Rural Remote Health
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Rural Remote Health · Sep 2018
Paramedic and physician perspectives on the potential use of remotely supported prehospital ultrasound.
During remotely supported prehospital ultrasound (RSPU), an ultrasound operator performs a scan and sends images to a remote expert for interpretation. This novel technology has been undergoing investigation in the randomised controlled SatCare trial, which seeks to assess the capability of RSPU to improve patient outcomes and standard of prehospital care in the Highlands of Scotland. This study aimed to explore the views of emergency medicine physicians and paramedics prior to starting the trial. ⋯ There are substantial differences in emergency physician and paramedic perspectives on RSPU; however, both parties were willing to engage with the research process. Both groups have reservations, especially the emergency physicians who perceive significant barriers to the acquisition of skills, as well as the relational and contextual integration of RSPU. This study demonstrates the importance of conversations with physicians and paramedics throughout the research process, particularly as the role of prehospital care remains controversial.
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Rural Remote Health · Aug 2018
'When you're it': a qualitative study exploring the rural nurse experience of managing acute mental health presentations.
A higher proportion of chronic mental illness is reported for populations residing in inner and outer regional (IOR) areas when compared to major cities in Australia. Conversely, fewer mental health professionals work in IOR areas when compared to major cities indicating poorer access to services for rural populations. Rural emergency departments (EDs) and urgent care centres (UCCs) deliver a broad range of services. Often they are the first point of care for consumers experiencing acute mental health issues. Rural nurses working in EDs and UCCs require a diverse clinical skill set to manage complex presentations, often with limited support and resources. Developments in telehealth services have reportedly improved access for rural consumers. It is known that nurses report a lack of skills and confidence when managing mental health presentations. Despite these challenges, there is little documented regarding the experience of generalist nurses managing acute mental health presentations in rural hospitals that have limited support of community mental health teams and no onsite inpatient mental health facilities. ⋯ The findings from this study suggest generalist nurses are the frontline providers of care for mental health consumers in rural EDs and UCCs. Nurses feel ill-equipped for assessing and managing mental health presentations, relying heavily on local mental health teams and telephone triage who provide limited onsite support. The need to support nurses through training and mentoring relationships with community mental health teams is highlighted by this study in conjunction with improving the delivery of mental health services in rural areas.
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Rural Remote Health · Aug 2018
Surviving, not thriving: a qualitative analysis of parents' perceptions of physical activity participation for rurally residing children with a disability.
Preliminary research suggests that rurally residing children with a disability seldom participate in the recommended 60 minutes of moderate-to-vigorous physical activity per day and face multiple barriers to participation. The purpose of this study was to explore parents' perceptions of physical activity participation of rurally residing children with a disability, including barriers and any factors that may facilitate their participation. ⋯ This investigation of parents' perceptions suggests that the physical activity participation of rurally residing children with a disability is currently insufficient to adequately support the health of this population. It appears service providers need to address the factors that impede participation, including issues surrounding access, ability and isolation, but should also support the parents' behaviours, community opportunities and the child's own drive to participate. Existing support structures aimed at promoting physical activity should be enhanced and more inclusive, and accessible strategies should be developed.
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Rural Remote Health · Jul 2018
Comparative StudyScope of practice of family medicine graduates who completed a rural versus urban program.
In Canada, rural-based family medicine residency programs were established largely in response to a shortage of rural physicians and the perception that urban-based training programs were not meeting the needs of rural populations. Examinations of practice patterns of physicians trained in rural and urban programs are lacking. The purpose of this study was to compare the scope of practice of family medicine graduates who completed a rural versus an urban residency program, by practice location. ⋯ A combination of site of training (rural or urban program) and location of practice appear to work together to influence scope of practice of family physicians. A conceptual framework that summarizes the factors that have been reported to be associated with the scope of family practice is proposed.
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Rural Remote Health · Jun 2018
Prevalence and determinants of smoking and secondhand smoke exposure in a rural population of central Greece: a cross-sectional study.
Smoking is one of the most important risk factors for heart and lung disease and is responsible for many forms of cancer. The resulting morbidity and mortality weigh heavily upon countries with high prevalence, such as Greece. According to the Global Adult Tobacco Survey (GATS) Greece, 38.2% of Greeks aged ≥15 years, namely 51.2% of men and 25.7% of women, are smokers. Smoking is also common among the young and people of high education. Despite laws prohibiting smoking at indoor places, exposure to environmental tobacco is very high both in private and public places. The study goal was to estimate the prevalence and characteristics of smoking, the level of tobacco exposure and the factors that affect both in a rural population. ⋯ There are very few studies studying the characteristics of smoking and tobacco exposure exclusively in rural populations in Greece, such as the present study. Both the high prevalence of smoking and the high levels of exposure to tobacco show a population at increased risk for tobacco-related disease. These call for immediate action to reduce smoking prevalence, help smokers quit and protect the health of non-smokers. The present study's conclusions provide the basis for designing local prevention programs and the baseline for monitoring of future trends in the area.