Canadian Journal of Rural Medicine最新文献

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Erratum: Can implementation of in situ simulation support rural emergency provider self confidence and improve patient safety? A mixed methods study. 勘误：现场模拟的实施能否支持农村急救人员的自信并提高患者的安全？混合方法研究。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_89_25

引用次数: 0

Improving resource stewardship in post-pandemic primary care: Insights into choosing Wisely Canada guidelines. 改善大流行后初级保健的资源管理：对明智选择加拿大指南的见解。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_87_24

Nathan Jeffery, Div Patel, Taylor Marshall, Lisa Allen, Roy Kirkpatrick

Introduction: The COVID-19 pandemic significantly disrupted primary care delivery, amplifying challenges in resource stewardship. Choosing Wisely Canada (CWC) guidelines aim to reduce unnecessary interventions. However, barriers to their implementation persist, particularly in rural settings where access to resources is limited and patient expectations often conflict with evidence-based care. Our study explored primary care physicians' awareness of, utilisation of and barriers to implementing CWC guidelines in a post-pandemic context, focusing on challenges, quality improvement opportunities and innovative approaches to reduce low-value care.Methods: An online survey of primary care physicians across Canada was used to collect demographic data, practice habits and perspectives on CWC guidelines. Quantitative analysis measured trends, while qualitative analysis of open-ended responses identified recurring themes.Results: One hundred and twenty-seven primary care physicians responded to the survey. Results revealed high awareness of CWC guidelines (97.6%) but low familiarity with post-pandemic adaptations (36.2%) and patient-facing materials (61.4%). Key barriers included time constraints, fear of missed diagnoses and limited rural resources. Physicians highlighted the need for tailored approaches in rural settings, where deviations from guidelines are often necessary because of challenges related to healthcare access. Participants identified several opportunities for improvement, including integrating guidelines into electronic medical records and developing mobile applications to support decision-making. Enhanced patient education emerged as critical for addressing demands for unnecessary tests, often fuelled by misinformation from social media.Conclusion: Targeted medical and patient education, interprofessional collaboration and technology integration are essential for improving CWC adoption. Tailored solutions that address rural-specific challenges and systemic barriers are pivotal for achieving sustainable resource stewardship in primary care.Introduction: La pandémie de COVID-19 a profondément bouleversé l'organisation des soins primaires, accentuant les défis liés à l'utilisation judicieuse des ressources. Les recommandations de Choisir avec soin visent à réduire les interventions inutiles, mais leur mise en œuvre demeure difficile, surtout en milieu rural où l'accès aux services est restreint et où les attentes des patients s'harmonisent parfois mal avec les pratiques fondées sur les données probantes. Notre étude examine la connaissance, l'utilisation et les obstacles à l'intégration des recommandations de Choisir avec soin chez les médecins de famille en contexte postpandémique, en mettant l'accent sur les défis rencontrés, les occasions d'amélioration de la qualité des soins et les approches innovantes pour diminuer les ac

2019冠状病毒病大流行严重扰乱了初级保健服务，加大了资源管理方面的挑战。明智地选择加拿大（CWC）指南旨在减少不必要的干预。然而，实施的障碍仍然存在，特别是在农村地区，那里获得资源的机会有限，患者的期望往往与循证护理相冲突。我们的研究探讨了初级保健医生在大流行后背景下对实施《禁止化学武器公约》指南的认识、利用和障碍，重点关注挑战、质量改进机会和减少低价值护理的创新方法。方法：对加拿大各地的初级保健医生进行在线调查，收集人口统计数据、执业习惯和对CWC指南的看法。定量分析衡量趋势，而定性分析的开放式答复确定了反复出现的主题。结果：127名初级保健医生参与了调查。结果显示，对CWC指南的认知度较高（97.6%），但对大流行后适应（36.2%）和面向患者的材料的熟悉度较低（61.4%）。主要障碍包括时间限制、担心漏诊和农村资源有限。医生们强调需要在农村地区采取量身定制的方法，因为在农村地区，由于与获得医疗保健有关的挑战，往往需要偏离指南。与会者确定了若干改进机会，包括将准则纳入电子病历和开发移动应用程序以支持决策。加强患者教育对于解决对不必要检查的需求至关重要，这种需求往往是由社交媒体上的错误信息推动的。结论：有针对性的医疗和患者教育、跨专业协作和技术整合对于提高《禁止化学武器公约》的采用至关重要。针对农村特有挑战和系统性障碍的量身定制解决方案对于实现初级保健领域的可持续资源管理至关重要。导言：La pandmie de COVID-19是一种深度的（组织），强调的是（组织），（组织）和（资源）的利用。这些建议包括：预防预防疾病、预防预防疾病、预防预防疾病、预防预防疾病、预防农村疾病où预防预防疾病、预防预防疾病、预防预防疾病、预防预防疾病、预防预防疾病、预防预防疾病、预防预防疾病、预防预防疾病、预防预防疾病。诺练习曲检查la connaissance l 'utilisation et les障碍l 'integration des recommandations de让用行动组织在莱斯德虽然en contexte postpandemique, en将l 'accent苏尔les违抗邂逅,les场合d 'amelioration de la质量des行动等les方法innovantes倒会使莱斯发动faible的数值。方法：在加拿大各省的主要省份中，采用enquête en - ne - ne - ne - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys - ys。调查问卷收集的资料包括：未登记的个人资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人习惯资料、未登记的个人建议资料。我分析定量的和准定性的趋势，我分析定性的和准定性的趋势，我分析定量的和准定性的趋势。组织Rsultats:分vingt-sept y repondu。主要病例包括：未确定患者预后（97.6%）、未确定患者预后（36.2%）、未确定患者预后（61.4%）。主要提到的障碍包括：时间障碍、过境障碍、重要诊断障碍和资源障碍。汇汇会决定汇汇会决定汇汇会决定汇汇会的决定汇汇会决定汇汇会的决定汇汇会决定汇汇会的决定汇汇会决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定汇汇会的决定里面的参与者并非对mis de l 'avant几个滑道d 'amelioration,像l 'integration des recommandations在档案medicaux electroniques et la创造d 'applications手机倒soutenir la撬德的决定。对患者进行的一项新培训确定了患者的健康状况，确定了患者的健康状况，确定了患者的健康状况，确定了患者的健康状况，确定了患者的健康状况，确定了患者的健康状况。结论：加强临床培训和公众培训，加强专业间协作，提高培训解决方案的技术含量，提高培训建议的采纳率。战略调整、环境调整、环境调整、环境调整、障碍调整、系统调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整、环境调整等。

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引用次数: 0

Les défis posés par l'IA dans l'édition scientifique. 人工智能在科学出版中的挑战。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_88_25

Peter Hutten-Czapski

引用次数: 0

The Occasional limb tourniquet application and tourniquet conversion. 偶尔的肢体止血带应用和止血带转换。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_60_25

David Jerome, Sean William Moore

引用次数: 0

Teledermatology. Teledermatology。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_58_23

Eric P McMullen

引用次数: 0

The challenges of dealing with A.I. in academic publishing. 在学术出版中处理人工智能的挑战。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_82_25

Peter Hutten-Czapski

引用次数: 0

The impact of the COVID-19 pandemic on burnout and resilience amongst healthcare personnel in rural Northern Ontario: A cross-sectional study. 2019冠状病毒病大流行对安大略省北部农村医护人员职业倦怠和恢复力的影响：一项横断面研究。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_2_25

Iain R Lamb, Navishka C Brahmbhatt, Margaret Cousins, Lindsay E Nutbrown, Eliseo Orrantia, Lily DeMiglio

Introduction: The COVID-19 pandemic imposed an unprecedented strain on the healthcare system, resulting in rising burnout levels among healthcare personnel. The pandemic's effect on the mental well-being of those working within resource-limited healthcare settings remains unexplored. We assessed the impact of the pandemic on burnout and resilience in healthcare personnel working in rural Northern Ontario.Methods: We surveyed healthcare personnel across 15 rural communities in Northern Ontario, gathering demographic, occupational, burnout and resilience data. Chi-square tests (χ2) determined response variations by demographic and occupational factors, whereas ANOVAs assessed mean differences. Pearson correlation coefficient measured the relationship between burnout and resilience, and linear associations were identified using the Mantel-Haenszel test.Results: Ninety-nine healthcare workers from 15 rural communities were sent the survey. Seventy-six (77%) responded. Fifty-five per cent of respondents experienced burnout, with 81% rating it as moderately severe or worse. Those who grew up in their current community reported higher burnout rates, and 73% of participants reported strong resilience. Childhood community ties correlated with lower resilience, whereas higher resilience was linked to lower burnout severity. Physicians had lower Connor-Davidson-Resilience Scale© (CD-RISC 2) scores compared to hospital CEOs.Conclusion: Despite high burnout, respondents had strong resilience. A correlation between burnout severity and resilience suggests that higher resilience is linked to less severe burnout which suggests that resilience can buffer the impact of burnout. Enhancing resilience could improve the ability to cope with stress and adversity. The data emphasises the need to consider factors, such as occupation and community history, when assessing burnout risk and designing well-being interventions.2-25 L'impact de la pandémie de COVID-19 sur l'épuisement professionnel et la résilience du personnel de la santédans le Nord rural de l'Ontario: Une étude transversale.Introduction: La pandémie de COVID-19 a exercé une pression sans précédent sur le système de santé, entraînant une hausse marquée de l'épuisement professionnel chez le personnel soignant. Les répercussions de cette crise sur la santé mentale des professionnels œuvrant dans des milieux où les ressources sont limitées demeurent peu documentées. Cette étude évalue l'impact de la pandémie sur l'épuisement professionnel et la résilience du personnel de la santé travaillant dans des communautés rurales du Nord de l'Ontario.Mthodes: Une enquête a été menée auprès de membres du personnel de la santé provenant de 15 communautés rurales du Nord ontarien. Nous avons recueilli des données démographiques, professionnelles, ainsi que des mesures d'épuisement profes

导语：2019冠状病毒病大流行给医疗保健系统带来了前所未有的压力，导致医疗保健人员的倦怠程度不断上升。大流行对在资源有限的卫生保健环境中工作的人的心理健康的影响仍未得到探讨。我们评估了大流行对在安大略省北部农村工作的卫生保健人员的倦怠和复原力的影响。方法：我们调查了安大略省北部15个农村社区的卫生保健人员，收集了人口统计、职业、倦怠和恢复力数据。卡方检验（χ2）确定了人口统计学和职业因素的反应差异，而方差分析评估了平均差异。Pearson相关系数测量倦怠与心理弹性之间的关系，并采用Mantel-Haenszel检验确定线性相关。结果：共有来自15个农村社区的99名卫生工作者参与了调查。76人（77%）做出了回应。55%的受访者经历过职业倦怠，81%的受访者将其评为中度或更严重。那些在当前社区长大的人报告了更高的倦怠率，73%的参与者报告了很强的适应能力。童年时期的社区关系与较低的恢复力相关，而较高的恢复力与较低的倦怠严重程度相关。与医院首席执行官相比，医生的Connor-Davidson-Resilience Scale©（CD-RISC 2）得分较低。结论：尽管被调查者的职业倦怠程度较高，但其心理弹性较强。倦怠严重程度与心理弹性之间的相关性表明，心理弹性越高，倦怠程度越轻，这表明心理弹性可以缓冲倦怠的影响。增强韧性可以提高应对压力和逆境的能力。这些数据强调，在评估倦怠风险和设计健康干预措施时，需要考虑职业和社区历史等因素。2-25关于COVID-19病毒携带者携带者的影响，根据携带者携带者携带者携带者携带者的影响，根据携带者携带者携带者携带者的影响，安大略北部农村地区的携带者携带者的影响：横向的携带者。简介：La pandmie de COVID-19 a exerceune pression sans pracimacendent sur le system de sant, entranant une hausse marquacemode l' samuement professionnel chez le personnel soignant。在职业人员心理健康危机的影响下，职业健康和职业健康危机的影响下，职业健康和职业健康危机的影响下，职业健康和职业健康危机的影响下，职业健康和职业健康危机的影响。在加拿大北部的安大略省，所有的职业和职业都是由职业和职业的人组成的，所有的职业都是由职业和职业的人组成的。方法：在安大略省北部15个社区的人力资源和人力资源部门的人力资源和人力资源部门的人力资源管理部门的人力资源管理部门的人力资源管理部门的人力资源管理部门的人力资源管理部门。一般情况下，应采取的措施包括： - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -这些测试（χ2）不允许检查者在个体个体、社会个体和职业个体之间进行变异。方差分析表明，与其他因素相比，这些因素的效用更小。皮尔逊的系数（coefficient de corcoration de Pearson）是指人际关系中心（relationship center）是指人际关系中心（relationship center），即人际关系中心（relationship center）是指人际关系中心，即人际关系中心，即人际关系中心，即人际关系中心，即人际关系中心，即人际关系中心。结果：帕尔米有15个社区、农村、社会、特使、个人和个人，其中76人（77%）为非个人和个人。Cinquante-cinq pour cent des rs - mondancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancidancid.com)。“人与社会的差别”（Les persones ayant grandi dans la communautest） où“人与社会的差别”（Les travaillent rapentent）是指，“与其他组织的差别”，即73%的参与者表示“与其他组织的差别”。4 .社区内的所有人都是与其他组织有联系的，例如：与其他组织有联系的、与其他组织有联系的、与其他组织有联系的、与其他组织有联系的、与其他组织有联系的。在Conor-Davidson弹性量表（Conor-Davidson Resilience Scale）中，Les msamuedins附属的samuedins分数©（CD-RISC 2）比较与PDG d'hôpitaux。结论:Malgre des掌握eleves d 'epuisement来完成,les参与者presentaient一个弹性显著。和。和 ···········关于“职业”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”、“职业范围”等概念。

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引用次数: 0

Reactivate. 重新激活。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_81_25

Gavin Gerard Parker

引用次数: 0

Letter to the editor concerning 'can implementation of in situ simulation support rural emergency provider self-confidence and improve patient safety? A mixed-methods study'. 致编辑的信，内容涉及“实施现场模拟能否支持农村急救人员的自信并改善患者安全？”一项混合方法研究”。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_84_25

Shyam Sundar Sah, Abhishek Kumbhalwar

引用次数: 0

Réactiver. 再次启动。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Canadian Journal of Rural Medicine

Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.4103/cjrm.cjrm_87_25

Gavin Gerard Parker

引用次数: 0

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