transfer were affected by the balance between the care provision (professional and informal care) and the changes in the patient's needs. Experiences regarding patient transfers strongly varied depending on the setting and were based on the personnel's conduct and the quality of receiving information. Study results revealed shortcomings in perceived inter-professional communication and continuity of information during a patient's hospitalization. Concomitant feelings of relief, anxiety or feeling insecure could arise in situations of a patient's transfer. CONCLUSIONS This study highlighted the adaptability of family carers when caring for their next of kin with palliative care needs. To support carers in coping with their role as caregivers and to share the responsibility of caregiving, involved healthcare professionals should timely evaluate family carers' preferences and needs and adapt the care organization accordingly. A pro-active attitude, which anticipates on the possibility of an impending decompensation of the family carer, is recommended. When the decision for a patient's transfer is taken, multiple factors influenced the choice of the care setting. Healthcare professionals need to take these factors into account when discussing, with patients and carers, the need for a transfer. Continuity of information can be improved. Further development and evaluation of interventions, aimed at improving informational continuity can be recommended.
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Affiliation(s)
- Fien Mertens
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium; Vrije Universiteit Brussel, Brussel, Belgium; End-of-Life Care Research Group, Ghent University, Gent & Vrije Universiteit Brussel, Brussel, Belgium
| | - Steven Vanderstichelen
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium; Vrije Universiteit Brussel, Brussel, Belgium; End-of-Life Care Research Group, Ghent University, Gent & Vrije Universiteit Brussel, Brussel, Belgium
| | - Myriam Deveugele
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Luc Deliens
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium; Vrije Universiteit Brussel, Brussel, Belgium; End-of-Life Care Research Group, Ghent University, Gent & Vrije Universiteit Brussel, Brussel, Belgium
| | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium; End-of-Life Care Research Group, Ghent University, Gent & Vrije Universiteit Brussel, Brussel, Belgium
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Walshe C, Pawłowski L, Shedel S, Vanderstichelen S, Bloomer MJ, Goossensen A, Limonero JT, Stoelen KS, Caraffa C, Pelttari L, Scott R. Understanding the role and deployment of volunteers within specialist palliative care services and organisations as they have adjusted to the COVID-19 pandemic: A multi-national EAPC volunteer taskforce survey. Palliat Med 2023; 37:203-214. [PMID: 36428254 PMCID: PMC9705505 DOI: 10.1177/02692163221135349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Early indications were of a major decline in specialist palliative care volunteer numbers during COVID-19. It is important that ongoing deployment and role of volunteers is understood, given the dependence of many palliative care services on volunteers for quality care provision. AIM To understand the roles and deployment of volunteers in specialist palliative care services as they have adjusted to the impact of COVID-19. DESIGN Observational multi-national study, using a cross-sectional online survey with closed and free-text option questions. Disseminated via social media, palliative care networks and key collaborators from May to July 2021. SETTING/PARTICIPANTS Any specialist palliative care setting in any country, including hospices, day hospices, hospital based or community teams. The person responsible for managing the deployment of volunteers was invited to complete the survey. RESULTS Valid responses were received from 304 organisations (35 countries, 80.3% Europe). Most cared for adults only (60.9%), provided in-patient care (62.2%) and were non-profit (62.5%). 47.0% had cared for people with COVID-19. 47.7% changed the way they deployed volunteers; the mean number of active volunteers dropped from 203 per organisation to 33, and 70.7% reported a decrease in volunteers in direct patient/family facing roles. There was a shift to younger volunteers. 50.6% said this drop impacted care provision, increasing staff workload and pressure, decreasing patient support, and increasing patient isolation and loneliness. CONCLUSION The sustained reduction in volunteer deployment has impacted the provision of specialist palliative care. Urgent consideration must be given to the future of volunteering including virtual modes of delivery, micro-volunteering, and appealing to a younger demographic.
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Affiliation(s)
- Catherine Walshe
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| | - Leszek Pawłowski
- Department of Palliative Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Melissa J Bloomer
- Griffith University School of Nursing and Midwifery & Princess Alexandra Hospital Intensive Care Unit, Brisbane, QLD, Australia
| | | | - Joaquín T Limonero
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | | | | | | | - Ros Scott
- University of Dundee, Dundee, Scotland, UK
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5
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Bakelants H, Vanderstichelen S, Chambaere K, Van Droogenbroeck F, De Donder L, Deliens L, Dury S, Cohen J. Researching Compassionate Communities: Identifying theoretical frameworks to evaluate the complex processes behind public health palliative care initiatives. Palliat Med 2023; 37:291-301. [PMID: 36576313 DOI: 10.1177/02692163221146589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Compassionate Communities have been put forward as a new model for community-based palliative care to positively impact the health and wellbeing of those experiencing challenges of serious illness, death, dying, and loss. Despite the growing international movement to develop these public health initiatives to end-of-life care, only a handful of initiatives have undergone some form of evaluation. AIM To provide guidance on designing evaluation research by identifying theoretical frameworks to understand the development, implementation, and underlying mechanisms of Compassionate Communities. METHODS To identify suitable theoretical frameworks for the study of Compassionate Communities, we applied two steps. The first step examined the characteristics of Compassionate Communities and translated them into assessment criteria for the selection of theoretical frameworks. The second step consisted of applying the identified assessment criteria to a list of widely used and highly cited theoretical frameworks. RESULTS Three well-established theoretical frameworks were identified as being most suitable to study the development, implementation, and underlying mechanisms of Compassionate Communities: The Consolidated Framework for Implementation Research (CFIR), the integrated-Promoting Action on Research Implementation in Health Services framework (i-PARIHS), and the Extended Normalization Process Theory (ENPT). CONCLUSIONS The article supports and encourages the use of theoretical frameworks to evaluate the complex processes behind public health palliative care initiatives. The complementary use of two determinant frameworks and an implementation theory provides theoretical grounding to gain rich insights into the emergent and shifting interplays between agency, social processes, and contextual factors that shape the development and implementation of Compassionate Communities.
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Affiliation(s)
- Hanne Bakelants
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium.,Vrije Universiteit Brussel (VUB), Society and Ageing Research Lab, Belgium
| | - Steven Vanderstichelen
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium
| | - Kenneth Chambaere
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium
| | - Filip Van Droogenbroeck
- Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium.,Vrije Universiteit Brussel (VUB), Tempus Omnia Revelat, Belgium
| | - Liesbeth De Donder
- Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium.,Vrije Universiteit Brussel (VUB), Society and Ageing Research Lab, Belgium
| | - Luc Deliens
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium
| | - Sarah Dury
- Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium.,Vrije Universiteit Brussel (VUB), Society and Ageing Research Lab, Belgium
| | - Joachim Cohen
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium
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Vanderstichelen S, Dury S, De Gieter S, Van Droogenbroeck F, De Moortel D, Van Hove L, Rodeyns J, Aernouts N, Bakelants H, Cohen J, Chambaere K, Spruyt B, Zohar G, Deliens L, De Donder L. Researching Compassionate Communities From an Interdisciplinary Perspective: The Case of the Compassionate Communities Center of Expertise. Gerontologist 2022; 62:1392-1401. [PMID: 35263765 DOI: 10.1093/geront/gnac034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Indexed: 12/13/2022] Open
Abstract
Compassionate Communities are places and environments in which people, networks, and institutions actively work together and are empowered to improve the circumstances, health, and well-being of those facing serious illness, death, dying, and loss. The study of their development, implementation, and evaluation requires an interdisciplinary research approach that has hitherto been lacking. In 2020, 8 research groups from 4 faculties at Vrije Universiteit Brussel united in the interdisciplinary Compassionate Communities Center of Expertise (COCO) to investigate Compassionate Communities. This article describes the first results of COCO: (a) an interdisciplinary mode of collaboration, (b) a shared conceptual understanding and definition of Compassionate Communities, and (c) a shared research agenda on Compassionate Communities.
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Affiliation(s)
- Steven Vanderstichelen
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sarah Dury
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Belgian Ageing Studies, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sara De Gieter
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Work and Organisational Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Filip Van Droogenbroeck
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Tempus Omnia Revelat, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Deborah De Moortel
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Interface Demography, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Lisa Van Hove
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Brussels University Consultation Centre, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Julie Rodeyns
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Brussels Research Centre on Innovation in Learning and Diversity, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Nele Aernouts
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Cosmopolis Centre for Urban Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Hanne Bakelants
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Joachim Cohen
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Kenneth Chambaere
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,End-of-Life Care Research Group, Ghent University, Ghent, Belgium
| | - Bram Spruyt
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Tempus Omnia Revelat, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Gabriel Zohar
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Brussels Research Centre on Innovation in Learning and Diversity, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Luc Deliens
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Liesbeth De Donder
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Belgian Ageing Studies, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Vanderstichelen S. Palliative care volunteering: Pressing challenges in research. Palliat Med 2022; 36:564-566. [PMID: 35360995 DOI: 10.1177/02692163221089483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Steven Vanderstichelen
- End-of-Life Care Research Group, Ghent University, Ghent, Belgium.,Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Vanderstichelen S, Pelttari L, Scott R. Evaluating the EAPC Madrid Charter on volunteering in hospice and palliative care: Reflections on impact. Progress in Palliative Care 2021. [DOI: 10.1080/09699260.2021.1964678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Steven Vanderstichelen
- Vrije Universiteit Brussel (VUB), End-of-Life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Pleinlaan 2, 1050 Brussels, Belgium
- Ghent University, Department of Public Health and Primary Care, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | | | - Ros Scott
- School of Education and Social Work, University of Dundee, Dundee, UK
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Vanderstichelen S, Cohen J, Van Wesemael Y, Deliens L, Chambaere K. Volunteers in palliative care: A healthcare system-wide cross-sectional survey. BMJ Support Palliat Care 2020; 12:e83-e93. [PMID: 32826268 DOI: 10.1136/bmjspcare-2020-002321] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/17/2020] [Accepted: 06/23/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Volunteers are an important resource in bridging palliative care (PC) services and communities. However, no studies have systematically mapped volunteers' actual contributions to PC provision and how well they are supported by healthcare services at the volunteer level. Such insights are important to shape and optimise supportive environments for volunteering in PC. This study aimed to describe organised volunteering practices in PC across dedicated PC services and healthcare services providing generalist PC, in terms of tasks, training, supervision and how volunteers evaluate these. METHODS A cross-sectional postal survey of 2273 volunteers from healthcare organisations providing care for people with serious illnesses in the Flemish healthcare system (Belgium) was conducted between June and November 2018. A two-step cluster randomised sample was used. Volunteers were recruited through their respective volunteering organisations. RESULTS Response was obtained for 801 (35.2%) volunteers. Volunteers were predominantly women (75.5%), retired (70.8%) and aged 60-69 years (43.4%). Almost all volunteers provided psychosocial care (96.3%). Volunteers were found to provide either (1) broad volunteer support, emphasising psychosocial and existential care and signposting tasks or (2) narrow volunteer support, emphasising nursing care tasks. Nursing home volunteers had the lowest prevalence of PC training (7.7% vs 53.7% total, p<0.001). CONCLUSIONS Multidimensional support was most prevalent among dedicated PC volunteers, while practical support was most prevalent among sitting service volunteers. Results indicate that volunteers can offer complementary support for patients with serious illnesses, although this requires training and consistent supervision. This is currently suboptimal for volunteers in nursing homes and community home care.
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Affiliation(s)
- Steven Vanderstichelen
- End-of-Life Care Research Group, Vrije Universiteit Brussel - Ghent University, Brussels, Belgium .,Department of Public Health and Primary Care, Ghent University, Ghent, Oost-Vlaanderen, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel - Ghent University, Brussels, Belgium
| | | | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel - Ghent University, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Oost-Vlaanderen, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel - Ghent University, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Oost-Vlaanderen, Belgium
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10
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Vanderstichelen S, Cohen J, Van Wesemael Y, Deliens L, Chambaere K. The involvement of volunteers in palliative care and their collaboration with healthcare professionals: A cross-sectional volunteer survey across the Flemish healthcare system (Belgium). Health Soc Care Community 2020; 28:747-761. [PMID: 31803986 DOI: 10.1111/hsc.12905] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 11/04/2019] [Accepted: 11/12/2019] [Indexed: 06/10/2023]
Abstract
Volunteers occupy a specific space in the delivery of palliative care (PC), addressing specific aspects of care and providing a link between professional healthcare providers and informal care. Engaging and empowering these volunteers can be an important strategy to deliver more integrated and comprehensive PC. Insights into current actual volunteer involvement and collaboration across different healthcare services providing generalist and specialist PC is lacking. This study aims to describe volunteers' involvement in the organisation of PC, collaboration with professionals and how they evaluate this. A cross-sectional postal survey of volunteers was conducted between June and November 2018 using a written questionnaire. A two-step disproportionately stratified cluster randomised sample of 2,273 registered volunteers was taken from different strata of healthcare organisations providing care for people with serious illnesses in the Flemish healthcare system (Belgium). Overall response was 35% (15%-60% for individual strata). About 67% of volunteers were often to always informed about the organisation of patient care and 48% felt the organisation often to always takes their opinion into account, while a minority report having decision rights (18%) or autonomy (24%). For some, their organisation failed to inform (17%), consult (27%), take into account their opinion (21%), give them decision rights (20%) or autonomy (16%) over certain aspects of patient care provision often enough. Overall, volunteer-professional collaboration was low, and mostly limited to information sharing. Dedicated PC volunteers collaborated extensively with nurses, often involving task coordination (46%). Ambiguity regarding tasks, agreements and/or rules (15%) and lack of information exchange (14%) were the most cited barriers to volunteer-professional collaboration. Many volunteers were open to stronger involvement in the organisation of care in PC services. Collaboration with professionals seemed lacking in width and depth. Particularly, nursing home volunteers indicated a desire and large potential for more involved and collaborative roles in PC provision.
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Affiliation(s)
- Steven Vanderstichelen
- End-of-Life Care Research Group (VUB - UGent), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group (VUB - UGent), Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Luc Deliens
- End-of-Life Care Research Group (VUB - UGent), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group (VUB - UGent), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Vanderstichelen S, Cohen J, Van Wesemael Y, Deliens L, Chambaere K. Perspectives on Volunteer-Professional Collaboration in Palliative Care: A Qualitative Study Among Volunteers, Patients, Family Carers, and Health Care Professionals. J Pain Symptom Manage 2019; 58:198-207.e7. [PMID: 31028875 DOI: 10.1016/j.jpainsymman.2019.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 11/30/2022]
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.
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Affiliation(s)
- Steven Vanderstichelen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium; End-of-Life Care Research Group, Ghent University, Ghent, Belgium; Department of Public Health and Primary Care Corneel Heymanslaan, Ghent University, Ghent, Belgium.
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium; End-of-Life Care Research Group, Ghent University, Ghent, Belgium
| | | | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium; End-of-Life Care Research Group, Ghent University, Ghent, Belgium; Department of Public Health and Primary Care Corneel Heymanslaan, Ghent University, Ghent, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium; End-of-Life Care Research Group, Ghent University, Ghent, Belgium; Department of Public Health and Primary Care Corneel Heymanslaan, Ghent University, Ghent, Belgium
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Vanderstichelen S, Cohen J, Van Wesemael Y, Deliens L, Chambaere K. Volunteer involvement in the organisation of palliative care: A survey study of the healthcare system in Flanders and Dutch-speaking Brussels, Belgium. Health Soc Care Community 2019; 27:459-471. [PMID: 30325557 DOI: 10.1111/hsc.12666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 08/14/2018] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
Ageing populations increasingly face chronic and terminal illnesses, emphasising the importance of palliative care and quality of life for terminally ill people. Facing resource constraints in professional healthcare, some governments expect informal caregivers like volunteers to assume a greater share of care provision. We know volunteers are present in palliative care and perform many roles, ranging from administration to providing companionship. However, we do not know how involved they are in the organisation of care and how healthcare organisations appraise their involvement. To address this, we provide an extensive description of the involvement of volunteers who provide direct patient palliative care across the Flemish healthcare system in Belgium. We conducted a cross-sectional postal survey of 342 healthcare organisations in Flanders and Brussels in 2016, including full-population samples of palliative care units, palliative day care centres, palliative home-care teams, medical oncology departments, sitting services, community home-care services, and a random sample of nursing homes. Volunteer involvement was measured using Sallnow and Paul's power-sharing model, which describes five hierarchical levels of engagement, ranging from being informed about the organisation of care to autonomy over certain aspects of care provision. Response was obtained for 254 (79%) organisations. Volunteers were often informed about and consulted regarding the organisation of care, but healthcare organisations did not wish for more autonomous forms of volunteer involvement. Three clusters of volunteer involvement were found: "strong involvement" (31.5%), "restricted involvement" (44%), and "uninvolved" (24.5%). Degree of involvement was found to be positively associated with volunteer training (p < 0.001) and performance of practical (p < 0.001) and psychosocial care tasks (p < 0.001). Dedicated palliative care services displayed a strong degree of volunteer involvement, contrary to generalist palliative care services, suggesting volunteers have a more important position in dedicated palliative care services. A link is found between volunteer involvement, training, and task performance.
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Affiliation(s)
- Steven Vanderstichelen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
| | | | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
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Vanderstichelen S, Cohen J, Van Wesemael Y, Deliens L, Chambaere K. The liminal space palliative care volunteers occupy and their roles within it: a qualitative study. BMJ Support Palliat Care 2018; 10:e28. [PMID: 30530629 DOI: 10.1136/bmjspcare-2018-001632] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/26/2018] [Accepted: 10/31/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Volunteers have an important place in palliative care (PC), positively influencing quality of care for seriously ill people and those close to them and providing a link to the community. However, it is not well understood where volunteers fit into PC provision or how to support them adequately. We therefore chose to describe volunteer roles across care settings through the perspective of those closely involved in the care of terminally ill people. METHODS A qualitative study was conducted using both focus groups with volunteers, nurses, psychologists and family physicians and individual semistructured interviews with patients and family caregivers. Participants were recruited from hospital, home, day care and live-in services. RESULTS 79 people participated in the study. Two volunteer roles were identified. The first was 'being there' for the dying person. Volunteers represent a more approachable face of care, focused on psychological, social and existential care and building relationships. The second was the 'liaison' role. Volunteers occupy a liminal space between the professional and the family domain, through which they notice and communicate patient needs missed by other caregivers. Patient-volunteer matching was a facilitator for role performance; barriers were lack of communication opportunities with professional caregivers and lack of volunteer coordination. CONCLUSION Volunteers complement professional caregivers by (1) occupying a unique space between professionals, family and patients and fulfilling a liaison function and (2) being a unique face of care for patients. Healthcare services and policy can support volunteer role performance by ensuring frequent communication opportunities and volunteer coordination.
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Affiliation(s)
- Steven Vanderstichelen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium .,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
| | | | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Abstract
BACKGROUND Volunteers fulfil several roles in supporting terminally ill people and their relatives and can positively influence quality of care. Healthcare in many countries faces resource constraints and some governments now expect communities to provide an increasing proportion of palliative care. However, systematic insights into volunteer presence, tasks and training and organisational challenges for volunteerism are lacking. AIM Describe organised volunteerism in palliative direct patient care across the Flemish healthcare system (Belgium). DESIGN A cross-sectional postal survey using a self-developed questionnaire was conducted with 342 healthcare organisations. SETTING/PARTICIPANTS The study included full population samples of palliative care units, palliative day-care centres, palliative home care teams, medical oncology departments, sitting services, community home care services and a random sample of nursing homes. RESULTS Responses were obtained for 254 (79%) organisations; 80% have volunteers providing direct patient care. Psychosocial, signalling and existential care tasks were the most prevalent volunteer tasks. The most cited organisational barriers were finding suitable (84%) and new (80%) volunteers; 33% of organisations offered obligatory training (75% dedicated palliative care, 12% nursing homes). Differences in volunteer use were associated with training needs and prevalence of organisational barriers. CONCLUSION Results suggest potential for larger volunteer contingents. The necessity of volunteer support and training and organisational coordination of recruitment efforts is emphasised. Organisations are encouraged to invest in adequate volunteer support and training. The potential of shared frameworks for recruitment and training of volunteers is discussed. Future research should study volunteerism at the volunteer level to contrast with organisational data.
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Affiliation(s)
- Steven Vanderstichelen
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
| | - Dirk Houttekier
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
| | - Joachim Cohen
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
| | | | - Luc Deliens
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,3 Department of Medical Oncology, Ghent University, Brussel, Belgium
| | - Kenneth Chambaere
- 1 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium
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