ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00510.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00511.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractRural communities, rural advocacy organizations, and policy makers persist in perpetuating two serious but related misconceptions, namely: (1) The continuing deterioration of health services in most rural communities is primarily the result of forces and factors outside of the communities themselves, and (2) the solution to reverse this deterioration will come mainly from changes in reimbursement and other types of public policy initiatives. Overemphasis on the role of external factors has created a serious imbalance in programs, resources, and policy efforts, including those supported by the NRHA, resulting in inadequate national efforts and resources to foster community‐based solutions. Suggested solutions include: (1) application by communities of a proven set of principles for organizing and developing local health services, and (2) creation of a national network to promote suck community‐based soluti

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00512.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:This study examines the issues associated with enhancing the representation of rural areas in the National Medical Expenditure Survey (NMES). It reviews alternative definitions of rural areas and describes the classification schemes considered for future cycles of the NMES. A review of the NMES sample representation in rural areas and an examination of the analytical capabilities and limitations of the current design for deriving health care estimates of the rural population is provided. The options presented in this article would extend the analytical capacity of the NMES to permit estimates of rural areas of the national classified by census region, by gradations of rural classification, and for individuals residing in rural frontier counties.

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00513.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:This study examines the health insurance coverage of the nonelderly population in U.S. urban and rural areas in 1989, using data from the March 1990 Current Population Survey conducted by the Bureau of the Census. Access to coverage was assessed by classifying all persons by family employment status and income. Rural residents had less access to coverage than urban residents but were only slightly less likely to be insured. In comparison to urban residents, fewer rural residents obtained coverage through employment, and more purchased private coverage outside the work place. The differences in coverage by family employment status and income were generally much greater than the differences by place of residence.

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00514.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:A greater understanding of the health‐protective and ‐promotive aspects of family hardiness may assist health professionals in preventing some illnesses or relational problems or in lessening their effects on the family. Farm and ranch families may be at particular risk due to their unique stressors and strains, including social and geographic isolation, unstable incomes, lack of or distance from community resources, and, perhaps, societal stereotypes that support the notion that these families have fewer stresses and problems than urban families. This study tested three path models focusing on the direct and indirect effects of stressors (i.e., life changes) and strains (daily frustrations), in relation to physical illness and relational difficulties (family discord and distress) reported by 188 farm and ranch husbands and wives. Three dimensions of family hardiness served as intervening variables: commitment, challenge, and control. A series of multiple regression analyses revealed that family stressors and strains unique to farming and ranching were strongly predictive of reported family illnesses, discord, and distress. Although the buffering effects of family hardiness in relation to reported illness were minimal, the hardiness dimension of challenge did have a strong mediating influence on reported family discord. In addition, the commitment and control dimensions had mediating effects on family distress. The results suggest that while stressors and strains unique to farming and ranching can have negative outcomes, hardier families may be more apt to respond to stress as challenging and growth producing rather than as debilitat

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00515.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:The first objective of this article is to summarize literature on selected variables that can influence parents' efforts to enhance their parenting skills, including participation in prevention‐oriented education and skills‐training programs. The second objective is to report the results of a survey of rural parents with preadolescents (N=203) on prevention‐relevant parenting beliefs and past parenting enhancement efforts, such as parent education program attendance. Descriptive analyses of these variables and their relationships to socioeconomic status and family composition are reported. Results regarding prevention‐relevant parenting beliefs indicate relatively low levels of perceived susceptibility to adolescent problem behaviors and high levels of perceived parent efficacy in preventing adolescent problems. High levels of past parenting enhancement efforts also were reported. Little evidence of gender differences on the parenting belief and enhancement variables was found, but education, income, and family structure and composition variables were significantly associated with several key parenting belief and enhancement va

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00516.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract:A major disadvantage of rural medical practice is the limited reserve of consultative options. To determine the perceived clinical utility and educational impact of the West Virginia University Medical Access and Referral System (MARS), a 24‐hour prompt telephone‐consultation service, a mailed questionnaire was administered to 303 West Virginia clinicians who had used MARS for infectious disease problems. The overall questionnaire response rate was 62 percent. Callers included family practitioners (35%), medical specialists (32%), surgical specialists (13%), pediatricians (11%), obstetricians (5%), and nonphysicians (4%). Major referral questions posed were therapeutic (60%), diagnostic (48%), and epidemiologic (10%) in nature. On a scale of 1 (not useful) to 5 (very useful), survey responders rated the overall clinical usefulness of MARS as either a 4 (22%) or 5 (76%). Callers felt that MARS consultation assisted in accurate case diagnosis in 80 percent of cases, and aided in successful therapeutic management of 96 percent of cases. An educational benefit was reported by 96 percent of responders. Physicians located in more rural, underserved areas tended to use MARS to a greater degree than colleagues in more populated, medically accessible areas (P<0.005). These findings suggest that an academic telephone‐access consultation program can be a clinically relevant and educational consultative tool for practicing clinicians, especially those located in rural

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00517.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This section ofThe Journal of Rural Healthis intended to assist readers in the efforts to keep current with the research literature relevant to rural health. In monitoring the journals from neighboring disciplines, we attempt to alert readers to new research and scholarly debate. The scope of this section is, for the most part, limited to publications from the United States. Inclusion of a publication does not represent an endorsement of the research or the validity of the conclusions reported. As research reviews editor, I invite comments on this section.

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00518.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Book reviewed in this article:Increasing Rural Health Personnel: Community‐Based Strategies for Recruitment and Retention: American Hospital Association, ChicagoAdolescents at Risk: David E. Rogers and Eli Ginzberg (Editors

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1993.tb00519.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY