Australian Journal of Rural Health最新文献

{"title":"Sleep patterns among Aboriginal and Torres Strait Islander Peoples and non-Indigenous Australians: A South Australian descriptive exploratory study","authors":"Jainy Shah BDS,&nbsp;Sneha Sethi PhD,&nbsp;Brianna F. Poirier PhD,&nbsp;Joanne Hedges MPhil,&nbsp;Lisa Jamieson PhD","doi":"10.1111/ajr.13210","DOIUrl":"10.1111/ajr.13210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Irregularities with sleep patterns and behaviours are commonly observed in Australia, but there is lack of information regarding sleep patterns among Aboriginal or Torres Strait Islander adults. This study explores sleep patterns in Aboriginal or Torres Strait Islander adults, comparing it with non-Indigenous Australian adults in addition to investigating any potential effects on daytime behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 730 Aboriginal and Torres Strait Islander Peoples aged 18 years and above were included in the study. The participants completed a self-reported questionnaire on various aspects of sleep, such as difficulty falling asleep, waking up during the night, feeling well-rested upon waking, snoring loudly, gasping/choking during sleep, use of prescription medication and experiencing fatigue or sleepiness during the day. Additionally, the participants were interviewed using the ‘Top End Sleepiness Scale’ to report increased sleepiness during daily activities. The responses were compared with those of non-Indigenous Australians in the 2016 Sleep Health Foundation national survey, using questions that measures similar variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Aboriginal and Torres Strait Islander Peoples experienced higher rates of sleep disturbances, including difficulty in falling asleep and waking in the night. Snoring and breathing pauses during sleep were more common in middle-aged men, and sleeping difficulties and daytime symptoms related to insufficient or unrefreshing sleep were more common in women. Sleep issues increased with age among adult Australians but were more common in the age group of 25–34 years for Aboriginal and Torres Strait Islander Peoples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The data suggest that Aboriginal and Torres Strait Islander adults report irregularities in sleep patterns. Early interventions and management of sleep habits could potentially have benefits for overall physical and mental health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911263","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 Utility of a Digital Glucose-Like Peptide-1 Receptor Agonist-Supported Weight-Loss Service in Regional Australia: A Qualitative Analysis of Interviews With Current Patients of the Eucalyptus Program","authors":"Louis Talay,&nbsp;Matt Vickers,&nbsp;Sarah Loftus","doi":"10.1111/ajr.13220","DOIUrl":"10.1111/ajr.13220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Against the backdrop of alarming obesity rates and growing concerns about access to specialist care across Australia, this study aims to assess the utility of the nation's largest digital weight-loss service (DWLS) in regional Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>This study focuses on patients of the Eucalyptus DWLS who live in regional Australia (Monash Modified Model classification 3–6).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Thirty-two adults living with overweight or obesity who have been subscribed to the Eucalyptus DWLS for at least 3 weeks were invited to participate in phone-based interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Interviewers prompted discussion around 6 questions, pertaining to reasons for Eucalyptus subscription, previous attempts at weight loss, views on the service's comprehensiveness, access to face-to-face alternatives, areas for program improvement and general program satisfaction. Investigators conducted a Braun and Clarke thematic analysis of all interview transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six key themes were identified in the analysis, including unmanageable travel times to face-to-face obesity services; inadequate Eucalyptus app functionality; satisfaction with Eucalyptus care continuity; frustration with previously attempted standalone lifestyle interventions; aversion to or dissatisfaction with surgical interventions; and early weight loss increases confidence and exercise motivation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Comprehensive DWLSs such as Eucalyptus have the potential to significantly increase access and adherence to continuous obesity care for regional Australians. However, platforms need to contain special provisions for users with lower literacy and integrate advanced lifestyle trackers to ensure patients are not simply using the DWLS to access weight-loss medications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911228","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 nursing and allied health placements during the latter stage of the COVID-19 public health emergency: A national study","authors":"Belinda Jessup PhD,&nbsp;Anthea Brand PhD,&nbsp;Melissa Kirschbaum PhD,&nbsp;Penny Allen PhD,&nbsp;Lisa Bourke PhD,&nbsp;Jodie Bailie PhD,&nbsp;Susan Heaney PhD,&nbsp;Lyndal Sheepway PhD,&nbsp;Tegan Podubinski DPsych(Clin),&nbsp;Ha Hoang PhD,&nbsp;Kehinde Obamiro PhD,&nbsp;Santosh Jatrana PhD,&nbsp;Sabina Knight MTH,&nbsp;Robyn Fitzroy BApSci,&nbsp;Rohan Rasiah PhD","doi":"10.1111/ajr.13209","DOIUrl":"10.1111/ajr.13209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore changes to rural nursing and allied health placements during the latter stage of the COVID-19 public health emergency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Regional, rural and remote Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Nursing and allied health students with a scheduled University Department of Rural Health (UDRH) facilitated rural placement between 1 January 2022 and 31 October 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional online survey (<i>n</i> = 333), followed by semi-structured interviews (<i>n</i> = 21).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Almost all students surveyed (98.5%) were able to undertake their placement, although 13.1% reported changes to the setting, timing or delivery of training. Placement tasks (47.3%), experience of the local community (39.0%) and connection with other students (39.6%) were the placement aspects most commonly reported to have changed. However, most students were satisfied with their placement (86.0%), agreed their placement provided quality clinical training (79.3%) and wanted to work rurally after their experience (73.2%). Nursing students had lower odds of reporting satisfaction with placement (OR, 0.49 [95% CI 0.24–0.99, <i>p</i> = 0.03]), while placements longer than 4 weeks had almost twice the odds of promoting rural intention (OR, 1.84 [95% CI 1.09–3.15, <i>p</i> = 0.02]). Placement changes were associated with: fear of contracting COVID-19; circulating illness; health workforce shortages; and health and safety compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite changes, most students found rural placements undertaken during 2022 to be quality learning experiences which left them satisfied and wanting to work rurally. UDRHs should advocate for longer placements, improve remote supervision and accommodation infrastructure, and help prepare and support students for challenging learning environments to promote positive rural training experiences during public health emergencies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900649","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":"Royal Far West's Allied Health Telehealth Services for Children Post-Bushfires","authors":"Michael Curtin,&nbsp;Tayla Iellamo,&nbsp;Donnah Anderson,&nbsp;Mehdi Rassafiani,&nbsp;Tracey Parnell,&nbsp;Sarah Eagland,&nbsp;Rachel Whitsed","doi":"10.1111/ajr.13218","DOIUrl":"10.1111/ajr.13218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effectiveness of Royal Far West allied health telehealth services to support the health and well-being of children affected by the bushfires.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>In response to the 2019/2020 Black Summer bushfires, Royal Far West (RFW) implemented the Community Recovery Services (CRS) targeting the health and well-being of affected children. One component of the CRS was the delivery of allied health telehealth services to children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>One hundred and thirty-five children participated in occupational therapy, psychology and/or speech pathology telehealth. Forty-eight parents/carers completed a telehealth satisfaction survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Measures used to determine effectiveness included child and parent/carer satisfaction surveys, the Canadian Occupational Performance Measure (COPM), the Goal Attainment Scale (GAS) and the Strengths and Difficulties Questionnaire (SDQ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The children overwhelmingly stated that they felt listened to (89%), enjoyed telehealth sessions (84%) and learned new ways to cope with their feelings (87%). Parents/carers reported that children had developed effective emotional regulation and coping strategies. COPM outcomes indicated the children demonstrated statistically significant large improvements in their self-perceived performance of and satisfaction with their identified goals, <i>p</i> &lt; 0.001. The GAS outcomes indicated that 86% of children attained or exceeded their set goals. A statistically significant improvement in children's mental health outcomes post-telehealth was found, as measured by the SDQ (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Occupational therapy, psychology and speech pathology telehealth sessions contributed to positive health and well-being outcomes for children affected by the bushfires. The findings support the implementation of RFW's five key principles for telehealth services: (1) Access to a multidisciplinary team; (2) Practical resources; (3) Flexible delivery; (4) Providing in-person session to support telehealth and (5) Take a ‘whole of child’ approach. Innovative telehealth offered children in geographically remote areas access to effective allied health support post-disaster that was not readily available in their local communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900648","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":"Challenges of Dementia Care in a Regional Australian Hospital: Exploring Interventions to Minimise Length of Stay for Dementia Patients","authors":"Sandeep Reelh,&nbsp;Rahul Suri,&nbsp;Matthew Hiskens,&nbsp;Clement Tan,&nbsp;Alok Rana","doi":"10.1111/ajr.13212","DOIUrl":"10.1111/ajr.13212","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>There are significant difficulties associated with the management of dementia patients in hospitals, leading to adverse patient outcomes, prolonged length of stay (LOS), strain on resources and high readmission rates. This study aimed to investigate these factors in the context of a regional hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This study retrospectively reviewed all dementia admissions in a publicly funded Australian regional hospital from January 2022 to December 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All admissions including an ICD-10 coded dementia diagnosis were assessed, and data extracted using the integrated electronic medical record.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Overall, 257 bed Australian regional hospital in an area with a Modified Monash Model rating of 2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>There were 105 dementia patients admitted within the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcomes Measures</h3>\u0000 \u0000 <p>Dementia severity, LOS, consultation liaison (CL) psychiatry involvement, readmission rates, and discharge destinations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The LOS in patients with dementia was 23.3 (± 35.2) days compared to age-matched patients without dementia admitted in the same period with a LOS of 8.2 (± 4.7) days. Dementia patients who died in hospital had the longest acute LOS at 14.4 (± 8.8) days. Dementia patients who were admitted from their usual residential aged care facility had the longest maintenance LOS at 69 (± 83.3) days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This research contributes information to the current knowledge gap of dementia care in regional hospitals. Data from this study may help to inform the development of strategies for effective hospital-based dementia care and interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900647","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":"Co-creating an Indigenous-led virtual health services model for Indigenous Australians living with chronic disease","authors":"Bushra Farah Nasir PhD,&nbsp;William MacAskill PhD,&nbsp;Floyd Leedie,&nbsp;Priya Martin PhD,&nbsp;Khorshed Alam PhD,&nbsp;Katharine Wallis PhD,&nbsp;Matthew McGrail PhD,&nbsp;Srinivas Kondalsamy-Chennakesavan MBBS","doi":"10.1111/ajr.13206","DOIUrl":"10.1111/ajr.13206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the co-design process and understand consumer perspectives of a virtual health services (VHS) model of primary healthcare delivery, for Indigenous Australians with chronic disease and living in regional, rural, and remote Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Using decolonising methodologies, the study used an Indigenous consensus method to undertake the co-design process and generate findings. For analysis, a qualitative interpretive-description framework was applied. Thematic analysis generated themes, describing consumer perspectives of virtual healthcare models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The Goondir Health Services (Aboriginal Community Controlled Health Organisation) operating clinics in rural and remote Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Fourteen Indigenous VHS consumers who resided in Modified Monash Model 3–7 communities across Queensland, met the eligibility criteria and provided informed consent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two themes emerged: (1) personalised approaches to autonomous care using digital technologies, with two sub-themes of the benefits and challenges of technology, and the integration of culturally inclusive healthcare elements; (2) person-centred, culturally appropriate healthcare elements within a VHS model, with three sub-themes on the vital role of health coaches, the importance of community connections, and enabling holistic personalised healthcare access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides important consumer perspectives on the potential of VHS models of health care to empower Indigenous healthcare service consumers. VHS holds promise on multiple fronts: improved access, timeliness, continuity of care, and culturally sensitive health care, enabling improved self-management of chronic conditions, and provide crucial support from local Indigenous healthcare providers within the community. Future research on the sustainability and impact of personalised, consumer-centric digital health services in Indigenous populations is essential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840223","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":"Rural and metropolitan applicants' experiences of the admissions process for a provisional entry regional medical training pathway","authors":"Jordan Fox PhD,&nbsp;Sonia Saluja MD,&nbsp;Romeo Batacan Jr. PhD,&nbsp;Candice Pullen PhD,&nbsp;Faith Yong PhD,&nbsp;Matthew McGrail PhD","doi":"10.1111/ajr.13211","DOIUrl":"10.1111/ajr.13211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the experiences and perceptions of rural and metropolitan applicants preparing for and completing all admission components for a provisional entry regional medical pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Provisional entry regional medical pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Provisional entry (school-leaver) applicants (<i>N</i> = 18) who completed a Multiple Mini-Interview (MMI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Applicants were invited to participate in a semi-structured interview regarding their experiences of the admissions process relative to their background (rural/metropolitan origin). A constructivist approach with a social accountability lens was taken for these semi-structured interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Themes were related to whether the applicants were classified as rural or metropolitan origin and the impact of the applicant's geographical location and connections to the local community, differences in local school and social support, and challenges in allocating medical school preferences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, applicant perceptions and experiences of the admissions process were influenced both positively and negatively by whether they were of rural or metropolitan origin. Strategies are required to ensure applicants with genuine rural interest, whether they are of rural or metropolitan origin, have access to sufficient support and resources while applying to regional medical pathways to ensure they are not disadvantaged, thus meeting admissions goals of the program.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840229","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":"Stress and coping in Australian male farmers","authors":"Michele Anne Mitten MPsych (Clin),&nbsp;Pascal Molenberghs PhD","doi":"10.1111/ajr.13207","DOIUrl":"10.1111/ajr.13207","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Farmers face high levels of stress, often related to unique farming industry stressors. Coping strategies in dealing with stress, can be less (avoidant) or more (approach) effective. No previous research has investigated coping strategies across a range of farming-specific stressors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine levels of stress in various categories and the relationship between these stressors and coping strategies used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional survey, using self-report questionnaire. Independent variables included five stressor categories, and two types of coping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>One hundred and twenty-five rural male farmers, over 18 years of age, across Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Demographic data were collected in addition to responses regarding stress and coping. The Australian Family Farming Stressor Scale, comprising five stressor categories, measured the stressors unique to Australian farming. The Brief COPE (B-COPE) measured approach and avoidant coping strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 125 responses to the survey were analysed, with ages ranging from 19 to 84. While varying levels of stress were found in all stressor categories, Daily Stressors rated highest, followed by Financial Stressors. Higher levels of avoidant coping were utilised for Family Stressors, whereas higher levels of approach coping were utilised for farm-related stressors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings indicate that the rating of stressors may be determined by current affairs, such as Daily Stressors rating highest. This could be due to the lack of available workforce during the COVID-19 pandemic. Furthermore, coping strategy findings could better inform clinical practice in assisting farmers in utilising their approach coping skills across all stressors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840232","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 collaborative potential of the rural health and student equity fields in higher education","authors":"Claire Quilliam PhD,&nbsp;Mollie Dollinger PhD,&nbsp;Carol McKinstry PhD,&nbsp;Nicole Crawford PhD,&nbsp;Pim Kuipers PhD,&nbsp;Philip Roberts PhD,&nbsp;Vincent Versace PhD","doi":"10.1111/ajr.13204","DOIUrl":"10.1111/ajr.13204","url":null,"abstract":"&lt;p&gt;There have been multiple government and community initiatives over the last 20 years to strengthen Australia's rural health workforce. At a national level, the Australian Government's Rural Health and Multidisciplinary Training (RHMT) Program is one of numerous Commonwealth rural health workforce programs aiming to address the maldistribution of the rural health workforce and comprises a network of Rural Clinical Schools (RCS) and University Departments of Rural Health (UDRHs). Demand for rural health professionals in regional, rural and remote Australia continues to outstrip supply; a trend that extends to other sectors, as illustrated by the Towards a Regional, Rural and Remote Jobs and Skills Roadmap Interim Report, https://www.jobsandskills.gov.au/publications/regional-rural-and-remote-australia-jobs-and-skills-roadmap.&lt;/p&gt;&lt;p&gt;A recent national review of Australian higher education, known as the Australian Universities Accord, https://www.education.gov.au/australian-universities-accord/resources/final-report, has recommended a range of higher education initiatives to address student inequities, including the expansion of higher education infrastructure in rural areas, most notably through the Regional University Study Hub (RUSH) program around the nation. UDRHs and RUSHs are funded by different Australian government departments (the Department of Health and Aged Care and the Department of Education respectively) and have different objectives, although they share broader overlapping aims of building higher education attainment for people living in rural communities and fostering the workforce across in-demand industries, including health. We believe there is potential unrealised synergy between RUSHs and UDRHs—noting that most RUSHs are relatively new compared with the UDRH network, which was established in the mid-1990s. We suggest that developing and harnessing collaborations and initiatives between the rural health and student equity in higher education fields could result in greater benefits for rural communities. We build on previous editorials in this Journal and call on our readership to consider how they can be better aligned with other rural higher education initiatives to strengthen the rural health workforce and improve the health of our rural communities.&lt;/p&gt;&lt;p&gt;For decades, policymakers in the field of higher education have focused on improving the access, participation and attainment of students from ‘equity groups’, including students from ‘regional and remote’ areas, which may include those from lower socio-economic areas, relative to their metropolitan counterparts. Australia has a long history of providing learning opportunities for regional, rural, remote and isolated students. Correspondence courses were first offered early last century, followed by learning over distance via School of the Air. Online learning has been provided by Open Universities and by universities that have prioritised distance learning and online deli","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1095-1099"},"PeriodicalIF":1.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820098","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":"Facilitating the future of small rural hospitals","authors":"Stephen Duckett PhD, DSc, FASSA, FAHMS","doi":"10.1111/ajr.13205","DOIUrl":"10.1111/ajr.13205","url":null,"abstract":"&lt;p&gt;I'm not a rural person. I was born in Sydney; I now live in Melbourne. I've never lived in a small town, so I feel like somewhat of a fraud talking about the future of small rural hospitals. In the past, my attitude towards rural health care could be characterised as benign neglect, with an important exception I'll come to. For some of my career, I was responsible for budgets and budget savings in particular. My view then was that the big money is in the big hospitals, so I didn't look to rural closures or amalgamations to solve budget deficits. This is still my view.&lt;/p&gt;&lt;p&gt;Almost a decade ago, I was asked to lead a review of quality and safety in Victorian hospitals following tragic outcomes at Bacchus Marsh Hospital associated with poor clinical governance. As part of that review, I was forced to think more carefully about the trade-offs involved in rural health provision, between access, the workforce and clinical governance challenges, and the broader role of hospitals that I will talk about later.&lt;/p&gt;&lt;p&gt;Victoria has seen a flurry of amalgamation talk over the last year with on again—off again—on again oscillations favouring mergers either forced or voluntary. There are good reasons to argue for amalgamations—particularly those that are voluntary—as they can create improvements for both staff and communities in rural Victoria as our Grampians Health case study shows.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Money is not the only reason to look to amalgamations, care quality is another and my observation—based on anecdote only I'm afraid—is that there are significant weaknesses in clinical governance in some small hospitals that need to be addressed. Part-time, advisory medical administrative oversight, especially without clear and transparent lines of accountability, has been shown to be a recipe for disaster (Medical Board of Australia v Dr. Gruner (Review and Regulation) (2022) VCAT 1116; Medical Board of Australia v Dr. Gruner (Review and Regulation) (2023) VCAT 273). Medical practitioners in some cases are able to hold small communities and their hospitals to ransom.&lt;/p&gt;&lt;p&gt;But I think the obsession with structural solutions is not the place to start. The critical issue to address is workforce, and not enough is being done about this. Secondly, and what I want to focus most of this talk on, is thinking through what a small rural hospital is, as we move into the second quarter of this century. The failure to fully understand the role that small hospitals play contributes to muddled policy thinking and poor policy prescriptions.&lt;/p&gt;&lt;p&gt;But first workforce. Australia has a plethora of rural workforce incentives, policies and strategies. They are interacting, overlapping, expensive and ineffective. If you add them all up, you might even have one program for every rural doctor! Unfortunately, this mish mash seems to me to be developed by bureaucrats and politicians who look for solutions in the wrong place.&lt;/p&gt;&lt;p&gt;If we conceptualise the problem as too ","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1091-1094"},"PeriodicalIF":1.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820097","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}