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Rural health care has been affected by health care changes. Twenty-seven percent of the U.S. population live in rural areas (Adams, 1993; Weinert & Long, 1991). The purpose of this study was to examine the tenure of rural Directors of Nursing (DONs) in the DON position, to examine the tenure of rural DONs in the organization, and to profile the personal system of the DON in a rural hospital. The significance of the study was that little is known about rural DONs.The Neuman Systems Model (Neuman, 1989) provided the theoretical. framework for the study using the personal system level. The sample included all rural acute care DONs in one midwestern state. The Assessment of DON Tenure Questionnaire (Rowles, 1992) was the instrument used to collect data. Thirty-three questionnaires were mailed to rural acute careDONs with a return rate of 100%.Rural DONs were found to have a longer tenure in the DON position than the tenure data in the nursing literature. Tenure in the organization was also found to be longer. The typical DON was found to be female, married, with children,45 years old, with a BSN in nursing. The rural DONS were found to be slightly dissatisfied with the job.The return rate of questionnaires demonstrated the rural DONs interest in nursing education, practice and research. The research implication called for further investigation into the tenure measure of rural DONs in other geographic location along with urban DONs tenure measure for comparative analysis. Rural DONs have limited education opportunities based on geographic location. Continuing education programs in nursing administration and practice that are accessible in the rural setting via TVs or computers would be beneficial. / School of Nursing

In the context of a country and a continent that is largely rural, education for rural medical practice in Africa is relatively undocumented and poorly conceptualized. The arena of medical education in South Africa has been largely unchanged by the transition to democracy, despite intentions of reform. The literature reveals a lack of empirical evidence as well as theory in education for rural health, particularly in developing countries. This report presents twelve original papers on a range of key issues that represent the author’s contribution to filling this gap in South Africa. It aims to contribute to the development of a discourse in education for rural medical practice in an African context, and culminates in a theoretical paper regarding pedagogy for rural health. A conceptual framework is utilized that is based on the standard chronological steps in the initial career path of medical doctors in South Africa. Beginning with the literature that is focused around the need to recruit and retain health professionals in rural and underserved areas around the world, the report then addresses the policy context for medical education in South Africa, examining the obstacles to true reform of a transformatory nature. The selection of students of rural origin, and the curricular elements necessary to prepare graduates for rural practice are then investigated, including the actual career choices that medical graduates make in South Africa. Out in the workplace, the educational components of the year of compulsory community service are described, including organizational learning and apprenticeship as novice practitioners, placed under severe pressure in rural hospitals in the South African public health service. A community-oriented type of medical practice is described amongst exemplary individuals, indicating the aspiration towards a different kind of educational outcome. Finally the thesis as such is presented in the final paper regarding a theoretical basis for education for rural health, consisting of the combined notions of placed-based and critical pedagogy. It is argued that while the geographic elements of rural practice require a pedagogy that is situated in a particular rural context, the developmental imperatives of South Africa demand a critical analysis of health and the health care system, and the conceptual basis of this position is explained. / Thesis (Ph.D.) - University of KwaZulu-Natal, Durban, 2010.

The goal of the dissertation research was to understand and conceptualize the process of developing palliative care in rural communities from the perspective of health care providers. Canadian research about rural palliative care is timely and important. Since 1995, two Senate committees and two national reviews of the health care system have called for increased access to palliative care throughout Canada. Several provinces have subsequently launched strategies aimed at improving access to palliative or end-of-life care; however practical models for developing rural programs are lacking. This research contributes to improving access to palliative care for people dying in rural Canada by generating practical and theoretical knowledge about developing local programs in rural communities. Data were transcripts of nine group interviews of interdisciplinary providers involved in providing rural palliative care in six different provinces and territories of Canada. The outcome of the research was an original model called Developing Rural Palliative Care that conceptualized four sequential and incremental phases of development: antecedent community conditions, a catalyst, creating the team and growing the program. The model articulates the major processes and activities within each phase. Throughout the developmental process, the nature of the rural community both supported the work of providers and created their challenges. Working together and being community-focused emerged as the overarching keys to success. Most of the palliative care work utilized existing local resources. Throughout the analysis, the research used ideas of community capacity development as sensitizing concepts. The research concluded that developing palliative care can be understood and represented as a process of community capacity development, offering an innovative way of thinking about developing health services that can guide the process of implementing palliative care services. Ultimately, the research findings suggest that access to palliative care can be improved in rural communities by creating local palliative care teams and supporting them to develop services.

Remote area staff performing manual patient handling tasks in the absence of patient lifting hoists available in most health care settings are at an elevated risk of musculoskeletal injuries. The objective of this project was to identify the patient handling methods that have the lowest risk of injury. The patient handling task of lifting a patient from floor to a chair or wheelchair is a common task performed in a remote health care setting. The task was performed utilising three methods, these being: (1) heads/tails lift, (2) use of two Blue MEDesign?? slings and (3) use of a drawsheet. The task of the heads/tails lift was broken down into two distinctly separate subtasks: lifting from the (1) head and (2) tail ends of the patient load. These techniques were selected based on criteria including current practice, durability, portability, accessibility, ease of storage and cost to supply. Postural data were obtained using a Vicon 370 three - dimensional motion measurement and analysis system in the Biomechanics & Gait laboratory at the University of New South Wales. Forty reflective markers were placed on the subject to obtain the following joint angles: ankle, knee, hip, torso, shoulder, elbow, and wrist. The raw data were converted into the respective joint angles (Y, X, Z) for further analysis. The postural data was analysed using the University of Michigan???s Three-Dimensional Static Strength Prediction Program (3D SSPP) and the relative risk of injury was based on the following three values: (1) a threshold value of 3,400 N for compression force, (2) a threshold value of 500 N for shear force, and (3) population strength capability data. The effects on changes to the anthropometric data was estimated and analysed using the in-built anthropometric data contained within the 3D SSPP program for 6 separate lifter scenarios, these being male and female 5th, 50th and 95th percentiles. Changes to the patient load were estimated and analysed using the same computer software. Estimated compressive and shear forces were found to be lower with the drawsheet and tail component of the heads/tails lift in comparison to the use of the Blue MEDesign?? straps and head component of the heads/tails lift. The results obtained for the strength capability aspect of each of the lifts indicated a higher percentage of the population capable of both the drawsheet and tail end of the heads/tails lift. The relative risk of back injury for the lifters is distributed more evenly with the drawsheet lift as opposed to the heads/tails (tail) lift where risk is disproportionate with the heavier end being lifted. The use of lifter anthropometrics does not appear to be a realistic variable to base assumptions on which group of the population are capable of safely performing this task in a remote setting. This study advocates the use of the drawsheet lift in a remote setting based on the author???s experience and the biomechanical results obtained in this study. The drawsheet lift is both more accessible and provides a more acceptable risk when more than two patient handlers are involved, in comparison to the other lifts utilised lifting patients from floor to a chair.

Doctor of Philosophy / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

Diss. (sammanfattning) Stockholm Karol. inst., 2002. / Härtill 7 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Thesis (M.U.A.)--Virginia Polytechnic Institute and State University, 1994. / Vita. Abstract. "This study was a component of a larger project -- The Dickenson County Women's Health Project."--P. [i]. Includes bibliographical references (leaves 53-55). Also available via the Internet.