Rural Remote Health
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Rural Remote Health · Jan 2012
Remote participants' experiences with a group-based stroke self-management program using videoconference technology.
Telehealth is an all-inclusive term for the provision of health services using information and communication technology. Videoconference delivery is one form of telehealth whereby a synchronous, two-way audio and visual connection is made between two or more sites. Videoconference is used in remote areas to improve access to healthcare, perform individual clinical assessments and deliver group education. Moving On after Stroke (MOST®) is a group-based, self-management program for stroke survivors and their caregivers, which consists of information sharing, facilitated discussion, goal-setting, and exercise. This program was delivered simultaneously to local participants onsite in Thunder Bay, Canada, and distant participants in smaller, remote communities in Northwestern Ontario using videoconferencing (MOST-Telehealth Remote). The objective of this study was to explore the experiences of remote participants, their perceptions regarding factors that enable or limit videoconference participation, and to obtain suggestions for enhanced delivery of videoconferenced group programs. ⋯ For MOST-TR participants, videoconference participation was valuable. Addressing the limitations of videoconference connection and enhanced local support may improve the experience for remote participants in small-group, videoconferenced, self-management programs. Using videoconference technology to participate in existing programs greatly increases accessibility for people living in remote areas.
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Rural Remote Health · Jan 2012
Medical student characteristics predictive of intent for rural practice.
The shortage of physicians in rural areas of the USA has led medical schools to focus on recruiting and selecting students who will choose to work in non-urban settings. The purpose of this study was to examine the effect of student characteristics previously correlated to choosing rural practice (ie being older, being male, being raised in a rural community, having a spouse or significant other who was raised in a rural community, having a spouse or significant other whose parents live in a rural community, having parents with high school education or less, and graduating from a smaller college) on osteopathic medical students' intent to practice in a rural setting. This study also examined the correlation between personality type and intent for rural practice using the Myers Briggs Type Indicator (MBTI). Finally, this study examined factors that would increase interest in practicing in a rural setting, such as financial assistance and students' opinions about physicians who choose to practice in rural areas. ⋯ The results of this study support past research showing that medical students with a rural background and with spouses or significant others having a rural background are more likely to have intent for rural practice. This study also found that students' personality types may be correlated with intent to practice in a rural area. In order to provide physicians who will serve the population living in rural areas of the USA, it is imperative that medical schools select students who are most likely to practice in a non-urban setting. Financial incentives are important to students, suggesting that programs such as loan forgiveness may be useful in recruiting students to rural practice. Medical students may benefit from career counseling utilizing the MBTI to facilitate an understanding of personality type and how it may impact their preference for rural practice.
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Farmers as a group have unique attitudes, sources of stress and a heightened risk of suicide. In the context of a prolonged drought and associated stress and increased risk of mental-health problems, this study provides an insight into the levels of psychological distress experienced by different demographic groups within the Australian farming community. The study also addresses a significant gap in the literature by exploring ways in which this unique cohort copes and may better cope, with the inevitable challenges of life 'on the land'. ⋯ This study offers a rare examination of farmers' psychological distress and coping in a time of drought. The results demonstrate that in this unique context it is erroneous to assume the universality of models of coping that have been validated in other samples. The results provide for the development of tailored interventions to help farmers cope more effectively during future times of drought.
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Rural Remote Health · Jan 2012
Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists.
The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. ⋯ Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to those reported in the rural health literature but rarely in the context of allied health and disability services. Relatively recent innovations such as therapy assistants, information technology, and trans-disciplinary approaches, were raised as important service delivery considerations within the region. These and other innovations were expected to extend the coverage provided by therapists. Non-government organisations played a significant role in service delivery and support in the region. Participants recognised the need for therapists working for different organisations, in rural areas, to collaborate both in terms of peer support and service delivery to clients.
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Rural Remote Health · Jan 2012
Recruiting and retaining rural students: evidence from a faculty of dentistry in South Africa.
There is a shortage internationally of adequately trained health professionals to service rural areas. Health professionals are more likely to practice in communities that are like the one in which they grew up. The WHO therefore suggests targeted university admission policies to facilitate the enrolment of students from rural areas. In South Africa, rural students have special needs with regard to university access and throughput because they come from the most economically disadvantaged communities and often are the first in their families to attend university. This descriptive study, the first in South Africa with a cohort of dentistry students, draws on data from undergraduates at a single faculty of dentistry in South Africa. It investigates the factors affecting rural students' access to university, their academic success, as well as their employment intentions. ⋯ Only a minority of dentistry students came from rural areas, and rural schools did not adequately prepare these students academically for university. Rural students also lacked immediate access to people with insight into the academic and socio-cultural aspects of higher education, including the process of independent learning. Despite financial and academic challenges, rural students had a significantly stronger commitment to rural employment than students from cities and towns. It is recommended that rural students should receive academic, financial, and mentoring support both before and during their studies.