Rural and remote health最新文献

{"title":"Learning process of implementing a cutaneous leishmaniasis capacity-building program, using an innovative pedagogy for rural populations in Colombia.","authors":"Laura Sofia Zuluaga, Natalia Gómez-Quenguán, Jennifer Estrella-Insuasty, Martha Milena Bautista-Gomez","doi":"10.22605/RRH8201","DOIUrl":"10.22605/RRH8201","url":null,"abstract":"<p><strong>Introduction: </strong>Participatory approaches to health often link capacity building as an indispensable process for strengthening the social capital of communities, in order to develop empowerment processes that lead to social transformation at the local level. In Pueblo Rico (Colombia), a capacity-building program in cutaneous leishmaniasis and social skills for community work was implemented with school students, health workers and local leaders. This article seeks to evaluate the implementation, results, and impact of that program.</p><p><strong>Methods: </strong>Primary data were collected through participant observation, questioners, the development of artistic products, and a focus group. Qualitative data were coded and analyzed through thematic analysis, and the quantitative data were quantitively coded and analyzed.</p><p><strong>Results: </strong>The capacity-building program had positive results in terms of the three aspects evaluated: the pedagogical model's implementation, the learning process, and the impact of the program. Three key elements that contributed to the success of the program were identified: the application of the principles of meaningful learning as a guide for the pedagogical model, the use of Social Innovation in Health case studies to broaden participant's perspective, and the creation of artistic products as facilitators for the appropriation of knowledge.</p><p><strong>Conclusion: </strong>Participatory pedagogical models adequate to the context and its participants allow the implementation of effective training programs that develop capacities within the communities. To achieve a significant impact, it is necessary to ensure the continuity and long-term sustainability of capacity building through transfer of knowledge with cooperation between health institutions and the community. In this way, the capacities developed by the community constitute a valuable social capital for achieving transformations within and outside the health field.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"24 1","pages":"8201"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132438","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":"Shaping the future rural healthcare landscape: perspectives of young healthcare professionals.","authors":"Ian Couper, Manoko Innocentia Lediga, Ndivhuho Beauty Takalani, Mayara Floss, Alexandra E Yeoh, Alexandra Ferrara, Amber Wheatley, Lara Feasby, Marcela A de Oliveira Santana, Mercy N Wanjala, Mustapha A Tukur, Sneha P Kotian, Veronika Rasic, Vuthlarhi Shirindza, Alan Bruce Chater, Theadora Swift Koller","doi":"10.22605/RRH8792","DOIUrl":"10.22605/RRH8792","url":null,"abstract":"<p><strong>Introduction: </strong>Rural communities continue to struggle to access quality healthcare services. Even in countries where the majority of the population live in rural and remote areas, resources are concentrated in big cities, and this is continuing. As a result, countries with the highest proportion of rural residents correlate with the poorest access, which has negative implications for the health and wellbeing of people. Healthcare professionals (HCPs) have been identified as key informants in the construction and implementation of policies aimed at addressing rural health issues. We sought to understand the perspectives of young HCPs, representing the potential future rural workforce, regarding the future of rural health care.</p><p><strong>Methods: </strong>An interpretivist paradigm was adopted for the study. Data were collected in two phases over Zoom using semi-structured individual interviews and focus group discussions (FGDs). Participants included selected HCPs who are members of Rural Seeds, which is a global movement for young HCPs. A total of 11 exploratory interviews and six FGDs were conducted. The 11 interviewees consisted of medical doctors and medical students from 10 countries classified at different levels of development by the WHO. The six FGDs ranged from three to nine participants, and they included medical doctors and medical students, nurses and rehabilitation therapists. Participants came from South Asia, Africa, Asia-Pacific, North America and Europe, and South America. Both interviews and FGDs were conducted in English, recorded, and transcribed verbatim. Data were analysed utilising thematic analysis.</p><p><strong>Results: </strong>Similar themes were identified across both individual interviews and FGDs. The state of rural health care was perceived to be problematic by all the participants. Access to care, lack of equity and multiple socioeconomic challenges, particularly in relation to living conditions, human resources and infrastructure, were seen as the most significant issues in rural health care. Several ideas for addressing rural health issues, with examples, were proposed by the young HCPs from their perspectives as frontline healthcare providers. They particularly recognised the importance of addressing the local socioeconomic and developmental needs of rural communities, and the needs of present and future HCPs.</p><p><strong>Conclusion: </strong>Young health professionals from across the world interested in a rural career have common concerns about the state of rural health in their countries and constructive insights into how these can be addressed. They suggest effective solutions that must include listening to their voices. This article is a step in that direction.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"24 1","pages":"8792"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053309","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":"A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease.","authors":"Kristin Graham, Katrina Fitzpatrick, Joseph Agius, Cathy Loughry, Emilee Ong, Neil McMillan, Kate Gunn, Robert Fitridge","doi":"10.22605/RRH7970","DOIUrl":"10.22605/RRH7970","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes-related foot disease (DFD) is one of the most prevalent causes of global hospitalisation and morbidity, and it accounts for up to 75% of lower-extremity amputations globally. The 5-year mortality rate following any amputation ranges from 53% to 100%. Early identification of wounds and multidisciplinary management can reduce amputation rates by 39-56%. Rural and remote communities and Indigenous populations are disproportionately affected by DFD. This is reflected in amputation rates, which are much higher for Indigenous than for non-Indigenous Australians and for those in very remote areas than for those in major cities or inner regional areas. The large geographical spread of the population in Australia is a substantial barrier for those providing or accessing health services, particularly multidisciplinary and specialist services, which undoubtedly contributes to poorer DFD outcomes in rural and remote communities.</p><p><strong>Methods: </strong>A real-time, video-based telehealth service for DFD management was established at the Royal Adelaide Hospital Vascular Services clinic to improve access to specialist services for rural and remote Aboriginal and Torres Strait Islander communities. An exploratory qualitative study that utilised one-on-one, semi-structured interviews was conducted with 11 participants who identified as Aboriginal and who had participated in the telehealth foot service. Interviews were transcribed, de-identified and analysed using thematic analysis, using an inductive approach.</p><p><strong>Results: </strong>Four interrelated themes emerged. 'Practical benefits of staying home' describes the reduced burden of travel and advantages of having local healthcare providers and support people at consultations. 'Access to specialists and facilities' highlights how some participants felt that there was a lack of appropriate facilities in their area and appreciated the improved access telehealth provided. 'Feeling reassured that a specialist has seen their feet' reflects the positive impact on wellbeing that participants experienced when their feet were seen by specialist health staff. 'Facilitates communication' describes how participants felt included in consultations and how seeing a person on screen assisted conversation.</p><p><strong>Conclusion: </strong>The advantages of real-time, video-based telehealth go beyond reduced travel burden and improved access to specialist care. This model of care may facilitate relationship-building, patient wellbeing, and feelings of trust and safety for Aboriginal and Torres Strait Islander DFD patients.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"24 1","pages":"7970"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983711","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":"The landscape of non-psychotic psychiatric illness in rural Canada: a narrative review.","authors":"Jacquelyn Paquet, Katharine Hibbard, Pamela Brett-MacLean","doi":"10.22605/RRH8341","DOIUrl":"10.22605/RRH8341","url":null,"abstract":"<p><strong>Introduction: </strong>Canada's rural population has diverse demographic features and accounts for 18.9% of Canada's population. Indigenous Peoples (First Nations, Inuit, and M&eacute;tis), who are highly represented in rural communities, have additional risk factors related to colonialism, and historical and ongoing trauma. Understanding how to best respond to elevated rates of psychiatric illness in rural and remote communities requires an understanding of the unique challenges these communities face in accessing and providing high quality psychiatric services. This article reports a review of published literature on prevalence of non-psychotic psychiatric conditions, as well as the risk and protective factors influencing rates and experience of mental illness in rural and remote communities in Canada to help inform approaches to prevention and treatment.</p><p><strong>Methods: </strong>This focused narrative review of literature related to rural non-psychotic psychiatric illness in rural and remote Canada published over a 20-year period (October 2001 - February 2023). A review of CINAHL, Medline and Academic Search Complete databases supplemented by gray literature (eg federal and provincial documents, position papers, and clinical practice guidelines) identified by checking reference lists of identified articles, and web searches. A textual narrative approach was used to describe the literature included in the final data set.</p><p><strong>Results: </strong>A total of 32 articles and 13 gray literature documents were identified. Findings were organized and described in relation to depression and anxiety and substance use suicidality and loss; rates for all were noted as elevated in rural communities. Different mental health strategies and approaches were described. Variability in degree of rurality, or proximity to larger metropolitan centers, and different community factors including cohesiveness and industrial basis, were noted to impact mental health risk and highlighted the need for enhancing family physician capacity and responsiveness and innovative community-based interventions, in addition to telepsychiatry.</p><p><strong>Conclusion: </strong>Further focus on representative community-based research is critical to expand our knowledge. It is also critical to consider strategies to increase psychiatric care access, including postgraduate medical training and telehealth training.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"24 1","pages":"8341"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707722","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":"Rural healthcare provider recruitment: time to focus on opportunities rather than scarcity.","authors":"Benjamin W Weber","doi":"10.22605/RRH8481","DOIUrl":"10.22605/RRH8481","url":null,"abstract":"","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"24 1","pages":"8481"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983712","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":"The iron status of rural Nigerian women in the second and third trimesters of pregnancy: implications for the iron endowment and subsequent dietary iron needs of their babies.","authors":"Bennett Chima Nwanguma, Herietta Chinonso Odo, Bravo Udochukwu Umeh, Amarachukwu Vivian Arazu","doi":"10.22605/RRH7906","DOIUrl":"10.22605/RRH7906","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to determine the iron status of rural-dwelling pregnant Nigerian women in the second and third trimesters, and to predict their risk of giving birth to babies with suboptimal iron endowment.</p><p><strong>Methods: </strong>This was a prospective cohort study conducted between April and August 2021. A total of 174 consecutive and consenting pregnant rural dwellers, who met the inclusion criteria, were recruited by convenience sampling from the antenatal clinic of a public hospital in Nsukka, a semirural town in south-east Nigeria. The study participants were aged 21-40 years, and their iron status was determined by measuring blood haemoglobin (Hb) and serum ferritin (SF) concentration. Hb concentration was determined by the cyanmethemoglobin method and the SF concentration was determined by enzyme immunoassay method.</p><p><strong>Results: </strong>Almost half (47.7%) of the participants had Hb concentrations below 11 g/dL, while about two out of every five (40.8%) had SF concentrations less than 15 &micro;g/L. The prevalence of iron deficiency, iron deficiency anaemia (IDA) and non-iron deficiency anaemia were 40.8%, 23.6% and 24.7%, respectively. The mean SF levels varied with maternal age, gestation stage, pregnancy intervals and the intake of iron supplements. The mean SF concentration was higher in the second trimester than in the third. The mean SF concentration &plusmn; standard deviation (37.10&plusmn;3.02 &micro;g/L) was higher in the group that took iron supplements than in the group that did not (20.76&plusmn;2.11 &micro;g/L). However, two out of five participants in both groups had SF concentrations less than 15.0 &micro;g/L.</p><p><strong>Conclusion: </strong>The prevalence of IDA was quite high among the participants in both trimesters even with the widespread intake of the recommended oral iron supplements. About four out of 10 of the participants had SF concentrations of less than 15 &micro;g/L and were thus judged at risk of giving birth to babies with poor iron deposits. Therefore, more effective strategies are needed to monitor and prevent IDA among pregnant women in rural populations of Nigeria and, by inference, other parts of tropical Africa.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"24 1","pages":"7906"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723955","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":"A rural doctor's telehealth training program during the COVID-19 pandemic.","authors":"Alan D Taylor, Jane Connolly, Christopher Pearce","doi":"10.22605/RRH8032","DOIUrl":"10.22605/RRH8032","url":null,"abstract":"<p><strong>Introduction: </strong>In Australia, remote consultations have been used as an adjunct to traditional healthcare delivery during the COVID-19 pandemic using telephone and video techniques with an increase in the use of telephone consultations, and to a lesser extent video consultations, for management of patient conditions, assessment, treatment, monitoring and diagnosis.</p><p><strong>Methods: </strong>To establish the needs of rural doctors for training in the provision of remote consultations, an online survey of members of the Australian College of Rural and Remote Medicine was undertaken. Subsequently an online scenario-based training program was designed to improve the competencies of members in providing these consultations. The outcomes of this program were analysed using pre- and post-intervention surveys, and qualitative analysis of session recordings.</p><p><strong>Results: </strong>The program improved trainee confidence and competence in providing safe, quality remote consultations, particularly when using video technologies. Competencies in communication, history taking, physical online examination, clinical management and professionalism improved. Trainees adapted their practice because they were then able to manage potential issues, were more aware of the capabilities of telehealth technologies and could assist a health professional, such as a nurse or Aboriginal Health Worker (with the patient) to do an examination. Concerns remained about set-up time, technical quality, privacy, interaction with and examination of patients, and how to assess the severity of conditions.</p><p><strong>Conclusion: </strong>The outcomes of the program showed significant improvement in the levels of confidence and competencies required for providing remote consultations using telehealth services. A need remains to improve virtual interactions with patients, and to acquire better technology and financial support for remote consultations. In an environment where government is asking whether remote consultations are appropriate and clinically effective, these findings provide guidance from a professional group of experienced rural practitioners.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"24 1","pages":"8032"},"PeriodicalIF":2.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698151","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":"Self-identified rurality in a nationally representative population in the US","authors":"Krutsinger, Yadav, Hart","doi":"10.22605/rrh8483","DOIUrl":"https://doi.org/10.22605/rrh8483","url":null,"abstract":"","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"55 20","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139447038","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":"Do predator attacks on productive species and the respective economic losses influence the psychological distress of farmers in Uruguay? A cross-sectional study","authors":"Ruiz, Benítez, Bobadilla, Piedracueva, Damián","doi":"10.22605/rrh7614","DOIUrl":"https://doi.org/10.22605/rrh7614","url":null,"abstract":"","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"20 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139383479","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":"Informing the surgical workforce pathway: how rural community characteristics matter","authors":"Hughes, Mammen, Griebling, Brooks","doi":"10.22605/rrh8363","DOIUrl":"https://doi.org/10.22605/rrh8363","url":null,"abstract":"","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"124 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139391043","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}