{"title":"The term ‘Comprehensive Cancer Centre’ is outdated in contemporary Australian health systems","authors":"Sabe Sabesan FRACP, Abhishek Joshi FRACP, Shivanshan Pathmanathan FRACP","doi":"10.1111/ajr.13180","DOIUrl":"10.1111/ajr.13180","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1087-1088"},"PeriodicalIF":1.9,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082676","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}
Russell Roberts PhD, Sarah-Anne Munoz PhD, Karla Thorpe MSc, Hazel Dalton PhD, Leith Deacon PhD, David Meredith PhD, Mark Gussy PhD, Steve F. Bain DMin, Christian Swann PhD, Maria Lindstrom MSc, Jordi Blanch MD, PhD, Annette Beautrais PhD, Helene Silverblatt MD, Luis Salvador-Carulla PhD, MD, Finola Colgan BA, LLB, LLM, Tammy D. Heinz MSc, David Perkins PhD, Sean Russell MBA, Laura Grattidge MPH
{"title":"International declaration on rural mental health research: 10 guiding principles and standards","authors":"Russell Roberts PhD, Sarah-Anne Munoz PhD, Karla Thorpe MSc, Hazel Dalton PhD, Leith Deacon PhD, David Meredith PhD, Mark Gussy PhD, Steve F. Bain DMin, Christian Swann PhD, Maria Lindstrom MSc, Jordi Blanch MD, PhD, Annette Beautrais PhD, Helene Silverblatt MD, Luis Salvador-Carulla PhD, MD, Finola Colgan BA, LLB, LLM, Tammy D. Heinz MSc, David Perkins PhD, Sean Russell MBA, Laura Grattidge MPH","doi":"10.1111/ajr.13167","DOIUrl":"10.1111/ajr.13167","url":null,"abstract":"<p>Rural communities have unique mental health needs and challenges which are often related to the uniqueness of the community itself. On a per-capita basis, the investment in rural mental health research is far less than that in urban communities. Added to this, rural communities are often at risk of researchers, based in large urban universities, visiting, conducting the research with minimal engagement with local stakeholders and limited understanding of the community's social-service-environmental context. Often this research leaves no visible benefit to the community with respect to increased knowledge, resources or community capacity. This commentary is based on the insights of a panel of authors from 9 countries, each with extensive experience of rural mental health research and work. And it seeks to stimulate the discourse on responsible rural mental health practice. The aim of this commentary is to provide a reference on research practice for novice and experienced researchers on rural mental health research and practice, to assist policymakers, government and funding bodies to establish appropriate standards and guidelines for rural mental health research, and support rural communities to advocate for equity of funding and sustainable research as they engage with researchers, funders and governments. The 10 standards in this declaration will help guide researchers toward research that is beneficial to rural communities and also help develop the local community's research capability, which ultimately will serve to enhance the mental health and well-being of rural communities.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"611-616"},"PeriodicalIF":1.9,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082677","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}
Elham Saberi MPH, Marie Hutchinson PhD, John Hurley PhD
{"title":"Rising to the challenge: The motivation to champion routine intimate partner violence screening in rural emergency departments","authors":"Elham Saberi MPH, Marie Hutchinson PhD, John Hurley PhD","doi":"10.1111/ajr.13176","DOIUrl":"10.1111/ajr.13176","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To understand the motivations of champions who worked to bring about system and practice change that supported routine screening for intimate partner violence (IPV) in two rural emergency departments (EDs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Practice changes are required to achieve routine and effective identification and response to IPV. Nurses play a significant role in affecting such practice change. This paper identifies the motivations of champions in the ED setting who successfully brought about such change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The EDs of two Level 5 tertiary hospitals within a rural Local Health District (LHD) of New South Wales, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Twenty-three individuals who identified as champions and worked to introduce routine IPV screening in two rural hospital EDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative longitudinal semi-structured interviews employing a process of constant comparison and an interpretive framework to analyse data thematically. Interviews were carried out between June and August 2017 and again between July and August 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the period of the study, routine screening was established, and screening rates steadily increased from a low baseline to a significantly higher rate. Three aspects of champion motivation emerged from the analysis: formation of an identity as a champion, making a difference to a significant social justice issue and providing quality and community-relevant care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first study to report on champions and their motivation as they supported IPV practice change in the ED. The findings highlight the capacity for innovation in rural health services, with important implications for other settings looking to translate similar programs. Understanding motivating factors may assist in improved utilisation and support for champions. This is vital if champions are to bring about required practice change within their service and ensure the needs of individuals experiencing IPV are effectively met.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1018-1030"},"PeriodicalIF":1.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047585","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}
Gavin J. Carmichael BSc, Joshua G. Kovoor MS, Win Le Shwe Sin Ei MPH, Thiep Kuany MD, James Stafford May MD (Dist.), Alexander Beath MD, Yasser Arafat FRACS, Mathew O. Jacob FRACS
{"title":"Efficiency considerations for acute surgical units in rural and regional Australia","authors":"Gavin J. Carmichael BSc, Joshua G. Kovoor MS, Win Le Shwe Sin Ei MPH, Thiep Kuany MD, James Stafford May MD (Dist.), Alexander Beath MD, Yasser Arafat FRACS, Mathew O. Jacob FRACS","doi":"10.1111/ajr.13179","DOIUrl":"10.1111/ajr.13179","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1084-1086"},"PeriodicalIF":1.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005987","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}
Sandra C. Thompson PhD, Emma V. Taylor Grad Dip, Ha Hoang PhD, Lisa Hall PhD, Bahram Sangelaji PhD, Charmaine Green PhD, Carolyn Lethborg PhD, Joanne Hutchinson MPS
{"title":"An overview of outputs of Aboriginal- and Torres Strait Islander-related publications from University Departments of Rural Health in Australia; 2010–2021","authors":"Sandra C. Thompson PhD, Emma V. Taylor Grad Dip, Ha Hoang PhD, Lisa Hall PhD, Bahram Sangelaji PhD, Charmaine Green PhD, Carolyn Lethborg PhD, Joanne Hutchinson MPS","doi":"10.1111/ajr.13177","DOIUrl":"10.1111/ajr.13177","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Disparities in the health of Indigenous people and in the health of rural populations are well described. University Departments of Rural Health (UDRHs) in Australia are federally funded under a program to address ongoing challenges with health workforce distribution for rural and remote areas. They have a significant role in research in regional, rural and remote areas, including research related to Indigenous health. However, a comprehensive analysis of their contributions to original Indigenous health related to Indigenous health is lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examines the contributions of UDRHs to Indigenous issues through analysis of publications of UDRHs focused on Indigenous health during the period 2010–2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This paper examines a database of UDRH Indigenous-related publications from 2010 to 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A total of 493 publications to which UDRHs contributed were analysed, including 354 original research articles. Health services research was the most common category, followed by epidemiology and papers exploring Indigenous culture and health. While health services research substantially increased over the period, the numbers of original research papers specifically focused on Indigenous workforce issues, whether related to Indigenous people, students or existing workforce was relatively small.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This broad overview shows the nature and trends in Indigenous health research by UDRHs and makes evident a substantial contribution to Indigenous health research, reflecting their commitment to improving the health and well-being of Indigenous communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The analysis can help direct future efforts, and future analyses should delve deeper into the impact of this research and further engage Indigenous researchers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"906-917"},"PeriodicalIF":1.9,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001420","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}
Lisa Bourke PhD, Noha Merchant BSc, Supriya Mathew PhD, Michelle Fitts PhD, Zania Liddle MEd, Deb Russell PhD, Lorna Murakami-Gold MEd, Narelle Campbell PhD, Bronwyn Rossingh PhD, John Wakerman MBBS, MTH, FACRRM, FAFPHM, DSc h.c.
{"title":"Who is suited to work in remote First Nations health? Perspectives of staff in remote Aboriginal Community-Controlled Health Services in northern Australia","authors":"Lisa Bourke PhD, Noha Merchant BSc, Supriya Mathew PhD, Michelle Fitts PhD, Zania Liddle MEd, Deb Russell PhD, Lorna Murakami-Gold MEd, Narelle Campbell PhD, Bronwyn Rossingh PhD, John Wakerman MBBS, MTH, FACRRM, FAFPHM, DSc h.c.","doi":"10.1111/ajr.13175","DOIUrl":"10.1111/ajr.13175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>There is a shortage of nurses, Aboriginal Health Practitioners, GPs and other staff in remote Australian health clinics. There is also high turnover of staff, leading to questions of ‘who’ is appropriate for remote First Nations practice? The aim of this paper was to identify the characteristics of staff who are likely to work well in remote First Nations settings, from the perspectives of remote health practitioners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This is a qualitative study involving content analysis of interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The study is conducted in and with 11 Aboriginal Community Controlled Health Services across northern and central Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Eighty-four staff working in these clinics who spoke about staff qualities suited to remote practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants identified a range of qualities desirable in remote practitioners, which were grouped into three topics: (1) professional qualifications and experience, including cultural skills; (2) ways of working, including holisitic approach, resilience, competence, and being a team player, approachable, flexible and hard-working; and (3) specific community needs, namely the need for local First Nations staff, male practitioners and returning short-term staff. The combination of experiences, ways of working, and fit to both the team and community were emphasised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Identifying the characteristics of staff who are likely to work well in these settings can inform recruitment strategies. This study found that a combination of professional qualifications, skills and experience as well as ways of working, individual characteristics and needs of communities are desirable for working in remote, First Nations settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1008-1017"},"PeriodicalIF":1.9,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918195","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}
Dan Curley MBBS, Leigh Kinsman PhD, Graeme Mooney MSW, Gail Whiteford PhD, Tony Lower PhD, Megan Hobbs PhD, Beverley Morris BN, Kerry Bartlett BHSc, Alycia Jacob BL
{"title":"A cross-sectional study assessing concordance with advance care directives in a rural health district","authors":"Dan Curley MBBS, Leigh Kinsman PhD, Graeme Mooney MSW, Gail Whiteford PhD, Tony Lower PhD, Megan Hobbs PhD, Beverley Morris BN, Kerry Bartlett BHSc, Alycia Jacob BL","doi":"10.1111/ajr.13166","DOIUrl":"10.1111/ajr.13166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To measure compliance with Advance Care Directives (ACDs) for decedents in a rural setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Observational, cross-sectional medical records audit comparing requests in ACDs with actual outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural Australian coastal district.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>People who had an ACD, died during the study period (30 May 2020 to 15 December 2021) and participated in a local research project.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure(s)</h3>\u0000 \u0000 <p>Compliance was measured by comparing stated requests in the ACD with outcomes recorded in medical records. This included the place of death and a list of ‘unacceptable interventions’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-eight people met the inclusion criteria (age range of 46–92 [mean 67 years; median 74 years]; 42 [62%] male). The main cause of death was cancer (<i>n</i> = 48; 71%). Preferred place of death was not stated in 16 ACDs. Compliance with documented preferred place of death was 63% (33/52): 48% (16/33) when the preferred place of death was home; 78% (7/9) when sub-acute was preferred; and 100% (10/10) when hospital was preferred. Compliance was 100% with ‘unacceptable interventions’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results demonstrate strong compliance with rural patients' requests in ACDs, particularly ‘unacceptable interventions’. Home was the most common preferred place of death, but the compliance measure (48%) was the lowest in this study. This requires further exploration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"969-975"},"PeriodicalIF":1.9,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914586","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}
Joanne Adams PhD, Virginia Dickson-Swift PhD, Evelien Spelten PhD, Irene Blackberry PhD, Carlene Wilson PhD, Eva Yuen PhD
{"title":"Mobile breast screening services in Australia: A qualitative exploration of perceptions and experiences among rural and remote women aged ≥75 years","authors":"Joanne Adams PhD, Virginia Dickson-Swift PhD, Evelien Spelten PhD, Irene Blackberry PhD, Carlene Wilson PhD, Eva Yuen PhD","doi":"10.1111/ajr.13174","DOIUrl":"10.1111/ajr.13174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This qualitative descriptive study draws on data collected from a sub-sample of 15 women participating in a national study (<i>n</i> = 60) exploring the breast cancer screening motivations and behaviours of women aged ≥75 years. The study aimed to understand why women living in rural and remote areas might continue accessing mobile breast cancer screening despite being outside the targeted age range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Settings ranged from large towns to very remote communities (according to Monash Modified Model (MMM) classification 3–7) where BreastScreen Australia mobile screening services were available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Interview data from 15 women aged ≥75 years living in rural and remote locations who had used mobile screening services was utilised for this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>In-depth individual interviews were conducted via telephone or online platform (Zoom). These were transcribed verbatim and imported into NVivo software to enable thematic analysis to identify key themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Many women aged ≥75 years in rural and remote areas expressed clear intentions to continue breast cancer screening, despite no longer being invited to do so. They perceived great value in the mobile service and were highly appreciative for it yet acknowledged limited sources of information about the process of ongoing screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Few women in rural and remote areas had discussed ongoing breast cancer screening with their general practitioner (GP). More information is required to inform women about the risks and benefits of ongoing screening. Without an invitation to attend screening rural women reported difficulty in knowing when the service would be available. Ongoing notification of the availability of mobile services for women aged ≥75 years in rural areas is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"1031-1040"},"PeriodicalIF":1.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903695","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}
Rosemary Frey PhD, Janine Wiles PhD, Deborah Balmer PhD, Pare Meha PhD, John Parsons PhD, Mary Simpson PhD, Vanessa Burholt PhD
{"title":"Rural unpaid caregivers' experiences in northern Aotearoa, New Zealand during the Covid-19 pandemic: A qualitative study","authors":"Rosemary Frey PhD, Janine Wiles PhD, Deborah Balmer PhD, Pare Meha PhD, John Parsons PhD, Mary Simpson PhD, Vanessa Burholt PhD","doi":"10.1111/ajr.13173","DOIUrl":"10.1111/ajr.13173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Rural unpaid caregivers experience different opportunities and challenges than their urban counterparts. Our aim was to understand rural unpaid caregivers' experiences of challenges and opportunities during the Covid-19 pandemic in New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural northern New Zealand during the Covid-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>A convenience sample of 10 unpaid rural caregivers, most supporting an older person living with dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative descriptive design. Data included interviews and online workshops, and a thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Rural unpaid caregivers observed that some aspects of living in a rural context were helpful during the Covid-19 pandemic. However, tasks such as shopping and long-distance travel and communication (both telephonic and digital) became more complex. Abrupt changes to routine and closure of resources and support groups created challenges. Unpaid caregivers worried about what would happen if they were hospitalised themselves. There was a diversity of experience both across caregivers, of familiar routines and rural context as resources, increased challenges requiring resourcefulness to adapt, and experiences of crisis. Many experienced all three states at different times.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This research provides valuable insights into challenges and opportunities experienced by rural unpaid caregivers during the Covid-19 pandemic and may help policy-makers and healthcare professionals develop improved emergency preparedness. Multilevel, multisector responses are needed to ensure effective health and social support and access to resources including health care, access to groceries and medication, transport, and communications (telephone and digital). Enhancing rural access to effective and inexpensive online services is particularly important, as is recognition of the value of rural sites or hubs of connection and social interaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"996-1007"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861682","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}
Margaret Thomas MMHN, Elizabeth Martin MPH, Sophie Isobel PhD
{"title":"‘Profound personal and professional impacts’: A qualitative study of clinician experiences of a mental health disaster response to Australia's black summer bushfires","authors":"Margaret Thomas MMHN, Elizabeth Martin MPH, Sophie Isobel PhD","doi":"10.1111/ajr.13163","DOIUrl":"10.1111/ajr.13163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the experiences of clinician and management stakeholders involved in a rural/metropolitan collaborative mental health disaster response to the 2019–2020 Black Summer bushfires in the Snowy Valleys region of southern New South Wales (NSW), Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A mental health and drug health service in the Snowy Valleys region of rural NSW in collaboration with a mental health service from metropolitan Sydney, NSW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Mental health clinicians and managers from a rural health district (<i>n</i> = 6) and a metropolitan health district (<i>n</i> = 8) involved in a collaborative disaster response to the 2019–2020 Black Summer bushfire disaster in the Snowy Valleys region of southern NSW, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>An interpretive qualitative study design using semi-structured individual interviews, with transcripts analysed using Reflexive Thematic Analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thematic findings on participant experiences are presented under three organising constructs of before (<i>stepping up and jumping right in</i>), during (<i>finding a rhythm of working together</i>), and after (<i>profound personal and professional impacts</i>) the mental health disaster response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participant experiences had shared and distinct components before, during and after the mental health disaster response, culminating in profound personal and professional impacts. Findings highlight positive aspects and challenges for clinicians participating in a rural/metropolitan collaborative mental health disaster response. The findings of this study contribute new knowledge about experiences of mental health clinicians participating in a disaster response after bushfires, from dual perspectives of members of a bushfire-affected community and those responding from outside a bushfire-affected community, which may inform ongoing planning of responses to disaster in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"959-968"},"PeriodicalIF":1.9,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753450","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}