Rural Remote Health
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Rural Remote Health · Sep 2019
Talking skin: attitudes and practices around skin infections, treatment options, and their clinical management in a remote region in Western Australia.
Skin infections including scabies and impetigo have a high burden and cause significant morbidity in remote Aboriginal communities in Australia. Nevertheless, there is limited knowledge about community, healthcare practitioner and service provider perspectives on skin infections and treatment preferences. An increased understanding of their respective knowledge, attitudes and practices will contribute to improving healthcare seeking behaviour, improved diagnosis, treatment acceptability and quality of care within remote Aboriginal communities. The aim of this study was to explore Aboriginal parent/carer, healthcare practitioner, and service provider attitudes and practices regarding skin infections in Aboriginal communities in remote communities in the Pilbara, Western Australia. The study documents their perspectives and preferences regarding treatments for skin infections, as well as the perceived barriers and enablers to treatment uptake for scabies and impetigo amongst Aboriginal families in this region. ⋯ Documenting carer, service provider and healthcare practitioner perspectives on skin infections provides a more informed understanding of the context in which treatment decisions are made. The ongoing need for culturally appropriate targeted, translational health education; improved treatment guidelines and feasible, painless treatments; and potential for the use of bush medicines for skin infections were themes that emerged.
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Rural Remote Health · Sep 2019
Status of coverage of MR vaccination, after supplementary immunization activities in a rural area of South India: a rapid immunization coverage survey.
After a commendable achievement on polio-free status for the South-East Asian Region (SEAR), WHO is now focusing towards measles elimination, which is still a major contributor of under-five mortality in SEAR. India has introduced measles and rubella (MR) vaccination throughout the country through supplementary immunization activity, followed by introducing the same in the routine vaccination. Health indicators and public health system functioning in the southern states of India are good, so India introduced the MR campaign in the southern high-performing states as phase 1 on 5 April 2017. The aim of the campaign was to vaccinate more than 95% of eligible children (aged 9 months to 15 years). At the same time, rumors and negative campaigning about this initiative started in social media. This study aimed to measure the coverage of MR vaccination among the target population in South India. ⋯ Despite the negative propaganda by social media, the coverage of vaccination by the public healthcare providers was near optimal in phase 1, which shows the strength of the public health system in this rural area of southern India. In accordance with the modern technology, public health policymakers should think about and plan information education and communication activities.
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Rural Remote Health · Sep 2019
Are we there yet? Exploring the journey to quality stroke care for Aboriginal and Torres Strait Islander peoples in rural and remote Queensland.
The burden of stroke for Aboriginal and Torres Strait Islander peoples in Australia is significant. The National Stroke Foundation has identified that Aboriginal and Torres Strait Islander people are more likely to have a stroke at a younger age than the non-Indigenous population and are twice as likely for stroke to result in death, and that those Aboriginal and Torres Strait Islander people living in rural and remote areas are less likely to have access to an acute stroke unit. The only acute stroke unit in Far North Queensland treats six times more Aboriginal and Torres Strait Islander patients than the Queensland average, a large proportion of whom reside in the rural and remote communities of the Cape and Torres Strait. This article describes part of the qualitative phase of a project titled 'Culturally appropriate stroke services for Aboriginal and Torres Strait Islander people', received Closing the Gap funding to identify the needs of Aboriginal and Torres Strait Islander stroke survivors in Far North Queensland and establish a model of care that is responsive to these needs. ⋯ An integrated patient centred model of care that spans the care continuum and places value on an extended role for the Aboriginal and Torres Strait Islander health worker workforce is indicated, as is an increased utilisation of allied health and specialist follow-up close to home.
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Rural Remote Health · Sep 2019
Psychosocial care provision for terminally ill clients in rural Australian communities: the role of social work.
Despite being one of the most avoided topics of all time, death is a guaranteed eventuality for us all. However, quality psychosocial care as death approaches is not a guarantee. Where people reside is likely to impact a person's accessibility to quality psychological, emotional, social, spiritual and cultural support. Structural forces such as funding and resourcing will also be a contributing factor. Social workers have specific expertise in the psychosocial domain, yet enablers and inhibitors to social work referrals to support terminally ill clients in rural and remote communities have not been well explored. This study had two primary aims: to investigate the provision of psychosocial care for palliative clients in rural Australian communities and to identify barriers and facilitators of social work referrals to address psychosocial concerns for palliative care clients. ⋯ Palliative care funding in Queensland is insufficient to effectively address the existing demand. Resourcing for rural and remote palliative care in Queensland is inadequate to ensure holistic and quality approaches to psychosocial care in the end stages of life. Increased resourcing would result in better care, for longer time frames throughout a disease trajectory. Education and training for health practitioners to address skills and competencies in psychosocial care for terminally ill clients is a recommendation for professional development. Furthermore, there is a need for social work to develop national standards and competencies to enhance practitioner confidence to efficiently address psychosocial concerns for terminally ill clients. Whilst this study was undertaken in Queensland, Australia, the findings are echoed in other international rural communities.
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Rural Remote Health · Sep 2019
Powerless facing the wave of change: the lived experience of providing services in rural areas under the National Disability Insurance Scheme.
Australia's National Disability Insurance Scheme (NDIS) is the catalyst for a significant shift in the delivery of disability services to people with a disability and their families, including those residing in rural and remote parts of Australia. Allied health services in rural areas of Australia are often limited, existing services are characterised as being of a generalist nature and demand for services often exceeds service capacity. This shift in the delivery of disability services with the rollout of NDIS could have a poignant impact on the rurally based allied health providers delivering these services. The aim of this study was to explore in depth the experiences of providing clinical services under the NDIS in a rural area. ⋯ These findings offer insights into the particular challenges for rural clinicians in providing services under the NDIS. While there is improved funding support for people with a disability, this places additional pressure on rural clinicians who are already likely to be working at or beyond their workload capacity. Issues with recruitment and retention of new clinicians into rural and remote areas appear to be ongoing, which was identified as compounding the impact of the NDIS on existing service providers. Supporting the rural and remote workforce appears critical to avoid de-registration of existing NDIS service providers.