Rural and remote health最新文献

{"title":"Prescribing for acute migraine in a rural Australian hospital.","authors":"John J van Bockxmeer, Sarah Briody, Marshall Makate, Jack Kalotas","doi":"10.22605/RRH8686","DOIUrl":"https://doi.org/10.22605/RRH8686","url":null,"abstract":"<p><strong>Introduction: </strong>Migraine is an episodic, debilitating form of headache. Guidelines exist for the management of acute migraine, concluding that opioids should be avoided, unless as a last resort. Australian research shows a poor consistency in ED prescribing patterns with no published rural hospital data. Treatment of acute migraine often involves multiple medications used in succession. The overprescription of opioids is reported and often accompanied by an underuse of triptans. Previous studies do not differentiate prescriber intervention over time. It is unclear if opioid medications are routinely selected as first-line therapy in rural Australian EDs. The aim of this research is to complete an evaluation of migraine management in a rural Australian ED and compare trends to pre-existing data.</p><p><strong>Methods: </strong>This study is a retrospective cohort analysis of clinician-diagnosed migraine patients presenting to a single Australian ED between 1 January 2017 and 31 December 2021. Cases with migraine were defined by a primary G439 diagnosis (International Classification of Diseases 10th Revision). Patients with alternative diagnoses and those who did not wait were excluded. Cases underwent a non-blinded chart review extracting demographic and clinical data. Diagnoses were not evaluated against the international headache society criteria. ED interventions were recorded as first-, second-, third- or fourth-line based on the ordering time by the prescribing doctor. Medications were classified as being compliant or non-complaint with current standards of care. Trends were compared to previous studies.</p><p><strong>Results: </strong>A total of 341 patients were diagnosed with migraine, 72.4% female, median 35 years. A total of 6.5% arrived by ambulance, 76.8% had a prior history of migraine, 6.5% were admitted, 36.4% underwent blood investigations and 12.0% neuroimaging. A total of 7.6% of patients received opioids as first-line therapy, 44.3% failed self-medication and 21.7% of patients with migraine history trialled opioids prior to presentation. Regarding prescriptions, 795 were written, 18.1% were non-compliant with guidelines. Seventy percent of patients received dopamine and 5-HT3 antagonists, 43.1% non-steroidal anti-inflammatory drugs (NSAIDs), 27.0% serotonin receptor agonists and 27.0% opioids. There was a statistically significant prescribing difference for aspirin, used in 16.4% of those with a migraine history and 5.1% without (p=0.01). A total of 13.8% reported allergies/contraindications to guideline therapies.</p><p><strong>Conclusion: </strong>Prescribing for acute migraine in Australia is highly variable by context. This single-site study has similarities and differences with prior research. Rates of opioid prescribing were lower, possibly due to the known sparing effect of serotonin receptor agonist usage. Similar rates of NSAID and intravenous hydration prescription occurred. Patterns of intervention o","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 2","pages":"8686"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public healthcare personnel's experiences and opinions on access and readiness to provide mental health care in a remote rural area in South Africa.","authors":"Divan Rall, Leslie Swartz","doi":"10.22605/RRH8961","DOIUrl":"https://doi.org/10.22605/RRH8961","url":null,"abstract":"<p><strong>Introduction: </strong>WHO encourages decentralising mental health care away from the tertiary locus of care into lower levels of care so as to reform mental healthcare worldwide. Recently, attempts have been made to facilitate the integration of public mental health care into general healthcare systems in South Africa. It is well established that the country's public healthcare system faces numerous multifaceted challenges - including very limited human, structural and material resources needed to accommodate and treat patients. We studied the experiences and opinions of public healthcare workers at primary healthcare clinics and the associated referral hospitals, focusing mainly on exploring their views on the ability and readiness for access to and provision of mental health to state health patients.</p><p><strong>Methods: </strong>The Mental Health Knowledge Schedule (MAKS), the Mental Illness: Clinicians' Attitudes Scale (MICA-4) and a purpose-made questionnaire were used for data collection. The data from the MAKS and MICA-4 were imported into IBM SPSS Statistics Software to yield descriptive information, and Spearman's rank correlations were performed between the measures. The purpose-made questionnaire produced descriptive quantitative data and qualitative data that were analysed through conventional content analysis.</p><p><strong>Results: </strong>Results from the MAKS suggest that participants experienced gaps in mental health knowledge and had fair levels of familiarity and ability to recognise different mental health conditions. Results from the MICA-4 suggest that participants in our study generally displayed a positive attitude towards people with mental illness and aspects involving psychiatry. Quantitative results from the purpose-made questionnaire describe aspects around mental health services, training, resources and care. Qualitative findings suggest healthcare workers wished for more mental-health-specific resources and contact with the healthcare system to facilitate interventions and care.</p><p><strong>Conclusion: </strong>This research presents possible solutions to the challenges faced in public mental health care. Some of these solutions are within workers' control, while many of the solutions to the successful integration of more comprehensive basic care are out of their ambit of control, remaining locked up in policy and implementation rather than in field-level practice.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"8961"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplement use among a diverse sample of perimenopausal and menopausal women in rural Hawai&#x02BB;i.","authors":"Paris N Stowers, Emilie Stickley, Russell Woo, Andras Bratincsak","doi":"10.22605/RRH9490","DOIUrl":"https://doi.org/10.22605/RRH9490","url":null,"abstract":"<p><strong>Introduction: </strong>Supplement use is common among women experiencing menopause and perimenopause. Previous studies have identified regional, cultural, and ethnic differences in supplement use patterns and have identified a high prevalence of supplement use among rural populations. The objective of this study was to characterize supplement use among an ethnically diverse population of perimenopausal and menopausal women living in a rural region of Hawai&#x02BB;i in the US.</p><p><strong>Methods: </strong>From May to August 2023, women aged over 40 years presenting for care at an academic women's health clinic were recruited to participate in this cross-sectional study. A 10-minute survey including questions concerning demographic characteristics and supplement use was administered. Descriptive statistics were used to describe data obtained from the survey.</p><p><strong>Results: </strong>One hundred participants completed the survey. Of these, most participants identified as Asian, White, or Native Hawaiian. Ninety-four percent of respondents reported using at least one supplement in the previous 6 months. Most participants (60%) used four or more supplements, and the mean monthly cost was US$55 (A$83). The most commonly reported supplements included vitamin D, calcium, a multivitamin, and magnesium. Health professionals were the most commonly identified source of information regarding supplement use (69%). The most common motivations for supplement use were promotion of general health (51%) and replacement of dietary deficiencies (11%).</p><p><strong>Conclusion: </strong>The prevalence of supplement use among perimenopausal and menopausal women in rural Hawai&#x02BB;i is higher than previously published measures of supplement use among similarly aged women in the continental US, the UK, and Canada. In the setting of such widespread use, clinicians caring for this population may consider initiating thoughtful discussions with patients on the risks and benefits of using these products.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"9490"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical analysis of interprofessional student-led community health promotion workshops.","authors":"Catherine O'Connor, Alyssa Labelle, Tyler Pretty, Kayla Katerynuk, Gayle Adams-Carpino","doi":"10.22605/RRH9522","DOIUrl":"https://doi.org/10.22605/RRH9522","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Health promotion interventions can empower communities and individuals by focusing on social and environmental interventions, rather than on individual behaviour changes. The settings-based approach, rooted in WHO's Health for All initiative, emphasizes community involvement, collaboration, and equity. Community-based health promotion, especially in rural and remote areas where there is a higher proportion of underserved populations, can leverage community assets and promote health equity. Student-led health promotion initiatives are gaining traction, benefiting both students and communities. Reach Acc&egrave;s Zhibbi (RAZ), a student-led organization in Sudbury, Ontario in Canada delivers evidence-based health promotion workshops to vulnerable populations, promoting health literacy and equity. This study examines the impact of RAZ's workshops, addressing a gap in research on student-led, non-clinical health promotion efforts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional mixed-methods study examined RAZ workshops at five partnering community agencies. Data was collected with two surveys: a web-based survey for staff and a paper-based survey for workshop participants. The first gathered perspectives on long-term impacts of the workshops, while participant surveys were given before and after the workshops to assess baseline knowledge, learning, and behavioural intent. The surveys were developed using the Health Behaviour Scale-16 and were designed at a grade 5 reading level for accessibility. Data analysis involved frequency analysis and Wilcoxon signed-rank test to assess perceived learning gains. Thematic analysis was conducted on qualitative data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven employees from three of the five partnering agencies rated the effectiveness of RAZ workshops, with a mean score of 9 out of 10. They highlighted benefits such as increased knowledge, skills, and mental wellness. Thematic analysis identified three key themes: long-term impact, practical application, and mutual collaboration. Among 33 workshop participants, significant improvements were observed in health literacy, decision-making, and physical and mental health knowledge post-workshop. A Wilcoxon signed-rank test on adjusted change scores for pre- and post-workshop data revealed statistically significant gains in perceived learning across all aspects. Most attendees found the workshop helpful, with 57.6% planning behaviour changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study showed that interprofessional student-led health promotion workshops effectively enhance health literacy and empower underserved communities. Significant improvements in participants' knowledge and confidence suggest these workshops help address health disparities. The findings highlight their potential scalability and adaptability across communities, promoting sustainable health promotion efforts, an important consideration for rural and remote commu","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"9522"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors that promote success in a maternal-child program serving Indigenous families: a community-based participatory research project in Northern Saskatchewan, Canada.","authors":"Charlene A Thompson, Angela Bowen, Rebecca Clark, Donna Rennie, Michael L Szafron","doi":"10.22605/RRH8894","DOIUrl":"https://doi.org/10.22605/RRH8894","url":null,"abstract":"<p><strong>Introduction: </strong>Despite investment in maternal-child health programs, there has been little impact on the health outcomes of Indigenous mothers and their children, creating a need to understand how programs can be successfully implemented. Community input is essential for successful programs; however, there is little research exploring the perspectives of frontline workers providing these programs. To gain a better understanding of how to support maternal-child health program success a research partnership was formed with the KidsFirst North program in Northern Saskatchewan, Canada. Using a community-based participatory research approach, this study was codeveloped to (1) explore families', frontline workers', and administrators' perceptions of factors that contribute to the success and barriers of a program for Indigenous families; and (2) describe the current role of frontline workers within health program planning, implementation, and evaluation.</p><p><strong>Methods: </strong>From September 2019 to January 2020, data were collected through in-person meetings, focus groups, and semi-structured interviews with KidsFirst North families (n=9), frontline workers (n=18), and administrators (n=7) from 11 sites in Northern Saskatchewan. Data were analyzed using the Collective Consensual Data Analytic Procedure.</p><p><strong>Results: </strong>The identified factors of program success included the importance of staff, where staff demonstrated certain positive characteristics and created a welcoming atmosphere for families; community events that were open to the entire community; and the integration of Indigenous culture in the program. Program barriers included jurisdictional policy that negatively impacted frontline workers, a lack of father inclusion in program activities, and community challenges such as a lack of access to other services within the community. All frontline workers had a role in program delivery, most reported involvement in program development and planning, and approximately half were included in program evaluation.</p><p><strong>Conclusion: </strong>Factors of success and barriers from the KidsFirst North project have illustrated elements to build on and areas to address in public health program planning, implementation, and evaluation of maternal-child health programs that serve Indigenous families. KidsFirst North has demonstrated ways a contemporary maternal-child health program can utilize frontline workers outside of program delivery to influence all aspects of health program planning, implementation, and evaluation. Contributing to the evidence base of maternal-child health programs for Indigenous families may help foster the success of public health programs; inform the role of frontline workers in health program planning, implementation, and evaluation; and positively impact the health of Indigenous children and families.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"8894"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the impact of a health justice partnership service on the health and wellbeing of regional young people.","authors":"Margaret Camilleri, Alison Ollerenshaw","doi":"10.22605/RRH8984","DOIUrl":"https://doi.org/10.22605/RRH8984","url":null,"abstract":"<p><strong>Introduction: </strong>Young people with unaddressed legal matters are at risk of adverse consequences to their health and wellbeing. Health justice partnerships (HJPs) can support young people in regional areas to address their legal matters and reduce consequential deleterious impacts. A health justice partnership for youth (HJPY) was established in western Victoria, Australia. The program was unique for both its regional location and focus on supporting young people with their legal matters. This article reports on research that was conducted alongside the program, examining (1) the perceptions of regional young people and workers about the impact of legal matters on the health and wellbeing of young people and (2) the role of this HJPY in addressing these legal matters on the health of young people.</p><p><strong>Methods: </strong>Surveys were used to collect data from young people (n=64) attending the HJPY, and youth and allied health workers (n=48) from partner and other agencies. Data about the program were collected by the legal service operating at the time. Data were collected across multiple time points over 6 years, upon commencement and completion of the program.</p><p><strong>Results: </strong>The findings showed that young people attending the program required assistance for a wide range of legal matters. Upon attending the HJPY, most young people indicated that their unresolved legal matters influenced their health and wellbeing including sleep, stress, concentration and relationships. After attending the program, young people reported perceived improvements in their health and wellbeing, with workers observing improvements in young people's mental health, mood and self-confidence.</p><p><strong>Conclusion: </strong>The research highlights the importance of HJPs to young people in addressing their unmet legal needs, with resolution of these matters supporting improved health and wellbeing and enabling them to move forward and focus on other areas of their lives. Youth and allied health workers in regional areas are integral in the early identification of young people with legal matters. They are integral to facilitating suitable referral pathways and services that support young people with their unresolved legal matters.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"8984"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote health solutions in Far East Gippsland: a mixed-methods, co-designed evaluation of health service availability in isolated communities.","authors":"Joanne E Porter, Megan R Simic, Naomi Cruz, Valerie Prokopiv, Eleni McIlroy","doi":"10.22605/RRH8506","DOIUrl":"https://doi.org/10.22605/RRH8506","url":null,"abstract":"<p><strong>Introduction: </strong>Australians living in isolated communities are more likely to experience poorer health outcomes as a result of rurality. This article provides a needs assessment of healthcare services in a geographically isolated region of Victoria, Australia.</p><p><strong>Methods: </strong>The research project employed a mixed-methods design. The study population consisted of members of the isolated communities in Victoria. The incorporation of qualitative data added depth to the quantitative data, ensuring that voices of community members were adequately represented in the needs assessment. Data analysis was undertaken using descriptive statistics and thematic analysis techniques.</p><p><strong>Results: </strong>Survey respondents from isolated regional locations highlighted the extended travel time and increasing wait times to see a medical practitioner, leading to a delay in seeking healthcare assistance. Respondents were less likely to have access to and use telehealth services, yet highlighted the service as beneficial to isolated regions. Survey findings were supported by in-depth interviews, with participants stating access to care was difficult, providing place-based suggestions of services to remove barriers to care such as a virtual care model and mobile services visiting the isolated regions.</p><p><strong>Conclusion: </strong>Access, use and facilitation of appropriate place-based health care within isolated Australia has the potential to increase wellbeing and enables residents to remain in regions that hold long historical and familial connections. By incorporating innovative technologies and models of care that have been evaluated across other isolated regions of Australia and globally, there is an opportunity to adapt existing models to conform to a post-COVID world.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"8506"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile and factors associated with low birth weight in Indonesia: a national data survey.","authors":"Mario Ekoriano, Anugerah Widiyanto, Muthmainnah Muthmainnah, Yuli Puspita Devi, Bambang Eko Cahyono, Izatun Nafsi, Teguh Widodo","doi":"10.22605/RRH9170","DOIUrl":"https://doi.org/10.22605/RRH9170","url":null,"abstract":"<p><strong>Introduction: </strong>The third objective of the UN Sustainable Development Goals (SDGs), 'ensure healthy lives and promote well-being for all at all ages', is manifest in Indonesia's commitment to health. One of the SDG3 targets is to reduce under-five mortality and infant mortality. In rural areas of Indonesia, there is a lack of access to medical facilities (healthcare services, anthropometry tools) and health workers, so low birth weight (LBW, <2500 g) in rural areas remains high. This study aimed to determine the profile of and test the factors that cause LBW in Indonesia.</p><p><strong>Methods: </strong>This study used secondary data from the National Socio-Economic Survey/Survei Sosial Ekonomi Nasional (SUSENAS) 2021 with a national sample of 4 711 455 women (weighted), which is analyzed descriptively and inferentially. The analysis was conducted descriptively to determine the profile and distribution of LBW at the national and provincial levels, while inferential analysis was performed using logistic regression to determine the variables that most influence LBW.</p><p><strong>Results: </strong>The prevalence of LBW in Indonesia was found to be 11.7%. North Maluku was the province with the highest LBW rate (20.1%), and West Java had the highest number of LBW infants in Indonesia, with 104 585 infants. This study found that smoking, rural areas, poor nutrition, age of childbirth, age and birth spacing significantly affected the incidence of LBW in Indonesia. In rural Indonesia, women tend to give birth to LBW babies (adjusted odds ratio: 1.249; 95%CI: 1.241-1.256). The incidence of LBW babies in rural areas was higher than in urban areas (12.9% v 10.8%) in Indonesia.</p><p><strong>Conclusion: </strong>This study concluded that smoking behavior is the main variable that influences the incidence of LBW in Indonesia. Therefore, there should be assistance to families by prioritizing significant factors for LBW (living in a village/rural area, low education, smoking behavior, not or rarely consuming nutritious food, maternal age at first birth 35 years and birth spacing <33 months). Especially for rural areas, governments need to improve access to healthcare facilities including availability of anthropometry tools, health workers, and healthcare services.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"9170"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating health care for children with disabilities: perspectives of male caregivers in rural Kenya.","authors":"Amani Karisa, Silas Onyango, Paul Otwate, Margaret Nampijja, Patricia Kitsao-Wekulo","doi":"10.22605/RRH9323","DOIUrl":"https://doi.org/10.22605/RRH9323","url":null,"abstract":"<p><strong>Introduction: </strong>UN Sustainable Development Goal 3 and the nurturing care framework highlight the importance of healthcare services and preventive measures to ensure optimal health outcomes for children, including those with disabilities. However, the contributions of male caregivers in the general care of children with disabilities in Sub-Saharan African contexts are often overlooked. This article therefore aims to understand how male caregivers navigate and negotiate healthcare options for their children with disabilities in rural Kenya.</p><p><strong>Methods: </strong>A qualitative approach was adopted, following the phenomenological tradition, to collect data from 22 male caregivers of children with neurodevelopmental disabilities in rural Kenya using four focus group discussions. The data were analyzed using inductive thematic analysis. The interpretation of the findings was guided by the theoretical approach of critical disability studies.</p><p><strong>Results: </strong>The article contributes new knowledge to the understanding of the roles and experiences of male caregivers in the healthcare of children with disabilities in rural Sub-Saharan African contexts. Four emergent themes are presented: '... hospitals around cannot offer a solution to their problems ...', '... regarding finances, I have to struggle alone ...', '... the only place one can pity you is the traditional herbalist ...' and 'I pray to God to heal him'.</p><p><strong>Conclusion: </strong>Faced with significant challenges in accessing conventional healthcare services, male caregivers employ the local cultural resources available to them to address the healthcare needs of their children with disabilities. This emphasizes the need to complement their efforts by mobilizing the healthcare system to offer quality, equitable, culturally sensitive and inclusive healthcare solutions.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"9323"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of selected factors influencing mortality of patients with COVID-19 treated in a community hospital in a rural region of Poland.","authors":"Marek Kos, Renata Hatalska-Żerebiec, Małgorzata Jurczyk-Stachyra, Karol Paciura, Justyna Janeczko, Robert Podsiadły, Piotr Sobolewski","doi":"10.22605/RRH8939","DOIUrl":"https://doi.org/10.22605/RRH8939","url":null,"abstract":"<p><strong>Introduction: </strong>Factors influencing mortality in patients with COVID-19 treated in a community hospital in a rural region in south-eastern Poland during the first and the second wave of the pandemic were analyzed.</p><p><strong>Methods: </strong>A retrospective observational study based on a hospital-based registry of Holy Spirit Specialist Hospital in Sandomierz was conducted. The study population consisted of patients treated between 1 March 2020 and 31 May 2021.</p><p><strong>Results: </strong>We analyzed data of 24 057 Caucasian patients including 798 patients with COVID-19. During both waves of the COVID-19 pandemic 22.4% of patients hospitalized in the community hospital in Sandomierz died due to COVID-19. The multivariate logistic regression model showed that older age (p<0.001), fever (p<0.001), diagnosis of sepsis (p<0.001) and high levels of C-reactive protein (p=0.041) were factors related to mortality. In the group of patients in whom oxygen therapy (p<0.001) and invasive mechanical ventilation (p<0.001) were used more frequently, mortality was higher, whereas treatment with convalescent plasma increased the chance of survival (p<0.001).</p><p><strong>Conclusion: </strong>Fever and high laboratory values of inflammation, in particular coexisting sepsis, worsened the prognosis in patients with COVID-19. Most traditional methods of treating the infection did not affect the course of the disease.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"25 1","pages":"8939"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}