Rural and Remote Health

Journal Information
ISSN / EISSN : 14456354 / 14456354
Current Publisher: Rural and Remote Health (10.22605)
Total articles ≅ 323
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Latest articles in this journal

Teresa Sharp, Joyce Weil, Audrey Snyder, Kathleen Dunemn, Gwyneth Milbrath, Jeanette McNeill, Elizabeth Gilbert
Published: 15 November 2019
Rural and Remote Health, Volume 19; doi:10.22605/rrh5335

Matthew L Smith, Samuel Towne Jr, Caroline D Bergeron, Donglan Zhang, Carly Mccord, Nelda Mier, Heather H Goltz
Published: 9 November 2019
Rural and Remote Health, Volume 19; doi:10.22605/rrh5147

Claire Snell-Rood, Michele Staton, Athena Kheibari
Published: 9 November 2019
Rural and Remote Health, Volume 19; doi:10.22605/rrh5279

Louise Keogh, Samantha Croy, Danielle Newton, Marianne Hendron, Shannon Hill
Published: 2 November 2019
Rural and Remote Health, Volume 19; doi:10.22605/rrh5156

Emmanouil Symvoulakis, Adelais Markaki, George Rachiotis, Manolis Linardakis, Spyridon Klinis, Myfanwy Morgan
Published: 30 October 2019
Rural and Remote Health, Volume 19; doi:10.22605/rrh5241

Abstract:Behavioral determinants can enable or hinder motivation towards registration and donorship and, subsequently, action or inertia towards organ donation. Nevertheless, there is limited information about the role of self-efficacy in relation to organ donation awareness and presumed consent among individuals and their families. The aim of this study was to explore knowledge, attitudes and general self-efficacy as behavioral determinants for organ donation among rural primary care attendants, in order to tailor awareness strategies for reversing inertia within an opt-out system. This was a prospective face-to-face survey during regularly scheduled appointments of 203 attendants at a rural primary care unit in northern Greece. Responses to a 12-item adapted 'Organ donation awareness' questionnaire measuring knowledge, attitudes and awareness were related to participants' General Self-Efficacy (GSE) Scale score. Hierarchical modelling of a multiple linear regression model was adopted with GSE score added. About one-third of respondents (34.0%) had discussed presumed consent with a partner, family member or friend. More than half (54.2%) were concerned that donated organs might be used without consent for other purposes, such as medical research. A total of 30% found organ donation unacceptable because of religious beliefs. Organ donation awareness was not influenced by respondents' specific characteristics, but was significantly related to the GSE score (standard β=0.155, p=0.033). Overall, organ donation perceptions among rural primary care recipients were determined by knowledge of the presumed consent procurement system, pre-conceptions, religious beliefs, altruism and GSE scores. The association of self-efficacy with raised awareness could potentially explain the gap between high intent to consent as a donor and subsequent lack of follow-up action. Further comparative research across behavioral determinants between rural/urban groups is needed in order to tailor awareness strategies suitable for an opt-out system.
Bridget Kenny, Elizabeth Hoban, Ponnary Pors, Joanne Williams
Published: 28 October 2019
Rural and Remote Health, Volume 19; doi:10.22605/rrh5240

Abstract:Adolescents from indigenous populations in Ratanak Kiri Province in Cambodia experience worse sexual and reproductive health (SRH) outcomes when compared to their urban counterparts. However, few qualitative studies have been conducted to identify factors that may explain the poor SRH outcomes experienced by this population group. The socioecological model was used as the analytical lens to explore the SRH knowledge and sources of SRH information of adolescent mothers (aged 15-19 years) from indigenous populations in north-eastern Cambodia. Adolescent mothers from the Tompoun and Jarai indigenous population groups (n=22) were purposively recruited from seven villages in two districts of Ratanak Kiri Province. All adolescent mothers engaged in a combined body mapping exercise and semi-structured interview; this approach was considered the most appropriate qualitative data collection method to use in this context as it reduced language, cultural and social barriers that have previously restricted qualitative exploration of sensitive issues among this population group. The body maps and semi-structured interview transcripts were analysed using thematic analysis. Adolescent mothers demonstrated limited SRH knowledge including that pertaining to the anatomy of the female reproductive body, the physiology of human reproduction, fertility and pregnancy. Adolescents' primary source of SRH information was interaction with female family members and friends within their community. Adolescents' limited SRH knowledge was influenced by factors on individual (eg educational attainment, child marriage), relationship (eg social interaction with female family members and friends), community (eg access to educational and healthcare services) and societal (eg barriers to accessing national SRH programs and initiatives) levels. The%u202Ffindings support the need for SRH education in the primary and secondary school curriculum. In 2018 the Cambodia Ministry of Education, Youth and Sports introduced a Comprehensive Sexuality Education (CSE) program into the government primary and secondary school curriculum. The CSE, which is delivered in the Khmer language, provides Cambodian youth with an avenue to access accurate SRH information that will aid their SRH decision-making. However, indigenous girls face numerous social, cultural, economic and language barriers that restrict or prevent their access to formal education. Therefore, additional SRH materials and resources that are culturally and linguistically appropriate need to be developed for indigenous students attending primary and secondary schools in Ratanak Kiri Province and for young people who have ceased formal education. Educating village chiefs to deliver non-formal, community-based education programs is proposed as a means of increasing SRH knowledge and reducing health inequalities faced by this population group while ensuring that accurate information is delivered in a culturally appropriate manner.
Umair Majid, Sujane Kandasamy, Kelly Farrah, Meredith Vanstone
Published: 23 October 2019
Rural and Remote Health, Volume 19; doi:10.22605/RRH5190

Abstract:Cervical cancer is one of the leading causes of mortality in women. Population-based cervical cancer screening programs have been highly effective in reducing the incidence and mortality of cervical cancer worldwide. However, disparities remain in women's cervical cancer screening participation rates, especially in rural and remote areas, where access to health care may be circumscribed due to logistical barriers. Until now, there has been no effort to review and synthesize the perspectives and experiences of women accessing cervical cancer screening in rural and remote areas. This systematic review and qualitative meta-synthesis of 14 studies aimed to describe and elaborate the issues women face when accessing cervical cancer screening in rural and remote areas. This study used the qualitative meta-synthesis approach to review 14 studies on rural women's participation in cervical cancer screening. This research approach synthesized findings from multiple, primary qualitative studies to produce a new interpretation of the phenomenon while retaining the original meaning of each qualitative study. After 4937 citations were screened by database searching, 117 were retrieved for full-text review, of which 14 studies were included. This study identified two themes that modulate rural women's access to cervical cancer screening: interactions with healthcare providers and healthcare system access. Furthermore, this study found that women frequently expressed issues around patient-centered care in their interactions with healthcare providers. The implications of these findings for program design and delivery efforts in rural and remote areas are discussed. This article provides the foundation for tailoring interventions and programming to increase cervical cancer screening rates in women who reside in rural and remote areas. This review also clarifies the factors of patient-centered care that may be adopted to enhance the quality of care for women in rural and remote areas. In summary, this systematic review and qualitative meta-synthesis provide information about women's perspectives and experiences accessing cervical cancer screening in rural and remote areas. The review has strong implications for this population and can be used to inform future research and program design initiatives.
Hensllyn Boseto, Marion Gray, Ruth Langmead
Published: 21 October 2019
Rural and Remote Health, Volume 19; doi:10.22605/RRH5376

Abstract:In most Western countries occupational therapy is well established as a crucial aspect of overall health care; however, in low-middle-income countries it is still an emerging profession. This article investigates the role of occupational therapy in the Solomon Islands by examining the experiences and perceptions of occupational therapists (OTs) and other rehabilitation health workers who have worked there. Using a qualitative research design, participants were recruited using purposive sampling, and data were gathered through in-depth interviews, diary entries and observations of an occupational therapy setting in the Solomon Islands. Ten participants were interviewed. A significant role in health-promoting practices was revealed through the various tasks undertaken by OTs in the Solomon Islands, including influencing health policy and practice broadly through advocacy and education. Challenges relating to geography, cultural, language and resource barriers, and professional practice issues were identified. Implications for practice were drawn from the data including the need for culturally safe practice, pragmatism, creativity and practising across disciplinary boundaries. Results illustrate a clear role for occupational therapy in promoting health and sustainability of rehabilitation therapy services in the Solomon Islands, which also have relevance throughout Pacific island nations.