Alexandra Gregory BAPsych(Hons), Kayli Wild PhD, Danielle Aquino MPH, Gary Robinson PhD
Objective
The client–practitioner relationship is the cornerstone of nurse home-visiting programs. Little is understood about how relationship-based maternal and early childhood health care is perceived by women in remote Aboriginal communities. As part of an evaluation of nurse home-visiting in the Northern Territory, this research examines how relationships are established with clients, and what elements are valued most by women.
Setting
Maternal Early Childhood Sustained Home-visiting (MECSH) is an Australian model of nurse-led home-visiting targeted at women facing adversity who need extra support. The model provides parenting information, health education and psychosocial support during pregnancy and the first 3 years of children's development.
Participants
Interviews were conducted with 92 Aboriginal women and 11 practitioners including nurses, social workers and community workers.
Design
Qualitative semi-structured interviews were conducted with convenience samples of MECSH clients and practitioners. Data were analysed using a two-step process of structural coding and thematic analysis.
Results
Trust was the foundation of clients' positive perception of the relationship with their MECSH provider. Relationships took time to develop, often beginning with practical support to meet clients' basic needs. Practitioner dependability and flexibility to client priorities, communication, confidentiality and being helpful to the woman and her family was important. Clients emphasised emotional support and friendship.
Conclusion
The relationship-based approach was valued and consistent with culturally safe and trauma informed ways of working with Aboriginal families. Effort is required to commit to the model to address ongoing healthcare engagement and health outcomes in remote Northern Territory communities.
{"title":"‘They got my back’: Thematic analysis of relationship building in nurse home visiting in Aboriginal communities","authors":"Alexandra Gregory BAPsych(Hons), Kayli Wild PhD, Danielle Aquino MPH, Gary Robinson PhD","doi":"10.1111/ajr.13199","DOIUrl":"10.1111/ajr.13199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The client–practitioner relationship is the cornerstone of nurse home-visiting programs. Little is understood about how relationship-based maternal and early childhood health care is perceived by women in remote Aboriginal communities. As part of an evaluation of nurse home-visiting in the Northern Territory, this research examines how relationships are established with clients, and what elements are valued most by women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Maternal Early Childhood Sustained Home-visiting (MECSH) is an Australian model of nurse-led home-visiting targeted at women facing adversity who need extra support. The model provides parenting information, health education and psychosocial support during pregnancy and the first 3 years of children's development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Interviews were conducted with 92 Aboriginal women and 11 practitioners including nurses, social workers and community workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative semi-structured interviews were conducted with convenience samples of MECSH clients and practitioners. Data were analysed using a two-step process of structural coding and thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Trust was the foundation of clients' positive perception of the relationship with their MECSH provider. Relationships took time to develop, often beginning with practical support to meet clients' basic needs. Practitioner dependability and flexibility to client priorities, communication, confidentiality and being helpful to the woman and her family was important. Clients emphasised emotional support and friendship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The relationship-based approach was valued and consistent with culturally safe and trauma informed ways of working with Aboriginal families. Effort is required to commit to the model to address ongoing healthcare engagement and health outcomes in remote Northern Territory communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1227-1238"},"PeriodicalIF":1.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633087","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}
Mohamed Naqeeb, Gavin J. Carmichael MD, Helena Kyriazopoulos, Hanaa' Grave, Vasiliki Arachi LLB, LLM, Joshua G. Kovoor MBBS, David R. Tivey Bsc (Hons), PhD
{"title":"The 7Cs to reduce dental hesitancy for culturally and linguistically diverse rural Australians","authors":"Mohamed Naqeeb, Gavin J. Carmichael MD, Helena Kyriazopoulos, Hanaa' Grave, Vasiliki Arachi LLB, LLM, Joshua G. Kovoor MBBS, David R. Tivey Bsc (Hons), PhD","doi":"10.1111/ajr.13194","DOIUrl":"10.1111/ajr.13194","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1256-1257"},"PeriodicalIF":1.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633073","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}
Sue Lenthall PhD, Sabina Knight MTH, Colin Watson PhD, Lyn Byers MNP, Fiona Cameron MPH, John Wright MRHP, Sally West MN, Roianne West PhD, Madeline Ford MN, Stuart Mobsby MNP, Katie Pennington MPH, Oluwatobi Ajayi MN
Aim
The aim of this revision was to update the Remote Area Nurse (RAN) Model of Consultation (MoC) and was prompted by publication of the National Rural and Remote Nursing Generalist Framework (2013–2018), shifts in RAN workforce patterns, community health patterns and technology use.
Context
Rural and remote residents face higher rates of hospitalisations, deaths and poorer access to health care with a significant burden of avoidable fatal conditions among Aboriginal and Torres Strait Islander peoples. Health care is mostly provided by RANs and Aboriginal and Torres Strait Islander Health Practitioners (ATSIHPs), addressing diverse health needs, a mobile population and navigating cross-cultural situations. Despite challenges such as clinician shortages, RANs manage a significant portion of non-emergency consultations. The RAN MoC was developed to ensure comprehensive, systematic and person-centred care and to mitigate risk to the client, the nurse and the health service.
Approach
The 11 expert panel members, all authors, revised the RAN MoC through a series of Microsoft Teams meetings, one face-to-face meeting and an exchange of emails. The principles were reorganised under the four domains of the National Rural and Remote Nursing Generalist Framework and mapped against the National Safety and Quality Primary and Community Health Care Standards.
Conclusion
The revised RAN MoC is designed to provide evidence based culturally informed care, standardise RAN consultation best practice and improve the health outcomes of their clients. With the increased turnover and number of nurses ‘new’ to remote, more innovative approaches to education and dissemination of the model is necessary.
目的：本次修订的目的是更新偏远地区护士（RAN）咨询模式（MoC），其推动因素包括国家农村和偏远地区护理通才框架（2013-2018年）的发布、偏远地区护士劳动力模式的转变、社区卫生模式和技术使用：背景：农村和偏远地区居民的住院率、死亡率较高，获得医疗保健的机会较少，土著居民和托雷斯海峡岛民中可避免的致命疾病负担沉重。医疗保健服务主要由区域医疗网络（RANs）和土著居民及托雷斯海峡岛民医疗从业人员（ATSIHPs）提供，以满足不同的医疗保健需求、解决流动人口问题并应对跨文化环境。尽管面临临床医生短缺等挑战，但区域医疗网络管理着很大一部分非急诊咨询。制定《区域网络医疗服务指南》的目的是确保提供全面、系统和以人为本的医疗服务，并降低客户、护士和医疗服务的风险：11 位专家组成员（均为作者）通过一系列 Microsoft Teams 会议、一次面对面会议和一次电子邮件交流，修订了《急诊护理原则》。这些原则在国家农村和偏远地区护理通才框架的四个领域下进行了重组，并与国家初级和社区医疗安全与质量标准进行了对照：修订后的 "农村和偏远地区护理标准 "旨在提供以证据为基础的文化知情护理、规范农村和偏远地区咨询最佳做法并改善客户的健康状况。随着护士流动率的增加和 "新 "到偏远地区的护士人数的增加，有必要采取更多创新方法来教育和传播该模式。
{"title":"The revised remote area nurse model of consultation","authors":"Sue Lenthall PhD, Sabina Knight MTH, Colin Watson PhD, Lyn Byers MNP, Fiona Cameron MPH, John Wright MRHP, Sally West MN, Roianne West PhD, Madeline Ford MN, Stuart Mobsby MNP, Katie Pennington MPH, Oluwatobi Ajayi MN","doi":"10.1111/ajr.13195","DOIUrl":"10.1111/ajr.13195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this revision was to update the Remote Area Nurse (RAN) Model of Consultation (MoC) and was prompted by publication of the National Rural and Remote Nursing Generalist Framework (2013–2018), shifts in RAN workforce patterns, community health patterns and technology use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Rural and remote residents face higher rates of hospitalisations, deaths and poorer access to health care with a significant burden of avoidable fatal conditions among Aboriginal and Torres Strait Islander peoples. Health care is mostly provided by RANs and Aboriginal and Torres Strait Islander Health Practitioners (ATSIHPs), addressing diverse health needs, a mobile population and navigating cross-cultural situations. Despite challenges such as clinician shortages, RANs manage a significant portion of non-emergency consultations. The RAN MoC was developed to ensure comprehensive, systematic and person-centred care and to mitigate risk to the client, the nurse and the health service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>The 11 expert panel members, all authors, revised the RAN MoC through a series of Microsoft Teams meetings, one face-to-face meeting and an exchange of emails. The principles were reorganised under the four domains of the National Rural and Remote Nursing Generalist Framework and mapped against the National Safety and Quality Primary and Community Health Care Standards.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The revised RAN MoC is designed to provide evidence based culturally informed care, standardise RAN consultation best practice and improve the health outcomes of their clients. With the increased turnover and number of nurses ‘new’ to remote, more innovative approaches to education and dissemination of the model is necessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1246-1255"},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11640197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607535","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}
Torres Webb Grad. Cert. Rural Leadership, Kathryn Meldrum PhD, Chenoa Wapau Cert. 4 Aboriginal and Torres Strait Islander Primary Health Care, Betty Sagigi Cert 4. Aboriginal and Torres Strait Islander Primary Health Care, Rachel Quigley M Phil, Edward Strivens MBBS, Sarah Russell PhD
Objective
This study was the first phase of a broader project designed to develop a new tool to screen social and emotional well-being (SEWB). Its objective was to identify words used by First Nations people living in the Torres Strait (Zenadth Kes) and Northern Peninsula Area (NPA) to describe and discuss SEWB. We pay our respects to Elders past and present. We acknowledge the First Nations peoples who took part in this project as holders of their cultural knowledge now and forevermore.
Setting
This study took place in community and primary health care settings located on islands of the Torres Strait and NPA of Australia.
Participants
Twelve yarns with 35 community members and health professionals were led by Torres Strait Islander members of the project team between August and December 2022.
Design
This study employed a descriptive qualitative design. Yarning, an Australian First Nations relational method, was used to share stories about SEWB. All but one yarn was audio recorded and subsequently professionally transcribed. Inductive thematic analysis was used to analyse the yarns.
Results
Worry, sad and stress were the words most often used by participants to describe feelings of low SEWB. Signs of low SEWB included behaviour change, particularly significantly reduced community engagement.
Conclusions
Worry is not a word that is used in Australian mainstream tools that screen for psychological distress. Findings of this study indicate that a question that asks about worries should be included when screening for low SEWB in Australian First Nations peoples living in the Torres Strait and NPA.
{"title":"How First Nations peoples living in the Torres Strait and Northern Peninsula Area describe and discuss social and emotional well-being","authors":"Torres Webb Grad. Cert. Rural Leadership, Kathryn Meldrum PhD, Chenoa Wapau Cert. 4 Aboriginal and Torres Strait Islander Primary Health Care, Betty Sagigi Cert 4. Aboriginal and Torres Strait Islander Primary Health Care, Rachel Quigley M Phil, Edward Strivens MBBS, Sarah Russell PhD","doi":"10.1111/ajr.13196","DOIUrl":"10.1111/ajr.13196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study was the first phase of a broader project designed to develop a new tool to screen social and emotional well-being (SEWB). Its objective was to identify words used by First Nations people living in the Torres Strait (Zenadth Kes) and Northern Peninsula Area (NPA) to describe and discuss SEWB. We pay our respects to Elders past and present. We acknowledge the First Nations peoples who took part in this project as holders of their cultural knowledge now and forevermore.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>This study took place in community and primary health care settings located on islands of the Torres Strait and NPA of Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Twelve yarns with 35 community members and health professionals were led by Torres Strait Islander members of the project team between August and December 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This study employed a descriptive qualitative design. Yarning, an Australian First Nations relational method, was used to share stories about SEWB. All but one yarn was audio recorded and subsequently professionally transcribed. Inductive thematic analysis was used to analyse the yarns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Worry, sad and stress were the words most often used by participants to describe feelings of low SEWB. Signs of low SEWB included behaviour change, particularly significantly reduced community engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Worry is not a word that is used in Australian mainstream tools that screen for psychological distress. Findings of this study indicate that a question that asks about worries should be included when screening for low SEWB in Australian First Nations peoples living in the Torres Strait and NPA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1216-1226"},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584975","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}
Bróna Nic Giolla Easpaig PhD, Melissa A Lindeman PhD, Penny Watson MA, Xianliang Liu PhD
<div> <section> <h3> Introduction</h3> <p>Growing the mental health peer workforce holds promise for rural communities, but we currently lack an understanding of the guidance available to support the development, implementation and sustainability of this workforce in rural settings.</p> </section> <section> <h3> Objective</h3> <p>Study aims are to: (1) determine the extent and nature of the literature that provides guidance for growing the peer workforce in rural mental health services; and (2) identify and explore any guidance relevant to rural peer work services dedicated to First Nations communities, including those promoting social and emotional well-being within this body of literature.</p> </section> <section> <h3> Design</h3> <p>A scoping review method was employed to identify relevant peer-reviewed and grey literature published between 2013 and 2022 across PsychInfo, Medline, Embase and CINAHL, Scopus and Informit HealthInfoNet databases, as well as targeted organisation websites and Google Advanced Search.</p> </section> <section> <h3> Findings</h3> <p>A total of 26 unique studies/projects were included from the US, UK, Canada and Australia with public mental health, non-government/for purpose and private sector service settings represented in the literature. Grey literature, such as reports of evaluations and frameworks, formed the majority of included texts. While there is a lesser volume of rurally focused literature relative to the general peer work literature, this is a rich body of knowledge, which includes guidance concerning services dedicated to First Nations communities. Via synthesis critical considerations were identified for the development, implementation and sustainability of peer work in rural mental health services across six domains: ‘Working with community members and stakeholders’, ‘Organisational culture and governance’, Working with others and in teams, Professional expertise and experience, Being part of and working in the community and ‘Local mental health services capacity’.</p> </section> <section> <h3> Discussion</h3> <p>While there are considerations relevant across a range of settings, the domains of: ‘working with community members and stakeholders’, ‘being part of and working in the community’ and ‘local mental health services capacity’, capture additional, distinct and nuanced challenges and opportunities for growing the peer work in rural services.</p> </section> <sec
{"title":"Growing the peer workforce in rural mental health and social and emotional well-being services: A scoping review of the literature","authors":"Bróna Nic Giolla Easpaig PhD, Melissa A Lindeman PhD, Penny Watson MA, Xianliang Liu PhD","doi":"10.1111/ajr.13192","DOIUrl":"10.1111/ajr.13192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Growing the mental health peer workforce holds promise for rural communities, but we currently lack an understanding of the guidance available to support the development, implementation and sustainability of this workforce in rural settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Study aims are to: (1) determine the extent and nature of the literature that provides guidance for growing the peer workforce in rural mental health services; and (2) identify and explore any guidance relevant to rural peer work services dedicated to First Nations communities, including those promoting social and emotional well-being within this body of literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A scoping review method was employed to identify relevant peer-reviewed and grey literature published between 2013 and 2022 across PsychInfo, Medline, Embase and CINAHL, Scopus and Informit HealthInfoNet databases, as well as targeted organisation websites and Google Advanced Search.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A total of 26 unique studies/projects were included from the US, UK, Canada and Australia with public mental health, non-government/for purpose and private sector service settings represented in the literature. Grey literature, such as reports of evaluations and frameworks, formed the majority of included texts. While there is a lesser volume of rurally focused literature relative to the general peer work literature, this is a rich body of knowledge, which includes guidance concerning services dedicated to First Nations communities. Via synthesis critical considerations were identified for the development, implementation and sustainability of peer work in rural mental health services across six domains: ‘Working with community members and stakeholders’, ‘Organisational culture and governance’, Working with others and in teams, Professional expertise and experience, Being part of and working in the community and ‘Local mental health services capacity’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>While there are considerations relevant across a range of settings, the domains of: ‘working with community members and stakeholders’, ‘being part of and working in the community’ and ‘local mental health services capacity’, capture additional, distinct and nuanced challenges and opportunities for growing the peer work in rural services.</p>\u0000 </section>\u0000 \u0000 <sec","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1118-1139"},"PeriodicalIF":1.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11640200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481590","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}
The objective of this study was to determine what professional factors impact the retention of pathology workers in regional, rural and remote Australia.
Design
A cross-sectional survey was used to collect data regarding the professional factors that impact the retention of regional, rural and remote pathology workers in Australia (n = 95). The survey focused on pathology workers’ satisfaction with specific professional factors and how long they intended to stay in their current position.
Setting
Regional, rural and remote (MM2-7) pathology laboratories in Australia.
Participants
There were a total of 95 participants, including 24 phlebotomists/laboratory assistants, 34 medical laboratory scientists and 29 supervisors/managers, with the majority of participants being from New South Wales, Queensland and Western Australia.
Results
Significant positive associations were found between satisfaction with career advancement opportunities, workplace culture and maintaining professional skills with the retention of regional, rural and remote pathology workers. Open-ended responses indicated that personal factors also played an important role in pathology worker retention in regional, rural and remote communities.
Conclusion
This study provides important insights into the professional factors that impact the retention of pathology workers in regional, rural and remote Australia. Personal factors were also found to play an important role in retention. These findings have highlighted the need for further research to be conducted to explore the relationship between professional and personal factors and how this impacts the retention of pathology workers in regional, rural and remote Australia.
{"title":"Understanding the professional factors that impact the retention of pathology workers in regional, rural and remote Australia","authors":"Kirrily Werth MHSM, Tiana Gurney PhD","doi":"10.1111/ajr.13191","DOIUrl":"10.1111/ajr.13191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to determine what professional factors impact the retention of pathology workers in regional, rural and remote Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A cross-sectional survey was used to collect data regarding the professional factors that impact the retention of regional, rural and remote pathology workers in Australia (<i>n</i> = 95). The survey focused on pathology workers’ satisfaction with specific professional factors and how long they intended to stay in their current position.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Regional, rural and remote (MM2-7) pathology laboratories in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>There were a total of 95 participants, including 24 phlebotomists/laboratory assistants, 34 medical laboratory scientists and 29 supervisors/managers, with the majority of participants being from New South Wales, Queensland and Western Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant positive associations were found between satisfaction with career advancement opportunities, workplace culture and maintaining professional skills with the retention of regional, rural and remote pathology workers. Open-ended responses indicated that personal factors also played an important role in pathology worker retention in regional, rural and remote communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides important insights into the professional factors that impact the retention of pathology workers in regional, rural and remote Australia. Personal factors were also found to play an important role in retention. These findings have highlighted the need for further research to be conducted to explore the relationship between professional and personal factors and how this impacts the retention of pathology workers in regional, rural and remote Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1185-1199"},"PeriodicalIF":1.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11640206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481591","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}
Angela Jackson MNursSci, Chris Hawkins M Hlth Sci, Theona Stone MNursSci, Petra Anderson MNursSci, Frances Wilesmith MNursSci, Mark Little FACEM
Objectives
There is very little literature examining the workload and impact of nurse practitioners (NPs) working in emergency departments (ED) in regional and rural Australia. The aim of this paper was to review the ED NPs scope of practice in the ED discharge stream and patient outcomes at Cairns Hospital over a 7-month period.
Methods
This retrospective study examined the ED electronic medical record between 14 May 2019 and 31 December 2019. Cases managed by ED NPs, referrals, procedures performed, representations and disposition data were collected. Adverse events were sought from the Qld Health adverse events register (Riskman), the department complaints register and the ED M&M meeting minutes.
Results
A total of 1443 patients were treated by NPs, with ages ranging from 0 to 98 years (median 40 years). Australasian Triage Score (ATS) 3 cases made up 30% of the workload. Other than ATS 3 cases, time to being seen was better than the general department. There were very few unexpected representations, complaints or adverse events.
Conclusions
This study supports the view that NPs working in a regional emergency department can safely manage a variety of patients outside a fast-track model, with a wide age range and a variety of triage categories and diagnoses. We believe this has important implications for the provision of emergency care, especially in regional and rural Australia.
{"title":"Evaluation of nurse practitioners' extended scope of practice in a regional hospital emergency department in tropical Australia","authors":"Angela Jackson MNursSci, Chris Hawkins M Hlth Sci, Theona Stone MNursSci, Petra Anderson MNursSci, Frances Wilesmith MNursSci, Mark Little FACEM","doi":"10.1111/ajr.13190","DOIUrl":"10.1111/ajr.13190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>There is very little literature examining the workload and impact of nurse practitioners (NPs) working in emergency departments (ED) in regional and rural Australia. The aim of this paper was to review the ED NPs scope of practice in the ED discharge stream and patient outcomes at Cairns Hospital over a 7-month period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study examined the ED electronic medical record between 14 May 2019 and 31 December 2019. Cases managed by ED NPs, referrals, procedures performed, representations and disposition data were collected. Adverse events were sought from the Qld Health adverse events register (Riskman), the department complaints register and the ED M&M meeting minutes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1443 patients were treated by NPs, with ages ranging from 0 to 98 years (median 40 years). Australasian Triage Score (ATS) 3 cases made up 30% of the workload. Other than ATS 3 cases, time to being seen was better than the general department. There were very few unexpected representations, complaints or adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study supports the view that NPs working in a regional emergency department can safely manage a variety of patients outside a fast-track model, with a wide age range and a variety of triage categories and diagnoses. We believe this has important implications for the provision of emergency care, especially in regional and rural Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1200-1206"},"PeriodicalIF":1.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395522","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}
<p>The Australian primary care system is currently in the storm of several government reviews which could reform the way primary care is delivered in the future.</p><p>In the Primary Care Division of the Department of Health and Aged Care, reviews are examining general practice incentives and after-hours primary care policies and programs. In Health Workforce Division, two significant reviews underway are the Scope of Practice Review examining the barriers and incentives health practitioners face working to their full scope of practice in primary care. There is also the Working Better for Medicare Review which has examined workforce distribution levers and how this impacts the distribution of health professionals to rural locations examining such factors as Monash Modified Model; Districts of Workforce Shortage; Distribution Priority Areas and use of Sections 19AA and 19AB of the <i>Health Insurance Act</i> 1973, which outline the geographic locations where doctors are allowed to use Medicare based on their level of training in Australia or overseas. This is in addition to various reviews and introduction of legislation for the aged care and disability sectors which also impact rural service delivery.</p><p>All the reviews are in their concluding phases with a suite of recommendations being put on the table for government to consider. We all know something needs to be done, in particular, for rural, remote and regional Australia. No doubt there will be some significant changes, because of these reviews and there does seem to be an optimistic feeling in the air that the primary care sector is ready to act. However, even in the optimist camp, there is a sense that change will need to be ‘changed managed’ and if it needs to be ‘change managed’ the change will need to be scheduled over a period of time. In fact, the GP Incentives Consultation paper which is in line with the Government's <b>Primary Health Care 10 Year Plan 2022–2032</b><span><sup>1</sup></span> anticipates changes over the best part of the next decade (up to 2032). Given the extent of the recommendations proposed, it is no doubt realistic, that significant change is not going to be in the short term.</p><p>There is one other major policy and funding piece that has the potential to lead on reforming how health, and importantly primary care, can be supported in rural communities.</p><p><b>The National Health Reform Agreement (NHRA)</b> is an agreement between the Australian Government and all state and territory governments and through this agreement, the Australian Government contributes funds to the states and territories for public hospital services. This includes services delivered through emergency departments, hospitals and community health settings.</p><p>To date there has only been limited scope in these agreements for innovation particularly in the area of primary health care. The current NRHA covers the period 2020–2025. A mid-term review of this current set of agreements was
{"title":"Real change for primary care is likely to be dependent on the next National Health Reform Agreement","authors":"Margaret Deerain BBus (Mgmt), MLitt, MLS","doi":"10.1111/ajr.13193","DOIUrl":"https://doi.org/10.1111/ajr.13193","url":null,"abstract":"<p>The Australian primary care system is currently in the storm of several government reviews which could reform the way primary care is delivered in the future.</p><p>In the Primary Care Division of the Department of Health and Aged Care, reviews are examining general practice incentives and after-hours primary care policies and programs. In Health Workforce Division, two significant reviews underway are the Scope of Practice Review examining the barriers and incentives health practitioners face working to their full scope of practice in primary care. There is also the Working Better for Medicare Review which has examined workforce distribution levers and how this impacts the distribution of health professionals to rural locations examining such factors as Monash Modified Model; Districts of Workforce Shortage; Distribution Priority Areas and use of Sections 19AA and 19AB of the <i>Health Insurance Act</i> 1973, which outline the geographic locations where doctors are allowed to use Medicare based on their level of training in Australia or overseas. This is in addition to various reviews and introduction of legislation for the aged care and disability sectors which also impact rural service delivery.</p><p>All the reviews are in their concluding phases with a suite of recommendations being put on the table for government to consider. We all know something needs to be done, in particular, for rural, remote and regional Australia. No doubt there will be some significant changes, because of these reviews and there does seem to be an optimistic feeling in the air that the primary care sector is ready to act. However, even in the optimist camp, there is a sense that change will need to be ‘changed managed’ and if it needs to be ‘change managed’ the change will need to be scheduled over a period of time. In fact, the GP Incentives Consultation paper which is in line with the Government's <b>Primary Health Care 10 Year Plan 2022–2032</b><span><sup>1</sup></span> anticipates changes over the best part of the next decade (up to 2032). Given the extent of the recommendations proposed, it is no doubt realistic, that significant change is not going to be in the short term.</p><p>There is one other major policy and funding piece that has the potential to lead on reforming how health, and importantly primary care, can be supported in rural communities.</p><p><b>The National Health Reform Agreement (NHRA)</b> is an agreement between the Australian Government and all state and territory governments and through this agreement, the Australian Government contributes funds to the states and territories for public hospital services. This includes services delivered through emergency departments, hospitals and community health settings.</p><p>To date there has only been limited scope in these agreements for innovation particularly in the area of primary health care. The current NRHA covers the period 2020–2025. A mid-term review of this current set of agreements was ","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 5","pages":"861-863"},"PeriodicalIF":1.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142429092","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}
Sylvia Ai MMed, Amarinder Thind PhD, Gurdeep Parmar MD
Objective
The objective of this study is to determine if there are differences in outcome for patients diagnosed with multiple myeloma in a rural setting compared to a metropolitan setting and which factors influence these outcomes.
Design
Retrospective cohort study.
Setting
Illawarra Shoalhaven Local Health District.
Participants
A total of 391 patients diagnosed with multiple myeloma between 2000 and 2022.
Main outcome measures
Treatment and survival outcomes of these patients.
Results
Patients being treated in a rural cancer care centre had lower overall survival compared to those treated at a metropolitan cancer care centre (median OS = 44.4 months vs. 80.2 months, p = 0.002), despite access to similar treatments by the same group of haematologists. There was a significantly higher rate of upfront autologous transplantation (38% vs. 20%, p = 0.001) and higher rate of inclusion in clinical trials (16% vs. 7%, p = 0.021) in patients treated at a metropolitan cancer care centre compared to the rural cancer care centre.
Conclusions
Multiple myeloma patients treated at a rural centre had shorter survival compared to patients treated at a metropolitan centre, and this may be related to lower rates of autologous transplantation and inclusion in clinical trials.
研究目的本研究的目的是确定在农村地区确诊的多发性骨髓瘤患者的预后与大都市相比是否存在差异，以及哪些因素会影响这些预后：设计：回顾性队列研究：伊拉瓦拉肖尔黑文地方卫生区：2000年至2022年期间被诊断为多发性骨髓瘤的391名患者：这些患者的治疗和生存结果：结果：与在大都市癌症治疗中心接受治疗的患者相比，在农村癌症治疗中心接受治疗的患者总生存期较低（中位OS = 44.4个月 vs. 80.2个月，p = 0.002），尽管同一组血液学专家提供了类似的治疗。与农村癌症治疗中心相比，在大都市癌症治疗中心接受治疗的患者接受前期自体移植的比例明显更高（38%对20%，p=0.001），纳入临床试验的比例也更高（16%对7%，p=0.021）：结论：在农村中心接受治疗的多发性骨髓瘤患者的生存期比在大都市中心接受治疗的患者短，这可能与自体移植率和临床试验纳入率较低有关。
{"title":"Differences in survival of patients with multiple myeloma in rural versus metropolitan regions: Analysis of population data of an Australian local health district","authors":"Sylvia Ai MMed, Amarinder Thind PhD, Gurdeep Parmar MD","doi":"10.1111/ajr.13189","DOIUrl":"10.1111/ajr.13189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to determine if there are differences in outcome for patients diagnosed with multiple myeloma in a rural setting compared to a metropolitan setting and which factors influence these outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Illawarra Shoalhaven Local Health District.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participant<b>s</b></h3>\u0000 \u0000 <p>A total of 391 patients diagnosed with multiple myeloma between 2000 and 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>Treatment and survival outcomes of these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients being treated in a rural cancer care centre had lower overall survival compared to those treated at a metropolitan cancer care centre (median OS = 44.4 months vs. 80.2 months, <i>p</i> = 0.002), despite access to similar treatments by the same group of haematologists. There was a significantly higher rate of upfront autologous transplantation (38% vs. 20%, <i>p</i> = 0.001) and higher rate of inclusion in clinical trials (16% vs. 7%, <i>p</i> = 0.021) in patients treated at a metropolitan cancer care centre compared to the rural cancer care centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Multiple myeloma patients treated at a rural centre had shorter survival compared to patients treated at a metropolitan centre, and this may be related to lower rates of autologous transplantation and inclusion in clinical trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1207-1215"},"PeriodicalIF":1.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373634","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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