Making sense of health and illness in palliative care: volunteers' perspectives.
OBJECTIVE
To encourage communication and contribute to the palliative care movement's need for interdisciplinary care, this article offers to explore the stance of volunteers on two fundamental concepts, "health" and "illness," as well as their related understanding of "palliative care." Volunteers' understandings are then compared with the concepts put forth by the Canadian Hospice Palliative Care Association (CHPCA) in its "Model to Guide Hospice Palliative Care."


METHODS
Focus groups with volunteers, and individual interviews with coordinators from five selected palliative care community action organizations from across Canada, are used. A total of 65 participants from three Canadian provinces were interviewed.


RESULTS
Participants view illness as a subjective, multidimensional, and transformative experience that requires multiple adjustments. It is an impediment to personal equilibrium and a challenge for the terminally ill and their close ones. Health, on the other hand, is a complex phenomenon that consists of physical, psychological, social, and spiritual well-being. For participants, health is most often embodied by a person's capacity to adjust to their challenging circumstances. Both volunteers and coordinators see palliative care as an alternative approach to care that centers on helping patients and their families through their ordeal by offering comfort and respite, and helping patients enjoy their life for as long as possible.


CONCLUSIONS
Participants describe illness as a destabilizing loss and palliative care as a means to compensate for the numerous consequences this loss brings; their actions reflect these principles and are compatible with the CHPCA model.
Sévigny
Andrée
A
Département de Médecine Familiale et de Médecine d'Urgence, Université Laval, Québec, Canada. andree.sevigny.cha@ssss.gouv.qc.ca
Cohen
S Robin
SR
Dumont
Serge
S
Frappier
Annie
A
D000223:Adaptation, Psychological; D001294:Attitude to Health; D002170:Canada; D003142:Communication; D004194:Disease; D005260:Female; D017144:Focus Groups; D006701:Home Nursing / Q000523:psychology; D017051:Hospice Care / Q000458:organization & administration; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000458:organization & administration / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D019452:Terminally Ill / Q000523:psychology; D014838:Volunteers / Q000523:psychology*