A Study on the Motivations of Korean Hospice Volunteers.

AIM: Volunteers play a key role in hospice and palliative service. This study was performed to investigate the motivations of Korean hospice volunteers and to identify the predictors that affect their service period.
MATERIALS AND METHODS: The accomplished questionnaire sheets of 93 subjects were included in the analysis. Inventory of Motivations for Hospice Palliative Care Volunteerism to measure the motivations of the hospice volunteers was used. The collected data were subjected to a statistical analysis of the mean and standard deviation, a t-test, and multinomial logistic regression analysis.
RESULTS: The motivation score of the hospice volunteers in South Korea is 75.57 ± 10.97, and the top three in the motivation list were altruism, civic responsibility, and self-promotion. Among the subdomains, altruism, 1-4-year working experience (B = 0.79, standard error (SE) = 0.26, P = 0.002, Exp (B) =0.45), and more than 10-year working experience (B = 1.00, SE = 0.30, P = 0.001, Exp (B) =0.36) had statistically significant influences.
CONCLUSIONS: The finding of this study can be used as basic information for the recruitment and management of hospice volunteers in South Korea. Copyright:

INTRODUCTION

In South Korea, hospice palliative care began in the 1960s, and since the 1990s, national volunteer education and activities have been developed.[1] The hospice palliative care service seeks to meet the needs of palliative care patients (and their family members) who want to receive dignified death with physical, psychological, and social help and stability. It is characterized by caring for the patient through the interdisciplinary team approach, which includes various workforce.[2] The participation of trained hospice volunteers is most important for the provision of high-quality, ongoing care for patients and their families.[3] Hospice volunteers are among the key members of the hospice palliative-care service team and spend the most time with terminally ill patients, alleviating their anxiety and that of their families in the desperate condition of near-death.[4] Hospice volunteers also help make the palliative care services more efficient and effective by relieving the hospice staff of their heavy workload.[5]

The tasks of hospice volunteers, however, are not simple. They have to deal with the heavy theme of death, having to take care of patients approaching death, not to mention their families. For the volunteers in this situation to work consistently with high responsibility and enthusiasm, their motivation must be fully understood and fulfilled.[678] Volunteers have a variety of motivations during their volunteer work. If their motivations are not fulfilled or if they are not satisfied with their voluntary service, they will stop offering such services. Therefore, it is important to explore the various motivations of hospice volunteers to fulfill their motivations, enhance their satisfaction with voluntary service, and improve the quality of hospice activities.

Research on the motivations of hospice volunteers has been conducted of late in several countries, including the USA,[9] the UK,[10] France,[11] Germany,[12] and Canada.[13] This has rarely been done, however, in South Korea. Therefore, this study intends to provide fundamental data for the development of programs for recruiting and managing volunteers in the future, by reviewing the motivations of Korean hospice volunteers, who carry out the most important roles in operating hospice service, and by identifying the predictors influencing their service period.

MATERIALS AND METHODS

The subjects of this study were hospice volunteers registered in general and long-term care hospitals located in the Seoul metropolitan areas and Gangwon-do. The sample size was calculated with the G * Power version 3.1.9. program (University of Düsseldorf, Düsseldorf, Northrhine-Westphalia, Germany). Accordingly, in the calculation made with a 0.05 significance level, a 0.15 medium effect size, 0.8 power, it was predicted that at least 92 participants were required, and the analysis was conducted on the 93 study participants. This study was approved by the institutional review board and written informed consent was obtained from each participant.

To measure the motivations of the subject hospice volunteers, Inventory of Motivations for Hospice Palliative Care Volunteerism (IMHPCV) developed by Claxton-Oldfield et al. was used.[14] This tool consists of 25 items scored based on a 5-point scale, with the following five subdomains: altruism, civic responsibility, self-promotion, leisure, and personal benefit. The higher the score is, the higher the motivation to become a hospice volunteer. At the time of its development, the Cronbach's α was 0.85, and the Cronbach's α in this study was 0.87.

The collected data were analyzed using SPSS Statistics for Windows version 20.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics were used to determine the participants' motivation level, and the t-test was used to compare the motivations of the hospice volunteers in South Korea and in other countries. Multinomial logistic regression analysis was performed to analyze the subdomains affecting the service period of hospice volunteers. The significance level was set at 0.05.

RESULTS

General characteristics of the subjects

The general characteristics of the study participants included their gender, age, religion, marital status, economic status, and service period. There were 84 female participants (90.3%), and the most common age group was 50–59 years old (42 persons, 45.1%). Seventy-one participants had a religion (76.1%), and the most common service period was 1–4 years (35 persons, 38.1%). The detailed general characteristics of the participants are presented in Table 1.

Table 1

General characteristics

Characteristics	Categories	n (%)
Gender	Male	4 (4.4)
	Female	89 (95.6)
Age (years)	20-29	6 (6.2)
	30-39	3 (2.7)
	40-49	18 (19.5)
	50-59	42 (45.1)
	≥60	25 (26.5)
Religion	Yes	71 (76.1)
	No	22 (23.9)
Marital status	Single	8 (8.8)
	Married	78 (84.1)
	Divorced	3 (2.7)
	Widowed	4 (4.4)
Economic status	High	9 (9.7)
	Middle	77 (82.3)
	Low	7 (8.0)
Length of service (years)	<1	11 (11.5)
	1-4	35 (38.1)
	5-9	29 (31.0)
	≥10	18 (19.5)

Motivation level of the subjects

The mean motivation level of the participants was 75.57 ± 10.97 points. The subdomain with the highest score was altruism and that with the lowest score was personal benefit [Table 2].

Table 2

Means and standard deviations on the Inventory of Motivations for Hospice Palliative Care Volunteerism

Category	Mean±SD
	Korean	British (Claxton-Oldfield et al., 2012)	Canadian (Claxton-Oldfield et al., 2011)	French (Garbay et al., 2015)
Altruism	19.39±3.10	19.97±4.52	21.44b±3.52	17.85a±4.06
Civic responsibility	18.08±3.61	16.02b±5.17	18.64±4.82	14.38b±4.59
Self-promotion	16.35±3.10	10.87b±4.76	11.46b±4.82	10.09b±3.42
Leisure	14.17±3.08	16.06±4.49	14.74±5.83	11.80a±3.24
Personal gain	8.58±1.54	9.26±4.67	9.46±4.48	-

aP<0.05, bP<0.01. SD: Standard deviation

Comparison of the motivations of the hospice volunteers in South Korea and in other countries

In the altruism domain, South Korea showed a similar level as the UK, and the civic responsibility level was similar to that of Canada. The self-promotion level of South Korea was higher than those of the UK, Canada, and France, and the level of leisure of South Korea was similar to that of Canada. The personal benefit level was lower than that of the UK or Canada [Table 2].

Predictors influencing the service period of hospice volunteers

To determine the domains affecting the service period of the hospice volunteers, multinomial logistic regression analysis was performed, with the five subdomains of motivation as independent variables and service period as a dependent variable. As a result, the fit of the analysis model was statistically significant (χ2 = 52.53, P = 0.000). The predictor that influences the service period the most is altruism.

DISCUSSION

This study was conducted to provide fundamental data for recruiting and managing volunteers by examining the motivations of the Korean hospice volunteers and identifying the subdomains affecting their service period.

Of the study participants, 95.6% were female, and only 4.4% were male, a much smaller proportion compared to 15.5% in Canada,[15] 39.0% in the UK,[16] and 13.2% in Poland.[17] This result shows that the active participation of male hospice volunteers is necessary in South Korea. In the present study, the proportion of males was low, and the difference in motivation according to gender was thus not analyzed. In the previous research work, however, the motivation of the volunteers varied according to gender.[181920] There have also been studies that aimed to support male hospice volunteers.[21] It is necessary to conduct studies on the difference in motivation according to the gender of the Korean hospice volunteers considering the necessity of recruiting and keeping male volunteers in South Korea.

The motivation level of the participants was 75.57 points, and altruism was the most influential factor in becoming a hospice volunteer. This is similar to 75.74 points in a study that measured the motivation level of the Canadian volunteers using IMHPCV[22] and is higher than 72.18 points among the UK volunteers.[10] Altruism has been presented as a key motivator of hospice volunteers in many studies. Nissim et al.[13] reported that in their study on 82 Canadian volunteers, the main motivation for hospice volunteering was found to be altruism. Planalp and Trost[9] also reported that in their study on 351 volunteers enrolled at 32 hospitals in the Western USA, the desire to help others was found to be the primary motivation of the volunteers. Similarly, in a study by Roessler et al.[23] in New Zealand, 67.5% of the hospice volunteers reported that they became a volunteer to serve others, supporting the results of this study.

The pursuit of personal benefit was the least influential motivation to become a hospice volunteer in this study, as also shown in the previous studies by Claxton-Oldfield et al.[1014] The motivation of personal benefit pertains to doing hospice voluntary service to acquire skills and experience for employment or to supplement one's resume,[9] which is more associated with younger volunteers than with older volunteers.[24]

The top three motivations of the Korean hospice volunteers were altruism, civic responsibility, and self-promotion. On the other hand, in a recent study on the British hospice volunteers, the top three motivations were found to be altruism, leisure, and civic responsibility,[10] and those in Canada and France were found to be altruism, civic responsibility, and leisure.[1114] In other words, among the Korean hospice volunteers, self-promotion had a greater influence compared to the British, Canadian, and French volunteers, and leisure had minimal influence. This means that Korean hospice volunteers have a higher desire to improve their image and to be recognized by others by volunteering rather than participating in volunteer activities because they have free time. I recommend that further studies are conducted concerning the self-promotion domain in developing hospice volunteer programs in South Korea.

The multinomial logistic regression analysis revealed that the predictor influencing the service period of Korean hospice volunteers is altruism. As there has been no previous study that examined the relationship between motivation and persistence in Korean hospice volunteers, it is difficult to directly compare the results of previous studies with the results of this study. Kim and Lee,[25] however, reported that among the motivations of volunteers in the field of public services, the altruistic motivation of helping others was significantly correlated with the willingness to continue volunteering. Kim and Kim[26] reported that the voluntary service satisfaction and persistence were higher when the intrinsic motivation related to the altruistic purpose or value of volunteering for others and devoting their time and efforts to the society was stronger. Many previous overseas studies have shown that altruism is a factor for continuing hospice volunteering.[4272829] To enhance the motivations of hospice volunteers, it is necessary to develop a research model for satisfaction with volunteering and willingness to continue for each motivation type.

This study has significance in that it is the first study to have investigated the motivations of Korean hospice volunteers and to have identified the predictors influencing their service period, and it suggested data necessary for recruiting and managing volunteers. The limitations of this study are as follows. First, care should be taken to generalize the results of the study because it was conducted on hospice volunteers in only one region, for convenience. Second, due to this study's small sample size, the differences in motivation according to the participants' general characteristics could not be analyzed. Further research is thus required to explore the relationships between the characteristics (gender, religion, etc.) and motivation of hospice volunteers.

CONCLUSIONS

This study examined the motivations of Korean hospice volunteers and identified the subfactors influencing their service period. The motivations that were found to have the greatest influence on the Korean volunteers were altruism, civic responsibility, and self-promotion, and the subfactor affecting the service period was found to be altruism. Considering the growing demand for hospice palliative care services, this study has significance in that it provided a basis for programs that can improve the satisfaction and persistence of hospice volunteers, who are among the important members of the hospice palliative care service team. To enhance the motivation of the hospice volunteers, a research model should be developed for their satisfaction and willingness to continue by motivation type.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.