Perceived barriers and facilitators to medical students participating in volunteer services for older adults with disabilities: a qualitative descriptive study

Abstract

With global aging accelerating, volunteer services have become a cornerstone for sustaining care for older adults with disabilities (older adults aged 60 and above with age-related functional limitations). Medical students play a unique role in this system due to their professional competencies. However, they encounter particular environmental and psychological pressures that impact their sustained engagement. Existing literature has mostly focused on general motivations, while the barriers and facilitators influencing sustained participation have not been sufficiently explored through the application of a theoretical framework. This study aims to explore the facilitators and barriers of medical students participating in volunteer services for older adults with disabilities. A qualitative descriptive study was conducted using purposive sampling from two medical schools in Southwest China. Sixteen semi-structured interviews were conducted between October 2025 and January 2026 based on the Capability, Opportunity, and Motivation-Behavior (COM-B) model. Data analysis utilized the framework approach, with the Theoretical Domains Framework (TDF) used to map behavioral factors. Analysis revealed nine core themes regarding medical students’ perceptions of the barriers and facilitators to volunteering with older adults with disabilities within the COM-B model and the TDF framework. Facilitators included strong professional identity and empathy, social influence and interpersonal support, and incentive structures with career ambitions. Barriers were identified as the gap between theoretical knowledge and practice, physical stamina, and emergency decision-making pressures, information accessibility issues, resource limitations, and emotional experiences, coupled with psychological obstacles. A dilemma of “high intention, low efficacy” was observed. The present findings highlight the complex relationship between students’ professional aspirations and practical constraints and could contribute to the development of more effective volunteer service models for older adults with disabilities. Medical educational institutions and community organizations should implement simulation-based training to bridge the theory-practice gap, establish psychological support systems to enhance resilience, and optimize resource allocation. These measures are necessary to transform medical students’ motivation into sustainable practical capability.