"God Hey, Now I've Been Through Something": Moral Resilience of Coordinators in Voluntary Palliative Terminal Care

Moral distress arises in the dynamic relationship between personal factors and the organizational and political contexts of care work. Whether moral distress actually leads to a reduced well-being of health care workers or a reduced quality of care in the sector depends to a large extent on how moral tensions are dealt with, also called moral resilience, and the protective conditions available. Research about moral distress and moral resilience within the field of health care has concentrated on staff nurses and physicians. Studies into palliative terminal care and/or about the role of coordinating staff are scarce. A study was conducted to gain insight into the moral challenges that coordinators in voluntary palliative terminal care encounter in their ambition to realize good care, how they deal with these challenges, and the individual and organizational characteristics that foster or hamper moral resilience. Interviews were conducted with 20 coordinators and were qualitatively analyzed. The results brought forward 3 moral challenges in working with volunteers and in collaborating with professional care, namely, striving for connection, negotiating autonomy, and struggling with open communication. However, coordinators seemed to face these challenges effectively. In conclusion, the relational narrative strategies used by coordinators to deal with these challenges, in combination with personal and organizational conditions, foster moral resilience.

Successful supportive encounters from the peer supporter's perspective: Do status similarities to support recipients matter?

Experientially similar others, or "peer supporters," are persons who have faced a support recipient's stressor before. Theory suggests that peer supporters' understanding of and empathy for support recipients will be heightened when they match recipients not only in stressor experience but on one or more social statuses (e.g., age, education). Thus, peer-support volunteers may perceive supportive encounters as more successful when participants' statuses match. To explore this, volunteer Mended Hearts Visitors (former heart patients who visit currently hospitalized cardiac patients and their family members) were interviewed in-depth (N = 84). Visitors more often perceived same age and gender, but not same race and education, as enhancing rapport and patients' receptivity to their help. The findings suggest statuses which are culturally relevant to a shared stressor (here, cardiac surgery) can boost supporters' effectiveness, with practical implications for peer support-giving organizations that bring together experiential peers with recipients in pairs or small groups.

[Prisoners, caregivers and volunteers faced with COVID-19]

An enclosed space with specific constraints, prison authorises volunteers to support seriously ill patients at the end of life. After receiving relevant training, these volunteers become members of an approved association and can enter compounds such as Fresnes penitentiary hospital in Val-de-Marne. While the missions of these volunteers have been disrupted by covid-19, solutions have been put in place to allow the connection with the prisoners to be maintained.

Involvement of Medical Students During the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Survey Study

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic affects the education of medical students around the world and countries have had differing responses in dealing with this dynamic situation. The role of medical students in fighting this pandemic is controversial and it is yet to be elucidated how they can best be of service. The aim of this study is to evaluate the working fields of volunteering students and the impact of the pandemic on final year students from a student's perspective.

METHODS

An anonymous online survey was conducted amongst 219 medical students from Hamburg (Germany), using an institutional online data collection program.

RESULTS

A total of 137 questionnaires (63.5%) were completed. Of these, 97 participants were students from academic year three to five (70.8%) and 40 students were in the final year of medical school (29.2%). Of the 97 students from academic year three to five, 68 students (70.1%) signed up for voluntary duties during the pandemic. Interestingly, only 25.0% of the students were called for voluntary work in hospitals or health authorities. Final year students had already been working in hospitals since before the outbreak, with 35.0% of them assisting doctors in the treatment of COVID-19 positive patients during their placements. Using a 5-Point Likert Scale, the students who volunteered self-assessed their work as more useful and received more gratitude than final year students (p<0.01).

CONCLUSIONS

The majority of medical students are willing to make a significant contribution in the response to COVID-19 and do not wish to be overlooked. Furthermore, the current pandemic offers novel educational opportunities for medical students.

Des étudiantes sages-femmes engagées pour soutenir les professionnels de santé

La pointe de la Bretagne a eu la chance d’être relativement épargnée par la première vague de la pandémie de Covid-19. Néanmoins, conscients de la situation sanitaire nationale, certaines étudiantes sages-femmes brestoises, avec qui nous nous sommes entretenues, se sont engagées, dès le mois de mars 2020, dans des actions concrètes, pour soutenir les professionnels de l’hôpital.

To Meet, to Matter, and to Have Fun: The Development, Implementation, and Evaluation of an Intervention to Fulfil the Social Needs of Older People

Interventions for older people are often not evaluated and, if evaluated, are not proven successful. Based on a systematic literature review and two qualitative studies about the social needs of older people, an intervention has been developed, implemented, and evaluated. Important social needs that emerged from these studies are connectedness, meaningfulness, and independence. Samsam, the developed intervention, aims to fulfil these needs. Samsam is a place where older (native Dutch speaking) people teach the Dutch language to expats, refugees, and immigrants. Two group interviews and one interview with a total of seven older participants were held to find out what the experiences are with this intervention to fulfil the social needs of older people. After analysis, three themes emerged: (1) The general experience of Samsam, (2) connectedness, and (3) meaningfulness and status. Results indicate that the volunteers are content with the conditions of the intervention, although it is sometimes hard work. The older participants indicated that helping other people and contributing to society is important for them. The intervention also has a strong social and fun element which contributes to their feeling of connectedness. The intervention fulfils various social needs, such as connectedness, meaningfulness, and status. When participating in Samsam, participants feel connected to each other, to the students, and to society. The older participants want to have meaningful lives and use their skills and talents. Samsam offers possibilities for them to do so. We further found that participants have some common characteristics such as an openness to others and to other cultures. An openness towards others and to society helps older people to connect. Most interventions focus on stimulating contact between older people, primarily on their need for affection. We conclude that meaningfulness and status are important social needs. Successful interventions for older people should focus more on fulfilling these needs-for example, by engaging in purposeful activities. It becomes easier to connect when a person feels useful.

Social participation among older adults (55+): Results of a survey in the region of South Limburg in the Netherlands

Social participation may improve the health and well-being of older adults, and may increase the social and human capacity of their communities. This study investigates the level and forms of social participation among older adults (aged 55 years or older) in the region of South Limburg, the Netherlands, and their association with socio-demographic and health-related characteristics. The study provides evidence that can be used by policy makers to enhance social participation in the region. We use cross-sectional data collected in a survey in 2012 among a sample of older adults (aged 55 years or older) representative for the region of South Limburg. The results indicate that 56% (N = 16,291/weighted sample N = 213,332) of the older adults in the region participate in social activities. Specifically, 25.5% perform paid labour, 20% give informal care and 25% participate in volunteer work. Older adults with a higher education (OR = 2.49 for the highest education group) or higher income (OR = 1.70 for the highest income group) are significantly more likely to participate in social activities compared with the respective reference categories. Increased age (OR = 0.23 for the oldest age group), female gender (OR = 0.83), loneliness (OR = 0.75 for severe loneliness) and restrictions (OR = 0.78 for restrictions on the OECD scale, OR = 0.68 for restrictions on the HDL scale, OR = 0.52 for transportation restrictions) significantly hinder social participation. The lower social participation rate among older adults that we observe compared with the national statistics can be explained by the relatively higher proportion of people with low or average socioeconomic status in South Limburg. And as South Limburg is the unhealthiest region of the Netherlands, this also contributes to the low social participation. Prevention of poor physical and mental health, and provision of care services are important to encourage social participation among the older adults in South Limburg.

Factors to Consider When Planning Short-Term Global Health Work

Volunteer opportunities in short-term global health work can be rewarding experiences, but careful planning and preparation are vital. Potential problems to avoid include ineffective, harmful care; cultural ego-centrism; and lack of sustainability and cost effectiveness. Short-term global health work is most effective when the focus is on ongoing sustainable projects that include a long-term commitment and partnership with host communities.

Sexual and reproductive health in Greenland: evaluation of implementing sexual peer-to-peer education in Greenland (the SexInuk project)

Background

For decades, the rates of sexually transmitted infections (STIs), such as gonorrhoea, chlamydia and syphilis, have increased in Greenland, especially within the young age groups (15–29 years). From 2006 to 2013, the number of abortions has been consistent with approximately 800–900 abortions per year in Greenland, which is nearly as high as the total number of births during the same period. Previous studies in Greenland have reported that knowledge about sexual health is important, both as prevention and as facilitator to stop the increasing rates of STIs. A peer-to-peer education programme about sexual health requires adaption to cultural values and acceptance among the population and government in order to be sustainable.

Objective

Formative evaluation of a voluntary project (SexInuk), in relation to peer-to-peer education with focus on sexual health. Two workshops were conducted in Nuuk, Greenland, to recruit Greenlandic students.

Design

Qualitative design with focus group interviews (FGIs) to collect qualitative feedback on feasibility and implementation of the project. Supplemented with a brief questionnaire regarding personal information (gender, age, education) and questions about the educational elements in the SexInuk project. Eight Greenlandic students, who had completed one or two workshops, were enrolled.

Results

The FGIs showed an overall consensus regarding the need for improving sexual health education in Greenland. The participants requested more voluntary educators, to secure sustainability. The articulation of taboo topics in the Greenlandic society appeared very important. The participants suggested more awareness by promoting the project.

Conclusion

Cultural values and language directions were important elements in the FGIs. To our knowledge, voluntary work regarding peer-to-peer education and sexual health has not been structurally evaluated in Greenland before. To achieve sustainability, the project needs educators and financial support. Further research is needed to investigate how peer-to-peer education can improve sexual and reproductive health in Greenland.

Volunteer work in the church among older Mexican Americans

The purpose of this study is to identify the factors that influence the amount of volunteer work that older Mexican Americans perform in the place where they worship. The relationship between religion and volunteering is viewed from a social identity perspective. Data from a nationally representative sample of older Mexican Americans suggest that Evangelical/Pentecostal church members spend more time performing volunteer work at church than older Mexican Americans who affiliate with other denominations. Moreover, the findings indicate that the difference in the amount of volunteering between the two groups can largely be explained by differences in the nature of the spiritual support that Evangelical/Pentecostal receive from their fellow church members as well as depth of their commitment to their faith.