Canadian Journal of Rural Medicine最新文献

{"title":"Improving resource stewardship in post-pandemic primary care: Insights into choosing Wisely Canada guidelines.","authors":"Nathan Jeffery, Div Patel, Taylor Marshall, Lisa Allen, Roy Kirkpatrick","doi":"10.4103/cjrm.cjrm_87_24","DOIUrl":"10.4103/cjrm.cjrm_87_24","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic significantly disrupted primary care delivery, amplifying challenges in resource stewardship. Choosing Wisely Canada (CWC) guidelines aim to reduce unnecessary interventions. However, barriers to their implementation persist, particularly in rural settings where access to resources is limited and patient expectations often conflict with evidence-based care. Our study explored primary care physicians' awareness of, utilisation of and barriers to implementing CWC guidelines in a post-pandemic context, focusing on challenges, quality improvement opportunities and innovative approaches to reduce low-value care.</p><p><strong>Methods: </strong>An online survey of primary care physicians across Canada was used to collect demographic data, practice habits and perspectives on CWC guidelines. Quantitative analysis measured trends, while qualitative analysis of open-ended responses identified recurring themes.</p><p><strong>Results: </strong>One hundred and twenty-seven primary care physicians responded to the survey. Results revealed high awareness of CWC guidelines (97.6%) but low familiarity with post-pandemic adaptations (36.2%) and patient-facing materials (61.4%). Key barriers included time constraints, fear of missed diagnoses and limited rural resources. Physicians highlighted the need for tailored approaches in rural settings, where deviations from guidelines are often necessary because of challenges related to healthcare access. Participants identified several opportunities for improvement, including integrating guidelines into electronic medical records and developing mobile applications to support decision-making. Enhanced patient education emerged as critical for addressing demands for unnecessary tests, often fuelled by misinformation from social media.</p><p><strong>Conclusion: </strong>Targeted medical and patient education, interprofessional collaboration and technology integration are essential for improving CWC adoption. Tailored solutions that address rural-specific challenges and systemic barriers are pivotal for achieving sustainable resource stewardship in primary care.</p><p><strong>Introduction: </strong>La pandémie de COVID-19 a profondément bouleversé l'organisation des soins primaires, accentuant les défis liés à l'utilisation judicieuse des ressources. Les recommandations de Choisir avec soin visent à réduire les interventions inutiles, mais leur mise en œuvre demeure difficile, surtout en milieu rural où l'accès aux services est restreint et où les attentes des patients s'harmonisent parfois mal avec les pratiques fondées sur les données probantes. Notre étude examine la connaissance, l'utilisation et les obstacles à l'intégration des recommandations de Choisir avec soin chez les médecins de famille en contexte postpandémique, en mettant l'accent sur les défis rencontrés, les occasions d'amélioration de la qualité des soins et les approches innovantes pour diminuer les ac","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"7-14"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Can implementation of in situ simulation support rural emergency provider self confidence and improve patient safety? A mixed methods study.","authors":"","doi":"10.4103/cjrm.cjrm_89_25","DOIUrl":"10.4103/cjrm.cjrm_89_25","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"34"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les défis posés par l'IA dans l'édition scientifique.","authors":"Peter Hutten-Czapski","doi":"10.4103/cjrm.cjrm_88_25","DOIUrl":"10.4103/cjrm.cjrm_88_25","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"4"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Occasional limb tourniquet application and tourniquet conversion.","authors":"David Jerome, Sean William Moore","doi":"10.4103/cjrm.cjrm_60_25","DOIUrl":"10.4103/cjrm.cjrm_60_25","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"25-29"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teledermatology.","authors":"Eric P McMullen","doi":"10.4103/cjrm.cjrm_58_23","DOIUrl":"10.4103/cjrm.cjrm_58_23","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"30"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The challenges of dealing with A.I. in academic publishing.","authors":"Peter Hutten-Czapski","doi":"10.4103/cjrm.cjrm_82_25","DOIUrl":"10.4103/cjrm.cjrm_82_25","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"3"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on burnout and resilience amongst healthcare personnel in rural Northern Ontario: A cross-sectional study.","authors":"Iain R Lamb, Navishka C Brahmbhatt, Margaret Cousins, Lindsay E Nutbrown, Eliseo Orrantia, Lily DeMiglio","doi":"10.4103/cjrm.cjrm_2_25","DOIUrl":"10.4103/cjrm.cjrm_2_25","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic imposed an unprecedented strain on the healthcare system, resulting in rising burnout levels among healthcare personnel. The pandemic's effect on the mental well-being of those working within resource-limited healthcare settings remains unexplored. We assessed the impact of the pandemic on burnout and resilience in healthcare personnel working in rural Northern Ontario.</p><p><strong>Methods: </strong>We surveyed healthcare personnel across 15 rural communities in Northern Ontario, gathering demographic, occupational, burnout and resilience data. Chi-square tests (χ2) determined response variations by demographic and occupational factors, whereas ANOVAs assessed mean differences. Pearson correlation coefficient measured the relationship between burnout and resilience, and linear associations were identified using the Mantel-Haenszel test.</p><p><strong>Results: </strong>Ninety-nine healthcare workers from 15 rural communities were sent the survey. Seventy-six (77%) responded. Fifty-five per cent of respondents experienced burnout, with 81% rating it as moderately severe or worse. Those who grew up in their current community reported higher burnout rates, and 73% of participants reported strong resilience. Childhood community ties correlated with lower resilience, whereas higher resilience was linked to lower burnout severity. Physicians had lower Connor-Davidson-Resilience Scale© (CD-RISC 2) scores compared to hospital CEOs.</p><p><strong>Conclusion: </strong>Despite high burnout, respondents had strong resilience. A correlation between burnout severity and resilience suggests that higher resilience is linked to less severe burnout which suggests that resilience can buffer the impact of burnout. Enhancing resilience could improve the ability to cope with stress and adversity. The data emphasises the need to consider factors, such as occupation and community history, when assessing burnout risk and designing well-being interventions.2-25 L'impact de la pandémie de COVID-19 sur l'épuisement professionnel et la résilience du personnel de la santédans le Nord rural de l'Ontario: Une étude transversale.</p><p><strong>Introduction: </strong>La pandémie de COVID-19 a exercé une pression sans précédent sur le système de santé, entraînant une hausse marquée de l'épuisement professionnel chez le personnel soignant. Les répercussions de cette crise sur la santé mentale des professionnels œuvrant dans des milieux où les ressources sont limitées demeurent peu documentées. Cette étude évalue l'impact de la pandémie sur l'épuisement professionnel et la résilience du personnel de la santé travaillant dans des communautés rurales du Nord de l'Ontario.</p><p><strong>Mthodes: </strong>Une enquête a été menée auprès de membres du personnel de la santé provenant de 15 communautés rurales du Nord ontarien. Nous avons recueilli des données démographiques, professionnelles, ainsi que des mesures d'épuisement profes","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"15-24"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reactivate.","authors":"Gavin Gerard Parker","doi":"10.4103/cjrm.cjrm_81_25","DOIUrl":"10.4103/cjrm.cjrm_81_25","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"5"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor concerning 'can implementation of in situ simulation support rural emergency provider self-confidence and improve patient safety? A mixed-methods study'.","authors":"Shyam Sundar Sah, Abhishek Kumbhalwar","doi":"10.4103/cjrm.cjrm_84_25","DOIUrl":"10.4103/cjrm.cjrm_84_25","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"31-33"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Réactiver.","authors":"Gavin Gerard Parker","doi":"10.4103/cjrm.cjrm_87_25","DOIUrl":"10.4103/cjrm.cjrm_87_25","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"31 1","pages":"6"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}