Volume twenty-two, Issue 3

Compared with urban populations, people living in rural areas can have less access to healthcare services, essential health treatment, and health professionals in an emergency. This study explores the experiences, beliefs and attitudes of nursing students performing health screening in rural areas. Findings from this study include the positive feelings of students about rural nursing, the characteristics of rural nursing and the advantages and disadvantages of doing health screening in rural areas. The authors suggest healthcare services in rural areas should be planned by taking these experiences into account.

This article presents the results of research that utilised Behavioral Risk Factor Surveillance System data to evaluate the prevalence of breast cancer and colorectal cancer screening by urban–rural locations. The authors present considerations for screening initiatives that can target rural regions and racial groups.

The COVID-19 pandemic affected provision of face-to-face outpatient services. Non-attendance in diabetes clinics potentially leads to suboptimal outcomes and poor utilization of resources. This Research Letter reports on the innovative solutions to service replacement during the pandemic of a paediatric diabetes service in rural Wales, including offering telephone clinics and drive-through clinics. Overall attendance for virtual clinics improved during the pandemic, although children who did not attend clinics pre-COVID were the same during the pandemic, suggesting clinic attendance for them needs further research to address reduced opportunity to access services.

Maternal suicide is one of the leading causes of maternal death across the world and maternal depression is particularly common in low and middle-income settings. Early detection and treatment of maternal depression and suicidal thoughts are important for reducing maternal morbidity and mortality and help-seeking by pregnant women plays a crucial role in this. Limited availability and accessibility to health care, poor knowledge of depression and the help-seeking process itself can all be barriers to women seeking help. This study explores the help-seeking intention and behaviours of pregnant women with depression and suicidal thoughts in rural Sri Lanka.

Many older adults live in rural and remote communities that are experiencing population ageing at a faster rate than more urban communities, but not much is known about how to best deliver geriatric models of care in these settings. This systematic review identifies necessary key components of existing models of geriatric care serving rural or remote populations, including an evidence-based framework based on 8 distinct model characteristics that aim to support the ideal provision of effective and accessible geriatric medical care.

Despite the increased understanding of Canadian rural and remote nursing in the past two decades, no nursing frameworks to guide rural and remote practice have been in place. Working with the Canadian Association for Rural & Remote Nursing (CARRN), a process was planned to develop a rural and remote nursing framework. This Project Report describes the process, the framework developed, implications of the framework and lessons learned from the development process.

In Bhutan, a small, mountainous country in South Asia situated between India and China, noncommunicable disease (NCD)-related morbidity and mortality have been rising. In 2019, Bhutan’s Ministry of Health introduced a set of interventions associated with the World Health Organization’s Package of Essential Noncommunicable Disease Interventions for Primary Health Care in Low-Income Settings (PEN HEARTS). This initiative encompassed six components: healthy lifestyle intervention; evidence-based protocols; access to medicines and technology; risk-based management; team-based care; and systems monitoring. Evaluations of PEN interventions in other countries documented barriers to implementation. This report provides the results of a 2019–2020 evaluation assessing implementation of PEN HEARTS in Bhutan and initial impacts on provision of care for NCDs and patient outcomes.

While vaccination is a key strategy in reducing morbidity and mortality from COVID-19, vaccination rates vary widely. This study examined the influence of political affiliation, religious identity, and rurality on vaccine hesitancy in the US state of Oregon. In multivariate analysis, White Christian identity and political affiliation with Trump in the 2020 election explained 84.1% of the variability in COVID-19 vaccination status in Oregon counties, with population density also found to be a significant influence. The author recommends public health agencies partner with religious leaders to address vaccine hesitancy in rural, conservative, religious communities in Oregon.

Informed consent is the foundation for research participation. This Commentary explores how we inform patients, and challenges the Eurocentric model of an extensive written consent form. The author reflects on her experience seeking study participants in another country, culture and language, and how this shaped her perspective. She addresses the need for researchers to protect vulnerable individuals, recognizing that vulnerability comes in many forms.

Rural and Remote Health, the Australian Journal of Rural Health and the Canadian Journal of Rural Medicine have committed to the editorial requirement that research published about Indigenous Peoples must genuinely engage Indigenous Peoples in all stages of the research process, including authoring manuscripts. This Commentary, published in all three journals, takes the next step. The authors propose the development of an Indigenous Cultural Identity of Research Authors Standard (ICIRAS) for health research publications. This would signpost the rights of Indigenous Peoples into academic publishing governance. It also aligns with the movement for integrating human rights into research with Indigenous and Tribal peoples. The ICIRAS is a call to action for research journals and institutions to rigorously improve research governance and leadership to amplify the cultural identity of Indigenous Peoples in rural health research and work towards genuine truth-telling and reconciliation.

Coronavirus disease-19 (COVID-19), caused by the severe acute respiratory syndrome SARS-CoV-2, has become a global pandemic, giving rise to a serious global health threat. In Greece, early measures kept the first pandemic wave at a relatively small scale, but the reported morbidity and mortality caused by the second wave were among the highest in Europe, with many deaths and regions with increased incidence of COVID-19. This study evaluated the prevalence of SARS-CoV-2 infection based on diagnosis of IgG antibodies from blood serum in an observational descriptive cohort study in a semi-closed rural area of Greece after the second wave.

Like many countries around the world, Scotland faces a shortage of general practitioners (GPs) due to increased workload and recruitment and retention issues. Such workforce shortages are of particular concern in rural areas.To maximise the effectiveness of strategies to improve GP retention, it is vital to understand what affects the job satisfaction of Scottish GPs. This study compared the job satisfaction, job stressors, job attributes and intentions to reduce work participation of rural and non-rural Scottish GPs.

This review of Larry Krotz's book "Nothing Ordinary" highlights the contribution the book makes to the literature on rural medical education. The reviewer characterizes the book as an "enjoyable and informative" read that "comes alive with descriptions of places and accounts of the people closely involved" in creating "a successful socially accountable rural-focused medical school".

Lesbian, gay, bisexual, transgender, intersex, queer and people with a diversity of sexual and gender identities (LGBTIQ+) residing in rural contexts may face additional challenges to attaining wellbeing, yet a comprehensive understanding of these experiences is lacking. This systematic review examines the wellbeing, healthcare access and experience and barriers and facilitators to health care for rural LGBTIQ+ communities.

Health professional leaders are key informants working at senior levels in various health facilities in the areas of policies and planning processes, and human resources. On the basis of a focus group discussion in three randomly selected hospitals, this study explores the factors affecting the nursing shortage in Vanuatu and recommends measures and interventions to resolve the shortage.