Online Journal of Rural Nursing and Health Care最新文献

{"title":"Health Care Experiences in Rural, Remote, and Metropolitan Areas of Australia","authors":"S. Bourke, Claire Harper, Elianna Johnson, Janet Green, Ligi Anish, Miriam Muduwa, L. Jones","doi":"10.14574/OJRNHC.V21I1.652","DOIUrl":"https://doi.org/10.14574/OJRNHC.V21I1.652","url":null,"abstract":"Background: Australia is a vast land with extremes in weather and terrain. Disparities exist between the health of those who reside in the metropolitan areas versus those who reside in the rural and remote areas of the country. Australia has a public health system called Medicare; a basic level of health cover for all Australians that is funded by taxpayers. Most of the hospital and health services are located in metropolitan areas, however for those who live in rural or remote areas the level of health service provision can be lower; with patients required to travel long distances for health care. \u0000Purpose: This paper will explore the disparities experienced by Australians who reside in regional and remote areas of Australia. \u0000Method: A search of the literature was performed from healthcare databases using the search terms: healthcare, rural and remote Australia, and social determinants of health in Australia.  \u0000Findings: Life in the rural and remote areas of Australia is identified as challenging compared to the metropolitan areas. Those with chronic illnesses such as diabetes are particularly vulnerable to morbidities associated with poor access to health resources and the lack of service provision. \u0000Conclusion: Australia has a world class health system. It has been estimated that 70% of the Australian population resides in large metropolitan areas and remaining 30% distributed across rural and remote communities. This means that 30% of the population are not experiencing their health care as ‘world-class’, but rather are experiencing huge disparities in their health outcomes. \u0000Keywords: rural and remote, health access, mental health issues, social determinants \u0000DOI:  https://doi.org/10.14574/ojrnhc.v21i1.652  ","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"21 1","pages":"67-84"},"PeriodicalIF":0.0,"publicationDate":"2021-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43429423","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":"Rural Populations’ Sources of Cancer Prevention and Health Promotion Information","authors":"M. E. Leimkuhler, Lindsay Hauser, Noelle Voges, P. Deguzman","doi":"10.14574/OJRNHC.V21I1.663","DOIUrl":"https://doi.org/10.14574/OJRNHC.V21I1.663","url":null,"abstract":"Purpose: Rural residents are less likely to engage in cancer risk-reduction behaviors than their urban counterparts. Rural cancer disparities may be related to limited access to and comprehension of cancer-related health information. The object of this study was to identify how rural residents access and understand cancer health promotion and prevention information. \u0000Sample: Twenty-seven residents of Central Virginia \u0000Methods: We used a qualitative design with semi-structured interviews and a focus group (n=27) with rural and non-rural residents living in Central Virginia to accomplish the study aim. \u0000Findings: Four themes were identified from the data: 1) non-rural Central Virginia residents seek health information from a variety of electronic sources, 2) rural Central Virginia residents typically seek health care information directly from health care professionals, 3) residents throughout Central Virginia encounter confusing health care information, and 4) rural residents report incorrect cancer-related information. \u0000Conclusions: Lack of internet access coupled with healthcare shortages may limit the ability of rural residents to contextualize and verify inaccurate health information. Nurses serving a rural population should consider assessing each rural patient’s internet access and disseminating printed cancer health promotion materials to rural clients without internet access. \u0000Keywords: rural health; healthcare disparities; access to care; cancer health promotion; health literacy; cancer \u0000DOI:  https://doi.org/10.14574/ojrnhc.v21i1.663 ","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"21 1","pages":"3-23"},"PeriodicalIF":0.0,"publicationDate":"2021-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46406776","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":"Workforce Demands of Rural Nurse Practitioners: A Descriptive Study","authors":"Jody Toerber-Clark, Marion M. Jamison, M. Scheibmeir","doi":"10.14574/OJRNHC.V21I1.656","DOIUrl":"https://doi.org/10.14574/OJRNHC.V21I1.656","url":null,"abstract":"Purpose: Nurse practitioners (NPs) are rendering health care services in rural areas in increasing numbers, yet little is known about clinical skills and patient care management activities performed by these advanced practice nurses in the rural environment. The purpose of this descriptive study of rural NPs was to identify skills and patient care management activities that they have performed and considered critical to Kansas rural practice. Sample: A convenience sample of 208 nurse practitioners (NP) in rural and frontier Kansas were emailed a survey that asked about skills and activities they perform in their rural practice. Sixtythree responded for a response rate of 30%. Findings: The analysis produced a list of 26 skills and 37 patient care management activities critical to Kansas rural NP practice. Most of the skills/procedures were learned after graduation. Almost all the respondents reported additional training/certifications in advanced life support and trauma. The majority of respondents were family nurse practitioners who practiced in a variety of rural settings. “I grew up in a rural setting” and “Autonomy of practice” were the two top factors that influenced their decision to practice in a rural setting.","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"21 1","pages":"49-66"},"PeriodicalIF":0.0,"publicationDate":"2021-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47636377","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 International Rural Nursing Conference is Coming to You in 2021","authors":"P. Fahs","doi":"10.14574/OJRNHC.V21I1.684","DOIUrl":"https://doi.org/10.14574/OJRNHC.V21I1.684","url":null,"abstract":"","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"21 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2021-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44448987","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":"Where Have They Gone? Recruiting and Retaining Older Rural Research Participants.","authors":"Elizabeth Grace Nichols,&nbsp;Jean Shreffler-Grant,&nbsp;Clarann Weinert","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Issue: </strong>Rural-dwelling elderly have been shown to suffer from health disparities when compared to the general population. Research involving these individuals is important, and to have meaningful results, sample sizes must be adequate. Recruiting and retaining these individuals pose significant challenges.</p><p><strong>Context: </strong>Nurse researchers in the rural northwestern United States conducted a 4-part educational intervention aimed at increasing general and complementary and alternative health care literacy of older rural dwellers. Significant challenges were faced in both recruiting and retaining participants over the 6-month study period. Despite careful planning and community selection, the team had to double the number of communities in which they carried out the project to meet recruitment goals. Retention was also a challenge. Of 127 participants initially enrolled in the study, only 52 remained to the end.</p><p><strong>Lessons learned: </strong>Challenges of recruiting and retaining are complex and compounded when the target population is rural, older and the study is longitudinal. Recruitment challenges included reaching older adults, offering a compelling program, and offering it in an acceptable format at a convenient time and place. A variety of outreach activities were conducted including in-person presentations, advertising or public interest stories in local newspapers or radio stations, and flyers on bulletin boards in restaurants, clinics, churches, community centers, and libraries. A project champion, an individual well known and connected within the community and committed to the success of the proposed study, is a major asset. Retention strategies included developing relationships with the participants and maintaining contact with them over the course of the study through such mechanisms as appointment cards, e-mail or regular mail, telephone reminders, and thank you cards. Oversampling was important as factors beyond the control of the researcher occurred; for example, illness, death, family crises, unexpected relocations, and weather events that prevented travel to scheduled research events.</p>","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"21 1","pages":"179-182"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570614/pdf/nihms-1729889.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39596951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural Status of Equine Assisted Activities and Therapies and Cancer Survivors","authors":"Khalid Bandar Almasloukh, P. Fahs","doi":"10.14574/ojrnhc.v20i2.601","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.601","url":null,"abstract":"Background: Although equine assisted activities and therapies (EAAT) are rapidly increasing, as are cancer survival rates, little is known about the engagement of cancer survivors in EAAT. One may conceptualize equine or horse related activities as occurring in rural areas; however, the rural status of EAAT centers are not fully reported.Purpose: To explore the rural status of EAAT centers, and whether EAAT is provided for cancer survivors and the more common service for post-traumatic stress disorder at those centers.Method: A quantitative descriptive analysis was conducted of publicly available data after an exempt status decision of an Institutional Review Board. Services using EAAT for those with terminal illnesses, post-traumatic stress disorder and cancer survivors were examined. Rural status was evaluated for all organizational members (N = 784) of Professional Association of Therapeutic Horsemanship International (PATH Intl.). Roy adaptation model was used as a theoretical framework in this project.Findings: All types of the organizational members, cluster in urban areas more than rural areas. Significant relationship (p = 0.039) was found between rural status and type of membership, where more urban than rural centers were premier accredited center members. Most of the contacted and responding centers stated that they do provided EAAT for cancer survivors (n = 204); however, only (n = 26) centers have programs specifically designed for cancer survivors.Conclusion: There are not only less EAAT rural than urban centers, but rural centers also tend to have lower quality level membership based on PATH Intl. standards. Although EAAT is provided for cancer survivors, identifying effective ways to provide EAAT and standardization of programs for cancer survivors is recommended. \u0000DOI:  http://doi.org/10.14574/ojrnhc.v20i2.601 ","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"213-240"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43122752","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":"Collaborating with Rural Practice Patners to Address the Need for RNs in Primary Care","authors":"Robin J. Brown, H. Mennenga, Alham A. Abuatiq, L. Burdette, L. Horsley, Christina Plemmons","doi":"10.14574/ojrnhc.v20i2.618","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.618","url":null,"abstract":"Abstract \u0000Purpose: Primary care in rural areas of the U.S. urgently need competent healthcare providers, especially registered nurses (RNs). Registered nurses are ideal team members to help meet the primary care needs in rural communities, yet RNs are underutilized in primary care settings and rarely practice to the full scope of their license in these settings. The purpose of the project was to conduct a needs assessment with rural primary care practice partners to address the need for RNs in primary care. \u0000Sample: A needs assessment was sent to nurse leaders at 13 rural primary care facilities via an online survey in December 2018. \u0000Methods: This descriptive exploratory study utilized an online needs assessment survey to gather information from 13 rural clinical practice partners regarding their knowledge, interest, and use of RNs in primary care. \u0000Results: Twelve of the 13 rural clinical practice partners completed the needs assessment survey. A majority of the clinical partners indicated they felt knowledgeable about the RN full scope of license and expressed a high interest in the expanded role of the RN in primary care. The clinical practice partners reported interest in providing independent RN chronic and acute care visits, care management, medication management, and collaborative provider and RN visits. \u0000Conclusion: Conducting a needs assessment and collaborating with rural primary care practice partners to address the need for RNs in primary care is the first step in developing policies and utilizing RNs to the full scope of their license. \u0000            Keywords: primary care, rural, registered nurses \u0000  \u0000 ","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"179-193"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43443088","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":"Assessment of Readmission in a Rural Medical Center","authors":"J. Mallow, Andrea Bailey, Karen Clark, Laurie A. Theeke","doi":"10.14574/ojrnhc.v20i2.615","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.615","url":null,"abstract":"Understanding and predicting hospital readmission has been of interest for more than three decades. To strategically place readmission reduction resources where most beneficial, organizations use readmission risk-stratification tools. However, common tools used to assess 30day risk do not incorporate health disparity and it is unknown how modifying currently validated tools affects their predictive value. The aims of this retrospective study were to describe the population of people who are admitted and re-admitted for hospital care in a rural population and examine the effectiveness of a common risk stratification tool to predict 30-day readmission in a rural population experiencing health disparities. This retrospective cohort study examined data","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"241-262"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43808441","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":"Hepatitis C Treatment at a Rural Navajo Health Clinic Using Project ECHO","authors":"A. Nance, L. Saiki, Elizabeth G. Kuchler, Conni J DeBlieck, S. Forster-Cox","doi":"10.14574/ojrnhc.v20i2.634","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.634","url":null,"abstract":"Purpose: Hepatitis C incidence is higher among American Indian/Alaskan Native populations than any other racial or ethnic group in the United States. Chronic Hepatitis C complications include cirrhosis of the liver, end stage liver disease, and hepatocellular cancer. Direct acting antiviral treatment taken orally results in > 90% cure, yet rural primary care providers lack the training and confidence to treat and monitor patients with chronic Hepatitis C. Rural patients are reluctant to travel to urban areas for Hepatitis C treatment. Project ECHO is an innovative telementoring program where specialists mentor primary care providers via videoconferencing to treat","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"133-155"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46521526","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":"Lived Experience of Nursing Appalachia","authors":"Evelyn P Brewer, F. Weierbach, R. Fletcher, Katherine Hall, W. Nehring","doi":"10.14574/ojrnhc.v20i2.619","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.619","url":null,"abstract":"Purpose: Research in rural areas presents special challenges for sampling and recruitment. Examples of considerations include smaller sampling population, privacy concerns, and the rural context. The purpose of this article is to discuss the results of sampling and recruitment strategies within this study. \u0000Sample: Nurses form a central hub of health care in rural communities. However, little is known about the lived experience of nurses serving in this capacity. This study explored stories of nurses in a six-county area of three adjoining states in rural South Central Appalachia. \u0000Method: Recruitment for the study was completed using state boards of nursing social marketing strategies and snowball sampling. \u0000Findings: Sampling and recruitment efforts enlisted 15 participants. The sample was deemed representative of the population as participants represented diverse employment contexts, education preparation levels, licensure duration, and multiple generations. \u0000Conclusions: Understanding implications of rural setting and cultural context are critical to successful recruitment and sampling. Privacy considerations may still be concerning, however, multiple de-identification strategies serve to help lessen this risk. Social marketing strategies failed to recruit the needed number of participants secondary to the fact that participants from only one state were recruited in this manner. Smaller population pool limitations were eased by snowball sampling, an approved recruitment method in qualitative research. Future researchers should be cognizant of the influence of rurality norms and cultural context on recruitment and sampling efforts. Social marketing proved less successful than snowball sampling strategies. Further research is needed to develop best practice for rural recruitment and sampling via social marketing. Finally, time and resource commitment for participation can be a barrier. Flexibility in scheduling interviews, location of interview sites, and the availability of audio/phone interviews served to facilitate agreement to participate. \u0000Key words: rural, nursing, Appalachia, research, sampling, recruitment \u0000 ","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"108-132"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47492606","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}