The experience of rural volunteer in-home support, community based health care: an exploration of the factors that facilitate and/or hinder rural volunteer in-home support through urban-based management of rural-based volunteers.
There is growing recognition of the benefits and increasing need for volunteers providing in-home support to individuals and families in the community. This is particularly the case in the domains of hospice palliative care, due to the impacts of an ageing population, and supporting families with children, due to the challenges presented in the early years of life especially in rural areas. The development of these services in rural areas often entails urban-based volunteer services extending services to rural communities through urban-based management of local, rural-based volunteers. The limited research in this area suggests that rural communities face distinctive complexities in the provision of volunteer in-home support, which are yet to be fully explored and are likely to be unaccounted for in urban-centric models. This highlights the need for new research to guide the reorientation of urban strategies to meet the particular challenges and opportunities associated with rural volunteer inhome health provision. The aim of this research study has been to explore the experience of rural volunteer in-home support, through urban-based management of rural-based volunteers, in order to further the understanding of this form of service delivery in rural communities. Specifically, it sought to identify factors that facilitate and/or hinder its provision and how their impact may be fostered or ameliorated. The study focused on the domains of hospice palliative care and supporting families with children through the multiple perspectives of urban-based volunteer coordinators, rural and urban specialist service providers and rural volunteers. A qualitative research study design involving 27 predominantly rural participants was undertaken utilising volunteer demographic information, semi-structured, in-depth interviews, a focus group, and thematic analysis of qualitative data. The findings identified multiple complex and interrelated factors which may facilitate and/or hinder rural volunteer in-home support. The overriding themes which emerged were the crucial importance of a community development approach which inherently considers the local rural context, and some manner of a locally based coordinating presence in facilitating the development of rural volunteer in-home support services which are appropriate to the specific rural setting. A synthesis of findings from the study and issues identified in the literature led to the development of a table of 'flags' or reference points, which provide insight into discerning and responding to particular rural socioeconomic and cultural factors which may facilitate and/or hinder rural volunteer in-home support: precedence of family support; self-reliance; multiple overlapping relationships; intermittent need; fragmented and under-resourced nature of the rural health system; and rural volunteers' strong sense of connection to their local community and volunteer organisation. This study contributes to an understanding of the nature of volunteer in-home support in the rural context, and how urban-based volunteer services seeking to provide services in rural areas may work with rural communities to meet rural exigencies.