Kathryn W. Fitzgerald, Katrina Fyfe, Sandra C. Thompson
Objective
Develop a framework to guide the design and delivery of dementia training for the rural and remote health and aged care workforce.
Methods
Phase 1 was a scoping review of barriers and enablers to dementia training in rural and remote settings. Phase 2 comprised semi-structured focus groups and a national health and aged care workforce survey. Findings from these phases were integrated to develop the framework.
Design
A two-phase mixed-method study and integration of the results to develop the framework.
Setting
Rural and remote areas across Australia.
Participants
There were six hundred and twenty-five rural and remote participants.
Main Outcome Measures
Representation from all seven Australian states and territories.
Results
Synthesis of the results identified three overarching key principles and seven actionable practices for consideration when designing or delivering dementia education to the rural and remote health and aged care workforce.
Conclusions
The first Rural and Remote Dementia Training Framework offers a practical guide for employers, training providers and professional organisations to design, deliver and evaluate dementia training programs, ensuring they meet the needs of the rural and remote health and aged care workforce in Australia.
{"title":"Development of a Rural and Remote Dementia Training Framework","authors":"Kathryn W. Fitzgerald, Katrina Fyfe, Sandra C. Thompson","doi":"10.1111/ajr.70133","DOIUrl":"10.1111/ajr.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Develop a framework to guide the design and delivery of dementia training for the rural and remote health and aged care workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Phase 1 was a scoping review of barriers and enablers to dementia training in rural and remote settings. Phase 2 comprised semi-structured focus groups and a national health and aged care workforce survey. Findings from these phases were integrated to develop the framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A two-phase mixed-method study and integration of the results to develop the framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural and remote areas across Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>There were six hundred and twenty-five rural and remote participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Representation from all seven Australian states and territories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Synthesis of the results identified three overarching key principles and seven actionable practices for consideration when designing or delivering dementia education to the rural and remote health and aged care workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The first Rural and Remote Dementia Training Framework offers a practical guide for employers, training providers and professional organisations to design, deliver and evaluate dementia training programs, ensuring they meet the needs of the rural and remote health and aged care workforce in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783814","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}
Sarah Cowan, Helen Waaka, Cameron Wells, Mania Campbell-Seymour, Turuki Tahuri, Jevon Puckett, Andrew Ing, Jamie-Lee Rahiri
Introduction
Health inequities, particularly for rural and Māori populations, persist in Aotearoa New Zealand (NZ) due to geographical and structural barriers to accessing healthcare. Te Whatu Ora—Health NZ aims to reduce these inequities, including through rural outreach clinics. This study evaluates the impact of rural outreach general surgical clinics in the Hawkes Bay region on access to benign elective surgeries for rural and Māori populations.
Methods
A retrospective cohort study was conducted on all adult patients who underwent elective general surgery in Hawkes Bay from August 2015 to December 2023. Data on patient demographics, ethnicity, rural status, clinic type and surgery type were collected. Primary outcomes were time from referral to first specialist assessment (FSA), waitlist to surgery and total time from referral to surgery. Data were analysed using chi-square and Mann–Whitney U-tests, with statistical significance set at p < 0.05.
Results
One thousand three hundred and ninety-seven patients met the criteria, of whom 19.4% (N = 271) resided rurally, and 24.1% (N = 337) identified as Māori. Rural patients had a longer median waitlist-to-surgery time (95.0 vs. 83.0 days, p = 0.006) and overall referral-to-surgery time (143.0 vs. 129.0 days, p = 0.04) compared with urban patients. Māori patients waited longer for surgery than non-Māori patients (p = 0.088). Outreach clinics had longer overall wait times than central clinics (p = 0.003).
Conclusions
Despite outreach clinics in our district, rural and Māori patients experience longer delays in receiving elective surgery. Additional investment in rural outreach clinics and equity-focused prioritisation could improve access and reduce healthcare disparities for these populations. Further qualitative research is needed to explore patient perspectives.
{"title":"Investigating Postcode Lottery: Do Regional Outreach Clinics Improve Waiting Times to Elective General Surgical Care for Rural and Māori Populations?","authors":"Sarah Cowan, Helen Waaka, Cameron Wells, Mania Campbell-Seymour, Turuki Tahuri, Jevon Puckett, Andrew Ing, Jamie-Lee Rahiri","doi":"10.1111/ajr.70127","DOIUrl":"10.1111/ajr.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Health inequities, particularly for rural and Māori populations, persist in Aotearoa New Zealand (NZ) due to geographical and structural barriers to accessing healthcare. Te Whatu Ora—Health NZ aims to reduce these inequities, including through rural outreach clinics. This study evaluates the impact of rural outreach general surgical clinics in the Hawkes Bay region on access to benign elective surgeries for rural and Māori populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted on all adult patients who underwent elective general surgery in Hawkes Bay from August 2015 to December 2023. Data on patient demographics, ethnicity, rural status, clinic type and surgery type were collected. Primary outcomes were time from referral to first specialist assessment (FSA), waitlist to surgery and total time from referral to surgery. Data were analysed using chi-square and Mann–Whitney U-tests, with statistical significance set at <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One thousand three hundred and ninety-seven patients met the criteria, of whom 19.4% (<i>N</i> = 271) resided rurally, and 24.1% (<i>N</i> = 337) identified as Māori. Rural patients had a longer median waitlist-to-surgery time (95.0 vs. 83.0 days, <i>p</i> = 0.006) and overall referral-to-surgery time (143.0 vs. 129.0 days, <i>p</i> = 0.04) compared with urban patients. Māori patients waited longer for surgery than non-Māori patients (<i>p</i> = 0.088). Outreach clinics had longer overall wait times than central clinics (<i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite outreach clinics in our district, rural and Māori patients experience longer delays in receiving elective surgery. Additional investment in rural outreach clinics and equity-focused prioritisation could improve access and reduce healthcare disparities for these populations. Further qualitative research is needed to explore patient perspectives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770055","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":"Sustaining Nursing Programs in Rural and Remote Australia Through UDRHs","authors":"Sabina Knight, Geoff Argus, Isabelle Skinner, James Debenham, Catrina Felton-Busch, Jessica Elliott, Kehinde Obamiro","doi":"10.1111/ajr.70129","DOIUrl":"10.1111/ajr.70129","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776624","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}
Luke Wakely, Claire Quilliam, Kerryn Bagley, Casey Stubbs, Jodie Bailie, Jo Spong, Clare McHugh, Natalie Ellis, Tony Fallon, Robyn Doney, Louise French, Josie Clarke, Carol McKinstry
Aims
This commentary highlights the development and impact of a rural disability research Community of Practice (CoP) within the University Department of Rural Health (UDRH) framework. It aims to demonstrate how privileging rural lived experience as a core qualification for research participation fosters inclusive, place-based inquiry that addresses the intersectional challenges faced by people with disabilities in rural Australia.
Context
People with disabilities in rural areas face compounded inequities due to geographic isolation, limited access to services and policy frameworks that remain metrocentric. Despite national and international efforts to promote inclusive disability policy, societal acceptance of the social model of disability has been slow. The UDRH programme, which embeds academic staff within rural communities, provides a unique platform for authentic engagement and research that reflects local realities.
Approach
In response to the need for coordinated, rural-led disability research, the ARHEN Rural Disability Research CoP was established in 2024. With 27 members across nine UDRHs and four states, the CoP operates through a flattened hierarchy and task-focused collaboration. It promotes co-designed research, peer support and advocacy, ensuring rural perspectives are embedded in national and international disability discourse.
Conclusion
The CoP exemplifies effective rural leadership in disability research, challenging metrocentric norms and amplifying rural voices. By prioritising lived experience and inclusive collaboration, it informs more responsive policy and strengthens rural research capacity. This model offers a pathway for equitable, community-driven inquiry and policy reform.
{"title":"Strengthening National Rural Disability Research Capacity Through a Community of Practice","authors":"Luke Wakely, Claire Quilliam, Kerryn Bagley, Casey Stubbs, Jodie Bailie, Jo Spong, Clare McHugh, Natalie Ellis, Tony Fallon, Robyn Doney, Louise French, Josie Clarke, Carol McKinstry","doi":"10.1111/ajr.70131","DOIUrl":"10.1111/ajr.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This commentary highlights the development and impact of a rural disability research Community of Practice (CoP) within the University Department of Rural Health (UDRH) framework. It aims to demonstrate how privileging rural lived experience as a core qualification for research participation fosters inclusive, place-based inquiry that addresses the intersectional challenges faced by people with disabilities in rural Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>People with disabilities in rural areas face compounded inequities due to geographic isolation, limited access to services and policy frameworks that remain metrocentric. Despite national and international efforts to promote inclusive disability policy, societal acceptance of the social model of disability has been slow. The UDRH programme, which embeds academic staff within rural communities, provides a unique platform for authentic engagement and research that reflects local realities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>In response to the need for coordinated, rural-led disability research, the ARHEN Rural Disability Research CoP was established in 2024. With 27 members across nine UDRHs and four states, the CoP operates through a flattened hierarchy and task-focused collaboration. It promotes co-designed research, peer support and advocacy, ensuring rural perspectives are embedded in national and international disability discourse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CoP exemplifies effective rural leadership in disability research, challenging metrocentric norms and amplifying rural voices. By prioritising lived experience and inclusive collaboration, it informs more responsive policy and strengthens rural research capacity. This model offers a pathway for equitable, community-driven inquiry and policy reform.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776566","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}
Elizabeth A. Johnston, Xanthia E. Bourdaniotis, Susannah K. Ayre, Hayley Fung, Nicole Craig, Fiona Crawford-Williams, Rebecca J. Bergin, Jon D. Emery, Raymond J. Chan, Belinda C. Goodwin
Objective
To identify facilitators and barriers to improving communication of survivorship care information to rural cancer survivors from the perspective of healthcare professionals.
Setting
Metropolitan and rural health services provide care to rural cancer survivors.
Participants
Healthcare professionals (n = 31), including cancer specialists, general practitioners, nurses, care coordinators and allied health practitioners.
Design
Qualitative descriptive study using semi-structured interviews to assess current practices for communicating survivorship care information, perspectives on how this information should be delivered and factors that may affect the implementation of a new method for delivering this information. Responses were categorised as a facilitator or barrier to improving information delivery. Barriers and facilitators were mapped to constructs of the Consolidated Framework for Implementation Research to identify the settings and contexts in which they occur.
Results
Facilitators included the evidence base and relative advantage of improving survivorship care information delivery to rural cancer survivors, indicating that healthcare professionals perceive this initiative as important and valuable. Participants also reported a tension for change (i.e., current practices for information delivery are not sustainable) and mission alignment, meaning improving survivorship information to rural cancer survivors is within participants' organisations' goals. Barriers included local conditions, policies and laws and financing, including challenges accessing support services in rural settings and limited funding for post-treatment care.
Conclusions
Guiding principles and suggested actions for improving survivorship care information delivery to rural cancer survivors are proposed, including strategies for minimising burden on healthcare teams, formalising transitional practices, streamlining referral pathways, partnering with community services and including family carers.
{"title":"What are the Facilitators and Barriers to Improving the Delivery of Survivorship Care Information to Rural Cancer Survivors? A Qualitative Study Using an Implementation Science Framework","authors":"Elizabeth A. Johnston, Xanthia E. Bourdaniotis, Susannah K. Ayre, Hayley Fung, Nicole Craig, Fiona Crawford-Williams, Rebecca J. Bergin, Jon D. Emery, Raymond J. Chan, Belinda C. Goodwin","doi":"10.1111/ajr.70125","DOIUrl":"10.1111/ajr.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify facilitators and barriers to improving communication of survivorship care information to rural cancer survivors from the perspective of healthcare professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Metropolitan and rural health services provide care to rural cancer survivors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Healthcare professionals (<i>n</i> = 31), including cancer specialists, general practitioners, nurses, care coordinators and allied health practitioners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative descriptive study using semi-structured interviews to assess current practices for communicating survivorship care information, perspectives on how this information should be delivered and factors that may affect the implementation of a new method for delivering this information. Responses were categorised as a facilitator or barrier to improving information delivery. Barriers and facilitators were mapped to <i>constructs</i> of the Consolidated Framework for Implementation Research to identify the settings and contexts in which they occur.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Facilitators included the <i>evidence base</i> and <i>relative advantage</i> of improving survivorship care information delivery to rural cancer survivors, indicating that healthcare professionals perceive this initiative as important and valuable. Participants also reported a <i>tension for change</i> (i.e., current practices for information delivery are not sustainable) and <i>mission alignment</i>, meaning improving survivorship information to rural cancer survivors is within participants' organisations' goals<i>.</i> Barriers included <i>local conditions, policies and laws</i> and <i>financing</i>, including challenges accessing support services in rural settings and limited funding for post-treatment care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Guiding principles and suggested actions for improving survivorship care information delivery to rural cancer survivors are proposed, including strategies for minimising burden on healthcare teams, formalising transitional practices, streamlining referral pathways, partnering with community services and including family carers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758469","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}
To summarise administrative and interview data relevant to the care of pregnant people with high BMI in rural British Columbia.
Methods
In this mixed methods analysis, we report administrative health data linked to maternal postal codes, to determine variations in rates of local births across BMI groups (n = 3247) and to examine associations between BMI and adverse maternal–newborn outcomes (n = 2527). Qualitative data from 169 healthcare providers and administrators at rural hospitals in BC were analyzed to understand rural providers’ experiences when caring for pregnant women with high BMI. Two clinical guidelines that were developed to improve care for women with obesity are presented, as examples of rural CQI initiatives.
Results
The proportion of local births decreased as BMI increased: 72.7% of those with normal BMI gave birth at rural hospitals compared to 34.9% with a BMI ≥ 40. For underweight, overweight, and obese women who gave birth at rural hospitals, the incidence of adverse perinatal outcomes was higher (IRR 1.85; 95% CI: 0.49–3.76, IRR = 1.19; 95% CI: 0.74–1.80; IRR = 1.81; 95% CI: 0.87–3.35), compared to those in the normal BMI range, but the associations were not significant. Healthcare providers also described challenges with maintaining quality and safety when caring for patients with high BMI in a low-volume rural setting and noted that a specialist ‘cookie cutter’ approach to managing and transferring people with high BMI was not practical in rural communities.
Discussion and Conclusion
Strategies that improve the care of pregnant women with high BMI must take into account the social risks incurred by birthers and families who leave the community alongside the clinical risks of remaining, with attention also given to the impact of adverse outcomes on health care providers. These processes must be underscored by engagement from regional referral specialists to ensure local providers are clinically supported and that there are efficient transfer pathways to higher levels of care should this be needed.
{"title":"‘I Am Not Going, So You're Doing It’: Management of Pregnant People With High BMI at Rural Hospitals in British Columbia: A Mixed Methods Analysis","authors":"Kathrin Stoll, Jude Kornelsen, Stephanie Lin, Christy Trafananko, Cecilia Jevitt","doi":"10.1111/ajr.70126","DOIUrl":"10.1111/ajr.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To summarise administrative and interview data relevant to the care of pregnant people with high BMI in rural British Columbia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this mixed methods analysis, we report administrative health data linked to maternal postal codes, to determine variations in rates of local births across BMI groups (<i>n</i> = 3247) and to examine associations between BMI and adverse maternal–newborn outcomes (<i>n</i> = 2527). Qualitative data from 169 healthcare providers and administrators at rural hospitals in BC were analyzed to understand rural providers’ experiences when caring for pregnant women with high BMI. Two clinical guidelines that were developed to improve care for women with obesity are presented, as examples of rural CQI initiatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The proportion of local births decreased as BMI increased: 72.7% of those with normal BMI gave birth at rural hospitals compared to 34.9% with a BMI ≥ 40. For underweight, overweight, and obese women who gave birth at rural hospitals, the incidence of adverse perinatal outcomes was higher (IRR 1.85; 95% CI: 0.49–3.76, IRR = 1.19; 95% CI: 0.74–1.80; IRR = 1.81; 95% CI: 0.87–3.35), compared to those in the normal BMI range, but the associations were not significant. Healthcare providers also described challenges with maintaining quality and safety when caring for patients with high BMI in a low-volume rural setting and noted that a specialist ‘cookie cutter’ approach to managing and transferring people with high BMI was not practical in rural communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>Strategies that improve the care of pregnant women with high BMI must take into account the social risks incurred by birthers and families who leave the community alongside the clinical risks of remaining, with attention also given to the impact of adverse outcomes on health care providers. These processes must be underscored by engagement from regional referral specialists to ensure local providers are clinically supported and that there are efficient transfer pathways to higher levels of care should this be needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764585","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}
Kelly McGrath, Lynda R. Matthews, Rob Heard, Nicola Hancock
<div> <section> <h3> Objective</h3> <p>This exploratory study sought to document compassion satisfaction, burnout and secondary traumatic stress in Australian rural and remote rehabilitation healthcare workers and compare the results with other professionals working in the Australian healthcare system who had previously completed the Professional Quality of Life Scale Version 5 (ProQOL5).</p> </section> <section> <h3> Design</h3> <p>We used a mixed methods approach, comprising a cross-sectional design and survey methodology with participants recruited via homogeneous purposive sampling. Data were collected using a web-based self-administered survey comprising demographic and work-related questions, ProQOL5 and open-response questions.</p> </section> <section> <h3> Setting</h3> <p>Rural and remote Australia where 28% of the population is spread across 99.3% of the country's eight million square kilometre landmass. These locations are sparsely populated, with the lowest number of health professionals relative to population size nationally.</p> </section> <section> <h3> Participants</h3> <p>Australian rural and remote rehabilitation healthcare workers that held membership with their professional body. They provide rehabilitation services to clients in workers' compensation, life insurance, the Australian National Disability Insurance Scheme (NDIS) and other rehabilitation settings in rural and remote Australia. Responses (<i>n</i> = 29) were included in the analysis; two were excluded due to non-completion of the survey. Most were female (86.2%), above 35 years old (76%), employed full-time (72.4%) and were rehabilitation counsellors (44.8%). Two-thirds were from Queensland and New South Wales (65.5%).</p> </section> <section> <h3> Main Outcome Measure(s)</h3> <p>Compassion satisfaction, burnout, secondary traumatic stress as measured by the ProQOL5. These outcome measures were reviewed in relation to demographic and workplace factors among rehabilitation healthcare professionals working in rural and remote Australia. Open-response questions were included in the survey to provide further context to the ProQOL5 results.</p> </section> <section> <h3> Results</h3> <p>Workplace and organisational factors were connected to compassion satisfaction and burnout outcomes, including work-life balance and workplace culture. When compared to other Australian healthcare worker groups, Australian rural and remote rehabilitation healthcare workers experienced significantly poorer compassio
{"title":"Levels of Compassion Satisfaction, Burnout and Secondary Traumatic Stress in Rehabilitation Healthcare Workers in Rural and Remote Australia and Their Associations With Demographic and Work-Related Variables","authors":"Kelly McGrath, Lynda R. Matthews, Rob Heard, Nicola Hancock","doi":"10.1111/ajr.70128","DOIUrl":"https://doi.org/10.1111/ajr.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This exploratory study sought to document compassion satisfaction, burnout and secondary traumatic stress in Australian rural and remote rehabilitation healthcare workers and compare the results with other professionals working in the Australian healthcare system who had previously completed the Professional Quality of Life Scale Version 5 (ProQOL5).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We used a mixed methods approach, comprising a cross-sectional design and survey methodology with participants recruited via homogeneous purposive sampling. Data were collected using a web-based self-administered survey comprising demographic and work-related questions, ProQOL5 and open-response questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural and remote Australia where 28% of the population is spread across 99.3% of the country's eight million square kilometre landmass. These locations are sparsely populated, with the lowest number of health professionals relative to population size nationally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Australian rural and remote rehabilitation healthcare workers that held membership with their professional body. They provide rehabilitation services to clients in workers' compensation, life insurance, the Australian National Disability Insurance Scheme (NDIS) and other rehabilitation settings in rural and remote Australia. Responses (<i>n</i> = 29) were included in the analysis; two were excluded due to non-completion of the survey. Most were female (86.2%), above 35 years old (76%), employed full-time (72.4%) and were rehabilitation counsellors (44.8%). Two-thirds were from Queensland and New South Wales (65.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure(s)</h3>\u0000 \u0000 <p>Compassion satisfaction, burnout, secondary traumatic stress as measured by the ProQOL5. These outcome measures were reviewed in relation to demographic and workplace factors among rehabilitation healthcare professionals working in rural and remote Australia. Open-response questions were included in the survey to provide further context to the ProQOL5 results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Workplace and organisational factors were connected to compassion satisfaction and burnout outcomes, including work-life balance and workplace culture. When compared to other Australian healthcare worker groups, Australian rural and remote rehabilitation healthcare workers experienced significantly poorer compassio","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739847","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}
Ruth Miriam Blank, Sebastiaan Paul Blank, Phuong Markman, Jennifer Hardman, Colin Urquhart, Janna Nathasja Hazelhoff, Richard Stone, James Sartain
Problem
Nerve blocks confer major benefits for patients with hip fractures, but the average time to surgery exceeds the duration of a single injection. We addressed this with an initiative to credential emergency department (ED) doctors and rural generalists to place fascia iliaca block catheters (FIBC), enabling ongoing analgesia until the time of surgery.
Setting
Cairns and Hinterland Hospital and Health Service, the major referral hospital for Far North Queensland.
Key Measures for Improvement
Proportion of hip fracture patients receiving an FIBC in ED or prior to interhospital transfer, time from arrival to block insertion, and complication rates.
Strategies for Change
Multidisciplinary initiative involving a formal training program and protocol for FIBC insertion, with ongoing follow-up by the acute pain service.
Effects of Change
ED doctors now place the majority of FIBC for our hospital, with a median time to block of 4.5 h compared to 13.2 h by anaesthetists (p < 0.001). Over 40% of patients from rural centres receive an FIBC before transfer. Complication rates were low and similar across specialties.
Lessons Learnt
FIBC insertion in ED and rural hospitals was feasible and safe after a simple training program. Multidisciplinary collaboration was essential to the success of the program.
{"title":"Emergency Department Fascia Iliaca Block Catheters: A Safe and Feasible Pathway to Hip Fracture Analgesia","authors":"Ruth Miriam Blank, Sebastiaan Paul Blank, Phuong Markman, Jennifer Hardman, Colin Urquhart, Janna Nathasja Hazelhoff, Richard Stone, James Sartain","doi":"10.1111/ajr.70124","DOIUrl":"10.1111/ajr.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Problem</h3>\u0000 \u0000 <p>Nerve blocks confer major benefits for patients with hip fractures, but the average time to surgery exceeds the duration of a single injection. We addressed this with an initiative to credential emergency department (ED) doctors and rural generalists to place fascia iliaca block catheters (FIBC), enabling ongoing analgesia until the time of surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Cairns and Hinterland Hospital and Health Service, the major referral hospital for Far North Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Measures for Improvement</h3>\u0000 \u0000 <p>Proportion of hip fracture patients receiving an FIBC in ED or prior to interhospital transfer, time from arrival to block insertion, and complication rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Strategies for Change</h3>\u0000 \u0000 <p>Multidisciplinary initiative involving a formal training program and protocol for FIBC insertion, with ongoing follow-up by the acute pain service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Effects of Change</h3>\u0000 \u0000 <p>ED doctors now place the majority of FIBC for our hospital, with a median time to block of 4.5 h compared to 13.2 h by anaesthetists (<i>p</i> < 0.001). Over 40% of patients from rural centres receive an FIBC before transfer. Complication rates were low and similar across specialties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Lessons Learnt</h3>\u0000 \u0000 <p>FIBC insertion in ED and rural hospitals was feasible and safe after a simple training program. Multidisciplinary collaboration was essential to the success of the program.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716985","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}
Leanne Hall, Clare Heal, Torres Woolley, Jane Harte, Aaron Hollins
Background
A balance of practical experience and theoretical knowledge is key in medical education, especially in underserved communities. The James Cook University medical curriculum includes rural and remote clinical placements to help prepare graduates to better meet local community healthcare needs.
Objective
To compare medical student learning experiences between rural and remote clinical placements in Years 4 and 6.
Methods
Post-placement surveys were administered to fourth-year (MBBS4) (2016–2023) and sixth-year (MBBS6) students (2021–2023) to assess the quality of rural and remote placements. Student ratings of clinical supervision and learning experiences were collected using a 5-point Likert scale. Placement locations were categorized into “Rural” (MM4 and MM5) and “Remote” (MM6 and MM7) and responses collapsed into “Agree” and “Disagree” for analysis. Chi-square and Fisher's exact tests were used to compare ratings between locations.
Results
A total of 558 MBBS4 and 95 MBBS6 students completed the survey, with 46.6% and 47.4% from rural placements respectively. Survey response rates were higher for the Remote group in both year levels. There were no differences in student ratings between rural and remote placements for any survey item for either year level.
Conclusion
There was no difference in student satisfaction between rural and remote placements suggesting both provide meaningful clinical learning experiences.
{"title":"Equivalence in Student Perceptions: A Study of Rural and Remote Medical Placements","authors":"Leanne Hall, Clare Heal, Torres Woolley, Jane Harte, Aaron Hollins","doi":"10.1111/ajr.70122","DOIUrl":"10.1111/ajr.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A balance of practical experience and theoretical knowledge is key in medical education, especially in underserved communities. The James Cook University medical curriculum includes rural and remote clinical placements to help prepare graduates to better meet local community healthcare needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare medical student learning experiences between rural and remote clinical placements in Years 4 and 6.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Post-placement surveys were administered to fourth-year (MBBS4) (2016–2023) and sixth-year (MBBS6) students (2021–2023) to assess the quality of rural and remote placements. Student ratings of clinical supervision and learning experiences were collected using a 5-point Likert scale. Placement locations were categorized into “Rural” (MM4 and MM5) and “Remote” (MM6 and MM7) and responses collapsed into “Agree” and “Disagree” for analysis. Chi-square and Fisher's exact tests were used to compare ratings between locations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 558 MBBS4 and 95 MBBS6 students completed the survey, with 46.6% and 47.4% from rural placements respectively. Survey response rates were higher for the Remote group in both year levels. There were no differences in student ratings between rural and remote placements for any survey item for either year level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was no difference in student satisfaction between rural and remote placements suggesting both provide meaningful clinical learning experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727157","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}
Domenico Barbaro, Alasdair Leslie, Brandon Stretton, Stephen Bacchi
{"title":"Unlocking the Potential of Virtual Cardiac Rehabilitation to Improve Rural and Remote Cardiovascular Care in Australia","authors":"Domenico Barbaro, Alasdair Leslie, Brandon Stretton, Stephen Bacchi","doi":"10.1111/ajr.70123","DOIUrl":"10.1111/ajr.70123","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727174","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}
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