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Hodge E, Sandford A. Workforce nurturing: an approach to improving wellbeing, burnout and professional fulfilment among Australian doctors. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2024; 15:59-65. [PMID: 38879880 DOI: 10.5116/ijme.6639.1a23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 05/06/2024] [Indexed: 06/18/2024]
Abstract
Objective To assess the workplace drivers of professional fulfilment, burnout and perceived impact of workplace issues on wellbeing in doctors working in a regional Australian hospital, following a 6-month period of comprehensive workforce nurturing strategies. Methods An online cross-sectional survey combined both qualitative feedback and quantitative measures of wellbeing including the Stanford Professional Fulfillment Index to assess professional fulfillment and burnout and a workplace issues inventory to assess the relative perceived influence on work-related wellbeing. Results Survey responses from 124 doctors comprised approximately 60% (n=74) prevocational doctors, 12% (n=15) registrars and 28% (n=35) specialist doctors. Around 63% (n=78) of participants were international medical graduates. Overall, 25% (n=31) reported professional fulfilment and 13% (n=13) reported burnout. The top 6 workplace issues were (i) inefficient work practices and/or processes, (ii) medical officer vacancies in my department, (iii) inadequate support staff and/or excessive admin burden, (iv) inadequate workplace staff amenities, (v) poor access to nutritious onsite food, (vi) inability to access my entitled daily meal break. Factors perceived as having a minimal impact on wellbeing included learning opportunities, rostering, access to leave and support during challenging clinical situations, were directly related to the workforce nurturing strategies implemented. Conclusions This comprehensive evaluation of wellbeing in a regional healthcare setting provides a novel contribution to the literature by illustrating the transformative potential of workforce nurturing. Notably, the findings reflect the potential impact of workforce nurturing upon professional fulfilment and burnout, in the context of a regional hospital setting.
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Affiliation(s)
- Emma Hodge
- Wide Bay Hospital & Health Service, Queensland, Australia
| | - Alan Sandford
- Wide Bay Hospital & Health Service, Queensland, Australia
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Shields M, James D, McCormack L. Organisational challenges to wellbeing in nuclear medicine technologists: Professionalism, burnout and pragmatic growth. Radiography (Lond) 2024; 30:622-627. [PMID: 38330894 DOI: 10.1016/j.radi.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Occupational risk for burnout in nuclear medicine technologists globally, and particularly during disaster demands on the profession, is poorly researched. This idiographic study explored the lived experience of nuclear medicine technologists during COVID-19 in a regional city in Australia. METHODS Data was collected from five participants using semi-structured interviews and transcribed and analysed according to the protocols of Interpretative Phenomenological Analysis (IPA). RESULTS Four group experiential themes were identified: Systemic Contraindications, Professional Strengths and Limitations, Pragmatic Growth, and Covid Rollercoaster. For these participants a dichotomous health care system, impacted by COVID-19, risked career longevity and burnout. Through empathic connection with vulnerable patients, they redefined their priorities, re-engaged in supportive connections with colleagues, and sought new pathways. CONCLUSION Multiple workplace stressors compounded by COVID-19, risked mental wellbeing, in these participants. Nevertheless, these challenges provided opportunities for reflection around career trajectory and longevity precipitating personal growth, job satisfaction and work-life balance. IMPLICATIONS FOR PRACTICE This study provided a lens on the risk factors inherent for nuclear medicine technologists in Australia, exacerbated by the COVID-19 pandemic. Current, and disaster protective practices, to ensure wellbeing and prevent burnout risk are recommended for future research.
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Affiliation(s)
- M Shields
- The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
| | - D James
- The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
| | - L McCormack
- The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
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3
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Mulligan EP, Hegedus EJ, Foucrier J, Dickson T. Influences of Financial and Workplace Factors on Physical Therapist Job Satisfaction. Phys Ther 2023; 103:pzad093. [PMID: 37440453 DOI: 10.1093/ptj/pzad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/11/2023] [Accepted: 05/12/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE The physical therapist labor market has recently noted higher rates of turnover and job vacancies. An understudied factor contributing to these trends in the profession is job satisfaction. The profession continues to experience relatively low wages compared with other health professions, and graduates of Doctor of Physical Therapy programs face increasingly high student debt. This study used the labor-search model as a conceptual framework to understand associations between job satisfaction, income, and educational debt. The purpose of this study is to observe the financial and workplace factors that are associated with higher levels of physical therapist job satisfaction. METHODS Data from 4764 physical therapists in 1 state were captured retrospectively through the state's licensure renewal process from 2014 to 2020. A random effects panel analysis, with job satisfaction as the dependent variable, was used to evaluate the relationships between job satisfaction and income, educational debt, and a variety of work-related factors. RESULTS Job satisfaction was negatively correlated with educational debt, number of hours worked per week, and some practice settings. Conversely, job satisfaction was positively correlated with the expected age of retirement. The percentage of time spent in research and administration was also positively correlated with job satisfaction, though additional research in this area is needed to draw meaningful conclusions on this association. CONCLUSION The results support the conceptual framework, which suggests that early career physical therapists, motivated by high amounts of educational debt, may choose more financially advantageous practice settings and increased working hours to the detriment of job satisfaction. IMPACT High levels of job satisfaction among physical therapists are correlated with low levels of educational debt, working 45 hours or less per week, a longer time horizon until retirement, and practice settings other than home health and skilled nursing facilities.
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Affiliation(s)
- Edward P Mulligan
- Doctor of Physical Therapy Program, Tufts University School of Medicine, Phoenix, Arizona, USA
| | - Eric J Hegedus
- Doctor of Physical Therapy Program, Tufts University School of Medicine, Phoenix, Arizona, USA
| | - Jeffrey Foucrier
- Doctor of Physical Therapy Program, Tufts University School of Medicine, Phoenix, Arizona, USA
| | - Tara Dickson
- Doctor of Physical Therapy Program, Tufts University School of Medicine, Phoenix, Arizona, USA
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Cochrane C, Easton C, Hoffman L. ‘Each person’s experience is different’: speech-language pathologists’ perspectives regarding their pathway to the Australian rural workforce. SPEECH, LANGUAGE AND HEARING 2023. [DOI: 10.1080/2050571x.2023.2177412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- Chloe Cochrane
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury, Australia
| | - Catherine Easton
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury, Australia
| | - Laura Hoffman
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury, Australia
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Couch A, Menz HB, O’Sullivan B, Haines T, Williams CM. Describing the factors related to rural podiatry work and retention in the podiatry workforce: a national survey. J Foot Ankle Res 2023; 16:4. [PMID: 36750854 PMCID: PMC9903282 DOI: 10.1186/s13047-023-00603-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Maldistribution of podiatrists limits capacity to address the footcare needs of the population. Understanding factors that impact recruitment and retention of Australian podiatrists is a key solution. The primary aim of this study was to describe factors related to rural podiatry work, and overall professional retention amongst Australian podiatrists. METHODS We used data collected from the most recent relevant response of a cohort of Australian podiatrists between 2017 and 2020 of four online surveys. Person and job role variables known to impact current work and retention were collected. Logistic regression models were used to determine factors associated with rural work and intent to leave direct patient care or the profession entirely. RESULTS There were 1129 podiatrists (21% of 5429) who participated in at least one of the survey waves. Podiatrists who had a rural background (30%) were less likely to work in a metropolitan location (OR = 0.20, 95%CI = 0.11,0.37). Podiatrists who undertook a regional/rural placement during their undergraduate education (43%) were more likely to work in a metropolitan location (OR = 1.86, 95%CI = 1.38,2.51). Podiatrists who indicated they were planning to leave direct patient care within 5 years (n = 282, 26%), were less satisfied with working conditions (OR = 0.77, 95% CI = 0.66, 0.92), less satisfied with opportunities to use their abilities (OR = 0.83, 95% CI = 0.69, 0.99), perceived less personal accomplishment (OR = 0.94, 95% CI 0.86, 0.94) and less job satisfaction (OR = 0.92, 95% CI = 0.91, 0.98). Podiatrists who indicated that they were planning to leave podiatry work entirely within 5 years (n = 223, 21%), were less satisfied with opportunities to use their abilities (OR = 0.74, 95% CI = 0.62, 0.88), agreed they had a poor support network from other podiatrists (OR = 1.35, 95% CI = 1.13, 1.61), had less job satisfaction (OR = 0.89, 95% CI = 0.86, 0.94), and did not have access to paid annual leave (OR = 0.62, 95% CI = 0.38, 0.99). CONCLUSION Findings suggest ways to promote rural work, including selecting university students with rural backgrounds, and optimising the experience of rural placements which currently predict metropolitan practice. To retain podiatrists, it is important to ensure access to leave, professional support, and appropriate physical working conditions. Further research is required to understand why intention to leave is so high.
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Affiliation(s)
- Anna Couch
- Peninsula Health, Allied Health, 2 Hastings Road, Frankston, VIC, 3199, Australia. .,Monash University, School of Primary and Allied Health Care, Moorooduc Hwy, Frankston, Australia.
| | - Hylton B. Menz
- grid.1018.80000 0001 2342 0938La Trobe University, School of Allied Health, Human Services and Sport, Bundoora, VIC 3086 Australia
| | - Belinda O’Sullivan
- grid.1003.20000 0000 9320 7537The University of Queensland, Rural Clinical School, Toowoomba, QLD 4350 Australia ,Murray Primary Health Network, Bendigo, Victoria 3550 Australia ,grid.1002.30000 0004 1936 7857Monash University School of Rural Health, Bendigo, Victoria 3550 Australia
| | - Terry Haines
- grid.1002.30000 0004 1936 7857Monash University, School of Primary and Allied Health Care, Moorooduc Hwy, Frankston, Australia
| | - Cylie M. Williams
- grid.466993.70000 0004 0436 2893Peninsula Health, Allied Health, 2 Hastings Road, Frankston, VIC 3199 Australia ,grid.1002.30000 0004 1936 7857Monash University, School of Primary and Allied Health Care, Moorooduc Hwy, Frankston, Australia
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Zou Y, Almond A, Forbes R. Professional development needs and decision-making of new graduate physiotherapists within Australian private practice settings. Physiother Theory Pract 2023; 39:317-327. [PMID: 34802384 DOI: 10.1080/09593985.2021.2007559] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Professional development contributes to new graduate health professionals' transition into the workplace. Current literature indicates that new graduate physiotherapists are often underprepared to work within private practice settings, however little is known of their professional development needs to facilitate their transition. OBJECTIVES This study aimed to understand new graduate physiotherapists' perceived needs and decision-making for professional development within private practice settings. METHODS This study used a qualitative interpretative phenomenological approach. A sample of new graduate physiotherapists employed within private practice settings (n = 14) participated in semi-structured telephone interviews, after being selected through convenience and randomized sampling. Interview data was subject to thematic analysis. RESULTS Four key themes emerged from the data: 1) practical and commercial relevance; 2) influence of self and others in decision-making; 3) professional development as a social construct; and 4) access is critical. CONCLUSION New graduate physiotherapists expressed needs for practically and clinically relevant professional development within formal and informal settings, and this extended to non-clinical skills specific to private practice. Their decision-making was shaped by social influences and perceived barriers to access. This study has identified implications for employers and professional development providers to support and cater to new graduate physiotherapists' perceived needs for professional development, which may facilitate their transition into private practice.
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Affiliation(s)
- Yixin Zou
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Allexandra Almond
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
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Evans A, Priestly J, Suthern M, Whelan M, Robertson S, Kelly O, Omar SH, Preddy J. Practical recommendations for planning and running live online education workshops for the rural health workforce. Aust J Rural Health 2023; 31:144-151. [PMID: 35429355 DOI: 10.1111/ajr.12863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/01/2022] [Accepted: 02/14/2022] [Indexed: 11/26/2022] Open
Abstract
AIM This commentary presents practical and evidenced based guidelines for the development and delivery of real-time online training workshops aimed at rural health professionals. CONTEXT Online learning is increasingly being used as an avenue for delivering education, particularly to rural and remote sites where barriers persist in upskilling health workers. Further, online learning has become essential during the coronavirus disease 2019 (COVID-19) pandemic. In response to the Australian 2020 COVID-19 social distancing requirements, our team rapidly transformed face-to-face educational workshops into an online format, to deliver over 20 workshops to more than 150 multidisciplinary staff across our large rural district. APPROACH There are no published guidelines regarding the conversion of face-to-face education programs into an online format within health care. We conducted a review of the literature regarding the implementation of online education programs. Three broad categories of evidence were identified: participant qualities, content development and content deliverance. CONCLUSION We present a set of practical and evidenced based recommendations, which will enhance live online workshops for a rural health workforce. These recommendations are derived both from published literature and our experience delivering our workshops. We argue that rural health professionals and organisations need relevant, up-to-date practical guidelines and more institutional support and training focused on creating and implementing live online educational programs in rural Australia.
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Affiliation(s)
- Adele Evans
- Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
| | | | - Megan Suthern
- Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
| | - Monica Whelan
- Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
| | - Sheree Robertson
- Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
| | - Olivia Kelly
- Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
| | - Syed Haris Omar
- Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
| | - John Preddy
- Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
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Kanaan SF, Abu Hanna AM, Hadoush H, Khalil H, Almhdawi K. Physiotherapists' job satisfaction in the workplace: A cross-sectional study in Jordan, Lebanon, West Bank, and Gaza. Work 2023:WOR211408. [PMID: 36683477 DOI: 10.3233/wor-211408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Job satisfaction among physiotherapists has been studied in many developing and developed countries, but not yet in areas recently affected by wars and refugee crises in the Middle East, including Jordan, Lebanon, West Bank, and Gaza regions. OBJECTIVES To explore physiotherapists' job satisfaction in Jordan, Lebanon, West Bank, and Gaza and examine differences in job satisfaction according to regions, gender, academic qualifications, and years of clinical experience. METHODS A cross-sectional study using a self-administered online questionnaire. The questionnaire consisted of participants' characteristics and a 17-items Likert scale of job satisfaction. RESULTS A total of 413 participants completed the online questionnaire. Most of the respondents were older than 27 years (55%), males (53.8%), and holding a bachelor's degree (70.2%), and had 5-10 years of experience (70.4%). The overall job satisfaction was 66.1%. There was no significant difference in job satisfaction according to the region in all questionnaire items. Female physiotherapists reported higher satisfaction in receiving career advice (p = .013). In many items, physiotherapists with higher qualifications and longer years of experience reported higher satisfaction (p < 0.05). Salaries and remunerations, lack of continuing education support, and lack of evidence-based practice in the workplace were the main reasons for job dissatisfaction. CONCLUSION To improve physiotherapy job satisfaction, healthcare administrators should increase physiotherapists' financial rewards, support continuing education, and set evidence-based practice policies.
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Affiliation(s)
- Saddam F Kanaan
- Department of Physical Therapy and Rehabilitation Sciences, Qatar University, Doha, Qatar.,Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Annie M Abu Hanna
- Al Hussein Society Jordan Center for Training and Inclusion, Amman, Jordan
| | - Hikmat Hadoush
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanan Khalil
- Department of Physical Therapy and Rehabilitation Sciences, Qatar University, Doha, Qatar
| | - Khader Almhdawi
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Al-Surimi K, Almuhayshir A, Ghailan KY, Shaheen NA. Impact of Patient Safety Culture on Job Satisfaction and Intention to Leave Among Healthcare Workers: Evidence from Middle East Context. Risk Manag Healthc Policy 2022; 15:2435-2451. [PMID: 36620517 PMCID: PMC9811957 DOI: 10.2147/rmhp.s390021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/13/2022] [Indexed: 01/01/2023] Open
Abstract
Background The association between patient safety culture and staff outcomes remains unclear to date. This study aimed to identify the relationship between patient safety culture/job satisfaction and intention to leave among healthcare workers. Methods A cross-sectional study was conducted using an online survey. Multinomial logistic regression analysis was used to investigate the association between the safety culture dimensions and the outcomes in terms of job satisfaction and intention to leave. Results Majority were females (77.2%); age between (20-30) years were (66.1%). 1-5 years work experience was reported by (98.2%); nurses accounted for (75.7%). (62.1%) reported very good patient safety grade. (78.3%) of respondents had no intention to leave; (84.3%) reported they like their job, (70.5%) stated that working in this hospital is like being part of a large family. However, (38%) said the hospital is not a good place to work, and morale in their clinical area is low. The overall composite scores were highest for "teamwork within hospital units (81.4)", and "organizational learning (79.4)", while lowest for "communication openness (37)",staffing (26.5)", and "non-punitive response to error (22.1)". Females were two times more likely to leave their jobs compared to males (AOR: 2.36, 95% CI: 1.24-3.46); intention to leave was 3.35 (95% CI = 2.19-5.09). As for job satisfaction, ages between 31-40 years tend to like their job two times more than other age groups (AOR: 1.90, 95% CI = 1.02-3.55). The safety culture domains "staffing" and "hospital management support for patient safety" were linked to a higher odds ratio for job satisfaction. Conclusion Aside from gender and age, the dimensions of safety culture, including staffing, hospital management support, hospital handover, and transition, may have a signification impact on job satisfaction and intention to leave among healthcare workers.
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Affiliation(s)
- Khaled Al-Surimi
- College of Public Health and Health Informatics, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia,School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates,Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Thamar University, Dhamar, Yemen,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Amirah Almuhayshir
- College of Public Health and Health Informatics, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid Y Ghailan
- Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Naila A Shaheen
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia,King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia,Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia,Correspondence: Naila A Shaheen, Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, P.O. Box 22490, Mail Code 1515, Riyadh, 11426, Saudi Arabia, Tel +966-11-4294472, Fax +966-11-4294466, Email
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Louazi A, Frías-Osuna A, López-Martínez C, Moreno-Cámara S. Perceptions, Motivations, and Empowerment Strategies of Midwives in Rural and Remote Areas of Northern Morocco. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14992. [PMID: 36429709 PMCID: PMC9690809 DOI: 10.3390/ijerph192214992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
The shortage of midwives is a problem in rural and remote areas. This is mainly the consequence of job insecurity and difficult living conditions. The present study aimed to identify and analyse the perceptions and motivations of midwives in rural and remote areas of northern Morocco on the quality of their working life and the motivational factors and empowerment strategies they use to maintain and develop their work. It is a qualitative study that follows Van Manen's hermeneutic phenomenology approach. Three focus groups and in-depth interviews were conducted with 15 midwives from rural and remote areas. The results indicate that midwives in rural and remote areas have a negative perception of the quality of the work and their personal life because of the scarcity of basic resources, unfavourable working conditions, and the personal sacrifices they have to make to support themselves. However, some factors favour their efforts. Therefore, there is a need to promote intersectoral policies that focus on improving material and human resources, as well as the working and personal conditions of midwives and the factors that support and empower them.
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Affiliation(s)
- Abdelouahid Louazi
- Higher Institute of Nursing Professions and Health Techniques of Tetouan (ISPITST), Tetouan 93020, Morocco
| | - Antonio Frías-Osuna
- Department of Nursing, School of Health Sciences, University of Jaén, 23071 Jaén, Spain
| | | | - Sara Moreno-Cámara
- Department of Nursing, School of Health Sciences, University of Jaén, 23071 Jaén, Spain
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Robertson C, Jones T, Southwell P. “Unchaining the doctor from the desk”: deliberate team-based care in action. JOURNAL OF INTEGRATED CARE 2022. [DOI: 10.1108/jica-03-2022-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeAs a model of integrated care (IC), deliberate team-based care (DTBC) can help address workforce shortages facing rural communities by improving the health and wellbeing of healthcare providers. This study focuses on a GP practice implementing DTBC in rural Australia. The aim of this research was to understand the perspectives of the healthcare workers involved and to ascertain factors impacting on the day to day running of the model, patient care and clinician work-life. The authors conducted a qualitative study on the experiences of the DTBC workers.Design/methodology/approachTeam members were invited to participate in semi-structured interviews (n = 9). Interviews were analysed using an iterative thematic analysis, summarised, collated and explored for emergent themes.FindingsKey themes included: creating change from old ways of doing things, development and implementation processes outlining how the model evolved and how it ran from day to day, model outcomes for patients and clinicians, as well as practical considerations like funding, technology and time.Originality/valueBuilding DTBC from the ground up has produced a high functioning team who demonstrate trust and equality, share information freely and all have a voice which is heard and respected. By acting as a champion and a leader, the GP has created a psychologically safe environment allowing the team to share knowledge, collaborate in problem solving and provide effective patient care which is holistic and community grounded. This work environment holds promise for creating improved work-life for rural clinicians and potential for workforce retention.
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12
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Dymmott A, George S, Campbell N, Brebner C. Experiences of working as early career allied health professionals and doctors in rural and remote environments: a qualitative systematic review. BMC Health Serv Res 2022; 22:951. [PMID: 35883068 PMCID: PMC9327222 DOI: 10.1186/s12913-022-08261-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022] Open
Abstract
Background Maintaining a health professional workforce in rural and remote areas poses a significant challenge internationally. A range of recruitment and retention strategies have had varying success and these are generally developed from the collective experience of all health professions, rather than targeted to professional groups with differing educational and support contexts. This review explores, compares and synthesises the evidence examining the experience of early career rural and remote allied health professionals and doctors to better understand both the profession specific, and common factors that influence their experience. Methods Qualitative studies that include early career allied health professionals’ or doctors’ experiences of working in rural or remote areas and the personal and professional factors that impact on this experience were considered. A systematic search was completed across five databases and three grey literature repositories to identify published and unpublished studies. Studies published since 2000 in English were considered. Studies were screened for inclusion and critically appraised by two independent reviewers. Data was extracted and assigned a level of credibility. Data synthesis adhered to the JBI meta-aggregative approach. Results Of the 1408 identified articles, 30 papers were eligible for inclusion, with one rated as low in quality and all others moderate or high quality. A total of 23 categories, 334 findings and illustrations were aggregated into three synthesised findings for both professional groups including: making a difference through professional and organisational factors, working in rural areas can offer unique and rewarding opportunities for early career allied health professionals and doctors, and personal and community influences make a difference. A rich dataset was obtained and findings illustrate similarities including the need to consider personal factors, and differences, including discipline specific supervision for allied health professionals and local supervision for doctors. Conclusions Strategies to enhance the experience of both allied health professionals and doctors in rural and remote areas include enabling career paths through structured training programs, hands on learning opportunities, quality supervision and community immersion. Systematic review registration number PROSPERO CRD42021223187. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08261-2.
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Affiliation(s)
- Alison Dymmott
- Flinders University Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
| | - Stacey George
- Flinders University Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Narelle Campbell
- Flinders University Northern Territory, College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia
| | - Chris Brebner
- Flinders University Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Ramsden R, Pit S, Colbran R, Payne K, Tan AJH, Edwards M. Development of a framework to promote rural health workforce capability through digital solutions: A qualitative study of user perspectives. Digit Health 2022; 8:20552076221089082. [PMID: 35493957 PMCID: PMC9044786 DOI: 10.1177/20552076221089082] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/06/2022] [Indexed: 11/15/2022] Open
Abstract
A high-quality, sustained, health workforce contributes to a healthy population.
However, a global reality is that rural health services, and the workforces that
provide those services, are under unprecedented pressure. It is posited that
improving a rural health practitioners’ capability could help to retain them
working rurally for longer. Capability refers to skills and experience and the
extent to which individuals can adapt to change, generate new knowledge and
continue to improve their performance. With rapidly increasing access to, and
use of, digital technology worldwide, there are new opportunities to build
capability and leverage personal and professional support for those who are
working rurally. In 2021, semi-structured interviews were conducted in rural
Australia with thirteen General Practitioners and allied health professionals.
Thematic analysis was adopted to analyse the data and map it to the Health
Information Technology Acceptance Model. Whilst it could be assumed that low
technology literacy would act as a barrier to the use of digital tools, the
study demonstrated that this was not a significant impediment to participants’
willingness to adopt digital tools when social and professional networks weren't
available face to face to address their capability challenges. The findings
provide insight into the concept of health workforce capability and important
considerations when designing capability support. This includes key features of
health apps or digital tools to support the capability of the rural health
workforce. Understanding the factors that make up a health professionals’
capability and the motivations or cues to act to build or maintain their
capability may have a positive effect on their retention in a rural
location.
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Okyere E, Ward P, Marfoh K, Mwanri L. What do Health Workers say About Rural Practice? Glob Qual Nurs Res 2021; 8:23333936211054812. [PMID: 34869792 PMCID: PMC8637704 DOI: 10.1177/23333936211054812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 11/18/2022] Open
Abstract
Adequately staffed rural health services improve healthcare delivery and health outcomes,
yet this is lacking in rural Ghana. We used a descriptive qualitative design to understand
the contextual issues that affect rural practice, in the Upper East Region, Ghana.
Sixty-eight in-depth interviews were conducted with healthcare workers and analysed
thematically. Four themes were identified: types of postings to rural settings, healthcare
workers’ perceptions of their rural postings, perceived enablers and motivators for rural
practice, and perceived challenges and barriers to rural practice. While adequate
supervision and family proximity are needed to improve the feelings of loneliness,
isolation and neglect in rural areas, challenges and barriers such as inadequate security,
unstable electricity supply, language barrier, lack of equipment and transport/ambulance
have been identified to have negative influence on healthcare workers. The findings
highlight the need for healthcare managers to improve fairness and transparency in the
posting and reshuffling processes of healthcare workers.
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Affiliation(s)
- Eunice Okyere
- College of Medicine, Nursing and Health
Sciences, Fiji National University, Suva, Fiji Islands
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia
- Eunice Okyere, Department of Public Health, College
of Medicine, Nursing and Health Sciences, Fiji National University, Princess Road,
Tamavua, Suva, Fiji Islands.
| | - Paul Ward
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia
| | - Kissinger Marfoh
- Department of Public Health, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia
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McMaster E, Reid T, Farquhar E, McMaster D, Buckley D, Green E. Responding to rural allied health workforce challenges in the public health system: Evaluation of the Allied Health Rural Generalist Pathway pilot in western New South Wales. Aust J Rural Health 2021; 29:701-720. [PMID: 34672053 DOI: 10.1111/ajr.12797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/05/2021] [Accepted: 08/12/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The Allied Health Rural Generalist Pathway pilot aimed to improve consistent access to physiotherapy services in rural communities using the "grow own" workforce strategy and existing resources. DESIGN A summative evaluation of the quality improvement project used to implement the Allied Health Rural Generalist Pathway was completed. A mixed method design was used and included focus groups and a framework analysis. PARTICIPANTS The temporary redesign of specific workforce resources created "development" positions. A shared same-discipline supervisor resource supported five early-career physiotherapists, the participants. SETTING The project was undertaken in rural New South Wales in the public health system. MAIN OUTCOME MEASURES The main outcome measures included a number of chronically vacant physiotherapy positions and stakeholder satisfaction. RESULTS Targeted vacancies were filled, services sustained with minimal service gaps and mean retention rate of 2.9 years. A statistically significant increase in service activity to patients in rural locations occurred as a result of the intervention (R-squared 29%, P < .05). Four out of five early career physiotherapists fulfilled terms of their contract and secured senior positions within the region. Whilst participants developed professionally, they did not complete the tertiary education component. CONCLUSIONS The Allied Health Rural Generalist multi-factorial approach supported recruitment, retention and capacity building within the targeted discipline of the allied health workforce. Patient need was met. The rural pipeline capacity was developed. The pathway was complementary of existing NSW Health systems. Systemic change is needed to overcome inefficiencies experienced during implementation and to ensure sustainability. Further research to develop discipline-specific clinical training guidance through the stages of a rural allied health professionals' career may be helpful.
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Affiliation(s)
- Ellen McMaster
- Griffith Base Hospital, Murrumbidgee Local Health District, Griffith, NSW, Australia
| | - Tegan Reid
- Murrumbidgee Local Health District Office, Wagga Wagga, NSW, Australia
| | - Emily Farquhar
- Wagga Wagga Base Hospital, Murrumbidgee Local Health District, Wagga Wagga, NSW, Australia
| | - Duncan McMaster
- Wagga Wagga Base Hospital, Murrumbidgee Local Health District, Wagga Wagga, NSW, Australia
| | - David Buckley
- Murrumbidgee Local Health District Office, Wagga Wagga, NSW, Australia
| | - Elyce Green
- Charles Sturt University, Three Rivers University Department of Rural Health, Wagga Wagga, NSW, Australia
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Beccaria L, McIlveen P, Fein EC, Kelly T, McGregor R, Rezwanul R. Importance of attachment to place in growing a sustainable Australian Rural Health Workforce: A rapid review. Aust J Rural Health 2021; 29:620-642. [PMID: 34612538 DOI: 10.1111/ajr.12799] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/19/2021] [Accepted: 08/12/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Personal, community, and environmental factors can influence the attraction and retention of regional, rural, and remote health workers. However, the concept of place attachment needs further attention as a factor affecting the sustainability of the rural health workforce. OBJECTIVE The purpose of this rapid review was to explore the influence of a sense of place in attracting and retaining health professionals in rural and remote areas. DESIGN A systematic rapid review was conducted based on an empirical model using four dimensions: place dependence, place identity, social bonding and nature bonding. English-language publications between 2011 and 2021 were sought from academic databases, including studies relevant to Australian health professionals. FINDINGS A total of 348 articles were screened and 52 included in the review. Place attachment factors varied across disciplines and included (a) intrinsic place-based personal factors; (b) learning experiences enhancing self-efficacy and rural health work interest; (c) relational, social and community integration; and (d) connection to place with lifestyle aspirations. DISCUSSION This rapid review provides insight into the role of relational connections in building a health workforce and suggests that community factors are important in building attachment through social bonding and place identity. Results indicate that future health workforce research should focus on career decision-making and psychological appraisals including place attachment. CONCLUSION An attachment to place might develop through placement experiences or from a strong rural upbringing. The importance of the relational interactions within a work community and the broader community is seen as an important factor in attracting, recruiting, and sustaining a rural health workforce.
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Affiliation(s)
- Lisa Beccaria
- School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Peter McIlveen
- School of Education, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Erich C Fein
- School of Psychology and Counselling, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Tricia Kelly
- Library Services, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Rowena McGregor
- Library Services, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Rana Rezwanul
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
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Couch A, Menz HB, Coker F, White J, Haines T, Williams C. Factors that influence workplace location choices in the different allied health professions: A systematic review. Aust J Rural Health 2021; 29:823-834. [PMID: 34498324 DOI: 10.1111/ajr.12768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 01/11/2021] [Accepted: 05/31/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The maldistribution of health care workers between metropolitan, rural or remote areas is globally recognised. Allied health professional's workplace location choice is a complex interplay between professional and non-professional elements. Policy-makers should understand factors that influence workplace location choices when designing structures to attract allied health professionals to rural practice. OBJECTIVE To determine factors influencing recruitment and retention of allied health professionals in metropolitan, rural and remote locations. DESIGN Systematic review. FINDINGS Twenty-two studies met inclusion criteria. Extracted data were synthesised into subthemes: (a) opportunities for career development, (b) clinical load, (c) organisational and workplace structure, (d) previous location exposure and (e) personal factors. Of these 22 studies, 12 reported organisational/workplace structure and personal factors positively impacting recruitment and 11 studies discussed organisational and workplace structure also negatively impacting on retention. Career opportunities positively impacted on recruitment, while lack of opportunity negatively affected retention. Previous location exposure positively impacted recruitment however had limited impact on retention. Similarly, a diverse clinical load was reported as being attractive during recruitment, but unmanageable caseloads affected retention. DISCUSSION This review identifies the need for effective and sustainable solutions for the issues with recruitment and retention of allied health professionals. While the different allied health professions share similar recruitment and retention challenges, further research is needed to isolate factors impacting each discipline. CONCLUSIONS Retention and recruitment of different allied health professions is multifactorial. Organisational and workplace structure and opportunities for career development emerged as having impact on the recruitment of allied health professionals.
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Affiliation(s)
- Anna Couch
- Peninsula Health, Allied Health, Frankston, VIC, Australia.,School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| | - Hylton B Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Freya Coker
- School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| | - Jenni White
- Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Terry Haines
- Peninsula Health, Allied Health, Frankston, VIC, Australia.,School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| | - Cylie Williams
- Peninsula Health, Allied Health, Frankston, VIC, Australia.,School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
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Elstad JI, Vabø M. Lack of recognition at the societal level heightens turnover considerations among Nordic eldercare workers: a quantitative analysis of survey data. BMC Health Serv Res 2021; 21:747. [PMID: 34315457 PMCID: PMC8315089 DOI: 10.1186/s12913-021-06734-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Recruiting and retaining staff are standing challenges in eldercare. Low pay, difficult working conditions, and social relations at the workplace impact on turnover intentions. Few studies have used quantitative data for estimating the role of recognition by the wider society for staff instability. This study examines how perceived lack of recognition at the societal level affects Nordic eldercare workers’ considerations of leaving their jobs. Methods The 2015 Nordcare survey among frontline eldercare workers in Denmark, Finland, Norway, and Sweden (N = 3,677) is analysed. Issues such as working conditions, financial strain, work-life balance, and appreciation by care recipients and colleagues, were covered. Recognition at the societal level was measured by perceptions of being valued by top municipal leaders, mass media, and the general public. Analyses are made with cross-tabulations and multivariate linear probability regression models. Results In the total sample, 41.1 % had “seriously considered to quit during the last 12 months”. About one third felt “not at all valued” by top municipal leaders, while one fourth felt “not at all valued” by mass media. In bivariate analyses, perceptions of recognition were strongly associated with considerations to quit. These associations were reduced, but remained sizeable and highly significant in multivariate analyses adjusted for age, gender, health, working conditions, financial stress, workplace relations, and other known turnover predictors. Conclusions Lack of recognition by societal agents such as top municipal leaders, mass media, and the general public, is widely felt by Nordic eldercare workers. Feeling poorly valued by such sources is associated with frequent considerations to leave one’s employment. Perceived lack of recognition by the wider society has a significant and independent impact on staff instability in the eldercare sector. Societies’ recognition order is embedded in social structures which are resistant to change, but policies which succeed in raising the societal recognition of eldercare work may contribute to reduced retention difficulties in eldercare. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06734-4.
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Affiliation(s)
- Jon Ivar Elstad
- NOVA, Centre of Welfare and Labour Research, Oslo Metropolitan University, P.O.Box 4, St. Olavs Plass, 0130, Oslo, Norway.
| | - Mia Vabø
- NOVA, Centre of Welfare and Labour Research, Oslo Metropolitan University, P.O.Box 4, St. Olavs Plass, 0130, Oslo, Norway
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Barker R, Chamberlain-Salaun J, Harrison H, Nash R, Nielsen I, Harvey D, Sim J, Ciccone N, Carr J, Bird K, Palermo C, Devine S. Evaluation of the Allied Health Rural Generalist Program 2017-2019. Aust J Rural Health 2021; 29:158-171. [PMID: 33982849 DOI: 10.1111/ajr.12745] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To evaluate the development and implementation of the Allied Health Rural Generalist Program, a two-level online post-graduate education program, which includes Level 1, an entry-level non-award pathway program, and Level 2, a Graduate Diploma in Rural Generalist Practice. DESIGN A convergent mixed methodology evaluation in two overlapping stages: a process evaluation on quality and reach, together with a mixed method case study evaluation on benefits, of the program. SETTING Rural and remote Australia across ten sites and seven allied health professions: dietetics; occupational therapy; pharmacy; physiotherapy; podiatry; radiography; speech pathology. PARTICIPANTS Process evaluation included 91 participants enrolled in all or part of the Rural Generalist Program. Case study evaluation included 50 managers, supervisors and Rural Generalist Program participants from the ten study sites. INTERVENTIONS The Allied Health Rural Generalist Program. MAIN OUTCOME MEASURES Process evaluation data were derived from enrolment data and education evaluation online surveys. Case study data were gathered via online surveys and semi-structured interviews. Quantitative and qualitative data were collected concurrently, analysed separately and then integrated to identify consistency, expansion or discordance across the data. RESULTS The Rural Generalist Program was viewed as an effective education program that provided benefits for Rural Generalist Program participants, employing organisations and consumers. Key improvements recommended included increasing profession-specific and context-specific content, ensuring Rural Generalist Program alignment with clinical and project requirements, strengthening support mechanisms within employing organisations and ensuring benefits can be sustained in the long term. CONCLUSION The Rural Generalist Program offers a promising strategy for building a fit-for-purpose rural and remote allied health workforce.
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Affiliation(s)
- Ruth Barker
- James Cook University, Cairns, QLD, Australia
| | | | | | - Robyn Nash
- Queensland University of Technology, Brisbane, QLD, Australia
| | - Ilsa Nielsen
- Allied Health Professions Office of Queensland, Queensland Health, Brisbane, QLD, Australia
| | - Desley Harvey
- Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
| | - Jenny Sim
- Monash University, Melbourne, Vic., Australia
| | | | | | | | | | - Sue Devine
- James Cook University, Cairns, QLD, Australia
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20
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The role of digital technology in providing education, training, continuing professional development and support to the rural health workforce. HEALTH EDUCATION 2021. [DOI: 10.1108/he-11-2020-0109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PurposeEducation, training and continuing professional development are amongst the evidence-based initiatives for attracting and retaining rural and remote health professionals. With rapidly increasing access to and use of digital technology worldwide, there are new opportunities to leverage training and support for those who are working in rural and remote areas. In this paper we determine the key elements associated with the utility of digital technologies to provide education, training, professional learning and support for rural health workforce outside the University and tertiary sector.Design/methodology/approachA scoping review of peer-reviewed literature from Australia, Canada, US and New Zealand was conducted in four bibliographic databases – Medline complete, CINAHL, Academic Search complete and Education Complete. Relevant studies published between January 2010 and September 2020 were identified. The Levac et al. (2010) enhanced methodology of the Arksey and O'Malley (2005) framework was used to analyse the literature.FindingsThe literature suggests there is mounting evidence demonstrating the potential for online platforms to address the challenges of rural health professional practice and the tyranny of distance. After analysing 22 publications, seven main themes were found – Knowledge and skills (n = 13), access (n = 10), information technology (n = 7), translation of knowledge into practice (n = 6), empowerment and confidence (n = 5), engagement (n = 5) and the need for support (n = 5). Ongoing evaluation will be critical to explore new opportunities for digital technology to demonstrate enhanced capability and retention of rural health professionals.Originality/valueTo date there has been limited examination of research that addresses the value of digital platforms on continuing professional development, education and support for rural health professionals outside the university and tertiary training sectors.
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21
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Context Matters: Findings from a Qualitative Study Exploring Service and Place Factors Influencing the Recruitment and Retention of Allied Health Professionals in Rural Australian Public Health Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165815. [PMID: 32796738 PMCID: PMC7460531 DOI: 10.3390/ijerph17165815] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 11/17/2022]
Abstract
Chronic health workforce shortages significantly contribute to unmet health care needs in rural and remote communities. Of particular and growing concern are shortages of allied health professionals (AHPs). This study explored the contextual factors impacting the recruitment and retention of AHPs in rural Australia. A qualitative approach using a constructivist-interpretivist methodology was taken. Semi-structured interviews (n = 74) with executive staff, allied health (AH) managers and newly recruited AHPs working in two rural public health services in Victoria, Australia were conducted. Data was coded and categorised inductively and analysed thematically. The findings suggest that to support a stable and sustainable AH workforce, rural public sector health services need to be more efficient, strategic and visionary. This means ensuring that policies and procedures are equitable and accessible, processes are effective, and action is taken to develop local programs, opportunities and supports that allow AH staff to thrive and grow in place at all grade levels and life stages. This study reinforces the need for a whole-of-community approach to effectively support individual AH workers and their family members in adjusting to a new place and developing a sense of belonging in place. The recommendations arising from this study are likely to have utility for other high-income countries, particularly in guiding AH recruitment and retention strategies in rural public sector health services. Recommendations relating to community/place will likely benefit broader rural health workforce initiatives.
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22
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A study of the factors impacting on workforce distribution of Australian osteopaths: The perspectives of osteopathic students, academics and clinicians. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Muñoz-Blanco E, Merino-Andrés J, Aguilar-Soto B, García YC, Puente-Villalba M, Pérez-Corrales J, Güeita-Rodríguez J. Influence of Aquatic Therapy in Children and Youth with Cerebral Palsy: A Qualitative Case Study in a Special Education School. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103690. [PMID: 32456241 PMCID: PMC7277651 DOI: 10.3390/ijerph17103690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/16/2020] [Accepted: 05/20/2020] [Indexed: 12/12/2022]
Abstract
Cerebral palsy results in the progressive loss of motor functions, with a negative impact on daily activities and participation. Despite the well described benefits of aquatic therapy in children, little is known about the effects of the same in school settings. This study aimed to describe the experience of children and youth with cerebral palsy participating in an aquatic therapy program within a special education school considering their educational and therapeutic perspectives. A qualitative descriptive case study with embedded units was developed, comprising 27 participants. This study employed purposeful sampling to include children and youth with cerebral palsy from the Asociación Ayuda a la Paralisis Cerebral (APACE) special education school, together with their parents, the special education teachers, and health care professionals. Data were collected via non-participant observation, semi-structured and informal interviews, focus groups, and researcher field notes. A thematic analysis was conducted, revealing the following themes: (a) the connection with the environment; (b) postural improvements and mobility; (c) the opportunity to perform tasks; (d) learning and transfer. A motivating environment leads to physical, cognitive and social benefits, both at school and in the home. Aquatic therapy was viewed as a means for learning and participation. These findings may enhance understanding regarding the potential benefits of implementing multidisciplinary aquatic therapy programs in specialist school settings.
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Affiliation(s)
- Elisa Muñoz-Blanco
- Department of Physical Therapy, Faculty of Medicine, CEU-San Pablo University, 28003 Madrid, Spain;
- Research and Science Committee of Worldwide Aquatic Bodywork Association (WABA), 6802 Monteceneri, Switzerland
| | - Javier Merino-Andrés
- Faculty of Physical Therapy and Nursing, Universidad de Castilla La Mancha, 45071 Toledo, Spain;
- PedPT Research Lab, Grupo de Investigación de Fisioterapia en Toledo (GIFTO), 45071 Toledo, Spain
| | | | | | | | - Jorge Pérez-Corrales
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain;
- Research Group of Humanities and Qualitative Research in Health Science, Rey Juan Carlos University (Hum&QRinHS), Alcorcón, 28922 Madrid, Spain
| | - Javier Güeita-Rodríguez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain;
- Research Group of Humanities and Qualitative Research in Health Science, Rey Juan Carlos University (Hum&QRinHS), Alcorcón, 28922 Madrid, Spain
- Correspondence: ; Tel.: +34-4888600
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Cosgrave C. The Whole-of-Person Retention Improvement Framework: A Guide for Addressing Health Workforce Challenges in the Rural Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2698. [PMID: 32295246 PMCID: PMC7216161 DOI: 10.3390/ijerph17082698] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/03/2020] [Accepted: 04/12/2020] [Indexed: 12/11/2022]
Abstract
People living in rural places face unique challenges due to their geographic isolation and often experience poorer health outcomes compared to people living in major cities. The struggle to attract and retain an adequately-sized and skilled health workforce is a major contributing factor to these health inequities. Health professionals' decisions to stay or leave a rural position are multifaceted involving personal, organisational, social and spatial aspects. While current rural health workforce frameworks/models recognise the multidimensional and interrelated influences on retention, they are often highly complex and do not easily support the development of strategic actions. An accessible evidence-informed framework that addresses the complexity but presents the evidence in a manner that is straightforward and supports the development of targeted evidence- and place-informed retention strategies is required. The 'Whole-of-Person Retention Improvement Framework' (WoP-RIF) has three domains: Workplace/Organisational, Role/Career and Community/Place. The necessary pre-conditions for improving retention through strengthening job and personal satisfaction levels are set out under each domain. The WoP-RIF offers a person-centred, holistic structure that encourages whole-of-community responses that address individual and workforce level needs. It is a significant response to, and resource for, addressing avoidable rural health workforce turnover that rural health services and communities can harness in-place.
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Affiliation(s)
- Catherine Cosgrave
- Department of Rural Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Docker St, Wangaratta, VIC 3677, Australia
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25
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Kumar S, Tian EJ, May E, Crouch R, McCulloch M. "You get exposed to a wider range of things and it can be challenging but very exciting at the same time": enablers of and barriers to transition to rural practice by allied health professionals in Australia. BMC Health Serv Res 2020; 20:105. [PMID: 32041600 PMCID: PMC7011556 DOI: 10.1186/s12913-020-4954-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 02/04/2020] [Indexed: 11/26/2022] Open
Abstract
Background There is consistent evidence highlighting the mal-distribution of the health workforce between urban and rural and remote regions. To date, addressing this mal-distribution has focused on medicine and nursing with limited initiatives targeted at allied health. Therefore, the aim of this research was to explore the enablers of and barriers to transition to rural practice by allied health professionals across South Australia in Australia. Method Qualitative descriptive methodology was used to underpin this research. Individual, in-depth semi-structured interviews were conducted with employers, managers and allied health professionals from rural regions of South Australia who were identified using purposive maximum variation sampling strategy. Results A total 22 participants shared their perspectives on the enablers of and barriers to transition to rural practice by allied health professionals across South Australia. Thematic analysis of the interview data resulted in a number of key issues impacting transition to rural-based practice. These findings could be broadly categorised into three stages during the transition: ‘before’; ‘during’ and ‘after’. Discussion This study identified a range of enablers of and barriers to transition to rural practice by allied health professionals. Five overarching themes – nature of rural practice, exposure to rural ‘taster’, social/lifestyle, job availability/characteristics, and mentor and support were identified. In particular, exposure to rural ‘taster’, social/lifestyle, and mentor and support were the key themes reported by the stakeholders. The multifactorial nature of the barriers and enablers highlight the complexity underpinning how AHPs transition to rural-based practice. These barriers/ enablers are often inter-linked and continually evolving which pose significant challenges for health care stakeholders to successfully addressing these. Conclusion This research sheds light on the complexities that confront and successful strategies that are required for health care stakeholders when considering how best to support allied health professional transition to rural practice.
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Affiliation(s)
- Saravana Kumar
- School of Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, SA, 5001, Australia.
| | - Esther Jie Tian
- School of Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Esther May
- Division of Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Rosanne Crouch
- Department of Rural Health, University of South Australia, City East Campus, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Mandy McCulloch
- Rural Doctors Workforce Agency, 63 Henley Beach Road, Mile End, SA, 5031, Australia
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Hendrickx D, Amgarth-Duff I, C Bowen A, R Carapetis J, Chibawe R, Samson M, Walker R. Barriers and Enablers of Health Service Utilisation for Childhood Skin Infections in Remote Aboriginal Communities of Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E808. [PMID: 32012972 PMCID: PMC7037003 DOI: 10.3390/ijerph17030808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/16/2022]
Abstract
In Australia, children living in remote Aboriginal communities experience high rates of skin infections and associated complications. Prompt presentation to primary care health services is crucial for early diagnosis and treatment. We performed a qualitative study in four remote Aboriginal communities in the Pilbara region of Western Australia to explore factors that affected health service utilisation for childhood skin infections in this setting. The study consisted of semistructured interviews and focus group discussions with parents and carers (n = 16), healthcare practitioners (n = 15) and other community service providers (n = 25). We used Andersen's health service utilisation model as an analytical framework. Our analysis captured a wide range of barriers that may undermine timely use of health services for childhood skin infections. These included general factors that illustrate the importance of cultural competency amongst healthcare providers, patient-centred care and community engagement. Relating specifically to health service utilisation for childhood skin infections, we identified their apparent normalisation and the common use of painful benzathine penicillin G injections for their treatment as important barriers. Health service utilisation in this setting may be enhanced by improving general awareness of the significance of childhood skin infections, actively engaging parents and carers in consultation and treatment processes and strengthening community involvement in health service activities.
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Affiliation(s)
- David Hendrickx
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Ingrid Amgarth-Duff
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Asha C Bowen
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Jonathan R Carapetis
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Robby Chibawe
- Puntukurnu Aboriginal Medical Service Unit 5, 15, Iron Ore Parade, Newman, WA 6753, Australia
| | - Margaret Samson
- Jigalong Community Council, Pmb 8, Newman, WA 6753, Australia
| | - Roz Walker
- Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
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Malatzky C, Cosgrave C, Gillespie J. The utility of conceptualisations of place and belonging in workforce retention: A proposal for future rural health research. Health Place 2019; 62:102279. [PMID: 32479357 DOI: 10.1016/j.healthplace.2019.102279] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/08/2019] [Accepted: 12/17/2019] [Indexed: 11/28/2022]
Abstract
This paper explores the utility of sense of place, place attachment and belonging-in-place for research into rural health workforce retention. One of the key contributors to health disparities between rural and metropolitan-based residents is inadequate staffing of rural health services, and many rural places around the world struggle to retain health professionals. Despite some recognition of the complex array of factors and circumstances impacting rural workforce retention, research focuses primarily on organisational and role-based causes. Health geography and concepts associated with place currently being used in some rural research may offer much to workforce retention research, especially when applied alongside person-centred approaches.
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Cosgrave C, Maple M, Hussain R. Factors affecting job satisfaction of Aboriginal mental health workers working in community mental health in rural and remote New South Wales. AUST HEALTH REV 2019; 41:707-711. [PMID: 27914487 DOI: 10.1071/ah16128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 10/28/2016] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to identify factors affecting the job satisfaction and subsequent retention of Aboriginal mental health workers (AMHWs). Methods Five AMHWs working in New South Wales (NSW) for NSW Health in rural and remote community mental health (CMH) services participated in in-depth, semi-structured interviews to understand how employment and rural living factors affected workers' decisions to stay or leave their CMH positions. Results Using a constructivist grounded theory analysis, three aspects negatively impacting the job satisfaction of AMHWs were identified: (1) difficulties being accepted into the team and organisation; (2) culturally specific work challenges; and (3) professional differences and inequality. Conclusions Policy and procedural changes to the AMHW training program may address the lower remuneration and limited career opportunities identified with regard to the Bachelor Health Sciences (Mental Health) qualification. Delivering training to increase levels of understanding about the AMHW training program, and cultural awareness generally, to CMH staff and NSW Health management may assist in addressing the negative team, organisational and cultural issues identified. What is known about the topic? The Bachelor Health Sciences (Mental Health) qualification and traineeship pathway undertaken by AMHWs differs significantly from that of other health professionals working in NSW Health's CMH services. The health workforce literature identifies that each health professional group has its own culture and specific values and that forming and maintaining a profession-specific identity is an extremely important aspect of job satisfaction for health workers. What does the paper add? AMHWs working in rural and remote NSW CMH services commonly experience low levels of job satisfaction, especially while undertaking the embedded training program. Of particular concern is the health sciences qualification not translating into NSW Health's 'professionalised' workplace, as well as having negative effects with regard to remuneration and career opportunities within NSW Health. In addition, role challenges involving cultural differences and managing additional professional and personal boundaries negatively affects the job satisfaction of AMHWs. What are the implications for practice? The current structure of the AMHW training program creates workplace conditions that contribute to job dissatisfaction among rural and remote-based AMHWs. Many issues could be rectified by NSW Health making changes to the degree qualification obtained under the training program, as well as raising the level of understanding about the program and Indigenous cultural awareness generally among CMH staff and NSW Health management.
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Affiliation(s)
- Catherine Cosgrave
- Department of Rural Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 49 Graham Street, Shepparton, Vic. 3630, Australia
| | - Myfanwy Maple
- School of Health, University of New England, Armidale, NSW 2350, Australia. Email
| | - Rafat Hussain
- ANU Medical School & Research School of Population Health, Centre for Research on Ageing, Health and Well-Being, The Australian National University, Acton, ACT 0200, Australia. Email
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Mbada C, Olawuyi A, Oyewole OO, Odole AC, Ogundele AO, Fatoye F. Characteristics and determinants of community physiotherapy utilization and supply. BMC Health Serv Res 2019; 19:168. [PMID: 30871529 PMCID: PMC6419371 DOI: 10.1186/s12913-019-3994-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/06/2019] [Indexed: 12/02/2022] Open
Abstract
Background Demand for Physiotherapy is on the rise due to increasing ageing population and consequent disability and morbidity. However, the costs of healthcare in developing countries are rising, and healthcare resources are limited making the supply of Physiotherapy services challenging in rural communities. Availability of Physiotherapy may help to reduce the burden of disability and enhance efficiency of healthcare systems. This study investigated the characteristics and associations of utilization and supply of community Physiotherapy in Nigeria. Methods Cross-sectional survey of 336 consenting community dwelling individuals from three selected communities in Nigeria was carried out. A three-section validated self-developed questionnaire which sought information on socio-demographics, utilization and supply of community Physiotherapy, as well as how to improve community Physiotherapy services was used. A household was used as the primary sampling unit in the study. Inferential and Descriptive statistics were used to assess the data. Results Lifetime, 12-month and point utilization of physiotherapy was 21.7, 7.4 and 2.7% respectively. Physiotherapy utilization was significantly associated with level of education (p = 0.007), belief on pain as “spiritual” (p = 0.020) and religious belief (p = 0.001). The respondents with primary, secondary and tertiary education were 14.3, 13.9 and 26 times more likely to utilize physiotherapy services, respectively. Those who ‘agree’ or were ‘not sure’ that their religious belief was against physiotherapy were 92 and 83% less likely to utilize physiotherapy services, respectively compared with those who ‘disagree’. Availability and supply of Physiotherapy services were mostly at the township teaching hospital (47.9%) and private hospitals (20.5%). The supply of Physiotherapy services within the communities was mostly on temporary basis (24.7%) and through visiting Physiotherapists (21.4%). Physiotherapy services utilized was mainly exercise (46.6%) and soft tissue mobilization (41.1%). Travel costs (32.6%), time constraints (27.9%) and work commitments (24.8%) were the constraints for Physiotherapy utilization while positive beliefs and higher education improved Physiotherapy utilization. Conclusions Utilization and supply of Physiotherapy services in Nigerian rural community was low. Low utilization of Physiotherapy services in Nigerian rural communities were most significantly influenced by low educational status and beliefs about pain. Electronic supplementary material The online version of this article (10.1186/s12913-019-3994-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chidozie Mbada
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Abraham Olawuyi
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olufemi O Oyewole
- Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu, PMB 2001, Nigeria.
| | - Adesola C Odole
- Department of Physiotherapy, University of Ibadan, Ibadan, Nigeria
| | - Abiola O Ogundele
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Cosgrave C, Malatzky C, Gillespie J. Social Determinants of Rural Health Workforce Retention: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030314. [PMID: 30678350 PMCID: PMC6388117 DOI: 10.3390/ijerph16030314] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/13/2019] [Accepted: 01/21/2019] [Indexed: 11/29/2022]
Abstract
Residents of rural and remote Australia have poorer health outcomes than their metropolitan counterparts. A major contributor to these health disparities is chronic and severe health workforce shortages outside of metropolitan areas—a global phenomenon. Despite emerging recognition of the important influence of place-based social processes on retention, much of the political attention and research is directed elsewhere. A structured scoping review was undertaken to describe the range of research addressing the influence of place-based social processes on turnover or retention of rural health professionals, to identify current gaps in the literature, and to formulate a guide for future rural health workforce retention research. A systematic search of the literature was performed. In total, 21 articles were included, and a thematic analysis was undertaken. The themes identified were (1) rural familiarity and/or interest, (2) social connection and place integration, (3) community participation and satisfaction, and (4) fulfillment of life aspirations. Findings suggest place-based social processes affect and influence the retention of rural health workforces. However, these processes are not well understood. Thus, research is urgently needed to build robust understandings of the social determinants of rural workforce retention. It is contended that future research needs to identify which place-based social processes are amenable to change.
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Affiliation(s)
- Catherine Cosgrave
- Department of Rural Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Docker St Wangaratta, 3677 Victoria, Australia.
| | - Christina Malatzky
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove campus, Brisbane, 4059 Queensland, Australia.
| | - Judy Gillespie
- School of Social Work, Faculty of Health and Social Development, The University of British Columbia, Okanagan campus, Kelowna, BC V1V 1V7, Canada.
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Liu J, Zhu B, Wu J, Mao Y. Job satisfaction, work stress, and turnover intentions among rural health workers: a cross-sectional study in 11 western provinces of China. BMC FAMILY PRACTICE 2019; 20:9. [PMID: 30642261 PMCID: PMC6330754 DOI: 10.1186/s12875-019-0904-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/07/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Health workforce turnover remains a global concern, particularly in rural and remote areas. Western rural areas are the least developed in China, where it faces the serious challenge on the rural health worker (RHW) management. This study aimed to investigate job satisfaction, work stress, and turnover intentions of RHWs, and to explore prominent factors associated with turnover intentions of RHWs in rural western China. METHODS From June to September 2013, based on a three-stage random sampling method, a cross-sectional survey was conducted among RHWs in 11 western provinces in China. A brief, structured questionnaire filled in by RHWs was used for data collection. A total of 5046 RHWs participated in the study. The response rate was approximately 93.1%. Exploratory factor analyses, Pearson's chi-squared tests, one-way ANOVA, binary logistic regression analyses, and mediating effect tests were performed for data analyses. RESULTS Approximately 29.1% of the 5046 RHWs indicated turnover intentions. Most of the RHWs disclosed low educational levels, income levels, and professional technical titles. The RHWs expressed slight job satisfaction (mean 3.20) and moderate work stress (mean 3.22). Age, income, medical institution, and job satisfaction (i.e., organizational management, reward, and occupation satisfaction) were significant predictors of the RHWs' turnover intentions. The RHWs, who were younger (less than 41 years), receiving an income of $326.8-$490.1 per month, working in township hospitals, and having low job satisfaction, were more likely to have turnover intentions. Work stress had an indirect and positive effect on RHWs' turnover intentions. Job satisfaction weakened the positive effect of work stress on turnover intentions of RHWs by playing a total mediating role. Reward satisfaction was the strongest mediator. CONCLUSIONS The turnover intentions of RHWs in western China are significantly associated with job satisfaction, work stress, age, income, and medical institution. Appropriate strategies should be implemented to improve RHWs' job satisfaction and reduce their work stress. Meanwhile, providing more attractive wages and non-monetary support, improving working conditions, etc. could be effective to reduction in RHWs' turnover intentions.
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Affiliation(s)
- Jinlin Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jingxian Wu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
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Seet PS, Jones J, Acker T, Jogulu U. Meaningful careers in social enterprises in remote Australia: employment decisions among Australian Indigenous art centre workers. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2018. [DOI: 10.1080/09585192.2018.1528556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Pi-Shen Seet
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Janice Jones
- Flinders University, Adelaide, South Australia, Australia
| | - Tim Acker
- Tracker Development, Wembley, Western Australia, Australia
| | - Uma Jogulu
- Edith Cowan University, Joondalup, Western Australia, Australia
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Steel A, Jackson N, Blaich R, Kirk M, Wardle J. Impact of the workforce distribution on the viability of the osteopathic profession in Australia: results from a national survey of registered osteopaths. Chiropr Man Therap 2018; 26:34. [PMID: 30214715 PMCID: PMC6131917 DOI: 10.1186/s12998-018-0204-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 07/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Workforce distribution has an important influence on the quality of healthcare delivered in a region, primarily because it impacts access to health services in the community and overall health equity in the population. Distribution of osteopaths in Australia does not appear to follow the Australian population with the majority of osteopaths located in Victoria. The implications of this imbalance on the osteopathic workforce have not yet been explored. Methods A secondary analysis of data from a survey of 1531 members of Osteopathy Australia in 2013. The analysis focused on the practice and occupational characteristics associated with practice locality. Results The survey was completed by a representative sample of 432 osteopaths. Respondents practicing outside Victoria were more likely to report higher income across all income brackets, and were less likely to report a preference for more patients. Conclusions The Australian osteopathic profession should examine the issue of imbalanced workforce distribution as a priority. The results of this study are worth considering for all stakeholders as part of a coordinated approach to ensure the ongoing health of the Australian osteopathic workforce.
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Affiliation(s)
- Amie Steel
- 1University of Technology Sydney, Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, Ultimo, NSW Australia.,2Endeavour College of Natural Health, Office of Research, Brisbane, QLD Australia
| | - Nigel Jackson
- 3Southern Cross University, School of Health and Human Sciences, Lismore, NSW Australia
| | - Raymond Blaich
- 3Southern Cross University, School of Health and Human Sciences, Lismore, NSW Australia
| | - Mathew Kirk
- 3Southern Cross University, School of Health and Human Sciences, Lismore, NSW Australia
| | - Jon Wardle
- 1University of Technology Sydney, Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, Ultimo, NSW Australia
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Montilla-Pérez M, Zafra Anta MÁ, Palacios-Ceña D. Hospitalization due to bronchiolitis: factors influencing parents' experience. ENFERMERIA CLINICA 2018; 28:292-299. [PMID: 30030054 DOI: 10.1016/j.enfcli.2018.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 05/30/2018] [Accepted: 06/08/2018] [Indexed: 11/26/2022]
Abstract
AIM To describe the experience of the parents of children hospitalized due to bronchiolitis. METHOD Phenomenological qualitative study. Purposeful sampling was undertaken of parents with children diagnosed with bronchiolitis, from December 7, 2015 to January 8, 2016, and admitted to the paediatric department of a public hospital of the Madrid Health Service. Data collection strategies included focus groups and researchers' field notes. Afterwards, the data were analyzed using thematic analysis. We included 10 parents, aged between 30 and 39 years. Five themes were explored: perception of monitoring, need to know, perception of child fragility, coping strategies, and reorganization of the family environment. RESULTS Oxygen saturation monitoring through devices produced dependence and uncertainty in the parents. In addition, there was a need to know and understand the technical language, which encouraged searching for information on the Internet. The parents perceived the fragility of the hospitalized child through their appearance and physical state. In addition, they developed different coping strategies to seek and confirm information, to approach professionals and be present with their children. Finally, the family was reorganised to maintain the constant presence of the parents during hospitalization. CONCLUSIONS The results obtained can help paediatric professionals manage the information given to parents and thus empower them.
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Affiliation(s)
| | | | - Domingo Palacios-Ceña
- Facultad Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
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Arkwright L, Edgar S, Debenham J. Exploring the job satisfaction and career progression of musculoskeletal physiotherapists working in private practice in Western Australia. Musculoskelet Sci Pract 2018; 35:67-72. [PMID: 29549814 DOI: 10.1016/j.msksp.2018.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/21/2018] [Accepted: 03/09/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite increasing workforce numbers, new graduate physiotherapists are reporting short career intentions due to low job satisfaction. Job satisfaction improves retention among allied health professionals, however we have limited understanding of its influence specific to physiotherapists. OBJECTIVES The aim of this study was to explore factors contributing to the job satisfaction of musculoskeletal physiotherapists working in private practice across different career stages (new graduates, graduates, postgraduates, and owners) in Western Australia. DESIGN Mixed-methods design with an anonymous self-administered survey capturing job satisfaction and employment characteristics of Western Australian physiotherapists working in private practice. Factors including peer support and mentoring, career progression and professional development were explored. METHOD Physiotherapists were recruited through snowball sampling, with 60 practices approached to participate. Survey results were analysed using linear regression models and basic thematic analysis. RESULTS Two-hundred and five surveys were completed by physiotherapists across 52 practices. The mean job satisfaction score was 41.9 out of 50, and increased job satisfaction was associated with practice ownership, salary satisfaction, established career pathways, and access to mentoring and professional development. CONCLUSIONS Practice owners were significantly more satisfied with their job compared to new graduate, graduate and postgraduate physiotherapists. Findings illustrated the changing needs for support across different career stages, the importance of accessible senior clinicians, and the limited recognition for the efforts made by physiotherapists to pursue ongoing education.
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Affiliation(s)
- Laura Arkwright
- School of Physiotherapy, The University of Notre Dame Australia, Australia
| | - Susan Edgar
- School of Physiotherapy, The University of Notre Dame Australia, Australia.
| | - James Debenham
- School of Physiotherapy, The University of Notre Dame Australia, Australia
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Smith T, Cross M, Waller S, Chambers H, Farthing A, Barraclough F, Pit SW, Sutton K, Muyambi K, King S, Anderson J. Ruralization of students' horizons: insights into Australian health professional students' rural and remote placements. J Multidiscip Healthc 2018; 11:85-97. [PMID: 29430183 PMCID: PMC5797464 DOI: 10.2147/jmdh.s150623] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students' future rural practice intentions. METHODS Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. RESULTS The core concept identified from the thematic analysis was "ruralization of students' horizons," a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, "preparation and support," "rural or remote health experience," and "rural lifestyle and socialization," each of which includes multiple subthemes. From the content analysis, factors that promoted students' rural practice intentions were having a "positive" practice experience, interactions with "supportive staff," and interactions with the "community" in general. It was apparent that "difficulties," eg, with "accommodation," "Internet" access, "transport," and "financial" support, negatively impacted students' placement experience and rural practice intentions. CONCLUSIONS The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study may, therefore, further inform ongoing strategies for improving rural placement experiences and enhancing rural health workforce recruitment, retention, and capacity building.
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Affiliation(s)
- Tony Smith
- Department of Rural Health, University of Newcastle, Taree, NSW
| | - Merylin Cross
- Centre for Rural Health, University of Tasmania, Launceston, TAS
| | - Susan Waller
- Department of Rural Health, Monash University, Moe, VIC
| | | | - Annie Farthing
- Centre for Remote Health, Flinders University, Alice Springs, NT
| | | | - Sabrina W Pit
- University Centre for Rural Health, University of Western Sydney, Lismore, NSW, NSW
| | - Keith Sutton
- Department of Rural Health, Monash University, Moe, VIC
| | - Kuda Muyambi
- Department of Rural Health, University of South Australia, Whyalla, SA
| | - Stephanie King
- Centre for Rural and Remote Health, James Cook University, Mt Isa, QLD, Australia
| | - Jessie Anderson
- Centre for Remote Health, Flinders University, Alice Springs, NT
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Palacios-Ceña D, Martín-Tejedor EA, Elías-Elispuru A, Garate-Samaniego A, Pérez-Corrales J, García-García E. The impact of a short-term cohousing initiative among schizophrenia patients, high school students, and their social context: A qualitative case study. PLoS One 2018; 13:e0190895. [PMID: 29324773 PMCID: PMC5764336 DOI: 10.1371/journal.pone.0190895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 12/21/2017] [Indexed: 11/19/2022] Open
Abstract
Background A number of programs have been developed to promote the contact between adolescents and mentally-ill patients, in order to break the stigma, improve understanding, promote mental health and prevent substance abuse. The aim of this study was to describe the experience of patients with schizophrenia, high school students, and their social context, participating in a short-term cohousing initiative. Methods A qualitative case-study approach was implemented. Patients with schizophrenia from the San Juan de Dios Psychiatric Hospital, female students from Almen High School, and participants from their social context (parents, hospital staff, and teachers) were included, using purposeful sampling. Data were collected from 51 participants (15 patients, nine students, 11 hospital staff, six teachers, 10 parents) via non-participant observation, focus groups, informal interviews, researchers’ field notes and patients’ personal diaries and letters. A thematic analysis was performed. Results The themes identified included a) learning to live together: students and patients participate and learn together; b) the perception of the illness and the mentally-ill: the barrier between health and disease is very slim, and society tends to avoid contact with those who are ill; c) change: a transformation takes place in students, in their self-perception, based on the real and intense nature of the experience; d) a trial and an opportunity: patients test their ability to live outside the hospital; e) discharge and readmission: discharge is experienced as both a liberation and a difficulty, whereas relapse and readmission are experienced as failures. Conclusions Our findings can help us to better understand schizophrenia and encourage a more positive approach towards both the illness and those who suffer from it. These results may be used for the development of cohousing programs in controlled environments.
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Affiliation(s)
- Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Madrid, Spain
- * E-mail:
| | | | - Ana Elías-Elispuru
- Hospital Psiquiátrico San Juan de Dios Arrasate-Mondragón, Hermanos de San Juan de Dios, Arrasate, Spain
| | - Amaia Garate-Samaniego
- Hospital Psiquiátrico San Juan de Dios Arrasate-Mondragón, Hermanos de San Juan de Dios, Arrasate, Spain
| | - Jorge Pérez-Corrales
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Madrid, Spain
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Gwynne K, Lincoln M. Developing the rural health workforce to improve Australian Aboriginal and Torres Strait Islander health outcomes: a systematic review. AUST HEALTH REV 2017; 41:234-238. [PMID: 27209274 DOI: 10.1071/ah15241] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 04/01/2016] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to identify evidence-based strategies in the literature for developing and maintaining a skilled and qualified rural and remote health workforce in Australia to better meet the health care needs of Australian Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) people. Methods A systematic search strategy was implemented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist. Exclusion and inclusion criteria were applied, and 26 papers were included in the study. These 26 papers were critically evaluated and analysed for common findings about the rural health workforce providing services for Aboriginal people. Results There were four key findings of the study: (1) the experience of Aboriginal people in the health workforce affects their engagement with education, training and employment; (2) particular factors affect the effectiveness and longevity of the non-Aboriginal workforce working in Aboriginal health; (3) attitudes and behaviours of the workforce have a direct effect on service delivery design and models in Aboriginal health; and (4) student placements affect the likelihood of applying for rural and remote health jobs in Aboriginal communities after graduation. Each finding has associated evidence-based strategies including those to promote the engagement and retention of Aboriginal staff; training and support for non-Aboriginal health workers; effective service design; and support strategies for effective student placement. Conclusions Strategies are evidenced in the peer-reviewed literature to improve the rural and remote workforce for health delivery for Australian Aboriginal people and should be considered by policy makers, funders and program managers. What is known about the topic? There is a significant amount of peer-reviewed literature about the recruitment and retention of the rural and remote health workforce. What does this paper add? There is a gap in the literature about strategies to improve recruitment and retention of the rural and remote health workforce for health delivery for Australian Aboriginal people. This paper provides evidence-based strategies in four key areas. What are the implications for practitioners? The findings of the present study are relevant for policy makers, funders and program managers in rural and remote Aboriginal health.
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Affiliation(s)
- Kylie Gwynne
- Poche Centre for Indigenous Health, Sydney Medical School, Rm 223 Edward Ford Building A27, The University of Sydney, NSW 2006, Australia
| | - Michelle Lincoln
- Faculty of Health Sciences, The University of Sydney, Faculty of Health Sciences, The University of Sydney, PO Box 170,Lidcombe, NSW 1825, Australia. Email
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Berndt A, Murray CM, Kennedy K, Stanley MJ, Gilbert-Hunt S. Effectiveness of distance learning strategies for continuing professional development (CPD) for rural allied health practitioners: a systematic review. BMC MEDICAL EDUCATION 2017; 17:117. [PMID: 28701199 PMCID: PMC5506644 DOI: 10.1186/s12909-017-0949-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 06/26/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND Allied health professionals working in rural areas face unique challenges, often with limited access to resources. Accessing continuing professional development is one of those challenges and is related to retention of workforce. Effectiveness of distance learning strategies for continuing professional development in rural allied healthcare workers has not been evaluated. METHODS We searched 17 databases and the grey literature up to September 2016 following the PRISMA guidelines. Any primary studies were included that focussed on allied health and distance delivery regardless of education topic or study design. Two independent reviewers extracted data and critically appraised the selected studies. RESULTS The search returned 5257 results. With removal of duplicate references, we reviewed 3964 article titles and abstracts; n = 206 appeared potentially eligible and were scrutinised via full text screening; n = 14 were included. Studies were published between 1997 and 2016, were of varied methodological quality and were predominantly from Australia, USA and Canada with a focus on satisfaction of learners with the delivery method or on measures of educational outcomes. Technologies used to deliver distance education included video conference, teleconference, web based platforms and virtual reality. Early papers tended to focus more on the technology characteristics than educational outcomes. Some studies compared technology based delivery to face to face modes and found satisfaction and learning outcomes to be on par. Only three studies reported on practice change following the educational intervention and, despite a suggestion there is a link between the constructs, none measured the relationship between access to continuing professional development and workforce retention. CONCLUSION Technology based options of delivery have a high utility, however the complex inter-relatedness of time, use, travel, location, costs, interactivity, learning outcomes and educational design suggest a need for more sophisticated consideration by educational providers. TRIAL REGISTRATION Registration with PROSPERO 30 June 2016: CRD42016041588 .
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Affiliation(s)
- Angela Berndt
- University of South Australia, School of Health Sciences, Adelaide, Australia
| | - Carolyn M. Murray
- University of South Australia, School of Health Sciences, Adelaide, Australia
| | - Kate Kennedy
- University of South Australia, School of Health Sciences, Adelaide, Australia
| | - Mandy J. Stanley
- University of South Australia, School of Health Sciences, Adelaide, Australia
| | - Susan Gilbert-Hunt
- University of South Australia, School of Health Sciences, Adelaide, Australia
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Wenke RJ, Ward EC, Hickman I, Hulcombe J, Phillips R, Mickan S. Allied health research positions: a qualitative evaluation of their impact. Health Res Policy Syst 2017; 15:6. [PMID: 28166817 PMCID: PMC5292788 DOI: 10.1186/s12961-016-0166-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/21/2016] [Indexed: 11/10/2022] Open
Abstract
Background Research positions embedded within healthcare settings have been identified as an enabler to allied health professional (AHP) research capacity; however, there is currently limited research formally evaluating their impact. In 2008, a Health Practitioner industrial agreement funded a research capacity building initiative within Queensland Health, Australia, which included 15 new allied health research positions. The present project used a qualitative and realist approach to explore the impact of these research positions, as well as the mechanisms which facilitated or hindered their success within their respective organisations. Methods Forty-four AHP employees from six governmental health services in Queensland, Australia, participated in the study. Individual interviews were undertaken, with individuals in research positions (n = 8) and their reporting line managers (n = 8). Four stakeholder focus groups were also conducted with clinicians, team leaders and professional heads who had engaged with the research positions. Results Nine key outcomes of the research positions were identified across individual, team/service and organisational/community levels. These outcomes included clinician skill development, increased research activity, clinical and service changes, increased research outputs and collaborations, enhanced research and workplace culture, improved profile of allied health, development of research infrastructure, and professional development of individuals in the research positions. Different mechanisms that influenced these outcomes were identified. These mechanisms were grouped by those related to the (1) research position itself, (2) organisational factors and (3) implementation factors. Conclusions The present findings highlight the potential value of the research positions for individuals, teams and clinical services across different governmental healthcare services, and demonstrate the impact of the roles on building the internal and external profile of allied health. Results build upon the emerging evidence base for allied health research positions and have important implications for a number of stakeholders (i.e. individuals in the research positions, AHPs and their managers, university partners and state-wide executives). Key recommendations are provided for all stakeholders to enhance the ongoing impact of these roles and the potential advocacy for additional positions and resources to support them. Electronic supplementary material The online version of this article (doi:10.1186/s12961-016-0166-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rachel J Wenke
- Clinical Governance, Education and Research (Allied Health), Gold Coast Health, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia. .,School of Allied Health Sciences, Griffith University, Parklands drive, Southport, Queensland, 4215, Australia.
| | - Elizabeth C Ward
- Department of Health, Centre for Functioning and Health Research, Metro South Hospital and Health Service, Eight Mile Plains, Brisbane, Queensland, Australia.,School of Health & Rehabilitation Sciences, The University of Queensland, Level 7, Therapies Building, Services Rd, St Lucia, 4072, Queensland, Australia
| | - Ingrid Hickman
- Department Nutrition and Dietetics, Princess Alexandra Hospital, Ground Floor, Building 15, Ipswich Rd, Woolloongabba, Queensland, 4102, Australia
| | - Julie Hulcombe
- Allied Health Profession's Office of Queensland, Department of Health, Level 1, 15 Butterfield Street, Herston, Queensland, 4006, Australia
| | - Rachel Phillips
- Ipswich Hospital, West Moreton Hospital and Health Service, PO Box 73, Ipswich, Queensland, 4305, Australia
| | - Sharon Mickan
- Clinical Governance, Education and Research (Allied Health), Gold Coast Health, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia.,School of Allied Health Sciences, Griffith University, Parklands drive, Southport, Queensland, 4215, Australia
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Yagos WO, Tabo Olok G, Ovuga E. Use of information and communication technology and retention of health workers in rural post-war conflict Northern Uganda: findings from a qualitative study. BMC Med Inform Decis Mak 2017; 17:6. [PMID: 28068980 PMCID: PMC5223482 DOI: 10.1186/s12911-016-0403-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 12/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Information and communication technologies have become a vital infrastructural asset for use in the retention of rural health workers. However, little is known about the potential influence of ICT use, perceptions of health workers on ICT in healthcare delivery, and contribution of ICT to health care providers' retention in rural and remote areas in rural post-war and conflict situations of northern Uganda. METHODS Data from interviews were transcribed, coded and thematically analysed. RESULTS Participants generally exhibited low confidence, knowledge and low ICT skills. Majority of participants, however, perceived ICT as beneficial in relation to job performance and health care provider retention in rural areas. Common barriers for the implementation and use of ICT in health centres were inadequate ICT knowledge and skills, poor Internet networks, inadequate computers, inadequate power supply, lack of Internet Modems and expensive access to outside computer centres. CONCLUSIONS This qualitative study showed low confidence, poor knowledge and skills in ICT usage but positive perceptions about the benefits and contributions of ICT. These findings suggest the need for specific investment in ICT infrastructural development for health care providers in remote rural areas of northern Uganda.
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Affiliation(s)
- Walter Onen Yagos
- Department of Library and Information Services, Faculty of Medicine Library Gulu University Gulu, P.O. Box 166, Gulu, Uganda
| | - Geoffrey Tabo Olok
- Department of Computer Science, Faculty of Science Gulu University, P.O. 8 Box 166, Gulu, Uganda
| | - Emilio Ovuga
- Department of Mental Health, Faculty of Medicine Gulu University Gulu, P.O.Box 10 166, Gulu, Uganda
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Nancarrow SA, Young G, O'Callaghan K, Jenkins M, Philip K, Barlow K. Shape of allied health: an environmental scan of 27 allied health professions in Victoria. AUST HEALTH REV 2017; 41:327-335. [DOI: 10.1071/ah16026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/12/2016] [Indexed: 11/23/2022]
Abstract
Objective In 2015, the Victorian Department of Health and Human Services commissioned the Victorian Allied Health Workforce Research Program to provide data on allied health professions in the Victorian public, private and not-for-profit sectors. Herein we present a snapshot of the demographic profiles and distribution of these professions in Victoria and discuss the workforce implications. Methods The program commenced with an environmental scan of 27 allied health professions in Victoria. This substantial scoping exercise identified existing data, resources and contexts for each profession to guide future data collection and research. Each environmental scan reviewed existing data relating to the 27 professions, augmented by an online questionnaire sent to the professional bodies representing each discipline. Results Workforce data were patchy but, based on the evidence available, the allied health professions in Victoria vary greatly in size (ranging from just 17 child life therapists to 6288 psychologists), are predominantly female (83% of professions are more than 50% female) and half the professions report that 30% of their workforce is aged under 30 years. New training programs have increased workforce inflows to many professions, but there is little understanding of attrition rates. Professions reported a lack of senior positions in the public sector and a concomitant lack of senior specialised staff available to support more junior staff. Increasing numbers of allied health graduates are being employed directly in private practice because of a lack of growth in new positions in the public sector and changing funding models. Smaller professions reported that their members are more likely to be professionally isolated within an allied health team or larger organisations. Uneven rural–urban workforce distribution was evident across most professions. Conclusions Workforce planning for allied health is extremely complex because of the lack of data, fragmented funding and regulatory frameworks and diverse employment contexts. What is known about this topic? There is a lack of good-quality workforce data on the allied health professions generally. The allied health workforce is highly feminised and unevenly distributed geographically, but there is little analysis of these issues across professions. What does this paper add? The juxtaposition of the health workforce demographics and distribution of 27 allied health professions in Victoria illustrates some clear trends and identifies several common themes across professions. What are the implications for practitioners? There are opportunities for the allied health professions to collectively address several of the common issues to achieve economies of scale, given the large number of professions and small size of many.
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Mbemba GIC, Bagayoko CO, Gagnon MP, Hamelin-Brabant L, Simonyan DA. The influence of a telehealth project on healthcare professional recruitment and retention in remote areas in Mali: A longitudinal study. SAGE Open Med 2016; 4:2050312116648047. [PMID: 27231552 PMCID: PMC4871201 DOI: 10.1177/2050312116648047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/31/2016] [Indexed: 11/25/2022] Open
Abstract
Objectives: The telehealth project EQUI-ResHuS (in French, Les TIC pour un accès Équitable aux Ressources Humaines en Santé) aimed to contribute to more equitable access to care and support practice in remote regions in Mali. This study explored the evolution of perceptions concerning telehealth among healthcare professionals in the four district health centres that participated in the EQUI-ResHus project and identified variables influencing their perceptions of telehealth impact on recruitment and retention of health professionals. Methods: One year after a first survey (T1), a second data collection (T2) was carried out among healthcare professionals using a 91-item questionnaire. Questions assessing telehealth use and perceptions and perceived impact on recruitment and retention of healthcare professionals were rated on a 5-point Likert scale. A total of 10 independent variables were considered for the analyses. A Wilcoxon signed-rank test was performed to detect differences between T1 and T2, and a bivariate linear regression model for repeated measures was carried out to assess the impact of independent variables on dependent variables. Results: There were no noticeable changes in perceptions related to telehealth influence on recruitment and retention. Only access to information and communication technology significantly differed between T1 and T2 according the Wilcoxon rank test (p = 0.001). Perceived influence of telehealth on recruitment and retention was mostly explained by attitude towards telehealth, perceived effect on recruitment and retention and barriers to recruitment and retention. Conclusion: Based on our results, telehealth was perceived as having a positive influence but mostly indirect influence on healthcare professional recruitment and retention. Also, there were no major changes after 1 year of telehealth use.
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Affiliation(s)
| | - Cheick Oumar Bagayoko
- Centre d'Expertise et de recherche en Télémédecine et E-santé (CERTES), Bamako, Mali
| | - Marie-Pierre Gagnon
- Centre de recherche du CHU de Québec, Hôpital Saint-François d'Assise, Québec, QC, Canada; Faculté des sciences infirmières, Pavillon Ferdinand-Vandry, Université Laval, Québec City, QC, Canada
| | - Louise Hamelin-Brabant
- Faculté des sciences infirmières, Pavillon Ferdinand-Vandry, Université Laval, Québec City, QC, Canada
| | - David A Simonyan
- Centre de recherche du CHU de Québec, Hôpital Saint-François d'Assise, Québec, QC, Canada
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Palacios-Ceña D, Cachón-Pérez JM, Martínez-Piedrola R, Gueita-Rodriguez J, Perez-de-Heredia M, Fernández-de-las-Peñas C. How do doctors and nurses manage delirium in intensive care units? A qualitative study using focus groups. BMJ Open 2016; 6:e009678. [PMID: 26826150 PMCID: PMC4735179 DOI: 10.1136/bmjopen-2015-009678] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The aim of this study was to explore the experiences of doctors and nurses caring for patients with delirium in the intensive care unit (ICU) and to describe the process of delirium management. SETTING This study was performed in 5 ICUs located within 4 hospitals in Madrid (Spain). PARTICIPANTS Purposeful sampling was performed which included (1) doctors and nurses working in ICUs, (2) with >1 year experience in the ICU and (3) clinical experience with delirium. 38 professionals participated (19 doctors, 19 nurses), including 22 women and 16 men. The total mean age was 39 years. DESIGN A qualitative study using focus groups. METHODS 7 focus groups were held to collect data: 3 nurse focus groups, 3 doctor focus groups and 1 mixed focus group. Each group comprised 6-10 participants. A semistructured questions guide was used. Thematic analysis methods were used to analyse the data. RESULTS 3 themes were identified: (1) the professional perspective on delirium; (2) implementing pharmacological and non-pharmacological treatment for delirium and (3) work organisation in the ICU. The professionals regarded patients with delirium with uncertainty, and felt they were often underdiagnosed and poorly managed. Doctors displayed discrepancies regarding pharmacological prescriptions and decision-making. The choice of medication was determined by experience. Nurses felt that, for many doctors, delirium was not considered a matter of urgency in the ICU. Nurses encountered difficulties when applying verbal restraint, managing sleep disorders and providing early mobilisation. The lack of a delirium protocol generates conflicts regarding what type of care management to apply, especially during the night shift. A degree of group pressure exists which, in turn, influences the decision-making process and patient care. CONCLUSIONS Patients with delirium represent complex cases, requiring the implementation of specific protocols. These results serve to improve the process of care in patients with delirium.
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Affiliation(s)
- Domingo Palacios-Ceña
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcon/Madrid, Spain
- Grupo Excelencia Investigadora URJC-Banco Santander referencia N°30VCPIGI03: Investigación traslacional en el proceso de salud - enfermedad (ITPSE), Universidad Rey Juan Carlos, Alcorcon/Madrid, Spain).
| | | | - Rosa Martínez-Piedrola
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcon/Madrid, Spain
| | - Javier Gueita-Rodriguez
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcon/Madrid, Spain
| | - Marta Perez-de-Heredia
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcon/Madrid, Spain
| | - Cesar Fernández-de-las-Peñas
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcon/Madrid, Spain
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Schmidt D, Dmytryk N. Educating new graduate physiotherapists in a public-private partnership. Aust J Rural Health 2015; 25:128-129. [PMID: 26689719 DOI: 10.1111/ajr.12269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Neil Dmytryk
- Sapphire Coast Physiotherapy, Merimbula, New South Wales, Australia
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Gallego G, Chedid RJ, Dew A, Lincoln M, Bundy A, Veitch C, Bulkeley K, Brentnall J. Who are they and what do they do? Profile of allied health professionals working with people with disabilities in rural and remote New South Wales. Aust J Rural Health 2015; 23:227-34. [DOI: 10.1111/ajr.12163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Gisselle Gallego
- Centre for Health Research; School of Medicine; University of Western Sydney; Penrith New South Wales Australia
- Faculty of Health Sciences; University of Sydney; Lidcombe New South Wales Australia
| | - Rebecca Jean Chedid
- Faculty of Health Sciences; University of Sydney; Lidcombe New South Wales Australia
| | - Angela Dew
- Faculty of Health Sciences; University of Sydney; Lidcombe New South Wales Australia
| | - Michelle Lincoln
- Faculty of Health Sciences; University of Sydney; Lidcombe New South Wales Australia
| | - Anita Bundy
- Faculty of Health Sciences; University of Sydney; Lidcombe New South Wales Australia
| | - Craig Veitch
- Faculty of Health Sciences; University of Sydney; Lidcombe New South Wales Australia
| | - Kim Bulkeley
- Faculty of Health Sciences; University of Sydney; Lidcombe New South Wales Australia
- Family and Community Services; Ageing, Disability and Home Care; New South Wales Australia
| | - Jennie Brentnall
- Faculty of Health Sciences; University of Sydney; Lidcombe New South Wales Australia
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Gallego G, Dew A, Lincoln M, Bundy A, Chedid RJ, Bulkeley K, Brentnall J, Veitch C. Should I stay or should I go? Exploring the job preferences of allied health professionals working with people with disability in rural Australia. HUMAN RESOURCES FOR HEALTH 2015; 13:53. [PMID: 26122606 PMCID: PMC4486440 DOI: 10.1186/s12960-015-0047-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 06/19/2015] [Indexed: 05/20/2023]
Abstract
INTRODUCTION The uneven distribution of allied health professionals (AHPs) in rural and remote Australia and other countries is well documented. In Australia, like elsewhere, service delivery to rural and remote communities is complicated because relatively small numbers of clients are dispersed over large geographic areas. This uneven distribution of AHPs impacts significantly on the provision of services particularly in areas of special need such as mental health, aged care and disability services. OBJECTIVE This study aimed to determine the relative importance that AHPs (physiotherapists, occupational therapists, speech pathologists and psychologists - "therapists") living in a rural area of Australia and working with people with disability, place on different job characteristics and how these may affect their retention. METHODS A cross-sectional survey was conducted using an online questionnaire distributed to AHPs working with people with disability in a rural area of Australia over a 3-month period. Information was sought about various aspects of the AHPs' current job, and their workforce preferences were explored using a best-worst scaling discrete choice experiment (BWSDCE). Conditional logistic and latent class regression models were used to determine AHPs' relative preferences for six different job attributes. RESULTS One hundred ninety-nine AHPs completed the survey; response rate was 51 %. Of those, 165 completed the BWSDCE task. For this group of AHPs, "high autonomy of practice" is the most valued attribute level, followed by "travel BWSDCE arrangements: one or less nights away per month", "travel arrangements: two or three nights away per month" and "adequate access to professional development". On the other hand, the least valued attribute levels were "travel arrangements: four or more nights per month", "limited autonomy of practice" and "minimal access to professional development". Except for "some job flexibility", all other attributes had a statistical influence on AHPs' job preference. Preferences differed according to age, marital status and having dependent children. CONCLUSIONS This study allowed the identification of factors that contribute to AHPs' employment decisions about staying and working in a rural area. This information can improve job designs in rural areas to increase retention.
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Affiliation(s)
- Gisselle Gallego
- Centre for Health Research, School of Medicine, University of Western Sydney, Building 3, Campbelltown Campus, Locked Bag 1797, Penrith, New South Wales, 2751, Australia.
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, PO Box 175, East St, Lidcombe, New South Wales, 1825, Australia.
| | - Angela Dew
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, PO Box 175, East St, Lidcombe, New South Wales, 1825, Australia.
- School of Social Sciences, Faculty of Arts and Social Sciences, UNSW, Sydney, NSW, 2052, Australia.
| | - Michelle Lincoln
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, PO Box 175, East St, Lidcombe, New South Wales, 1825, Australia.
| | - Anita Bundy
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, PO Box 175, East St, Lidcombe, New South Wales, 1825, Australia.
| | - Rebecca Jean Chedid
- Centre for Health Research, School of Medicine, University of Western Sydney, Building 3, Campbelltown Campus, Locked Bag 1797, Penrith, New South Wales, 2751, Australia.
| | - Kim Bulkeley
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, PO Box 175, East St, Lidcombe, New South Wales, 1825, Australia.
| | - Jennie Brentnall
- Centre for Health Research, School of Medicine, University of Western Sydney, Building 3, Campbelltown Campus, Locked Bag 1797, Penrith, New South Wales, 2751, Australia.
| | - Craig Veitch
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, PO Box 175, East St, Lidcombe, New South Wales, 1825, Australia.
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Schmidt DD. What a great idea! Someone should evaluate that... AUST HEALTH REV 2015; 40:270-272. [PMID: 26093999 DOI: 10.1071/ah14215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 05/15/2015] [Indexed: 11/23/2022]
Abstract
How often, as clinicians, do we see a really clever idea implemented in the workplace? In rural health in particular, creative work-around solutions are relatively commonplace. However, the evaluation and promotion of these ideas is less so, and this leads to lost opportunities for perpetuating these clever ideas. This paper explores one rural clinician's experience of what can happen if, instead of appreciating and complementing a great idea, that step of evaluating the great idea is taken. A reflective narrative was created, beginning with a corridor conversation ('What a great idea! Someone should evaluate that...'), continuing through a formal research project and ending with the impact of that project and the way its findings were communicated and implemented. The narrative outlines the effect of evaluating one great idea at the individual, workplace, organisational, state and national levels. Clinicians are well placed to identify great ideas in practice. Making the decision to evaluate these ideas can lead to personal growth, professional discovery and organisational benefits. With motivation and organisational support, who knows where evaluation may lead?
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Gallego G, Dew A, Bulkeley K, Veitch C, Lincoln M, Bundy A, Brentnall J. Factors affecting retention of allied health professionals working with people with disability in rural New South Wales, Australia: discrete choice experiment questionnaire development. HUMAN RESOURCES FOR HEALTH 2015; 13:22. [PMID: 25895685 PMCID: PMC4414418 DOI: 10.1186/s12960-015-0013-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 04/09/2015] [Indexed: 05/02/2023]
Abstract
OBJECTIVE This paper describes the development of a discrete choice experiment (DCE) questionnaire to identify the factors (attributes) that allied health professionals (AHPs) working with people with disability identify as important to encouraging them to remain practising in rural areas. METHODS Focus groups and semi-structured interviews were conducted with 97 purposively selected service providers working with people with disability in rural New South Wales, Australia. Focus groups and interviews were digitally recorded, transcribed, and analysed using a modified grounded theory approach involving thematic analysis and constant comparison. RESULTS Six attributes that may influence AHPs working with people with disability in rural areas to continue to do so were inductively identified: travel arrangements, work flexibility, professional support, professional development, remuneration, and autonomy of practice. The qualitative research information was combined with a policy review to define these retention factors and ensure that they are amenable to policy changes. CONCLUSION The use of various qualitative research methods allowed the development of a policy-relevant DCE questionnaire that was grounded in the experience of the target population (AHPs).
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Affiliation(s)
- Gisselle Gallego
- Centre for Health Research, School of Medicine, University of Western Sydney, Building 3, Campbelltown Campus, Locked Bag 1797, Penrith, New South Wales, 2751, Australia.
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Angela Dew
- Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, 2052, Australia.
| | - Kim Bulkeley
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Craig Veitch
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Michelle Lincoln
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Anita Bundy
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Jennie Brentnall
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
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Zheng J, Li J, Jiang X, Zhang B. Sustaining health workforce recruitment and retention in township hospitals: a survey on 110 directors of township hospitals. Front Med 2015; 9:239-50. [PMID: 25893504 DOI: 10.1007/s11684-015-0392-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 03/04/2015] [Indexed: 10/23/2022]
Abstract
Township hospitals, the main provider of rural primary healthcare in China, are severely understaffed. International studies on factors influencing rural working are increasing; however, studies on factors affecting the recruitment and retention of health workers in Chinese township hospitals are limited. The current study aims to understand the motivation of health workers and arrive at a systematic framework of pluralistic factors that would help support health workers in terms of receiving posts and remaining in posts in township hospitals. A three-stage integrated quantitative and qualitative methodology was employed. First, a survey on 120 directors of township hospitals was conducted to learn the latest status of health workers in township hospitals and distinguish existing problems. Second, after sending these problems back to the directors, an open-ended pen-and-paper survey was conducted to ask the directors to identify the factors influencing the attraction and retention of health workers in township hospitals. Third, four focus groups were conducted to gauge the underlying reasons. Five problems from the questionnaire survey were recognized, and numbers of thematic factors were identified at the individual, professional, and treatment environment from the pen-and-paper survey and focus group. Similar to other studies, this framing of both non-financial and financial elements affected the attraction and retention of health workers in township hospitals, thereby filling the gap in a Chinese context. Although several factors had been recognized earlier, our findings further highlighted the importance of these factors. Meanwhile, the factors identified in this study were barely explored in literature. This paper identifies and develops multi-faceted factors to call for a bundled package of multidimensional incentives if decision-makers get interested. The evidence-based findings in our study can be used to provide China-specific policy recommendations on how to recruit and retain health workers in rural areas of China.
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Affiliation(s)
- Jingmin Zheng
- Department of Social Medicine, School of Public Health, Chongqing Medical University, Chongqing, 400016, China
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