Faculty of Business and Law, University of the West of England, Bristol, United Kingdom.
National End of Life Care Intelligence Network, Public Health England, Bristol, United Kingdom.
PLoS One. 2019 Jul 1;14(7):e0218597. doi: 10.1371/journal.pone.0218597. eCollection 2019.
Funding shortages and an ageing population have increased pressures on state or insurance funded end of life care for older people. Across the world, policy debate has arisen about the potential role volunteers can play, working alongside health and social care professionals in the community to support and care for the ageing and dying.
The authors examined self-reported levels of care for the elderly by the public in England, and public opinions of community volunteering concepts to care for the elderly at the end of life. In particular, claimed willingness to help and to be helped by local people was surveyed.
A sample of 3,590 adults in England aged 45 or more from an online access panel responded to a questionnaire in late 2017. The survey data was weighted to be representative of the population within this age band. Key literature and formative qualitative research informed the design of the survey questionnaire, which was further refined after piloting.
Preferences for different models of community volunteering were elicited. There was a preference for 'formal' models with increased wariness of 'informal' features. Whilst 32% of adults said they 'might join' depending on whom the group helped, unsurprisingly more personal and demanding types of help significantly reduced the claimed willingness to help. Finally, willingness to help (or be helped) by local community carers or volunteers was regarded as less attractive than care being provided by personal family, close friends or indeed health and care professionals.
Findings suggest that if community volunteering to care for elderly people at the end of life in England is to expand it may require considerable attention to the model including training for volunteers and protections for patients and volunteers as well as public education and promotion. Currently, in England, there is a clear preference for non-medical care to be delivered by close family or social care professionals, with volunteer community care regarded only as a back-up option.
资金短缺和人口老龄化增加了为老年人提供的国家或保险资助的临终关怀压力。在世界各地,政策辩论都围绕着志愿者可以发挥的潜在作用展开,他们可以与卫生和社会保健专业人员一起在社区中支持和照顾老年人和临终者。
作者研究了英国公众对老年人的自我报告护理水平,以及公众对社区志愿人员在临终时照顾老年人的看法。特别是,调查了声称愿意帮助和接受当地人民帮助的意愿。
从在线访问小组中抽取了 3590 名 45 岁以上的英国成年人,于 2017 年末对他们进行了问卷调查。该调查数据经过加权处理,以代表该年龄段的人群。关键文献和定性研究为调查问卷的设计提供了信息,经过试点后进一步完善了调查问卷。
提出了对不同社区志愿模式的偏好。人们更倾向于“正式”模式,对“非正式”特征则更为谨慎。虽然 32%的成年人表示他们“可能会加入”,这取决于他们帮助的对象,但毫不奇怪,更个人化和更具挑战性的帮助类型会显著降低他们帮助的意愿。最后,与由个人家庭、亲密朋友或医疗保健专业人员提供的护理相比,当地社区护理人员或志愿者的帮助(或被帮助)被认为吸引力较小。
研究结果表明,如果要在英国扩大社区志愿者对临终老年人的护理,可能需要对包括志愿者培训和患者及志愿者保护以及公众教育和宣传在内的模式给予相当关注。目前,在英国,人们显然更倾向于由亲密的家人或社会保健专业人员提供非医疗护理,而志愿者社区护理则被视为后备选择。