Australian Journal of Rural Health最新文献

{"title":"Indigenous Culture and Health in UDRH Research: An Indigenous-Led Narrative Review.","authors":"Michael Watkins, Colleen Kelly, Charmaine Green, Samantha Bay, Ginger Minahan, Bahram Sangelaji, Sandra C Thompson","doi":"10.1111/ajr.70175","DOIUrl":"10.1111/ajr.70175","url":null,"abstract":"<p><p>Whilst University Departments of Rural Health (UDRHs) have undertaken research relevant to Indigenous health over decades, understanding of the contributions in the context of culture and health has been largely unexplored.</p><p><strong>Objective: </strong>Through use of culturally appropriate methodology, this Indigenous-led narrative review aimed to summarise how the research has responded to Indigenous perspectives and priorities to provide insights into how UDRH research has considered Indigenous cultural ways, and summarise benefits associated with UDRH studies.</p><p><strong>Design: </strong>This narrative review analysed published UDRH Indigenous health research using systematic analysis and collaborative yarning.</p><p><strong>Results: </strong>Thirty-three papers were reviewed. Key themes identified Indigenous involvement and governance, self-determined research, Indigenous research methodologies, culture as a determinant of health and Indigenous perspectives and understanding of health phenomena, which featured across the included studies.</p><p><strong>Conclusions: </strong>UDRH Indigenous culture and health research studies highlight Indigenous participation and governance in research processes which contribute to positive health and well-being outcomes and build research capacities of both Indigenous and non-Indigenous researchers.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70175"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Quasi-Experimental Retrospective Cohort Study Evaluating Demand, Utilisation and Efficiency of a Pilot 7-Day Multidisciplinary Allied Health Assistant Model of Care in a Regional Australian General Medical Ward.","authors":"Kellie Preston, Carly Harrison, Lee-Anne Polkinghorne, Kirstie Faulkner, Brendan Humphries","doi":"10.1111/ajr.70188","DOIUrl":"https://doi.org/10.1111/ajr.70188","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate a 7 day multidisciplinary allied health assistant (mAHA) model of care in an acute general medical setting as a strategy to support service sustainability in the context of hospital bed block.</p><p><strong>Background: </strong>Regional and rural hospitals face challenges delivering timely allied health (AH) care due to workforce shortages, limited weekend coverage and increasing patient complexity. mAHAs may support service sustainability; however, evidence for acute 7-day models is limited.</p><p><strong>Methods: </strong>Analysis of 1615 delegations (pilot n = 594; BAU n = 1021) compared a 5 day business-as-usual (BAU) service (1/10/2021-28/2/2022) with a pilot 7-day model (1/10/2022-28/2/2023) servicing 56 acute beds. Outcomes assessed demand, utilisation and care efficiency.</p><p><strong>Design: </strong>A quasi-experimental evaluation of an organisational intervention.</p><p><strong>Setting: </strong>Regional hospital.</p><p><strong>Main outcome measures: </strong>Outcomes included measures of demand (delegations, occasions of service (OOS), therapy time), utilisation (by profession, day of week), and care efficiency (OOS/delegations per rostered day, time/OOS per delegation).</p><p><strong>Results: </strong>The 7-day model delivered increased delegations (81.9%, p < 0.0001), occasions of service (61.2%, p < 0.0001), and therapy time (127.4%, p < 0.0001), primarily for physiotherapy. The 7-day service model improved load-levelling, reducing early-week demand. Care efficiency improved, with more OOS and delegations per rostered day (p < 0.0001), shorter time per OOS (p < 0.0001) and greater therapy time per admission (p < 0.0001). These improvements occurred without additional AH productive FTE. Utilisation remained physiotherapy-led.</p><p><strong>Conclusions: </strong>In regional hospitals experiencing hospital bed block, a 7-day mAHA model improved access to and efficiency of AH services without the need for additional AH staffing. Limited uptake by non-physiotherapy disciplines constrained full multidisciplinary benefit and warrants further investigation.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70188"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647576","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 Medical Education: Finding the Right Recipe.","authors":"R B Hays, T K Sen Gupta, Aaron Hollins, Lucie Walters","doi":"10.1111/ajr.70186","DOIUrl":"https://doi.org/10.1111/ajr.70186","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70186"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647638","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":"An Evaluation of the Accuracy of Point of Care Ultrasound by Family Physicians in Rural British Columbia, Canada: Methodological Insights.","authors":"Anshu Parajulee, Oron Frenkel, Virginia Robinson, Patti Janssen, Jude Kornelsen","doi":"10.1111/ajr.70193","DOIUrl":"https://doi.org/10.1111/ajr.70193","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the diagnostic accuracy of point of care ultrasound (PoCUS) by rural family physicians (FPs), using consensus 'imaging expert' interpretation as the reference standard.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>British Columbia, Canada.</p><p><strong>Participants: </strong>Five rural FPs and seven specialist physicians (imaging experts).</p><p><strong>Methods: </strong>Rural FPs saved images from their PoCUS scans over 2-10 weeks. For each scan, two expert reviewers, who were unaware of the identity of FP study participants and their interpretation of scans, independently interpreted images.</p><p><strong>Main outcome measures: </strong>Image interpretation agreement between FPs and imaging experts: percentage agreement, sensitivity, and specificity. Inter-rater reliability between expert reviewers when interpreting images, as measured by percentage agreement.</p><p><strong>Results: </strong>Seven imaging experts reviewed images from 55 scans performed by five rural FPs. Among the 20 scans with expert pair agreement (that was not 'unable to assess'), expert interpretation was the same as an FP's for all but one scan (95%). For the other 35 scans, experts in a pair (a) both could not make an assessment based on images provided ('unable to assess') (n = 4) or (b) had differing interpretations (n = 31).</p><p><strong>Conclusion: </strong>We found interpretation agreement among imaging experts for a minority of scans, resulting in inadequate power to assess the diagnostic accuracy of PoCUS by rural FPs. When using secondary image review to assess rural PoCUS quality, we recommend limiting the number of PoCUS working diagnoses being investigated, developing image sharing guidelines for FP participants, and using consensus agreement by multiple experts as the reference standard.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70193"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Distance for Ischaemic Stroke Treatment in Regional Australia: A Retrospective Cohort Study.","authors":"Stephanie Caldwell, Bronwyn Griffin, Ramon Navarro, Michael Crowe, Firas Alnidawi, Elizabeth Forster","doi":"10.1111/ajr.70177","DOIUrl":"10.1111/ajr.70177","url":null,"abstract":"<p><strong>Background: </strong>One comprehensive stroke centre (CSC), in North Queensland, Australia, supports almost 700 000 people across 750 000 km². Access to urgent ischaemic stroke treatment is challenging for remote and regional residents, who are more likely to carry stroke risk factors and have a 17% higher stroke incidence than those in major cities.</p><p><strong>Aims: </strong>To review and report on patient demographics, stroke characteristics, interventions, and outcomes of ischaemic stroke in this regional population.</p><p><strong>Methods: </strong>Retrospective review of admissions to a North Queensland CSC (March 2022-September 2023) with acute ischaemic stroke (ICD-10-AM: 163).</p><p><strong>Results: </strong>Among 305 patients, the median age was 72 years, 57% were male, and 10.5% identified as First Nations. Common stroke risk factors included hypertension (83%), smoking background (58%) and hypercholesterolaemia (57%). Stroke aetiology was unknown in 42%, followed by cardioembolic (31%). Median onset-to-emergency department time was 90 min, and to the CSC was 343 min. Thrombolysis was administered to 6% at the referring facility, and 7% on arrival to the CSC (median door-to-needle time, 73 min). Endovascular clot retrieval occurred in 11.7% of the primary presenters, with an overall successful recanalisation rate of 89%. The 6-month mortality rate was 22%.</p><p><strong>Conclusions: </strong>High rates of modifiable risk factors require improved community management. Delayed presentation highlights potential gaps in stroke awareness and access to healthcare in this region. Reaching timely reperfusion targets should become a priority, which requires support from multiple stakeholders. The high proportion of unknown aetiologies may reflect incomplete stroke work-up, documentation, or loss to follow-up. Targeted stroke education for regional and remote communities and healthcare providers is recommended.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70177"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Related to Diabetes Educator Training and Credentialling to Meet the Needs of Rural and Remote Australians.","authors":"Arjun Chhabra, Andrew D K Nguyen, Meredith Hancock, Sandra C Thompson","doi":"10.1111/ajr.70187","DOIUrl":"10.1111/ajr.70187","url":null,"abstract":"<p><strong>Objective: </strong>With the burden of diabetes rising in Australia, it is important to understand the challenges for rurally based health practitioners to achieve credentialling as a diabetes educator.</p><p><strong>Setting: </strong>This is particularly relevant in rural and remote Australia with the shortage of credentialled diabetes educators and the great burden of disease.</p><p><strong>Participants: </strong>Participants were credentialled diabetes educators (25), health practitioners in the process of credentialling (5), health practitioners who did not complete credentialling (7), and diabetes education academics teaching the qualification required before credentialling (9).</p><p><strong>Design: </strong>Using qualitative research methods, relevant practitioners involved in credentialling were interviewed. The interviews explored hurdles for rural-based diabetes educators in achieving credentialling given the required clinical hours and the absence of available local mentors. Interviews were transcribed and thematic analysis followed established methods to ensure research rigour.</p><p><strong>Results: </strong>Participants described challenges, highlighting an inequitable credentialling process for rural health practitioners. Issues included the inadequacy of material explaining the credentialling process at the time of enrolment, challenges finding mentorship support and gaining sufficient clinical experience for credentialling in a rural context, issues with recording credentialling activities, challenges with distance, and finding available jobs due to the ambiguous scope of practice of credentialled diabetes educators, particularly for allied health professionals.</p><p><strong>Conclusion: </strong>The findings inform potential improvements for diabetes educator credentialling and offer insights into how processes could be improved to support development of a strengthened rural and remote-based diabetes educator workforce.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70187"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jack Best: Father of the Rural Clinical Schools-And Erudite Blogger.","authors":"Gordon Gregory","doi":"10.1111/ajr.70180","DOIUrl":"https://doi.org/10.1111/ajr.70180","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 3","pages":"e70180"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846702","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":"Healing Steps on Country-Exploring Care Pathways for Aboriginal People in the Kimberley With Diabetes-Related Foot Disease.","authors":"Sophie Moustaka, Ala Mckay, Ellen Stapleton, Jodie Millroy, Courtney Fairfull, Chantelle Carr, Sarah Tomlinson, Emma Griffiths","doi":"10.1111/ajr.70184","DOIUrl":"10.1111/ajr.70184","url":null,"abstract":"<p><strong>Objective: </strong>This project aimed to document the experiences of Aboriginal people living in the Kimberley region who have experienced diabetes-related foot disease (DFD) so that service delivery can be optimised.</p><p><strong>Setting: </strong>The Kimberley region, Western Australia.</p><p><strong>Participants: </strong>Aboriginal People in the Kimberley with DFD.</p><p><strong>Design: </strong>A mixed methods study design was used, incorporating quantitative analysis of primary and outpatient care presentations and hospitalisation data collected from in-depth medical record reviews (n = 35) and semi-structured interviews with participants (n = 28).</p><p><strong>Results: </strong>This study highlighted that DFD in the Kimberley has a significant impact on individuals and communities. While primary and outpatient services play a key role in DFD care, there is an opportunity to strengthen preventive foot care services. Participants valued flexibility and autonomy in managing their care, especially with the support of Aboriginal Community Controlled Health Services (ACCHS). Recommendations to improve DFD care are provided, incorporating the perspectives of patients and of the health professionals who participated in the data interpretation workshop. These include facilitating patient self-care, expanding high-quality foot care within ACCHS, strengthening support for hospitalised patients, and advocating for upstream service improvements.</p><p><strong>Conclusion: </strong>Addressing geographical and systemic barriers through improved patient education, better access to primary care resources, and increased patient choice may enhance autonomy and long-term DFD outcomes.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70184"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partnerships in Learning: The Rural Health Multidisciplinary Training Programme in Aged Care Services Pilot Site Evaluation.","authors":"Myles Clarkson Fletcher, Kathryn Fitzgerald, Mohammad Hamiduzzaman, Gordon Mander, Pascale Dettwiller, Lisa Dalton","doi":"10.1111/ajr.70182","DOIUrl":"10.1111/ajr.70182","url":null,"abstract":"<p><strong>Objective: </strong>To explore the perspectives of University Departments of Rural Health (UDRH) clinical educators and partner aged care provider managers involved in the Rural Health Multidisciplinary Training (RHMT) Aged Care pilot programmes, and to identify the barriers, enablers and context-specific strategies that supported the establishment of nursing and allied health student placements in rural and remote aged care settings.</p><p><strong>Setting: </strong>Five pilot sites were established through RHMT Aged Care Service Grants in partnership with aged care providers across New South Wales, Tasmania, South Australia, Western Australia and Queensland.</p><p><strong>Participants: </strong>Twelve participants, including nine UDRH clinical educators (CEs) and three partner aged care service managers, supported student placements at four of the five pilot sites.</p><p><strong>Design: </strong>Qualitative exploratory study using semi-structured interviews. Data were analysed using a thematic approach.</p><p><strong>Results: </strong>Three interdependent themes were identified: (1) engaged partnership; (2) creating a learning environment that benefits everyone; and (3) adapting to the local context. Participants valued strong relational partnerships, role clarity and the CE role. While perceived benefits to students, services and staff ensured buy-in to the value of creating a learning environment through placements. Feasibility required local adaptation to challenges, such as service capacity and workforce pressures.</p><p><strong>Conclusion: </strong>Rural aged care placements are feasible and valuable when supported by strong academic-provider partnerships, perceived benefits for everyone through establishing learning environments, and context-sensitive implementation. These findings offer practical guidance for implementing aged care placements in rural settings, while highlighting the need for further research into student, staff, and resident outcomes.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70182"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13049462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nurse-Led Multi-Disciplinary Model Enhancing Skin Cancer Early Detection in Regional/Rural Australia: Project Check Mate.","authors":"Marion Eckert, Pamela Adelson, Lachlan Darch, Greg Sharplin","doi":"10.1111/ajr.70179","DOIUrl":"https://doi.org/10.1111/ajr.70179","url":null,"abstract":"<p><strong>Objective: </strong>Skin cancer rates are rising and disproportionately higher in under-serviced regional and rural Australia compared to metropolitan areas. It is estimated that regional and rural areas will account for 47% of total incidence melanomas. This study aims to evaluate the feasibility and acceptability of a multi-disciplinary, nurse-led early detection model for skin cancer in regional and rural areas, called Project Check Mate. Three nurse-led pop-up skin cancer clinics were held at large rural community events in South Australia. Regional and rural nurses from local General Practitioner (GP) practices were trained in skin checks and worked in tandem with experienced nurse dermoscopists.</p><p><strong>Design: </strong>Pragmatic evaluation using quantitative and qualitative methods.</p><p><strong>Setting: </strong>The study examined: training completion of nurses and demonstrated skills application; the number and risk profile of consumers receiving a skin check; use of artificial intelligence (AI) technology and the acceptability of the model to nurses, GPs and consumers.</p><p><strong>Results: </strong>Thirteen of fourteen nurses completed the training and gained supervised clinical experience, reporting increased confidence in dermoscopy and image capture. Across the three sites, 509 total body skin checks were performed in 2023. Consumers had a median age of 58 years (men) and 54 years (women), with one-quarter identified as above-average risk for melanoma. Nurse-led skin checks were positively received; 99% of consumers indicated they would use the service again, and GPs expressed support for the model. AI was valued as an adjunctive learning tool but not used for clinical decision making.</p><p><strong>Conclusion: </strong>This study demonstrates that nurse-led skin checks, delivered in collaboration with GPs and communities, are acceptable to stakeholders and can improve access to skin cancer assessment in regional and rural settings. Training local nurses builds sustainable workforce capacity and offers a promising pathway for risk-tailored skin cancer assessments in under-served areas.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"34 2","pages":"e70179"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678667","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}