Re-conceptualizing the Information Use Environment: Enablers of and constraints to human information behavior in hospice care volunteerism in the southeastern Appalachian region

Hospice care has seen an explosive growth in the last decade, with 42% of all deaths in 2010 in the US occurring under the care of a hospice program. A central aspect of hospice care is (unpaid) volunteer work, which is unique among other types of volunteer work in that it is strictly regulated by the Medicare hospice benefit, in which 94% of all hospices currently participate. As a cost-saving measure, Medicare requires that at least 5% of total patient care hours are undertaken by volunteers. However, hospice care faces a number of challenges, including a rapidly aging society that increasingly relies on hospice care; volunteer recruitment and retention; volunteers’ uncertainties about their role in hospice care; and a lack of consistent and accurate information-sharing among the hospice team, including the volunteer. Therefore, it is crucial that the origin of the hospice volunteer’s knowledge gaps be identified so as to determine how best to address hospice volunteer retention and recruitment. This study adapts Robert Taylor’s concept of the information use environment (IUE) and Anthony Giddens’s structuration theory in order to identify and explore the information behavior of the hospice volunteer coordinator. Twenty-one interviews of hospice care volunteer coordinators were conducted over a two-year period in East Tennessee, northern Georgia, and western North Carolina. A major finding of this study reveals that a power structure imbues both hospice care volunteerism as an IUE and the information behavior of the volunteer coordinator. Implications for library and information science are discussed, and recommendations are made for future research.