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American Indian Perspectives on Palliative and End-of-Life Care 美国印第安人对姑息治疗和临终关怀的看法
Pub Date : 2021-09-01 DOI: 10.1891/9780826183644.0029
Yoshiko Colclough, M. Isaacson
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引用次数: 1
An Evidence-Based Policy and Educational Program for Neonates Experiencing Opioid Withdrawal 阿片类药物戒断新生儿的循证政策和教育计划
Pub Date : 2021-09-01 DOI: 10.1891/9780826183644.0030
A. Olson, Stacy M. Stellflug, Sandra W Kuntz
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引用次数: 0
Lack of Anonymity and Secondary Traumatic Stress in Rural Nurses 农村护士匿名性缺失与继发性创伤应激
Pub Date : 2021-05-10 DOI: 10.14574/OJRNHC.V21I1.651
M. Swan, B. Hobbs
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引用次数: 0
Improving Rural Emergency Nurses Comfort during Palliative and End-of-Life Communication 改善农村急救护士在姑息和临终沟通中的舒适度
Pub Date : 2021-05-04 DOI: 10.14574/OJRNHC.V21I1.647
A. Styes, M. Isaacson
Background: Emergency nurses (ENs) often care for patients nearing the end of their lives or with life-limiting illnesses. However, ENs are hesitant to initiate palliative or end-of-life (PEOL) discussions because of a lack of comfort with these topics. Many ENs have no formal PEOL communication training which contributes to the lack of comfort with PEOL discussions in the emergency department (ED). Thus, the purpose of this quality improvement project was to determine how PEOL communication training affected rural ENs perceived comfort level during PEOL conversations. Sample/Setting: A convenience sample of 14 registered nurses working in a rural Northern Plains ED. Methods: A quality improvement project was implemented where nurses received online education using the End-of-Life Nursing Education Consortium Critical Care Communication module. This was followed by communication scenario review and group discussion. Changes in nurse comfort with PEOL communication were evaluated using a pre and post survey and reflective practice in the group discussion. Findings: This quality improvement project demonstrated a statistically significant increased level of comfort (N = 14, p = 0.006) when communicating with PEOL patients and their families in the ED. Qualitatively, the ED nurses expressed fears and challenges specific to PEOL communication while also identifying new evidence-based strategies they can use during PEOL conversations. Conclusion: Communication is vital when caring for PEOL patients in the ED. Formal PEOL communication training is effective for improving PEOL communication skills among ENs. Increasing nurse comfort when communicating with PEOL patients has the potential to improve quality of care at end-of-life. Keywords: emergency nurses, communication, palliative, end-of-life DOI:  https://doi.org/10.14574/ojrnhc.v21i1.647 
背景:急诊护士(ENs)经常照顾接近生命终点或患有限制生命疾病的患者。然而,由于缺乏对这些话题的安慰,en对发起姑息治疗或临终(PEOL)讨论犹豫不决。许多急诊医师没有接受过正式的PEOL沟通培训,这导致在急诊科(ED)讨论PEOL时缺乏舒适感。因此,本质量改进项目的目的是确定PEOL沟通培训如何影响农村en在PEOL对话期间的感知舒适程度。样本/设置:选取北部平原农村急诊科的14名注册护士作为方便样本。方法:实施质量改进项目,护士接受临终护理教育联盟危重护理沟通模块的在线教育。接下来是交流场景回顾和小组讨论。通过前后调查和小组讨论中的反思性实践来评估护士对PEOL沟通的舒适度变化。结果:该质量改进项目显示,在与PEOL患者及其家属在急诊科沟通时,舒适度有统计学上的显著提高(N = 14, p = 0.006)。定性地说,急诊科护士表达了对PEOL沟通的恐惧和挑战,同时也确定了新的基于证据的策略,他们可以在PEOL对话中使用。结论:在急诊科护理PEOL患者时,沟通是至关重要的。正式的PEOL沟通培训对提高ens之间的PEOL沟通技巧是有效的,增加护士与PEOL患者沟通时的舒适度有可能提高临终护理质量。关键词:急诊护士,沟通,姑息治疗,临终DOI: https://doi.org/10.14574/ojrnhc.v21i1.647
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引用次数: 0
Community Characteristics and Readmissions: Hospitals in Jeopardy 社区特征和再入院:处于危险中的医院
Pub Date : 2021-05-04 DOI: 10.14574/OJRNHC.V21I1.638
Michele L. Summers, Serdar Atav
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引用次数: 0
ANEW Project to Develop and Support Rural Primary Practice 发展和支持农村初级实践的ANEW项目
Pub Date : 2021-05-04 DOI: 10.14574/OJRNHC.V21I1.649
N. Gibson, Brandi Pravecek, L. Burdette, L. Lamb
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引用次数: 0
Rural Resilience in Cancer Survivors: Conceptual Analysis of a Global Phenomenon 农村癌症幸存者的复原力:全球现象的概念分析
Pub Date : 2021-05-04 DOI: 10.14574/OJRNHC.V21I1.676
V. Bernacchi, J. Zoellner, J. Keim-Malpass, P. Deguzman
Aim: The aims of this analysis are to (1) identify the concept of rural resiliency in cancer survivors in the nursing literature and (2) propose a conceptual framework that may help nurses leverage rural resilience to improve survivorship care. Background: Rural cancer survivors demonstrate rural resiliency by utilizing aspects of rural culture to improve their psychosocial distress. However, resiliency in rural cancer survivors is poorly understood. Design: We used Walker & Avants’ concept analysis approach to direct article selection, review, and analysis. Review methods: We identified a definition, antecedents, consequences, attributes, empirical referents, and related terms, and provide model, contrary, and borderline case examples.
目的:本分析的目的是:(1)确定护理文献中癌症幸存者的农村复原力概念;(2)提出一个概念框架,可以帮助护士利用农村复原力来改善幸存者护理。背景:农村癌症幸存者通过利用农村文化的各个方面来改善他们的社会心理困扰来展示农村的弹性。然而,人们对农村癌症幸存者的复原力知之甚少。设计:我们使用Walker & Avants的概念分析方法直接进行文章的选择、回顾和分析。回顾方法:我们确定了定义、前件、结果、属性、经验参考物和相关术语,并提供了模型、相反和边缘案例示例。
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引用次数: 5
Navigating public health clinical placements for rural online RN-BSN students 引导农村在线RN-BSN学生的公共卫生临床实习
Pub Date : 2021-05-04 DOI: 10.14574/OJRNHC.V21I1.664
Jill C. Borgos
Purpose: In rural settings scare public health resources potentially limits the opportunities for nursing students living in these areas to participate in traditional one to one precepted experiences with public health agencies. To meet the revised Commission on Collegiate Nursing Education Standards related to direct clinical practice, creative strategies are needed for online degree seeking RN-BSN students who live in rural areas. This article explores an alternative learning experience by partnering students with a nonprofit healthcare institute to work on state health initiatives in the geographic region where the students reside. Process: In the absence of adequate opportunities for one to one precepted clinical experiences, student living in rural areas completing an online RN-BS program were partnered with a non-profit health organization. The students participate in an experiential learning experience to fulfill clinical hours in a public health setting as required by the Commission on Collegiate Nursing Education. In this case a cohort of students worked with a nonprofit healthcare institute on New York State’s T-21 campaign to further advance their knowledge on health initiatives driven by state health reform policy and actively participate community-based education. Conclusion: With a growing focus on population-based care and caring for vulnerable populations, particularly in rural areas, seeking clinical activities through partnerships with non-profit healthcare institute to improve health outcomes at the community level offers an alternative approach to engaging online degree seeking RN-BSN students in experiential clinical learning in communities with limited public health agency placements. Keywords: interprofessional learning, nursing accreditation, rural nursing students, service-learning pedagogy DOI:  https://doi.org/10.14574/ojrnhc.v21i1.664
目的:在农村环境中,稀缺的公共卫生资源可能限制了生活在这些地区的护理学生参与公共卫生机构传统的一对一经验的机会。为了满足修订后的大学护理教育委员会与直接临床实践相关的标准,农村地区的在线学位寻求RN-BSN学生需要创造性的策略。本文探讨了另一种学习体验,方法是让学生与非营利医疗保健机构合作,在学生所在的地理区域开展州卫生倡议工作。过程:在没有足够的机会获得一对一的临床经验的情况下,生活在农村地区的学生完成了一个在线RN-BS项目,与一个非营利卫生组织合作。根据美国大学护理教育委员会的要求,学生将在公共卫生机构完成临床实习。在本案例中,一群学生与一家非营利医疗保健机构合作,参与纽约州的T-21运动,进一步提高他们对由州医疗改革政策推动的卫生倡议的认识,并积极参与社区教育。结论:随着人们越来越关注基于人口的护理和对弱势群体的护理,特别是在农村地区,通过与非营利医疗机构合作寻求临床活动,以改善社区一级的健康结果,这为在公共卫生机构实习有限的社区中吸引寻求在线学位的RN-BSN学生进行体验式临床学习提供了另一种方法。关键词:跨专业学习护理认证农村护生服务学习教学法DOI: https://doi.org/10.14574/ojrnhc.v21i1.664
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引用次数: 0
Health Care Experiences in Rural, Remote, and Metropolitan Areas of Australia 澳大利亚农村、偏远和大都市地区的医疗保健经验
Pub Date : 2021-05-04 DOI: 10.14574/OJRNHC.V21I1.652
S. Bourke, Claire Harper, Elianna Johnson, Janet Green, Ligi Anish, Miriam Muduwa, L. Jones
Background: Australia is a vast land with extremes in weather and terrain. Disparities exist between the health of those who reside in the metropolitan areas versus those who reside in the rural and remote areas of the country. Australia has a public health system called Medicare; a basic level of health cover for all Australians that is funded by taxpayers. Most of the hospital and health services are located in metropolitan areas, however for those who live in rural or remote areas the level of health service provision can be lower; with patients required to travel long distances for health care. Purpose: This paper will explore the disparities experienced by Australians who reside in regional and remote areas of Australia. Method: A search of the literature was performed from healthcare databases using the search terms: healthcare, rural and remote Australia, and social determinants of health in Australia.  Findings: Life in the rural and remote areas of Australia is identified as challenging compared to the metropolitan areas. Those with chronic illnesses such as diabetes are particularly vulnerable to morbidities associated with poor access to health resources and the lack of service provision. Conclusion: Australia has a world class health system. It has been estimated that 70% of the Australian population resides in large metropolitan areas and remaining 30% distributed across rural and remote communities. This means that 30% of the population are not experiencing their health care as ‘world-class’, but rather are experiencing huge disparities in their health outcomes. Keywords: rural and remote, health access, mental health issues, social determinants DOI:  https://doi.org/10.14574/ojrnhc.v21i1.652  
背景:澳大利亚幅员辽阔,气候和地形极端。居住在大都市地区的人与居住在该国农村和偏远地区的人的健康状况存在差异。澳大利亚有一个名为“医疗保险”的公共卫生系统;由纳税人资助的所有澳大利亚人的基本医疗保险。大多数医院和保健服务都位于大都市地区,但对于那些生活在农村或偏远地区的人来说,提供保健服务的水平可能更低;患者需要长途跋涉进行医疗保健。目的:本文将探讨居住在澳大利亚地区和偏远地区的澳大利亚人所经历的差异。方法:从医疗保健数据库中检索文献,检索词为:医疗保健、澳大利亚农村和偏远地区以及澳大利亚健康的社会决定因素。调查结果:与大都市地区相比,澳大利亚农村和偏远地区的生活具有挑战性。患有糖尿病等慢性病的人特别容易患上与卫生资源获取不足和缺乏服务有关的疾病。结论:澳大利亚拥有世界级的卫生系统。据估计,70%的澳大利亚人口居住在大城市地区,其余30%分布在农村和偏远社区。这意味着,30%的人口没有体验到“世界级”的医疗保健,而是在健康结果方面存在巨大差异。关键词:农村和偏远地区,卫生服务,心理健康问题,社会决定因素DOI:https://doi.org/10.14574/ojrnhc.v21i1.652
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引用次数: 2
Rural Populations’ Sources of Cancer Prevention and Health Promotion Information 农村人口癌症预防和健康促进信息来源
Pub Date : 2021-05-03 DOI: 10.14574/OJRNHC.V21I1.663
M. E. Leimkuhler, Lindsay Hauser, Noelle Voges, P. Deguzman
Purpose: Rural residents are less likely to engage in cancer risk-reduction behaviors than their urban counterparts. Rural cancer disparities may be related to limited access to and comprehension of cancer-related health information. The object of this study was to identify how rural residents access and understand cancer health promotion and prevention information. Sample: Twenty-seven residents of Central Virginia Methods: We used a qualitative design with semi-structured interviews and a focus group (n=27) with rural and non-rural residents living in Central Virginia to accomplish the study aim. Findings: Four themes were identified from the data: 1) non-rural Central Virginia residents seek health information from a variety of electronic sources, 2) rural Central Virginia residents typically seek health care information directly from health care professionals, 3) residents throughout Central Virginia encounter confusing health care information, and 4) rural residents report incorrect cancer-related information. Conclusions: Lack of internet access coupled with healthcare shortages may limit the ability of rural residents to contextualize and verify inaccurate health information. Nurses serving a rural population should consider assessing each rural patient’s internet access and disseminating printed cancer health promotion materials to rural clients without internet access. Keywords: rural health; healthcare disparities; access to care; cancer health promotion; health literacy; cancer DOI:  https://doi.org/10.14574/ojrnhc.v21i1.663 
目的:与城市居民相比,农村居民从事癌症风险降低行为的可能性较小。农村癌症差异可能与获取和理解癌症相关健康信息的机会有限有关。本研究的目的是确定农村居民如何获得和了解癌症健康促进和预防信息。样本:弗吉尼亚州中部的27名居民方法:我们采用半结构化访谈的定性设计,并以居住在弗吉尼亚州中部农村和非农村居民为焦点小组(n=27)来实现研究目的。研究结果:从数据中确定了四个主题:1)非弗吉尼亚州中部农村居民从各种电子来源寻求健康信息,2)弗吉尼亚州中部乡村居民通常直接从医疗保健专业人员那里寻求医疗保健信息,3)整个弗吉尼亚州中部的居民遇到令人困惑的医疗保健信息,以及4)农村居民报告错误的癌症相关信息。结论:缺乏互联网接入,再加上医疗保健短缺,可能会限制农村居民了解和核实不准确健康信息的能力。为农村人口服务的护士应考虑评估每个农村患者的互联网接入情况,并向没有互联网接入的农村客户分发印刷的癌症健康宣传材料。关键词:农村卫生;医疗保健差距;获得护理;癌症健康促进;健康素养;癌症DOI:https://doi.org/10.14574/ojrnhc.v21i1.663
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引用次数: 1
期刊
Online Journal of Rural Nursing and Health Care
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