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Features of culturally and linguistically relevant speech-language assessments for Indigenous children: A scoping review 针对土著儿童的与文化和语言相关的言语-语言评估的特点:范围综述。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-09-29 DOI: 10.1111/ajr.13188
Zoe E. Higgins MHSc, Pascal Lefebvre PhD

Introduction

Indigenous children may be at higher risk of being misdiagnosed with speech-language difficulties due to Eurocentric practices in health care and education. The use of conventional speech pathology assessment practices contributes to inappropriate disorder identification, further stigmatising a vulnerable population. Few resources are available for speech pathologists, which examine the cultural and linguistic relevance of assessments for this population.

Objective

To provide important features for speech pathologists to account for when building assessment plans for Indigenous children.

Design

This comprehensive scoping literature review was completed using the Arksey and O'Malley 6-step methodological framework, including the optional consultation exercise, and reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. To be included, studies needed to have been published since 2000, discuss speech-language assessments and involve a significant proportion of Indigenous participants under 7 years old.

Findings

Three features were extracted from 32 studies that discussed First Nations, Métis, Inuit, Native American, Aboriginal and Torres Strait Islander communities: using a battery of resources including alternative approaches, ensuring authenticity and cultural relevance, and considering a child's linguistic characteristics.

Conclusion

While there remains a need to adapt according to a specific child's reality, this study provides a guideline for all allied health clinicians when they are building their culturally and linguistically relevant assessment plans.

导言:由于医疗保健和教育中的欧洲中心主义做法,土著儿童被误诊为有语言障碍的风险可能更高。使用传统的言语病理学评估方法会导致不恰当的障碍识别,进一步诋毁弱势人群。为语言病理学家提供的资源很少,这些资源研究了对这一人群进行评估时的文化和语言相关性:为语言病理学家提供为土著儿童制定评估计划时应考虑的重要特征:本综合范围文献综述采用 Arksey 和 O'Malley 的 6 步方法框架(包括可选的咨询练习)完成,并采用范围综述的系统综述和元分析扩展首选报告项目 (PRISMA-ScR) 指南进行报告。纳入的研究必须是 2000 年以来发表的,讨论过言语评估,并有相当一部分 7 岁以下的土著参与者:从 32 项讨论原住民、梅蒂斯人、因努伊特人、美洲原住民、土著居民和托雷斯海峡岛民社区的研究中总结出三个特点:使用包括替代方法在内的一系列资源,确保真实性和文化相关性,以及考虑儿童的语言特点:虽然仍需根据具体儿童的实际情况进行调整,但本研究为所有专职医疗临床医生在制定文化和语言相关评估计划时提供了指导。
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引用次数: 0
The role of the play therapist in supporting children and families following a natural disaster: A scoping review 游戏治疗师在支持自然灾害后的儿童和家庭中的作用:范围综述。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-09-21 DOI: 10.1111/ajr.13186
Nicole Nilsson MCPT, Natalie Hadiprodjo PhD, Judi Parson PhD

Background

The predicted rise in weather-related disasters indicates that many Australian children and their families will be affected by these events in the future. Play therapy, an emerging profession in Australia, may provide valuable support to children exposed to these events.

Methods

A scoping review was designed to map the existing literature and the role of the play therapist in supporting children (aged 3–12 years) and families following natural disasters, and to formulate a model to guide play therapists in the future.

Results

A systematic search of the literature was performed and a total of 25 articles were identified as relevant to the role of the play therapist in response to natural disasters.

Conclusion

Play therapists must be mindful of the different phases of natural disaster response and how their role may vary across these phases. In the early stages post-disaster, a play therapist may be involved in psychoeducation, facilitating therapeutic play and community involvement. More formal clinical play therapy interventions that focus on the individual child or family are better suited to the latter stages of disaster response. There is a need for further research into the impact of natural disasters on children and families and interventions that aid mental health and well-being, especially for children who may be more vulnerable and potentially overlooked in the wake of such disasters. Further research is also needed into the effectiveness of play therapy as a post-disaster intervention for children.

背景:预计与天气有关的灾害将会增加,这表明未来许多澳大利亚儿童及其家庭将受到这些灾害的影响。游戏疗法作为澳大利亚的新兴职业,可以为受到这些事件影响的儿童提供有价值的支持:方法:我们设计了一项范围界定研究,以了解现有文献以及游戏治疗师在支持自然灾害后的儿童(3-12 岁)和家庭方面所扮演的角色,并为游戏治疗师未来的工作提供指导:结果:对文献进行了系统搜索,共发现 25 篇与游戏治疗师在应对自然灾害中的角色相关的文章:游戏治疗师必须注意自然灾害应对的不同阶段,以及他们的角色在这些阶段的不同表现。在灾后的早期阶段,游戏治疗师可能会参与心理教育、促进治疗性游戏和社区参与。更正式的临床游戏治疗干预侧重于个别儿童或家庭,更适合灾后应对阶段。有必要进一步研究自然灾害对儿童和家庭的影响,以及有助于心理健康和幸福的干预措施,尤其是针对那些在灾害发生后可能更加脆弱、更容易被忽视的儿童的干预措施。还需要进一步研究游戏疗法作为儿童灾后干预措施的有效性。
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引用次数: 0
Key success factors in implementing allied health outreach services 实施专职医疗外联服务的关键成功因素。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-09-21 DOI: 10.1111/ajr.13183
Julie Cullenward B.Appl.Sci(OccTher), Lisa Hall B.Appl.Sci(SpeechPath), Amanda Cook B.Appl.Sci(OccTher), Donna Ambler MA(OrgComm), Brittany Cleary MA(SocialImpact), Tim Smith, Matt Thomas PhD(ClinPsych)
<p>Clinicians who provide outreach services to remote communities often encounter barriers to engaging with local people.<span><sup>1, 2</sup></span> Factors contributing to poor engagement include unwelcoming health settings, inflexible approaches to service delivery, a sense of alienation, poor understanding of services and referral pathways, long wait lists, inadequate care coordination and mistrust of mainstream health care.<span><sup>1-3</sup></span> However, there are effective ways of working with people in remote communities, which can build trust and authentic engagement.<span><sup>4-6</sup></span> This article provides a case study that highlights some key success factors that enabled engagement, and positive outcomes and experiences for people needing to access health and disability services in a remote community.</p><p>In 2023, our organisation was approached by Birrang Enterprise Development to provide Allied Health (Occupational Therapy [OT] and Speech Pathology [SP]) services in a remote rural community in NSW. Our approach to developing and delivering our clinical outreach services was drawn from the Wobbly Hub Rural and Remote Person-Centred Approach model.<span><sup>7</sup></span> This model enables people in remote communities to access the health and disability services they want and need by first asking ‘What would make a good life?’<span><sup>8</sup></span> In summary, our Allied Health clinicians used this model to take a flexible person-centred approach with each person seeking a service and sought to understand what existed locally, what the outreach service brings, what we travel for and what can be accessed online.<span><sup>7, 8</sup></span></p><p>Prior to implementing outreach services, our approach first focused on engaging at an organisational level with local service providers and leaders to clarify the local needs, budget available and agree on the scope of the outreach service to be delivered, through a codesign process.<span><sup>9</sup></span> This was an important first step that established the scope and expectations of the Allied Health outreach service and enabled our clinicians to maximise the effectiveness of their work within the community using the principles of the Wobbly Hub model.</p><p>Our Allied Health clinicians travelled to the community across two phases. In Phase 1, outreach clinicians conducted two visits to the remote community. In these first two visits, the outreach clinicians met with the clients who were referred (children and adults, hereafter referred to as person we are working with, or person/people). The clinicians had conversations in which each person identified what they wanted to talk about. The clinicians aimed to build rapport and trust by listening and respecting the person and asking what they wanted or needed to do.<span><sup>7, 8</sup></span> The outreach clinicians made a plan with each person for ‘What's next’. This was documented in a one-page easy English Assessment Sum
接受外展服务的当地居民的体验普遍良好。当地人通过在与临床医生的会谈结束时完成的简短评估提供了反馈意见。他们对与外展临床医生见面的机会、评估总结和后续程序的价值给予了积极评价(如 "我喜欢这样 "和 "这样做很好")。Birrang 的员工对使用评估摘要对患者进行跟进给予了积极评价。当地人和 Birrang 的员工都喜欢由同一批外展临床医生进行回访。外展医生喜欢花时间与每个人交谈。临床医生喜欢使用《评估摘要》,并对他们在社区期间完成的工作表示满意,并计划在下次与患者会面时跟进进展情况。专职医疗临床医生可以提供健康信息,培养健康素养,就转诊途径提供建议,将临床需求和目标转化为 NDIS 报告和其他医疗用途。作为一家提供专职医疗外展服务的机构,我们学到的一个重要经验是,临床医生必须做好充分准备,按照 Wobbly Hub 的模式提供以人为本的服务,并善于倾听、理解和灵活处理。他们可以帮助患者将他们的目标和需求转化为健康和残疾系统可以理解和应对的语言。使用这种方法的专职医疗临床医生可以在当地网络的支持下,有力地帮助人们确定自己的健康和幸福目标,并在健康和残障系统中游刃有余。这包括倾听、从对个人最重要的事情(他们的目标)入手、与个人一起确定并开始第一步(计划)、与个人一起确定下一步(结果衡量)、以简单的书面形式提供信息并跟进个人的进展:构思;方法;写作--原稿。丽莎-霍尔写作--审阅和编辑;方法论。阿曼达-库克方法论;写作--审阅和编辑。唐娜-安布勒验证;写作 - 审核和编辑;项目管理。布列塔尼-克利里(Brittany Cleary):获取资金;写作--审阅和编辑;验证。蒂姆-史密斯构思;写作--审查和编辑。马特-托马斯马特-托马斯:构思;撰写-原稿;监督。作者无利益冲突需要声明。
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引用次数: 0
Building the private practice workforce in the Northern Territory: Barriers and facilitators for implementation of the allied health assistant role 在北部地区建立私人执业医师队伍:实施专职医疗助理角色的障碍和促进因素。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-09-16 DOI: 10.1111/ajr.13187
Lori Roberts MPH, Bea Staley PhD, John Callanan PhD, Kristy Logan PhD

Objective

To identify barriers and facilitators contributing to the successful implementation of the allied health assistant role in private disability practice to better meet population needs.

Design

A qualitative case study.

Setting

This study was completed with staff working in private disability practices in a regional context in the Northern Territory.

Participants

Eight participants were interviewed, including three allied health assistants, three allied health professionals, and two managers with allied health backgrounds.

Results

More barriers were reported than facilitators, with four key themes identified. Financial risk was a barrier when employing allied health assistants. This risk was mediated by providing part-time employment or having allied health assistants in dual roles. Reduced confidence from allied health professionals and assistants to complete delegation work was the second barrier. A facilitator was increasing allied health assistants' task variation, which participants reported increased retention. Finally, a positive working relationship between allied health professionals and assistants facilitates delegation.

Conclusion

This research offers private disability providers insight into the realities of employing an allied health assistant. It also suggests that formal training programs for both allied health assistants and professionals require increased focus on delegation in the private disability sector. On a government level, a review of the NDIS price guide for allied health assistant rates is needed if private providers are to better meet the requirements for NDIS participants in regional areas.

目的确定在私人残疾实践中成功实施专职医疗助理角色的障碍和促进因素,以更好地满足人们的需求:设计:定性案例研究:这项研究是与北部地区私人残疾人诊所的工作人员共同完成的:八名参与者接受了访谈,包括三名专职医疗助理、三名专职医疗专业人员和两名具有专职医疗背景的管理人员:报告的障碍多于促进因素,确定了四个关键主题。财务风险是聘用专职医疗助理的一个障碍。提供兼职工作或让专职医疗助理担任双重角色可以降低这种风险。专职医疗人员和助理完成委托工作的信心不足是第二个障碍。促进因素之一是增加专职医疗助理的任务变化,据参与者报告,这增加了任务的保留率。最后,专职医疗人员和助理之间积极的工作关系有利于授权:这项研究让私人残疾服务提供者深入了解了聘用专职医疗助理的现实情况。研究还表明,针对专职医疗助理和专业人员的正规培训计划需要更加关注私营残疾服务机构的授权问题。在政府层面上,如果私营机构要更好地满足地区 NDIS 参与者的要求,就需要对 NDIS 专职医疗助理费率价格指南进行审查。
{"title":"Building the private practice workforce in the Northern Territory: Barriers and facilitators for implementation of the allied health assistant role","authors":"Lori Roberts MPH,&nbsp;Bea Staley PhD,&nbsp;John Callanan PhD,&nbsp;Kristy Logan PhD","doi":"10.1111/ajr.13187","DOIUrl":"10.1111/ajr.13187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify barriers and facilitators contributing to the successful implementation of the allied health assistant role in private disability practice to better meet population needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative case study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>This study was completed with staff working in private disability practices in a regional context in the Northern Territory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Eight participants were interviewed, including three allied health assistants, three allied health professionals, and two managers with allied health backgrounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More barriers were reported than facilitators, with four key themes identified. Financial risk was a barrier when employing allied health assistants. This risk was mediated by providing part-time employment or having allied health assistants in dual roles. Reduced confidence from allied health professionals and assistants to complete delegation work was the second barrier. A facilitator was increasing allied health assistants' task variation, which participants reported increased retention. Finally, a positive working relationship between allied health professionals and assistants facilitates delegation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This research offers private disability providers insight into the realities of employing an allied health assistant. It also suggests that formal training programs for both allied health assistants and professionals require increased focus on delegation in the private disability sector. On a government level, a review of the NDIS price guide for allied health assistant rates is needed if private providers are to better meet the requirements for NDIS participants in regional areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 6","pages":"1173-1184"},"PeriodicalIF":1.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11640188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301512","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}
引用次数: 0
Pandemic impacts on rural general practice: Trainees and supervision team working and learning together 大流行病对农村全科医生的影响:受训人员与督导团队一起工作和学习。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-09-10 DOI: 10.1111/ajr.13185
Kay Brumpton MClinEd, Nancy Sturman PhD, Megan O'Shannessy MPH, Christy Noble PhD, Stephen Billett PhD

Objective

To explore the impact of COVID-19 pandemic disruptions on general practice trainees interdependent learning, from the perspectives of trainees and the whole of the practice team.

Setting

Four rural general practices in Queensland that continued to supervise registrars, junior doctors and medical students through the pandemic.

Participants

Twenty-three members of the general practice teams, including general practitioners, practice managers, receptionists, practice nurses, registrars, junior doctors and medical students.

Design

Audio-recorded semi-structured interviews were conducted with all participants following an initial survey. Thematic analysis and the theory of interdependent learning were used to understand how supervision and training was both disrupted and sustained during the pandemic period. Reporting is informed by the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Results

Learning affordances were transformed by the rapid implementation of physical distancing and other infection control measures. Telehealth consultations and remote working impacted on the interdependent relationship between the work environment, supervision team and trainees.

Conclusion

Practice staff identified new ways of working that arose through this period, including changes to practice team roles and the supervisory dynamic that enabled patient care and trainee learning to continue. Social connectedness was important to the trainees and the implications for future training need to be further evaluated.

目的从受训者和整个实践团队的角度,探讨 COVID-19 大流行对全科实习生相互依赖学习的影响:昆士兰州的四家乡村全科诊所,在大流行期间继续指导注册医师、初级医师和医科学生:23 名全科诊所团队成员,包括全科医生、诊所经理、接待员、实习护士、注册医师、初级医师和医科学生:设计:在初步调查之后,对所有参与者进行了半结构化录音访谈。采用专题分析和相互依存学习理论来了解大流行期间监督和培训是如何中断和维持的。报告参考了定性研究报告综合标准(COREQ)指南:结果:由于迅速实施了物理隔离和其他感染控制措施,学习能力发生了变化。远程医疗咨询和远程工作对工作环境、督导团队和学员之间的相互依存关系产生了影响:实践人员发现了这一时期出现的新的工作方式,包括实践团队角色和督导动态的变化,这使得病人护理和受训人员的学习得以继续。社会联系对学员很重要,对未来培训的影响需要进一步评估。
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引用次数: 0
The reality of rurality: Understanding the impact of remoteness on out-of-hospital cardiac arrest in Western Australia – A retrospective cohort study 乡村的现实:了解偏远地区对西澳大利亚院外心脏骤停的影响--一项回顾性队列研究。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-09-10 DOI: 10.1111/ajr.13184
Ashlea Smith BSc, Stephen Ball PhD, Karen Stewart MHCM, Judith Finn PhD

Introduction

Western Australia (WA) spans a large, sparsely-populated area of Australia, presenting a challenge for the provision of Emergency Medical Service (EMS), particularly for time-critical emergencies such as out-of-hospital cardiac arrest (OHCA).

Objective

To assess the impact of rurality on the epidemiology, incidence and survival of OHCA in WA.

Methods

We conducted a retrospective cohort study of EMS-attended OHCA in WA from 2015 to 2022. Incidence was calculated on all OHCAs, but the study cohort for the multivariable regression analysis of rurality on survival outcomes consisted of OHCAs of medical aetiology with EMS resuscitation attempted. Rurality was categorised into four categories, derived from the Australian Standard Geographic Classification – Remoteness Areas.

Results

The age-standardised incidence of EMS-attended OHCA per 100 000 population increased with increasing remoteness: Major Cities = 104.9, Inner Regional = 123.3, Outer Regional = 138.0 and Remote = 103.9. Compared to Major Cities, the adjusted odds for return of spontaneous circulation (ROSC) at hospital were lower in Inner Regional (aOR = 0.71, 95%CI 0.53–0.95), Outer Regional (aOR = 0.62, 95%CI 0.45–0.86) and Remote areas (aOR = 0.52, 95%CI 0.35–0.77) but there was no statistically significant difference for 30-day survival. Relative to Major Cities, Regional and Remote areas had longer response times, shorter transport-to-hospital times, and higher rates of bystander CPR and automated external defibrillator use.

Conclusions

Out-of-hospital cardiac arrest in rural areas had lower odds of ROSC at hospital compared to metropolitan areas, despite adjustment for known prognostic covariates. Despite WA's highly sparse regional population, these differences in ROSC are consistent with those reported in other international studies.

简介:西澳大利亚州(WA)地广人稀,给紧急医疗服务(EMS)的提供带来了挑战,尤其是对于院外心脏骤停(OHCA)等时间紧迫的紧急情况:评估乡村地区对西澳大利亚州院外心脏骤停流行病学、发病率和存活率的影响:我们对 2015 年至 2022 年期间西澳大利亚州由急救服务提供的 OHCA 进行了一项回顾性队列研究。研究计算了所有 OHCA 的发病率,但对生存结果进行多变量回归分析的研究队列包括尝试过 EMS 复苏的内科病因 OHCA。根据《澳大利亚标准地理分类--偏远地区》将偏远地区分为四类:结果:每 10 万人口中急救中心接诊的 OHCA 年龄标准化发病率随着偏远程度的增加而增加:大城市=104.9,内地区=123.3,外地区=138.0,偏远地区=103.9。与大城市相比,内区域(aOR = 0.71,95%CI 0.53-0.95)、外区域(aOR = 0.62,95%CI 0.45-0.86)和偏远地区(aOR = 0.52,95%CI 0.35-0.77)的住院自发性循环恢复(ROSC)调整后几率较低,但在 30 天存活率方面没有显著的统计学差异。与大城市相比,地区和偏远地区的响应时间更长,送往医院的时间更短,旁观者心肺复苏术和自动体外除颤器的使用率更高:尽管对已知的预后协变量进行了调整,但与大都市地区相比,农村地区的院外心脏骤停患者在医院的ROSC几率较低。尽管西澳大利亚的地区人口非常稀少,但这些ROSC差异与其他国际研究报告的结果一致。
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引用次数: 0
Barriers and enablers to bowel cancer screening participation in remote Tasmania: A qualitative study using the theoretical domains framework 塔斯马尼亚偏远地区参与肠癌筛查的障碍和促进因素:采用理论领域框架的定性研究。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-08-30 DOI: 10.1111/ajr.13181
Nicola Gadd MNutrDiet, Simone Lee PhD, Jessica Hughes MProfPsych, Matthew J. Sharman PhD, Ha Hoang PhD, Kehinde Obamiro PhD

Objective

Identify barriers and enablers for remote Tasmanians participating in bowel cancer screening through the National Bowel Cancer Screening Program.

Setting

A small remote Tasmanian community.

Participants

Tasmanian remote community members aged 50 years and over.

Design

A qualitative study conducted 16 semi-structured interviews. Two researchers conducted in-person and telephone interviews. Questions were directed by an interview guide developed using the Theoretical Domains Framework for behaviour change and Behaviour Change Wheel. Two researchers analysed data using directed content analysis with a flexible inductive approach.

Results

Four themes related to barriers and enablers to completing the National Bowel Cancer Screening Program screening kit in remote Tasmania. Themes included the subject of screening, physical screening kit, the process and outcome of the kit. Several barrier and enabler sub-themes overlapped or were linked, as many enablers mitigated barriers. For example, social influences, awareness level, steps in completing screening, and planning and timing to screen. Social support and discussing screening with others were key enablers, whereas lack of these were barriers. For remote communities, taking the kit to the post office was a barrier from often knowing the post officer. A bowel bus providing screening and information support services may reduce the travel burden of follow-up diagnostic tests and support low-literacy individuals to screen.

Conclusion

Barriers and enablers exist within each stage of the screening process, from what influences an individual decision to screen, through to the outcome. To improve screening rates in rural/remote Tasmania, barriers and enablers to screening must be considered.

目标:确定偏远地区塔斯马尼亚人参与国家肠癌筛查计划的障碍和促进因素:确定偏远塔斯马尼亚人通过国家肠癌筛查计划参与肠癌筛查的障碍和促进因素:塔斯马尼亚州的一个偏远小社区:塔斯马尼亚州 50 岁及以上的偏远社区成员:设计:一项定性研究,进行了 16 次半结构化访谈。两名研究人员分别进行了面谈和电话访谈。问题由使用行为改变理论领域框架和行为改变轮制定的访谈指南指导。两名研究人员采用灵活的归纳法对数据进行了定向内容分析:四个主题涉及在塔斯马尼亚偏远地区完成国家肠癌筛查计划筛查工具包的障碍和促进因素。主题包括筛查主题、实物筛查工具包、过程和结果。有几个障碍和促进因素子主题重叠或相关联,因为许多促进因素减轻了障碍。例如,社会影响、认识水平、完成筛查的步骤以及筛查的计划和时间。社会支持和与他人讨论筛查是关键的促进因素,而缺乏这些因素则是障碍。对于偏远社区来说,将工具包带到邮局是一个障碍,因为他们往往不认识邮局的工作人员。提供筛查和信息支持服务的肠道巴士可减轻后续诊断检测的交通负担,并支持识字率低的人进行筛查:从影响个人筛查决定的因素到筛查结果,筛查过程的每个阶段都存在障碍和促进因素。为了提高塔斯马尼亚州农村/偏远地区的筛查率,必须考虑筛查的障碍和促进因素。
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引用次数: 0
Exploring learning characteristics and progression of GP trainees based in regional, rural and remote settings: A qualitative study 探索地区、农村和偏远地区全科医生学员的学习特点和进步:定性研究。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-08-29 DOI: 10.1111/ajr.13182
Emily Anderson PhD, Tiana Gurney PhD, Louise Young PhD, Belinda O'Sullivan PhD, Lawrie McArthur PhD, Matthew McGrail PhD, Aaron Hollins MBBS

Objective

Globally, most doctors train and work in metropolitan areas but a key strategy for developing the rural health workforce is expanding rural training. The aim of this study was to describe the scope and quality of learning along with skill acquisition of GP trainees based in regional, rural, and remote settings.

Setting

Regional, rural and remote settings in Queensland Australia excluding Brisbane.

Participants

Thirty-seven general practice trainees who had undertaken their first community placement were recruited from regional, rural and remote learning settings within Queensland.

Design

Qualitative descriptive methodology based on constructionist epistemology was employed which allowed for the exploration of current GP trainees' experiences. Trainees were interviewed and data were thematically analysed as to the scope and quality of learning by the setting of training. Learning experiences were then mapped against the Dreyfus and Dreyfus model to explore skill acquisition.

Results

In terms of the scope and quality of learning, rural and remote trainees mainly focused on the diverse and unique (sometimes challenging) experiences their setting offered compared with regionally based trainees. Mapping of the trainee comments to the Dreyfus model of skill acquisition demonstrated that regardless of setting, equivalent learning occurred by GP trainees.

Conclusions

This exploratory study provides evidence that rural and remote learning may provide a more diverse and challenging experience. It suggests an equivalence of quality of education and skill acquisition across settings rural, regional and remote. This suggests that the training distribution policies may not disadvantage GP trainees and the scope and quality of more remote learning may increase uptake of remote placements.

目标:在全球范围内,大多数医生都在大都市地区接受培训和工作,但发展农村医疗卫生队伍的一项重要战略是扩大农村培训。本研究旨在描述在地区、农村和偏远地区接受培训的全科医生的学习范围和质量以及技能掌握情况:研究地点:澳大利亚昆士兰州(不包括布里斯班)的地区、农村和偏远地区:从昆士兰州的地区、农村和偏远地区的学习环境中招募了 37 名进行了首次社区实习的全科实习生:设计:采用基于建构主义认识论的定性描述方法,探索当前全科医生学员的经验。对受训人员进行访谈,并根据培训环境对学习的范围和质量进行专题分析。然后根据德雷福斯和德雷福斯模型对学习经验进行映射,以探讨技能的获得:就学习的范围和质量而言,与地区学员相比,农村和偏远地区学员主要关注其培训环境所提供的多样化和独特(有时具有挑战性)的体验。将受训者的意见与德雷福斯技能习得模型进行对比后发现,无论在什么环境下,全科医生受训者的学习效果都是相同的:这项探索性研究提供的证据表明,农村和偏远地区的学习可能会提供更多样化、更具挑战性的体验。研究表明,在农村、地区和偏远地区,教育质量和技能掌握程度相当。这表明,培训分配政策可能不会使全科医生学员处于不利地位,更多远程学习的范围和质量可能会提高远程实习的接受率。
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引用次数: 0
The term ‘Comprehensive Cancer Centre’ is outdated in contemporary Australian health systems 在当代澳大利亚医疗系统中,"综合癌症中心 "一词已经过时。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-08-28 DOI: 10.1111/ajr.13180
Sabe Sabesan FRACP, Abhishek Joshi FRACP, Shivanshan Pathmanathan FRACP
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引用次数: 0
International declaration on rural mental health research: 10 guiding principles and standards 国际农村心理健康研究宣言:10 项指导原则和标准。
IF 1.9 4区 医学 Q2 NURSING Pub Date : 2024-08-27 DOI: 10.1111/ajr.13167
Russell Roberts PhD, Sarah-Anne Munoz PhD, Karla Thorpe MSc, Hazel Dalton PhD, Leith Deacon PhD, David Meredith PhD, Mark Gussy PhD, Steve F. Bain DMin, Christian Swann PhD, Maria Lindstrom MSc, Jordi Blanch MD, PhD, Annette Beautrais PhD, Helene Silverblatt MD, Luis Salvador-Carulla PhD, MD, Finola Colgan BA, LLB, LLM, Tammy D. Heinz MSc, David Perkins PhD, Sean Russell MBA, Laura Grattidge MPH

Rural communities have unique mental health needs and challenges which are often related to the uniqueness of the community itself. On a per-capita basis, the investment in rural mental health research is far less than that in urban communities. Added to this, rural communities are often at risk of researchers, based in large urban universities, visiting, conducting the research with minimal engagement with local stakeholders and limited understanding of the community's social-service-environmental context. Often this research leaves no visible benefit to the community with respect to increased knowledge, resources or community capacity. This commentary is based on the insights of a panel of authors from 9 countries, each with extensive experience of rural mental health research and work. And it seeks to stimulate the discourse on responsible rural mental health practice. The aim of this commentary is to provide a reference on research practice for novice and experienced researchers on rural mental health research and practice, to assist policymakers, government and funding bodies to establish appropriate standards and guidelines for rural mental health research, and support rural communities to advocate for equity of funding and sustainable research as they engage with researchers, funders and governments. The 10 standards in this declaration will help guide researchers toward research that is beneficial to rural communities and also help develop the local community's research capability, which ultimately will serve to enhance the mental health and well-being of rural communities.

农村社区有着独特的心理健康需求和挑战,这往往与社区本身的独特性有关。按人均计算,农村心理健康研究的投入远远低于城市社区。此外,农村社区还经常面临着这样的风险,即城市大型大学的研究人员在访问和开展研究时,很少与当地利益相关者接触,对社区的社会服务环境了解有限。这种研究往往不会给社区带来知识、资源或社区能力方面的明显好处。本评论基于一个由来自 9 个国家的作者组成的小组的见解,每个人都在农村心理健康研究和工作方面有着丰富的经验。本评论旨在促进有关负责任的农村心理健康实践的讨论。本评论旨在为农村心理健康研究和实践方面的新手和经验丰富的研究人员提供研究实践方面的参考,帮助政策制定者、政府和资助机构为农村心理健康研究制定适当的标准和指导方针,并支持农村社区在与研究人员、资助者和政府接触的过程中倡导公平资助和可持续研究。本宣言中的 10 项标准将有助于指导研究人员开展有益于农村社区的研究,也有助于发展当地社区的研究能力,最终将有助于提高农村社区的心理健康和福祉。
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引用次数: 0
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Australian Journal of Rural Health
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