Past research advocates the need for long-term care (LTC) facilities to adopt a person-centred model of care to optimize residents quality of life. The construct of quality of life in LTC has been defined by satisfaction with a set of domains identified by Kane and colleagues (2003). One goal of this study was to determine which domain is the most predictive of overall well-being among LTC residents in a rural setting. Based on past research and on Deci and Ryans (1985; 1991) self-determination theory, satisfaction with autonomy was predicted to emerge as most predictive of overall well-being. The present study also examined the relation between resident quality of life and well-being, and the degree of routinization (i.e., adherence to a rigid, inflexible daily schedule) within the LTC environment. Routinization is conceptually at odds with a person-centred model of care, yet its relation to the well-being of care recipients had not been examined prior. One hundred and ninety-eight residents from 15 LTC facilities in rural Saskatchewan participated in individual interviews to measure their satisfaction with 11 quality of life domains (Kane et al., 2003), and their overall well-being (using the Memorial University of Newfoundland Scale of Happiness; MUNSH; Kozma & Stones, 1980). One hundred and thirty-one staff from the 15 facilities completed a questionnaire designed to assess routinization within the LTC environment. Contrary to predictions, autonomy failed to emerge as a significant predictor of overall well-being among sample residents. The domain of meaningful activity received residents lowest satisfaction rating of the 11 domains, and also accounted for the most unique variance in overall well-being. Routinization was negatively related to resident quality of life, with staff rating routinization higher in facilities which residents reported lower satisfaction with quality of life. Results provide focus for improving the quality of life of LTC residents, and point to areas for further study.

Past research advocates the need for long-term care (LTC) facilities to adopt a person-centred model of care to optimize residents quality of life. The construct of quality of life in LTC has been defined by satisfaction with a set of domains identified by Kane and colleagues (2003). One goal of this study was to determine which domain is the most predictive of overall well-being among LTC residents in a rural setting. Based on past research and on Deci and Ryans (1985; 1991) self-determination theory, satisfaction with autonomy was predicted to emerge as most predictive of overall well-being. The present study also examined the relation between resident quality of life and well-being, and the degree of routinization (i.e., adherence to a rigid, inflexible daily schedule) within the LTC environment. Routinization is conceptually at odds with a person-centred model of care, yet its relation to the well-being of care recipients had not been examined prior. One hundred and ninety-eight residents from 15 LTC facilities in rural Saskatchewan participated in individual interviews to measure their satisfaction with 11 quality of life domains (Kane et al., 2003), and their overall well-being (using the Memorial University of Newfoundland Scale of Happiness; MUNSH; Kozma & Stones, 1980). One hundred and thirty-one staff from the 15 facilities completed a questionnaire designed to assess routinization within the LTC environment. Contrary to predictions, autonomy failed to emerge as a significant predictor of overall well-being among sample residents. The domain of meaningful activity received residents lowest satisfaction rating of the 11 domains, and also accounted for the most unique variance in overall well-being. Routinization was negatively related to resident quality of life, with staff rating routinization higher in facilities which residents reported lower satisfaction with quality of life. Results provide focus for improving the quality of life of LTC residents, and point to areas for further study.

Class of 2017 Abstract / Objectives: To facilitate a discussion among various healthcare professionals about the facets of interprofessionalism that occur, or do not occur, in a rural acute healthcare setting, and how interprofessionalism could be integrated into the facility’s current healthcare professional student programs. Methods: A focus group was conducted with 8 participants lasting about 45 minutes. Participants were one of three different professions (nurse, medical doctor, or pharmacist) and included administrators as well as staff employees. Six questions were discussed among participants and the answers from each participant were scripted onto a word document. This document was thematically analyzed and compared and contrasted to a previous study, which asked the same six questions in a different rural acute healthcare site. Results: The main findings of this study were that workforce shortage, lack of computerized physician order entry (CPOE), and lack of a uniformity throughout the hospital affected interprofessional practice, learning, and education. Conclusions: Perceived barriers of interprofessional practice at Canyon Vista Medical Center included: poor communication, understaffing, lack of a unified, computerized EHR throughout the hospital, and unclear policies. Some proposed ways to overcome these barriers include having a full staff, creating a unified electronic health record (EHR) system, offering interprofessional learning opportunities, and providing employees the opportunity to gain experience in departments other than their own.

No description available.

This Doctorate of Nursing Practice (DNP) Project is a program evaluation of a Motivational Interviewing (MI) Training Program provided by Southeast Arizona Health Education Center (SEAHEC). MI is a counseling style that focuses on exploring and resolving ambivalence to elicit behavior change. The purpose of this DNP Project was to: 1) describe the Motivational Interviewing Training Program provided by SEAHEC for ¡Vivir Mejor! healthcare providers; and 2) evaluate the long-term effectiveness of the MI training program by assessing: a) if program participants have retained the MI skills they learned in the training program, and b) if program participants apply these learned MI skills one-year post intervention in their encounters with patients diagnosed with T2DM. The Centers for Disease Control (CDC) Framework for Program Evaluation was used to guide this program evaluation. An online survey was administered to the ¡Vivir Mejor! healthcare providers to evaluate the MI program. Overall, based on the survey results, there was a positive response to the SEAHEC MI Training Program. The results of this program evaluation are limited due to a low response rate. However, these results will be shared with key stakeholders to inform the development of future MI training programs for rural healthcare providers.

No description available.

We are at the threshold of a great change in architectural design. With cheaper and more ubiquitous computing, ?smart? spaces and responsive environments are increasingly becoming plausible and affordable. Are we as architects prepared? Can the profession of architecture respond to current computing technologies? Most critics agree that one of the first (most important) problems that ?smart? homes will help to address is that of spiraling costs of elderly healthcare and care giving. But what is the problem with healthcare? Even if there is a problem, the rural home is different from an urban home. Will the technologies that are designed for the urban home work in a rural setting? What are the differences between urban and rural healthcare models? In this thesis, we address the above questions through research of current problems and models of rural healthcare and through a documentation of studies and reports published over the last decade. This research helps us to understand if architecture can really augment healthy aging in rural home settings. In conclusion, we will examine the role of architecture (and architects) in the context of ubiquitous computing and ?smart? spaces in rural areas and propose a possible solution for this problem.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: A portfolio assessment system was designed to meet the needs of a Rural Clinical School education platform, hosting final year MB ChB students for the duration of their final year. A study entitled “What can be learned from the implementation of a portfolio assessment system, to be used in the assessment of clinical reasoning of final MB ChB students placed in a Rural Clinical School in South Africa? “ was conducted. The experience of educators and students during this process was explored. The findings are in keeping with the literature. Van Tartwijk & Driessen 2009, Eley et Al 2002, Lake & Ryan 2004, Burch & Seggie 2008 claim that portfolios drive deep student learning and develop clinical reasoning. Burch & Seggie (2008) offer an assessment tool which has proved feasible within the South African setting on which this portfolio assessment system was modelled. The assessment tool design faced a number of challenges within the RCS setting which were addressed during a review process. The portfolio assessment system is viewed as a work in progress requiring further development. Despite the constraints and challenges, both staff and students unanimously supported the development of patient case studies within the design as a valuable learning tool. / AFRIKAANSE OPSOMMING: ‘n Portefeulje assesserings sisteem is ontwerp om die behoeftes van ‘n UKWANDA Landelike Kliniese Skool opvoedings program wat die gasheer van die MB ChB student tydens hul finale jaar is, na te kom. ‘n Studie genaamd “ Wat kan geleer word uit die implementering van ‘n portefeulje assesserings sisteem, wat gebruik gaan word om die kliniese redenering te bepaal van finale jaar MB ChB student wat geplaas is in ‘n Landelike Klinieke Skool in Suid Afrika? ” is uitgeoefen. Die ervaring van die dosent, so wel as die studente, is ondersoek. Die bevinding is in lyn met die literatuur. Van Tartwijk & Driessen 2009, Eley et Al 2002, Lake & Ryan 2004, Burch & Seggie 2008 beweer dat portfeuljes dryf student tot diep studie en ontwikkel kliniese redenasie. Burch & Seggie (2008) bied ‘n assesserings (hulp)middel aan wat toepaslik en uitvoerbaar is in die SA konteks , waarop die portfeulje assessering sisteem gebaseer is. Die ontwerp van die assesserings (hulp)middel het vele uitdagings binne die RCS opset in die oog gestaar. Dit is aangespreek tydens ‘n proses van hersiening. (Lather, 2006).Die portefeulje assesserings sisteem word gesien as ‘n werk onder hande en vereis verdere ontwikkeling. Ten spyte van die beperkinge en uitdagings het beide die staf en die student onomwonde die ontwikkeling van pasiente gevalle studies, binne die ontwerp, as ‘n waardevolle leermiddel gesien.

Access to health care in rural communities is challenged by workforce shortages. Nurse practitioners (NPs) have been filling the gap created by physician migration into specialty areas. Flex hospital legislation allows critical access hospitals (CAHs) to staff the emergency department with NPs or physician assistants without on-site physicians. NP education often lacks emergency and trauma curriculum, resulting in gaps in education and practice expectations and leading to significant role transition stress and turnover. The purpose of this project was to construct an evidence-based transition-to-practice residency program to support NPs providing emergency department care in the CAH. Theoretical frameworks used to guide the project include rural health theory, novice to expert, and from limbo to legitimacy frameworks. Global outcomes include increased quality of care, patient safety, NP job satisfaction, and decreased turnover. The quality improvement initiative engaged an interprofessional team of institutional and community stakeholders (n = 10) to develop primary products including the residency program, curriculum modules, and the secondary products necessary to implement and evaluate the project. Implementation will consist of a pilot followed by expansion throughout the rural health network. Evaluation will involve the CAH dashboard to monitor patient outcomes, Misener NP job satisfaction scale, and employee turnover rates. The project expands understanding of the on-boarding needs of rural NPs. The results of this project will serve as a guide to publish outcome data and collaborate with higher education to develop programs to award academic credit for paid clinical experiences leading to academic degrees.

The purpose of this study was to examine the preferences, impact, and attitude of respiratory care practitioners toward continuing education. A review of demographic characteristics was conducted to develop a professional profile of practitioners in Tennessee. An assessment of continuing education practices provided information concerning types of courses, preferences, and methods used to meet continuing education requirements. Data collection was made possible through the use of a questionnaire. A stratified random sample was drawn from the 1,966 respiratory care practitioners in Tennessee. Based on the practitioner's residence, 150 practitioners were selected from rural and urban communities. A total of 300 self-administered questionnaires were mailed to practitioners to comprise the sample. Data collection was conducted over a 4 week period with a second mailing occurring after the first 2 weeks. A total of 120 surveys were returned for a response rate of 40%. The findings in this study demonstrated that rural and urban respiratory care practitioners in Tennessee have similar preferences toward continuing education. Respiratory care practitioners felt mandatory continuing education was beneficial and should be retained in Tennessee. This study indicated no differences in the impact of mandatory continuing education on the attitude of rural and urban practitioners. Both groups reported that mandatory continuing education had impacted the attitude of respiratory care practitioners in a positive manner. The study produced findings that revealed differences between rural and urban practitioners most preferred and used methods of continuing education. Urban practitioners indicated an increase involvement of physicians as a method most preferred and used for continuing education when compared to rural respondents. Comparison of rural and urban respondents found both groups preferences for course content were the same. The need for continuing education in various content areas transcends geographical boundaries. The typical respiratory care practitioner tended to be a female between the ages of 26-45, while working as a full-time practitioner in an acute care hospital. However, differences were identified between the two populations when comparing professional characteristics. Most rural practitioners were credentialed as certified respiratory care technicians with urban practitioners identified themselves as registered respiratory therapist.