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Rural nursing

Leila Jansson, Ulla Hällgren Graneheim
This study describes nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas in Sweden. We used a qualitative, descriptive design based on twelve interviews that were subjected to qualitative content analysis. The results showed that the nurses felt anguish due to a lack of control. They expressed uncertainty and loneliness, and they struggled with ethical issues and organisational challenges. Having the sole responsibility to assess suicide risk can increase a person's emotional vulnerability and moral stress...
March 13, 2018: Issues in Mental Health Nursing
Susan Bidwell, Andrea Copeland
INTRODUCTION Pegasus Health Charitable Ltd, a Christchurch Primary Health Organisation, is contracted by the Canterbury District Health Board to provide continuing professional development for primary care practitioners in the region. Rurally located health practitioners have largely been unable to participate because of the travel time and distances involved. AIM The initiative reported in this paper aimed to fill this gap by developing an accessible and high-quality multidisciplinary model of professional development for general practitioners, nurse practitioners, practice nurses and community pharmacists in rural areas of North Canterbury, New Zealand...
December 2017: Journal of Primary Health Care
Robin Newhouse, Ha Do Byon, Emily Storkman Wolf, Meg Johantgen
PROBLEM: High-quality smoking cessation counseling guidelines for people who use tobacco are not fully integrated in acute-care services presenting missed opportunities to improve health outcomes. The role of the practice environment on enhancing or inhibiting guideline use is unknown. OBJECTIVE: To examine the relationship between the nurse practice environment and nurses' use of smoking cessation counseling practices, and to evaluate the effect of the individual nurse and organization characteristics on nurse smoking cessation counseling practices...
March 12, 2018: Worldviews on Evidence-based Nursing
Jane Goudge, Tobias Chirwa, Sandra Eldridge, Francesc Xavier F Gómez-Olivé, Chodziwadziwa Kabudula, Felix Limbani, Eustasius Musenge, Margaret Thorogood
Introduction: In low/middle-income countries with substantial HIV and tuberculosis epidemics, health services often neglect other highly prevalent chronic conditions, such as hypertension, which as a result are poorly managed. This paper reports on a study to assess the effect on hypertension management of lay health workers (LHW) working in South African rural primary healthcare clinics to support the provision of integrated chronic care. Methods: A pragmatic cluster randomised trial with a process evaluation in eight rural clinics assessed the effect of adding two LHWs supporting nurses in providing chronic disease care in each intervention clinic over 18 months...
2018: BMJ Global Health
Eva M Luo, Henry S Opare-Ado, Joseph Adomako, Kwabena A Danso, Talya Peltzman, Frank W J Anderson
Introduction To provide a qualitative perspective on the changes that occurred after newly placed OB/GYNs began working at district hospitals in Ashanti, Ghana. Methods Structured interviews of healthcare professionals were conducted at eight district hospitals located throughout the Ashanti district of Ghana, four with and four without a full-time OB/GYN on staff. Individuals interviewed include: medical superintendents, medical officers, district hospital administrators, OB/GYNs (where applicable), and nurse-midwives...
March 8, 2018: Maternal and Child Health Journal
May-Lill Johansen, Bente Ervik
BACKGROUND: Generalists such as general practitioners and district nurses have been the main actors in community palliative care in Norway. Specialised oncology nurses with postgraduate palliative training are increasingly becoming involved. There is little research on their contribution. This study explores how general practitioners (GPs) and oncology nurses (ONs) experience their collaboration in primary palliative care. METHODS: A qualitative focus group and interview study in rural Northern Norway, involving 52 health professionals...
March 7, 2018: BMC Health Services Research
Xiaolei Xiong, Zhiguo Zhang, Jing Ren, Jie Zhang, Xiaoyun Pan, Liang Zhang, Shiwei Gong, Si Jin
BACKGROUND: China's universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China. METHODS: Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS...
2018: PloS One
Mulamba Diese, Albert Kalonji, Bibiche Izale, Susie Villeneuve, Ngoma Miezi Kintaudi, Guy Clarysse, Ngashi Ngongo, Abel Mukengeshayi Ntambue
BACKGROUND: In early 2016, we implemented a community-based maternal, newborn, and child health (MNCH) surveillance using mobile phones to collect, analyze, and use data by village health volunteers (VHV) in Kenge Health Zone (KHZ), in the Democratic Republic of Congo (DRC). The objective of this study was to determine the perceptions of households, attitudes of community health volunteers, and opinions of nurses in Health center and administrative authorities towards the use of mobile phones for MNCH surveillance in the rural KHZ in the DRC...
March 5, 2018: BMC Public Health
Liane Connelly, Beth E Burbach, Colleen Kennedy, Lisa Walters
BACKGROUND: The U.S. nursing workforce is facing a severe shortage of professionals due to an anticipated retirement of more than 500,000 RNs in the next 5 years. METHOD: An Escape to Nursing event was created and delivered in a rural medical center college of nursing in the spring of 2017. This faculty team developed four distinct rooms that were designed with key nursing concepts and patient health conditions. Recruits worked in teams to solve the patient health care puzzle, which then enabled them to proceed to the next room...
March 1, 2018: Journal of Nursing Education
Kristine Williams, Diane Blyler, Eric D Vidoni, Clarissa Shaw, JoEllen Wurth, Denise Seabold, Yelena Perkhounkova, Angela Van Sciver
The number of persons with dementia (PWD) in the United States is expected to reach 16 million by 2050. Due to the behavioral and psychological symptoms of dementia, caregivers face challenging in-home care situations that lead to a range of negative health outcomes such as anxiety and depression for the caregivers and nursing home placement for PWD. Supporting Family Caregivers with Technology for Dementia Home Care (FamTechCare) is a multisite randomized controlled trial evaluating the effects of a telehealth intervention on caregiver well-being and PWD behavioral symptoms...
March 5, 2018: Research in Nursing & Health
Whitney E Zahnd, Wiley D Jenkins, Judy Shackelford, Rebecca Lobb, Jo Sanders, Angela Bailey
Rural populations often face higher cancer rates and have lower cancer screening rates than urban populations. Screening disparities may be mediated by limited access to care, less knowledge of screening, and psychosocial factors. While the improved insurance rates and more comprehensive coverage under the Affordable Care Act may address some of these barriers, rural-urban disparities in cancer screening may not be fully attenuated. Faith-based interventions have been an effective approach to improving cancer screening among rural and underserved populations...
2018: Journal of Health Care for the Poor and Underserved
JaBaris D Swain, Colleen Sinnott, Suellen Breakey, Rian Hasson Charles, Gita Mody, Napthal Nyirimanzi, Ceeya Patton-Bolman, Patricia Come, Gapira Ganza, Emmanuel Rusingiza, Nathan Ruhamya, Joseph Mucumbitsi, Jorge Borges, Martin Zammert, Jochen D Muehlschlegel, Robert Oakes, Bruce Leavitt, R Morton Bolman
OBJECTIVE: Despite its near complete eradication in resource-rich countries, rheumatic heart disease remains the most common acquired cardiovascular disease in sub-Saharan Africa. With a ratio of physicians/population of 1 per 10,500, including only 4 cardiologists for a population of 11.4 million, Rwanda represents a resource-limited setting lacking the local capacity to detect and treat early cases of strep throat and perform lifesaving operations for advanced rheumatic heart disease...
February 27, 2018: Journal of Thoracic and Cardiovascular Surgery
Jennifer L Reed, Stephanie A Prince, Andrew L Pipe, Suzanne Attallah, Kristi B Adamo, Heather E Tulloch, Douglas Manuel, Kerri-Anne Mullen, J George Fodor, Robert D Reid
BACKGROUND: Nurses are the largest professional group within the health care workforce, and their work is perceived as being physically demanding. Regular physical activity helps to prevent or ameliorate cardiometabolic conditions (e.g. cardiovascular disease, diabetes). It is not known whether Canadian nurses are meeting current physical activity guidelines. OBJECTIVE: To assess the influence of the workplace on the physical activity and cardiometabolic health of nurses from hospitals in the Champlain region of Ontario, Canada...
February 13, 2018: International Journal of Nursing Studies
Michelle Boltz, Norma G Cuellar, Casey Cole, Brent Pistorese
Introduction Since 2010, more than 75 rural hospitals have closed in the USA and more than one-third are at risk of closure due to lower patient volumes, lower funding levels, decreased hospital revenue and lower physician employment pools. Telemedicine can provide new models of care delivery that maintain quality and reduce cost of healthcare in rural populations. The purpose of this project was to evaluate a cross-organizational pilot program by comparing a NP/telemedicine physician hospitalist programme with a traditional physician hospitalist model to assess effects on length of patient stay, mortality rates, readmission rate, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings of provider communication, and total hospital costs...
January 1, 2018: Journal of Telemedicine and Telecare
Michelle Giles, Vicki Parker, Jane Conway, Rebecca Mitchell
BACKGROUND: Clinical Leaders drive healthcare performance in the provision of safe high quality patient care by influencing others and augmenting change. Clinical leadership features strongly in Nurse Consultant (NC) roles and holds potential to strengthen the NC's place in healthcare teams, making their contribution as clinical leaders more recognisable. This study explores how clinical leadership is enacted through the NC role, providing understanding of the elements that influence their effectiveness as clinical leaders...
March 1, 2018: Journal of Clinical Nursing
Diana-Lyn Baptiste, Jill B Hamilton, Cynthia Foronda, Elizabeth Sloand, Beth Fahlberg, Teresa Pfaff, Sabianca Delva, Patricia M Davidson
AIM: The aim of this integrative review is to determine what is known about hypertension among adults living in Haiti. BACKGROUND: Hypertension is the leading cause of morbidity, the identified cause of heart failure in 45% of patients, and is associated with more than 70% of cardiovascular disease-related hospital admissions in Haiti. DESIGN: An integrative review of literature. METHODS: Searching four databases from 2007-2018, Whittemore and Knafl's method was used to review the literature...
March 1, 2018: Journal of Clinical Nursing
Ian Hall
The Isles Network of Care (INOC) community nurses work at the extreme of the remote and rural continuum, working mostly as lone practitioners. Following the development of sustainable clinical supervision model for Isles nurses in Orkney, clinical supervision was found to improve both peer support and governance for this group of isolated staff. A literature overview identified the transition of clinical supervision in general nursing over 24 years from 'carrot' to 'stick'. The study included a questionnaire survey that was sent to the 2017 Queen's Nursing Institute Scotland cohort to elicit information about the nurses' experience of clinical supervision...
March 2, 2018: British Journal of Community Nursing
Susan A Boyer, Elizabeth A Mann-Salinas, Krystal K Valdez-Delgado
The clinical transition framework (CTF) is a competency-based practice development system used by nursing professional development practitioners to support nurses' initial orientation or transition to a new specialty. The CTF is applicable for both new graduate and proficient nurses. The current framework and tools evolved from 18 years of performance improvement and research projects engaged in both acute and community care environments in urban and rural settings. This article shares core CTF concepts, a description of coaching plans, and a professional accountability statement as experienced within the framework...
March 2018: Journal for Nurses in Professional Development
Dusanee Suwankhong, Pranee Liamputtong
Background: Chemotherapy treatment can increase survival rates among women with breast cancer elsewhere. However, it also has negative impact on women’s general appearance, body image and psychological functioning. This study aimed to describe the experiences of chemotherapy treatment among Thai women with breast cancer in rural communities, sounthern Thailand. Methods: Qualitative approach was employed to gain insights about the experiences of the women. In-depth interviewing and drawing methods were conducted with 20 Thai women who had been diagnosed with breast cancer...
February 26, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Susanne Palmcrantz, Disa K Sommerfeld
OBJECTIVES: Because healthcare and community organisations and treatment methods are always changing, continuous changes might also be needed in questionnaires that register patient-reported outcomes (PRO) and patient-reported experiences (PRE) of healthcare interventions and community support. Thus, the aim of this study was to test the content and face validity, including the readability, of two questionnaires used by the Swedish national stroke register Riksstroke to register PRO and PRE at 3 and 12 months poststroke...
February 22, 2018: BMJ Open
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