Australian Journal of Rural Health最新文献

{"title":"Predicting Hypotension Before It Hits the Highway in Rural Anaesthesia","authors":"Josh Andrews, Alasdair Leslie, Christina Gao, D-Yin Lin, Brandon Stretton, Stephen Bacchi","doi":"10.1111/ajr.70090","DOIUrl":"https://doi.org/10.1111/ajr.70090","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038260","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":"Farm Injury Deaths and Workers' Compensation Claims in Australia and Their Economic Costs","authors":"Carlos Mesa-Castrillon,&nbsp;Kerri-Lynn Peachey,&nbsp;Tony Lower","doi":"10.1111/ajr.70087","DOIUrl":"https://doi.org/10.1111/ajr.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the pattern and estimated direct economic burdens associated with unintentional deaths and injuries on Australian farms over the past 11 years (2013–2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Descriptive retrospective epidemiological study of National Coronial Information System (NCIS) data for persons fatally injured on a farm and workers' compensation injuries data from the National Data Set.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>All agricultural cases involving fatal injury events and those being injured accessing workers compensation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Nature of fatal and injury events, with estimates on the economic costs associated with deaths and workers' compensation injury claims costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 748 farm fatalities, with 544 (73%) being work-related. From these, 513 (94%) of the cases occurred in males, with almost half (48%) in farmers aged 60 years or older. The leading agents for fatalities were tractors (<i>n</i> = 118), quad-bikes (<i>n</i> = 117) and farm utilities (<i>n</i> = 52). Costs for all fatalities (work and non-work), approached $1.8 billion in the 2013-2023 period (~$164 million per year). Work-related fatalities accounted for $1.24 billion of this total, with an annual cost of approximately $112 million. There were around 5000 workers' compensation injury claims processed per year during 2013–2021, costing over $1.5 billion (~$190 million per year).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The costs for all on-farm injury deaths and workers' compensation injury claims conjointly during the period of 2013–2023, includes a conservative annual estimate of $355 million per year. Of this sum, approximately $300 million involved work-related incidents. Although there is a modest progression in reducing farm deaths and injuries, targeted and evidence-based approaches are required to stimulate improvements in these preventable incidents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021829","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}

{"title":"Towards a National Longitudinal Tracking Framework of Health Graduate Practice Locations","authors":"Vincent L. Versace,&nbsp;Pam Harvey,&nbsp;Geoff Argus,&nbsp;Christine Howard,&nbsp;Leanne Brown","doi":"10.1111/ajr.70085","DOIUrl":"https://doi.org/10.1111/ajr.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Workforce maldistribution is a challenge to the equitable provision of healthcare in Australia. This <i>Commentary</i> details how a multi-university, large-scale, and growing data asset is positioned to contribute strategically and operationally to addressing national workforce priorities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>The Nursing and Allied Health Graduate Outcome Tracking (NAHGOT) study is a prospective longitudinal research project with a commitment to nationwide geographical coverage. NAHGOT links practice location data (the outcome) from the Australian Health Practitioner Regulation Agency (Ahpra) with university administrative records, such as admission and placement data (explanatory variables). NAHGOT also links external surveys and publicly available spatial data describing socio-economic conditions and access to services. There are seven universities formally part of the collaboration, with five others in the process of joining. NAHGOT has established a framework including project governance, data linkage and management protocols, and a central repository for de-identified data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>The background of NAHGOT, the benefits to the Rural Health Multidisciplinary Training program, current limitations and challenges, and the case for scale-up and future direction are described.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Universities are uniquely positioned to lead graduate tracking as they have access to a suite of key explanatory variables not available elsewhere. Increasing the number of participating universities within NAHGOT is a priority, as is broadening the pool of disciplines beyond those covered by Ahpra. The geo-enrichment of placement and practice data is also a priority. This will allow a more granular understanding of local workforce dynamics that can be overlooked if analysis is limited to existing geographical classifications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012502","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}

{"title":"Patient-Reported Cataract Outcomes After the Introduction of the Griffith Ophthalmology Project in Regional Australia","authors":"Jason Chami,&nbsp;Marc P. Chami,&nbsp;Harrison M. Khan,&nbsp;Donna Glenn,&nbsp;Kerrie A. Legg,&nbsp;Dominic McCall,&nbsp;John R. Grigg,&nbsp;Geoffrey T. Painter","doi":"10.1111/ajr.70088","DOIUrl":"https://doi.org/10.1111/ajr.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effectiveness of the Griffith Ophthalmology Project in improving visual acuity and quality of life (QoL) among cataract surgery patients in regional New South Wales (NSW), Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Griffith Base Hospital's Department of Ophthalmology in the Western Murrumbidgee Local Health District (MLHD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>The 135 patients (168 eyes) undergoing cataract surgery between March 2022 and July 2023 completed QoL surveys.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Changes in vision-related QoL (assessed by National Eye Institute Visual Function Questionnaire; NEI-VFQ), health-related QoL (assessed by EuroQol 5-Dimensional 5-Level survey; EQ-5D-5L), visual acuity, and surgical waiting times.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients completed the NEI-VFQ and EQ-5D-5L surveys before and/or after surgery. Pre- and post-operative visual acuity and waiting list data were collected and analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EI-VFQ data showed significant enhancements in 11 of 12 QoL subscales (including social functioning and mental health) as well as the composite QoL score. EQ-5D-5L results indicated improvements in all five dimensions, with overall health-related QoL significantly increased. Visual acuity improved significantly, the surgical waitlist was reduced from 123 to 10 patients, and waiting times decreased from 15 to 2 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Griffith Ophthalmology Project significantly improved visual and QoL outcomes for cataract surgery patients in regional NSW and reduced surgical waiting times. This model of utilising visiting specialists and collaborative local support may serve as a template for sustainable regional healthcare services in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144927490","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}

{"title":"Informing a Clinical Pathway for Acute Knee Injuries: Survey Insights From Rural Clinicians","authors":"Tom Molloy,&nbsp;Benjamin Gompels,&nbsp;Matthew Dowsett,&nbsp;Stephen McDonnell","doi":"10.1111/ajr.70086","DOIUrl":"https://doi.org/10.1111/ajr.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Soft tissue knee injuries (STKIs) pose a significant healthcare challenge, particularly in rural settings with limited access to imaging and specialist consultation. This study aimed to evaluate current practices and challenges in diagnosing acute knee injuries in a rural setting and presented a pathway tailored for rural healthcare settings to improve diagnostic confidence, optimise imaging use, and streamline patient management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A survey-based study was conducted among seventeen medical officers in six rural medical centres across New South Wales and Queensland. The survey involved a structured questionnaire on current practices and challenges. A structured rural pathway for acute knee injury was presented, and feedback was reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most clinicians assessed knee injuries weekly, showing variable confidence in their assessments and special tests. Key barriers identified included limited access to imaging, lack of specialist consultation, and diagnostic uncertainty, which led to increased referrals. The proposed pathway was rated highly intuitive, aligned with clinical guidelines, and was expected to streamline management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The proposed pathway has clinical support and the potential to enhance knee injury management in rural settings by improving diagnostic accuracy, offering pathways aligned with the risk of injury, and promoting timely specialist care. Further research is necessary to assess long-term clinical outcomes and pathway integration across allied health services and rural healthcare facilities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144905414","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}

{"title":"‘It's Putting All the Burden on the Patient’: A Qualitative Study of Health Literacy and Shared Decision-Making in Rural Australian Communities","authors":"Heidi Gray,&nbsp;Tiana Kittos,&nbsp;Danielle M. Muscat","doi":"10.1111/ajr.70084","DOIUrl":"https://doi.org/10.1111/ajr.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Rural communities in Australia face significant barriers to health. Grounded in phenomenology as a research methodology, this study aimed to explore health literacy and shared decision-making in rural areas from the perspective of community members.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Semi-structured interview study, with data analysed using Framework Analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Twenty-five adults living in rural communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Interviews were conducted remotely, spanning seven Australian states and territories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three main themes were generated from the data (comprising 10 sub-themes): (a) service access, (b) healthcare engagement, trust and decision making, (c) ‘a different approach for us’: leveraging community strengths. Demands on health literacy in rural settings were amplified, with additional health literacy requirements related to accessing and using healthcare services, navigating the healthcare system and understanding how to take appropriate health action in a rural setting. Participants reflected on the transient nature of the healthcare workforce in rural areas and experiences of pressurised health systems as barriers to service access and shared decision-making. Our analysis also identified a complex interplay between the social determinants of health and health literacy in rural contexts; challenges in healthcare access and navigation were discussed in the context of socioeconomic status, education, literacy and language. However, we also identified rural community strengths which could be leveraged to support health literacy action and responsiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By addressing unique health literacy challenges and leveraging the strengths of rural communities, healthcare policies and interventions can better meet the needs of these populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881231","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}

{"title":"Impacts of University Departments of Rural Health to Their Regions Through Intellectual Capital","authors":"Lisa Bourke,&nbsp;Sandra Thompson,&nbsp;Katharine Freire,&nbsp;Robyn McNeil,&nbsp;Pam Harvey,&nbsp;Leanne Brown,&nbsp;James Debenham","doi":"10.1111/ajr.70081","DOIUrl":"https://doi.org/10.1111/ajr.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This paper aims to identify ways in which University Departments of Rural Health (UDRHs) contribute intellectual capital to their rural and remote regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>UDRHs contribute to their regions through various means, including student placements, workforce development, First Nations support and training, community engagement, economic impacts and research. UDRHs also contribute to various forms of community capital, although there remains a lack of detailed understanding of how UDRHs contribute to the intellectual capital of their regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Senior staff from six UDRHs worked from a constructivist research paradigm as ‘insider’ researchers to identify four key avenues through which UDRHs contribute and enhance intellectual capital in their regions. For each avenue, a case study was developed to examine these contributions in detail.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The four case studies illustrate how different UDRHs contribute intellectual capital through students and health professional education and training, community partnerships to address local issues, research and research capacity building and through UDRHs networks that cross regions and rural–urban boundaries. UDRHs were found to contribute to health practice, local evidence, partnerships and advocacy, all benefiting their regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The co-production of locally tailored knowledge by UDRHs offers a valuable contribution to rural and remote communities. The knowledge and evidence contributed by universities is often not provided by other sectors in rural areas, but is valued by communities, contributes to intellectual capital in these regions, and bridges the urban–rural knowledge divide.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869218","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}

{"title":"Assessing Comparative Dimensions of Access When Accessing Primary Care Across Different Levels of Rurality","authors":"Maddie Higgins,&nbsp;Tiana Gurney,&nbsp;Matthew McGrail","doi":"10.1111/ajr.70080","DOIUrl":"https://doi.org/10.1111/ajr.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the comparative importance of dimensions of access when accessing primary care across different levels of rurality in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A quantitative survey using the paired comparison method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Regional, rural, and remote communities in Queensland, Australia, are defined by the Modified Monash Model classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>3204 households were surveyed, with 192 responses received (6% response rate). After data cleaning, 163 usable surveys were included in the final analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure(s)</h3>\u0000 \u0000 <p>Level of importance for seven dimensions of access: availability, geography, affordability, accommodation, timeliness, acceptability, and awareness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Awareness was the most important dimension, consistent across all ruralities. Timeliness and availability also ranked highly, though their relative importance varied slightly with the level of rurality. Residents of the regional centre and small rural town ranked timeliness second, while remote and very remote community residents ranked availability second. Geography increased in importance as rurality increased, rising from least important for regional centre residents to mid-level importance for remote and very remote residents. Affordability consistently ranked low in importance across all ruralities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study reveals differences in the importance of dimensions of access when accessing primary care for residents of regional, rural, and remote Australian communities. These findings suggest that strategies to improve primary care access should be tailored to address the most critical factors across different levels of rurality, focusing on improving awareness, availability, and timeliness of primary care services. The increased importance of geography in the remote and very remote community highlights the need for innovative solutions to overcome geographical barriers for these residents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144782795","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}

{"title":"The Effect of Aged-Care Rural Clinical Placements on Health Student Self-Efficacy: A Mixed-Methods Evaluation.","authors":"Alizée McGregor, Mohammad Hamiduzzaman, Vanette McLennan, Sarah Miles, Sarah Crook, Lewis Grove, Frances Barraclough, Jennie Hewitt, Gillian Nisbet, Karn Nelson, Marianne Wallis, Nerida Volker, Victoria Flood","doi":"10.1111/ajr.70083","DOIUrl":"10.1111/ajr.70083","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to determine the effect of rural clinical placements on allied health students' perceived self-efficacy in service delivery, as part of a larger evaluation of facilitated student placements in Northern New South Wales residential aged-care homes.</p><p><strong>Methods: </strong>A mixed-methods design was employed. Allied health students from a variety of universities undertook at least five-week clinical placements in two rural residential aged-care homes via a programme designed and coordinated by the University Centre for Rural Health in partnership with the Aged Care Residential facility. Quantitative data were collected using a modified Self-Efficacy in Clinical Performance Scale, pre and post-placement. Semi-structured interviews were conducted post-placement. Self-efficacy scores were compared using the Wilcoxon Signed-Rank test, and the effect size was calculated. Reflexive thematic analysis was conducted to identify themes from interview transcripts.</p><p><strong>Results: </strong>Twenty-five students completed the surveys, and 12 interviews were included in this study. There was a statistically significant increase, post-placement compared to pre-placement, in total self-efficacy in clinical performance scores, as well as in subscale scores. The subscales related to assessment, diagnosis, and planning and implementation. Two themes were identified from the qualitative interviews: (1) heightened confidence, independence, and work readiness; and (2) confidence and enthusiasm for interprofessional work.</p><p><strong>Conclusions: </strong>Our findings provide beginning evidence that a well-resourced and focused programme of clinical placements can improve allied health student self-efficacy and may stimulate greater enthusiasm for working in the rural aged-care sector.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":"e70083"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796208","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}

{"title":"Rural Nursing Workforce Sustainability in Australia: A Scoping Review of Global Retention Strategies.","authors":"Atabong A Fortabong, Kate Kloot, Natasha Reedy, Blake Peck, Daniel Terry","doi":"10.1111/ajr.70079","DOIUrl":"10.1111/ajr.70079","url":null,"abstract":"<p><strong>Introduction: </strong>The global nursing shortage significantly impacts healthcare sustainability, particularly in rural Australia, where geographic isolation, professional remoteness and resource constraints amplify challenges.</p><p><strong>Objective: </strong>To map and synthesise evidence on factors influencing rural nursing workforce sustainability across individual, organisational and systemic levels.</p><p><strong>Design: </strong>A scoping review following PRISMA-ScR guidelines was conducted. Five databases and grey literature were searched for English-language publications (1995-2024) on rural nursing workforce sustainability. A micro-meso-macro conceptual framework guided the analysis of 33 publications, focusing on baccalaureate-prepared Registered Nurses.</p><p><strong>Findings: </strong>Key determinants were identified across three levels. Micro-level factors included personal characteristics, professional identity and safety considerations. Meso-level factors, addressed in 32 studies, encompassed health services programmes, organisational culture, management approaches and professional development opportunities. Macro-level factors included community engagement, educational pathways, scope of practice policies and government initiatives. Significant interconnections existed between factors across all levels.</p><p><strong>Discussion: </strong>While targeted interventions show promise, programmes need systematic evaluation using standardised frameworks. Research priorities include longitudinal effectiveness studies, economic impact analyses and the development of practical implementation tools.</p><p><strong>Conclusion: </strong>A sustainable rural nursing workforce requires integrated approaches that simultaneously address individual, organisational and systemic factors. Success depends on evidence-based collaboration between healthcare organisations, educational institutions and government bodies to strengthen rural healthcare delivery through coordinated multilevel strategies.</p>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 4","pages":"e70079"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800986","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}