Perspectives of Remote Volunteer Palliative Care Consultants During COVID: A Qualitative Study

Wendy Tong; Supriya Kapur; Alexa Fleet; Samantha Russo; Apurva Khedagi; Craig D Blinderman; Shunichi Nakagawa

doi:10.1016/j.jpainsymman.2021.07.028

Perspectives of Remote Volunteer Palliative Care Consultants During COVID: A Qualitative Study

J Pain Symptom Manage. 2022 Feb;63(2):321-329. doi: 10.1016/j.jpainsymman.2021.07.028. Epub 2021 Aug 4.

Authors

Wendy Tong¹, Supriya Kapur², Alexa Fleet², Samantha Russo², Apurva Khedagi³, Craig D Blinderman⁴, Shunichi Nakagawa⁴

Affiliations

¹ Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons (W.T., A.K.), New York, New York, USA. Electronic address: wyt2002@cumc.columbia.edu.
² Department of Sociomedical Sciences, Columbia Mailman School of Public Health (S.K., A.F., S.R.), New York, New York, USA.
³ Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons (W.T., A.K.), New York, New York, USA.
⁴ Department of Medicine, Columbia University Irving Medical Center (C.D.B., S.N.), New York, New York, USA.

Abstract

Context: A novel remote volunteer program was implemented in response to the initial COVID-19 surge in New York City, allowing out-of-state palliative care specialists to serve patients and families in need. No study has detailed the perceptions of these consultants.

Objectives: To understand the experiences of remote volunteer palliative care consultants during the initial COVID-19 surge.

Methods: This qualitative study utilized a thematic analysis approach. During January and February 2021, we conducted one-on-one semi-structured interviews with 15 board-certified palliative care physicians who participated in the program. Codes and emerging themes were identified through iterative discussion and comparison.

Results: Five overarching themes (with sub-themes in parentheses) were identified: 1) motivations for participating in the program, 2) logistical evaluation of the program (integration, telehealth model, dyad structure and debriefing sessions), 3) barriers to delivery (language and cultural differences, culture of high-intensity care, legal and administrative differences), 4) emotional burden (moral distress, burnout), and 5) ideas for improvements. Notably, participants observed institutional and cultural differences that posed challenges to delivery of care. Many expressed feelings of distress related to the uncertainty and scarcity caused by the pandemic, although volunteering may have been protective against burnout.

Conclusion: This study provides an in-depth look at the experiences of remote volunteer palliative care consultants during the initial COVID-19 surge from the unique perspectives of the consultants themselves. Participants expressed overall positive and meaningful experiences and felt that the model was appropriate given the circumstances. Additionally, participants provided recommendations that could guide future implementations of similar programs.

Keywords: COVID-19; Palliative care; emergency response; pandemic; telemedicine; volunteer.

MeSH terms

COVID-19*
Consultants
Humans
Palliative Care*
Qualitative Research
SARS-CoV-2
Volunteers