摘要:

ABSTRACT:This is a brief clinical description of a group of people from an Arnhem Land community with a population of about 1500. The community has five people on full‐time dialysis in Darwin, about 400 km away, and another four people who are being actively prepared for dialysis. Of these nine people, three come from within two generations of one clan: that is, from a group of about 40. This apparent family tendency is one of many factors producing kidney disease in Northern Territory Aboriginal people, who suffer extreme rates of end‐stage renal failure (ESRF). Our understanding of these causes is quite embryonic. Despite several years of lobbying by Aboriginal health organisations the Northern Territory government has no coherent plans for ongoing prevention and management of kidney problems, and no services outside the main urban centres. The issues involved are discussed from the perspective of our bush clinic, kilometres away from renal biopsies and formal clinical resea

ISSN:1038-5282    

DOI:10.1111/j.1440-1584.1996.tb00190.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACT:This paper provides a human face to advanced life support (ALS) and its assention within rural nursing practice. Over the past 5 years the issue of defibrillation and who performs it has been debated. This paper will add to the discussion. It examines the history surrounding the development of ALS, education within the hospital and isolated rural setting competency testing. It questions the limited role of current nursing practice and makes recommendations for stretching the boundaries of the nursing role in ALS. Emphasis is placed on the rural perspective and its consequent implications for individuals living in a rural environment.

ISSN:1038-5282    

DOI:10.1111/j.1440-1584.1996.tb00191.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACT:Border issues are commonly conceptualised as concerns about inequities in health care for people living near State boundaries or borders. This paper examines how border issues have been addressed in the implementation of primary healthcare at the community level. The paper focuses on the implementation of primary healthcare principles in two towns, Wallangarra in Queensland and Jennings in New South Wales. The primary healthcare approach employed by Stanthorpe Health Services addressed border issues by providing the residents of Wallangarra and Jennings with equitable access to health service provision. The structure of health service delivery, the funding differences in each State and the impact of State policies on the residents of these two towns are discussed. The paper demonstrates how application of primary healthcare principles has reduced the impact of some of the border issues faced by the residents of Wallangarra and Jennings.

ISSN:1038-5282    

DOI:10.1111/j.1440-1584.1996.tb00192.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACT:The challenge of how best to provide equitable, accessible and affordable health care in rural and remote settings is an international concern. It has been acknowledged that a multidisciplinary approach to current rural health issues involving social scientists and health practitioners may be crucial in developing appropriate responses. One initiative designed to facilitate multidisciplinary research and greater collaboration between researchers and practitioners was an International Summer Institute sponsored by the Social Science and Humanities Research Council of Canada. This article outlines an Australian perspective on the rationale for, background to, and structure of this initiative, and evaluates it as one option for promoting multi‐disciplinary approaches to rural health researc

ISSN:1038-5282    

DOI:10.1111/j.1440-1584.1996.tb00193.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACT:Recruitment and retention of professionals is a major issue in rural health care. Following a literature review and series of focus groups, a questionnaire to ascertain why professionals applied for, stayed in and would consider leaving rural mental health work was constructed. The questionnaire also included questions regarding possible initiatives that could be undertaken to improve recruitments. The questionnaire was distributed through informal networks to over 900 professionals. Four hundred and seventy eight questionnaires were returned, representing a 52% return rate. According to the response work related issues were generally more important than lifestyle/personal issues particularly as reasons for applying for rural work. Lack of organisational support and professional isolation were important detractors of rural work, with strong support being expressed for initiatives that would address these issues. The findings suggest that recruitment action might highlight the scope, variety, challenge and autonomy aspects of work, with retention focusing on professional support and contact and increased organisational support.

ISSN:1038-5282    

DOI:10.1111/j.1440-1584.1996.tb00194.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACT:This study was designed to develop a quick methodology to assess the healthcare needs of a rural community and to determine what factors make these communities ‘happy’ or ‘unhappy’ with respect to medical service provision. Two rural shires of approximately 4000 people each were chosen from different health regions of Western Australia. The methodology consisted of interviews with healthcare providers and key community informants as well as a community questionnaire. The interviewing process showed that key community informants offered no new information in addition to that already provided by the healthcare providers. Furthermore, all key points would have been covered by interviewing approximately 60% of all healthcare providers in each community. Hand delivery of the community questionnaire yielded the highest response rate. The level of community satisfaction with general practitioner (GP) and hospital services determines whether a community is medically ‘happy’ o

ISSN:1038-5282    

DOI:10.1111/j.1440-1584.1996.tb00195.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACT:People from rural and remote areas commonly need to attend provincial and metropolitan cities for specialist care. Their decisions to make such trips ‘away’ involve a number of non‐medical considerations that include economic, emotional and social factors. This paper reports the results of two surveys that sought information about the types and importance of nonmedical considerations taken into account by rural and remote Queensland householders when faced with a trip away. In addition, the problems encountered by respondents on their last trip away are reported and discussed. The data revealed that important considerations taken into account when planning the trip were predominantly related to urgency, household organisation and the costs likely to be incurred while away. A number of avoidable problems occurring at destination were also described. Generally, remote area respondents saw these impediments as more serious barriers to seeking care than did rural area respondents. When respondents were further asked to identify major problems associated with their last trip to an urban facility, problems at the destination figured more prominently, particularly problems directly related to the lack of understanding of the transport and distance needs of rural people. With one exception, these problems were reported by similar proportions of rural and remote area respondents. These are matters that merit high priority attention in any programs to enhance access to specialist medical services by people in rural and remote

ISSN:1038-5282    

DOI:10.1111/j.1440-1584.1996.tb00196.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACT:This paper outlines the programs that support country high school students with the potential to take tertiary health training, particularly in medicine and the details of mentor support and the transition into medical undergraduate training. Also, the establishment of rural clubs in Adelaide and Flinders Universities, together with their aims, objectives and activities are highlighted together with details of the evaluation process which has confirmed the success of rural clubs. The establishment of an effective database is described, with a summary of its objectives and scope.

ISSN:1038-5282    

DOI:10.1111/j.1440-1584.1996.tb00197.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

ABSTRACT:The General Rural Practice Incentives Program (GPRIP) part of the General Practice Strategy has progressively been introduced since 1992 to address a number of impediments to rural general practice. This article provides an overview of the GPRIP and an indication of its early successes.

ISSN:1038-5282    

DOI:10.1111/j.1440-1584.1996.tb00198.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY