Australian Journal of Rural Health最新文献

Objective: 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.

Design: 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.

Setting: The Goondir Health Services (Aboriginal Community Controlled Health Organisation) operating clinics in rural and remote Queensland.

Participants: Fourteen Indigenous VHS consumers who resided in Modified Monash Model 3-7 communities across Queensland, met the eligibility criteria and provided informed consent.

Results: 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.

Conclusion: 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.

Objective: 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.

Setting: Provisional entry regional medical pathway.

Participants: Provisional entry (school-leaver) applicants (N = 18) who completed a Multiple Mini-Interview (MMI).

Design: 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.

Results: 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.

Conclusion: 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.

Introduction: 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.

Objective: To determine levels of stress in various categories and the relationship between these stressors and coping strategies used.

Design: Cross-sectional survey, using self-report questionnaire. Independent variables included five stressor categories, and two types of coping.

Participants: One hundred and twenty-five rural male farmers, over 18 years of age, across Australia.

Main outcome measures: 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.

Results: 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.

Conclusions: 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.

Objective: This study aims to investigate in patients over 65 with neck of femur (NOF) fractures in Rural Australia, does initial presentation to a peripheral hospital result in a delay to surgery?

Design: Retrospective cohort study.

Setting: Dubba Base Hospital, Trauma Hospital Rural Australia (Modified Monash Model (MMM) 3) and catchment area (MMM 3-7), NSW, Australia.

Participants: The study includes 350 patients over 65, presenting with closed, unilateral NOF fractures who underwent operative management at the operating centre, 203 from peripheral hospitals.

Main outcome measures: Primary outcomes include time to surgery and adherence to recommended timeframes for NOF fixation. Secondary outcomes encompass complications, hospital length of stay and a subgroup analysis to identify causes of surgery delay.

Results: Patients transferred from peripheral hospitals experienced a statistically significant delay in time from presentation to surgery compared to those presenting directly to the operating centre (42 h vs. 24 h, p < 0.001) and were more likely to be outside of current guidelines for NOF fixation within 36 h of presentation (OR 5.1, p < 0.001). There were no differences in mortality at 1 year between the two groups (15% vs. 18%, p = 0.5). On subgroup analysis, distance from the operating centre, time to x-ray and after-hours presentation were associated with increased likelihood of surgery outside of 36 h in the peripheral hospital group.

Conclusion: This study underscores an inequity in service delivery for rural patients with NOF fractures, particularly those requiring transfer. Pre-arrival delays necessitate targeted interventions to address diagnostic service delays, logistical challenges and transport issues in rural health care.

Objective: The negative consequences of social disconnection, including loneliness and social isolation, is receiving considerable attention from researchers and policymakers, and growing as a global public health priority. Volunteering has emerged as a promising strategy to promote social connection and combat loneliness, calling for a closer examination of its potential benefits to individual social health and community cohesion. This study explores the experiences and impact of volunteering on individuals' social health, providing insights into both the positive impacts and possible limitations of volunteering in rural communities.

Design/setting/participants: Twenty-two volunteers (6 males; 16 females) in one rural Northern Victoria community participated in semi-structured interviews via telephone, online or face-to-face. Thematic analysis was used to develop descriptive themes from the qualitative data.

Results: Four themes were identified: (1) creating social and community bonds, (2) giving back to the community, (3) building identity through volunteering and (4) social identity and belonging. Findings suggest that volunteering helps individuals to meet new people, increase opportunities for social interactions with others and within social groups, positively influencing their social identity and the identity of the community. Volunteers, who felt connected through their volunteering, experienced a sense of belonging. However, when feeling overburdened or undervalued, volunteers disengaged and sought new volunteering opportunities.

Conclusions: This study demonstrates the influence of rural volunteering on volunteer's social connections, identity and social health. Creating flexible, accessible and inclusive volunteering opportunities acts as a valuable community resource for building and maintaining social health and connection and reduces social disconnection in rural populations.