Australian Journal of Rural Health (Aust J Rural Health)

Publications in this journal

• Article: Will the National Report Card 'A Contributing Life' make a meaningful contribution to mental health reform?

  Russell Roberts
  Australian Journal of Rural Health 04/2013; 21(2):59-60.
• Article: Improving eye care for Indigenous Australians in primary health care settings.

  Andrea I Boudville, Mitchell D Anjou, Hugh R Taylor
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  ABSTRACT: This paper aims to assess the barriers and solutions to the delivery of eye care in primary care settings and solutions to improve the use of comprehensive eye care among Indigenous Australians. Qualitative, mixed method study participants include Aboriginal community members, and health and eye care providers in urban, rural and remote settings. Present evidence for health care providers to better understand and address some of the barriers that limit access to eye care in primary care settings. Patient perspectives on barriers to accessing eye care and reasons they choose to seek care or not are presented. Health system barriers identified by health and eye care providers are also presented. Additionally, key enablers for improving access to eye care through primary care services are identified. Primary health care services have an important role in Indigenous eye health. There is a critical role for primary care in the coordination of the patient journey and cooperating with other services to improve access to comprehensive eye care. Through improved provision of primary eye care, monitoring of Indigenous eye health indicators and supporting patients to access eye care, it is possible to close the gap for vision.
  Australian Journal of Rural Health 04/2013; 21(2):121-7.
• Article: Rural Ethics Ward Rounds: Enhancing medical students' ethical awareness in rural medicine.

  Lisa Watts, Lisa Parker, Helen Scicluna
  Australian Journal of Rural Health 04/2013; 21(2):128-9.
• Article: Role of personality in medical students' initial intention to become rural doctors.

  Michael P Jones, Diann Eley, Lisa Lampe, Carissa M Coulston, Gin S Malhli, Ian Wilson, Brian Kelly, Nicholas J Talley, Cathy Owen, Gerry Corrigan, Barbara Griffin, John Humphreys, Beatrice Alba, Pamela Stagg
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  ABSTRACT: Recent efforts to redress the deficit of rural medical practitioners have considered the problem of recruitment and retention of rural doctors as one of influencing individuals' career choices. Exposure to rural medical environments during basic medical training is one long-standing example of an initiative aimed in this direction and there is some evidence that it is effective. This study sought to determine whether or not various domains of personality are related to medical students' attitude to practising as rural doctors after graduation. The sample comprised 914 students commencing medical studies in Australian universities. They were recruited as part of the Medical Schools Outcomes Database project and indicated intended location of future medical practice. Seven Australian basic medical training programs. All students completed the NEO five-factor index (NEO-FFI) and Adjective Checklist (ACL) personality instruments. A preference for a rural practice location was associated with a combination of six domains of personality. The probability of rural preference was greater with higher scores on openness to experience, agreeableness and self-confidence but lower with higher scores on extraversion, autonomy and intraception. Taken together these six domains of personality provide useful although imperfect discrimination between students with a rural versus urban location preference. After controlling for student age the associations with extraversion and agreeableness failed to reach statistical significance. While personality does not fully explain medical students' attitude towards practicing as a rural doctor, the data suggest it is an important factor and that some individuals may be better suited to a rural medical career than others. Considering personality along with other characteristics of the individual might allow targeted 'marketing' of rural practice.
  Australian Journal of Rural Health 04/2013; 21(2):80-9.
• Article: Elderly patients with hip fracture are treated promptly in a Tasmanian rural hospital.

  Yangyang Liu, Scott Fletcher, Ling Li
  Australian Journal of Rural Health 04/2013; 21(2):130-1.
• Article: The sociodemographic and health-related characteristics of a regional population with chronic disease at an interprofessional student-assisted clinic in Queensland Capricornia Allied Health Partnership.

  Kerrie-Anne Frakes, Sharon Brownie, Lauren Davies, Janelle Thomas, Mary-Ellen Miller, Zephanie Tyack
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  ABSTRACT: This paper describes the sociodemographic and health-related characteristics of people with chronic disease attending an interprofessional student-assisted clinic in regional Queensland. A retrospective review of data collected during the first 10 months of operation of the clinic was conducted. SETTING, PARTICIPANTS AND OUTCOME MEASURES: Data was collected on up to 378 patients during an intake appointment at the Capricornia Allied Health Partnership (CAHP) community-based clinic and compared with normative reference groups where available. Sociodemographic characteristics included age, gender and education level; health-related characteristics included body mass index and hospitalisations in the previous 12 months; and risk factors included prescribed medications, smoking status and general practitioner-diagnosed medical conditions. Patients attending the CAHP clinic had a mean number of chronic conditions of 4.9 ± 2.1 per patient, and 97% of patients had multimorbidities. A high level of socioeconomic disadvantage was found in comparison with normative comparison groups based on employment, highest level of schooling completed and the index of social disadvantage. Patients predominantly lived in inner regional areas (76.7%). The most common diagnoses of patients attending the clinic for the first time were hypertension, osteoarthritis, high cholesterol, diabetes and chronic back pain. The CAHP clinic offers a unique student-assisted service model for interprofessional management of patients who are socioeconomically disadvantaged, have multimorbid chronic disease and live in regional areas. The description of baseline data in this paper is important to refine clinic services, to guide other chronic disease clinics and to inform future research study designs.
  Australian Journal of Rural Health 04/2013; 21(2):97-104.
• Article: Attracting psychologists to practice in rural Australia: The role of work values and perceptions of the rural work environment.

  Alexis M Conomos, Barbara Griffin, Nadia Baunin
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  ABSTRACT: To investigate whether psychologists' career/work values and perceptions of the rural work environment influence their intentions or choice to practise in a rural location beyond the effect of rural background. Online, cross-sectional survey assessed rural background, work values and perceptions of the reinforcers available in rural and urban work environments. One hundred and eighty-nine first year psychology students (78.8% women) and 124 registered psychologists (84.7% women). Students' intention to practise in a rural location and psychologists' choice of practice location. Rural environments were seen as offering psychologists less opportunity than urban environments to fulfil their need for lifestyle, prestige, management and scholarly pursuits, but more opportunity for service and autonomy. Practitioners and students who placed less value on prestige were more likely to have worked in a rural area or be intending to do so. High value of service was also a predictor of rural intentions. Perceptions that rural work environments offered opportunities for scholarly pursuits increased the odds that a psychologist had spent time practising in a rural area. Person-environment fit was not significant. Recruitment and retention strategies to address the shortage of mental health professionals in rural areas need to consider perceptions of the work environment and how to fulfil practitioners' work values.
  Australian Journal of Rural Health 04/2013; 21(2):105-11.
• Article: Physical activity in three regional communities in Queensland.

  Wendy J Brown, Nicola W Burton, Shannon Sahlqvist, Kristiann C Heesch, Kylah B McCarthy, Norman Ng, Jannique G Z van Uffelen
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  ABSTRACT: To describe physical activity participation in three Queensland regional communities. Cross-sectional mail survey of randomly selected residents, stratified by age and sex. Esk, Mareeba and Mount Isa. 1219 (58% women) adults, with a mean age 46.7 (standard deviation 14.7) years. Proportion of people inactive, meeting Australian activity guidelines (a minimum of 150 min week(-1) and five sessions week(-1) ) and walking a dog daily; time spent walking and cycling for transport; location and type of recreational physical activities. Overall, 18% of respondents were inactive, with the highest proportions among women (22.3%) and older adults in Mount Isa (24.3%). The proportion meeting activity guidelines was 47%, with the lowest proportion among women in Mount Isa (40.4%). Although 63% reported owning a dog, only 22% reported walking a dog daily. Few people reported walking or cycling for transport. The most common types of activities were walking, home-based exercise, running/jogging and swimming, and the most common location was at or near home. Physical activity levels were lower in these regional communities than the state average. The findings indicate a need for physical activity policy and intervention strategies targeting regional and rural areas. This could focus on women and older adults, dog walking and physical activity opportunities in or near the home.
  Australian Journal of Rural Health 04/2013; 21(2):112-20.
• Article: A PowerPoint is for a conference, an article is forever.

  David Perkins
  Australian Journal of Rural Health 04/2013; 21(2):57-8.
• Article: Indigenous perspectives on the desired attributes of medical graduates practising in remote communities: A Northwest Queensland pilot study.

  Torres Woolley, Sundram Sivamalai, Simone Ross, Glenda Duffy, Adrian Miller
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  ABSTRACT: Providing an emphasis on Indigenous health in medical undergraduate education is seen as a high priority by Australian medical organisations. A regional North Queensland medical school asked local Indigenous people to list personal attributes they want to see in graduate doctors who choose to practise in their remote community. This 2011 pilot study used a participatory action research design, with 13 local Indigenous health professionals, elders and community members from Mount Isa participating as co-researchers in 'Yarning Circles' discussing desired medical graduate attributes. Medical school co-researchers inductively extracted themes from the discussions via a qualitative 'grounded theory' approach. Eight major subtopics were identified by the Mount Isa Indigenous community around desired skills, knowledge and attitudes for graduate doctors: provision of quality patient care; culturally appropriate communication; medical knowledge; culturally appropriate knowledge; knowing the local health system; a positive personality; a positive attitude to working with Indigenous peoples; and a desire to engage with the Indigenous community. Effective communications with Indigenous patients and working in remote Indigenous communities requires doctors to have appropriate clinical skills, medical knowledge, knowledge about how local health systems operate, familiarity with significant Indigenous health issues such as child safety and alcohol management, and positive attitudes to working with, learning about and providing an advocacy role for Indigenous peoples. Findings have implications for enhancing the professional behaviours and engagement of James Cook University medical students in Indigenous communities while on rural placement and after graduation, and for Australian medical and health practitioners more broadly.
  Australian Journal of Rural Health 04/2013; 21(2):90-6.
• Article: Training general practitioners in remote Western Australia in a method of screening and brief intervention for harmful alcohol use: A pilot study.

  Catherine Brennan, Melanie Newton, Fiona Wood, Stephan A Schug, Steve Allsop, Allyson L Browne
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  ABSTRACT: High levels of alcohol-related harm are a salient feature of many rural communities in Australia. General practitioners (GPs) are uniquely placed to identify and treat patients with harmful alcohol use in remote settings, yet corresponding opportunities for education in effective brief psychological interventions for harmful alcohol use are limited. This study piloted a training model for alcohol screening and brief intervention for GPs working in Kalgoorlie-Boulder, a remote Western Australian community facing significant alcohol-related problems. Observational pilot study. Primary care. Perceived role in responding to harmful alcohol use, and confidence and knowledge of alcohol screening and brief intervention; satisfaction with a short training session focused on alcohol screening and brief intervention; and impact of training on implementation of screening and brief intervention for harmful alcohol use. Fifty per cent of GPs took up the training opportunity. GPs recognised their professional responsibility for conducting brief intervention but reported comparatively lower confidence and skills in implementing screening and intervention prior to training. The training improved knowledge and confidence in conducting alcohol screening and brief intervention. All GPs increased their frequency of alcohol screening, and 88% of GPs reported increasing the frequency of brief intervention at 6 months. Preliminary findings suggest that among participating GPs, subsequent compliance with identification and management of harmful alcohol use was improved. Further work examining methods to improve rural and remote GP participation in alcohol-related harm prevention training is required, as the potential impact on communities with disproportionately high alcohol-related difficulties is significant.
  Australian Journal of Rural Health 04/2013; 21(2):72-9.
• Article: Helping policy-makers address rural health access problems.

  Deborah J Russell, John S Humphreys, Bernadette Ward, Marita Chisholm, Penny Buykx, Matthew McGrail, John Wakerman
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  ABSTRACT: This paper provides a comprehensive review of the key dimensions of access and their significance for the provision of primary health care and a framework that assists policy-makers to evaluate how well policy targets the dimensions of access. Access to health care can be conceptualised as the potential ease with which consumers can obtain health care at times of need. Disaggregation of the concept of access into the dimensions of availability, geography, affordability, accommodation, timeliness, acceptability and awareness allows policy-makers to identify key questions which must be addressed to ensure reasonable primary health care access for rural and remote Australians. Evaluating how well national primary health care policies target these dimensions of access helps identify policy gaps and potential inequities in ensuring access to primary health care. Effective policies must incorporate the multiple dimensions of access if they are to comprehensively and effectively address unacceptable inequities in health status and access to basic health services experienced by rural and remote Australians.
  Australian Journal of Rural Health 04/2013; 21(2):61-71.
• Article: Community understanding of the preventability of major health conditions as a measure of health literacy.

  Karen Moore, Ben J Smith, Karen Reilly
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  ABSTRACT: To examine health literacy in a rural community by measuring the understanding of the preventable nature of six major health conditions. Cross-sectional population survey. New housing areas of Strathfieldsaye, Victoria. A total of 197 adults aged 18 years or older. Perceived preventability of skin cancer, lung cancer, cervical cancer, high blood pressure, heart attack and diabetes. Skin cancer was the only condition which most people perceived as being all or mostly preventable (50.3%). Lung cancer was perceived to be all or mostly preventable by 35.5% of respondents, high blood pressure by 34.0%, cervical cancer by 27.4%, diabetes by 25.4% and heart attack by only 14.7%. This study shows that there is a lack of understanding of the preventability of these health conditions. Efforts need to be directed towards improving the public's knowledge of disease prevention and to ensure that health promotion programs reach populations with the most need.
  Australian Journal of Rural Health 02/2013; 21(1):35-40.
• Article: Do we need rural health researchers living in rural Australia?

  David Perkins
  Australian Journal of Rural Health 02/2013; 21(1):1-2.
• Article: A hub and spokes approach to building community capacity for eating disorders in rural Western Australia.

  Julie McCormack, Hunna J Watson, Chris Harris, Julie Potts, David Forbes
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  ABSTRACT: To determine whether an outreach community-based training program on eating disorders enhances perceived capacity of rural health and education professionals to respond to and manage eating disorders. Survey conducted upon completion of outreach training. Rural Western Australia. Health and education professionals working in rural Western Australia. Questionnaire responses analysed via descriptive statistics and inferential tests. There was a significant increase in perceived ability to identify, support and/or treat people with eating disorders among health and education professionals. Outreach training up-skilled rural gatekeepers and introduced systemic health system benefits of increased consultation and liaison, a fine-tuning of referral processes, a reduction in hospital admissions and better uptake of local services by patients discharged from hospital.
  Australian Journal of Rural Health 02/2013; 21(1):8-12.
• Article: Utilisation of multidisciplinary services for diabetes care in the rural setting.

  Jessica Madden, Amanda Barnard, Cathy Owen
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  ABSTRACT: To quantify utilisation of allied health care services by diabetics in rural NSW and explore reasons for any underutilisation. Self-administered mail survey of 268 patients with diagnosed diabetes identified from practice registers. Two rural general practices. One hundred seventeen respondents with diabetes. Annual frequency of visits to allied health practitioners. In the last year, 40.2% of patients had seen a diabetes educator (DE), 21.4% a dietitian and 47% a podiatrist. However, 25-40% of patients had never used each of the services. Reasons for nonutilisation were non-referral (35.9-68.0%) and lack of perceived need (40.6-59.0%). One third of patients who had not seen a DE in the last year thought their 'general practitioner (GP) provides a similar service'. However, mean annual GP visits (5.6) were significantly lower than urban and rural comparisons. Patients with formal management plans were, in the last year, twice as likely to have seen a DE and podiatrist, and reported two extra visits to their GP compared to those without. Rates of allied health service utilisation were not significantly lower than urban rates; however, there is room for increased uptake of multidisciplinary services. Patients who do not access these services may expect their GP to fulfil multiple roles within a limited number of visits and may not understand the role of other practitioners. Where allied health services are available locally, utilisation may be improved by increasing use of management plans and fostering awareness of the role of allied health practitioners in diabetes management.
  Australian Journal of Rural Health 02/2013; 21(1):28-34.
• Article: Supporting GP advanced rural skills training.

  Andrew McKenzie, Neil Beaton, Jane Hollins, Clare Jukka, Aaron Hollins
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  ABSTRACT: The aim of this study was to: investigate doctors' experiences of support during GP advanced rural skills training, and identify strategies to improve support. The qualitative responses from a cross-sectional, postal survey are reported. Rural vocational training sector. Sixty-one doctors who had completed GP advanced rural skills training (procedural or non-procedural) in Queensland between 1995 and June 2009 participated in the study. Advanced trained doctors' experiences of support and their strategy recommendations to improve support. Experiences and strategies to improve support were developed into a framework of support, consisting of three theme areas. Strategies included: provision of training and career advice to allow immediate use of advanced skills; introduction of rural attachments and rural case studies during training to ensure rural orientation; development of GP mentor and peer networks for clinical and non-clinical support; advocacy to improve understanding and recognition of advanced rural skills training. Expanded support is required across the pre-enrolment, training, early practice continuum. A holistic approach to support is required. Training providers, professional bodies, health departments, universities and workforce agencies need to work together to address and resource the support needs of advanced, rural GP trainees before, during and after training.
  Australian Journal of Rural Health 02/2013; 21(1):41-5.
• Article: Increasing the feasibility of the Role Functioning Scale as a measure of consumer outcomes in a rural Personal Helpers and Mentors service.

  Debra A Dunstan
  Australian Journal of Rural Health 02/2013; 21(1):46-9.
• Article: Moving from the city to the country.

  Rosemary Anderson
  Australian Journal of Rural Health 02/2013; 21(1):55.