The Feasibility of Creating Partnerships Between Palliative Care Volunteers and Healthcare Providers to Support Rural Frail Older Adults and Their Families: An Integrative Review

Connell, Braydon; Warner, Grace; Weeks, Lori E.

doi:10.1177/1049909116660517

Cited by 12 publications

(9 citation statements)

References 19 publications

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“…Additional barriers related to provider attitudes included a lack of understanding of the role volunteers could play in the circle of care, and not feeling confident volunteers know their role boundaries. Providers’ fears that volunteers may over step their role boundaries is an issue previously noted in the literature [ 54 ]. An additional contributor to negative attitudes toward volunteers is that primary care providers traditionally have limited contact with volunteers caring for individuals at end of life so they may not understand what support volunteers could provide to older adults with serious illness [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

How do inner and outer settings affect implementation of a community-based innovation for older adults with a serious illness: a qualitative study

Warner

Kervin

Pesut

et al. 2021

BMC Health Serv Res

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Background Implementing community-based innovations for older adults with serious illness, who are appropriate for a palliative approach to care, requires developing partnerships between health and community. Nav-CARE is an evidence-based innovation wherein trained volunteer navigators advocate, facilitate community connections, coordinate access to resources, and promote active engagement of older adults within their communities. Acknowledging the importance of partnerships between organizations, the aim of our study was to use the Consolidated Framework for Implementation Research (CFIR) to explore organizational (Inner Setting) and community or health system level (Outer Setting) barriers and facilitators to Nav-CARE implementation. Methods Guided by CFIR, qualitative individual and group interviews were conducted to examine the implementation of Nav-CARE in a Canadian community. Participants were individuals who delivered or managed Nav-CARE research, and stakeholders who provided services in the community. The Framework Method was used to analyse the data. Particular attention was paid to the host organization’s external network and community context. Results Implementation was affected by several inter-related CFIR domains, making it difficult to meaningfully separate key findings by only inner and outer settings. Thus, findings were organized into themes informed by CFIR, that cut across other domains and incorporated inductive findings: intraorganizational perceptions of Nav-CARE; public and healthcare professionals’ perceptions of palliative care; interorganizational partnerships and relationships; community and national-level factors that should have facilitated Nav-CARE implementation; and suggested changes to Nav-CARE. Themes demonstrated barriers to implementing Nav-CARE, such as poor organizational readiness for implementation, and public and health provider perceptions palliative care was synonymous with fast-approaching death. Conclusions Implementation science frameworks and theories commonly focus on assessing implementation of innovations within facilities and changing behaviours of individuals within that organizational structure. Implementation frameworks need to be adapted to better assess Outer Setting factors that affect implementation of community-based programs. Although applying the CFIR helped uncover critical elements in the Inner and Outer Settings that affected implementation of Nav-CARE. Our study suggests that the CFIR could expand the Outer Setting to acknowledge and assess organizational structures and beliefs of individuals within organizations external to the host organization who impact successful implementation of community-based innovations.

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Section: Discussionmentioning

confidence: 99%

How do inner and outer settings affect implementation of a community-based innovation for older adults with a serious illness: a qualitative study

Warner

Kervin

Pesut

et al. 2021

BMC Health Serv Res

Self Cite

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“…The use of non-professionally trained healthcare personnel to deliver palliative care in rural areas is increasing but their utilization and scope of practice varies widely. 51,52 A recent systematic review 51 examining partnerships between volunteers and palliative care professionals in rural areas emphasized the importance of volunteer education and training that emphasizes practice limits and boundaries and where volunteer communication and debriefing with overseeing healthcare professionals was imperative. The palliative and supportive care workforce is not expected to meet the demand in the coming decades relative to the growing need for services; 53 hence, developing models of care that leverage lay healthcare navigators may represent a solution to this impending crisis.…”

Section: Discussionmentioning

confidence: 99%

Adapting an Early Palliative Care Intervention to Family Caregivers of Persons With Advanced Cancer in the Rural Deep South: A Qualitative Formative Evaluation

Dionne‐Odom

Taylor

Rocque³

et al. 2018

Journal of Pain and Symptom Management

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“…These layperson-based programs suggest that individuals value the opportunity to exchange stories with peers who belong to their community group, are a similar age, or share similar experiences [ 12 ]. The involvement of volunteers in advance care planning conversations is a natural extension of the long-standing role volunteers have played in interdisciplinary hospice and palliative care teams [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Perceptions of trained laypersons in end-of-life or advance care planning conversations: a qualitative meta-synthesis

et al. 2018

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BackgroundLaypersons including volunteers, community health navigators, or peer educators provide important support to individuals with serious illnesses in community or healthcare settings. The experiences of laypersons in communication with seriously ill peers is unknown.MethodsWe performed an ENTREQ-guided qualitative meta-synthesis. We conducted a systematic search of MEDLINE, PsycINFO, CINAHL, Cochrane Library, and AMED to include qualitative studies with data regarding communication and laypersons in advance care planning, palliative care, or end-of-life settings. Study quality was appraised using a standardized tool. The analysis identified key domains and associated themes relating specifically to laypersons’ perspectives on communication.ResultsOf 877 articles, nine studies provided layperson quotations related to layperson-to-peer communication associated with advance care planning (n = 4) or end-of-life conversations (n = 5). The studies were conducted in United Kingdom (n = 4) or United States settings (n = 5). The synthesis of layperson perspectives yielded five main domains: 1) layperson-to-peer communication, focusing on the experience of talking with peers, 2) layperson-to-peer interpersonal interactions, focusing on the entire interaction between the layperson and peers, excluding communication-related issues, 3) personal impact on the layperson, 4) layperson contributions, and 5) layperson training. Laypersons described using specific communication skills including the ability to build rapport, discuss sensitive issues, listen and allow silence, and respond to emotions.ConclusionsPublished studies described experiences of trained laypersons in conversations with peers related to advance care planning or end-of-life situations. Based on these layperson perspectives related to communication, programs should next evaluate the potential impact of laypersons in meaningful conversations.

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The Feasibility of Creating Partnerships Between Palliative Care Volunteers and Healthcare Providers to Support Rural Frail Older Adults and Their Families: An Integrative Review

Cited by 12 publications

References 19 publications

How do inner and outer settings affect implementation of a community-based innovation for older adults with a serious illness: a qualitative study

How do inner and outer settings affect implementation of a community-based innovation for older adults with a serious illness: a qualitative study

Adapting an Early Palliative Care Intervention to Family Caregivers of Persons With Advanced Cancer in the Rural Deep South: A Qualitative Formative Evaluation

Perceptions of trained laypersons in end-of-life or advance care planning conversations: a qualitative meta-synthesis

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