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Rural Nurse
A nurse speaks of issues faced by those living in rural areas. |
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Issues for those in rural & remote areas
In Australia, approximately one third of the population live in rural areas. Another half a million people live in remote regions of the country. [2] Rural and remote communities are often not well served by support services and networks in palliative care [1].
Issues common to those in rural and remote areas
There are a range of unmet needs for rural palliative care patients and their families, including access to palliative care services, information about illness, practical care and support [2]. A decrease in the number of GPs in many rural areas means less medical input and less choice when being cared for at home. Accessing after hours care can be problematic. Distances to travel in conjunction with a lack of transport is also a very real issue, as are isolation and loneliness.
Primary healthcare providers are pivotal in palliative care provision in rural and remote Australia. GPs will often care for patients throughout the disease trajectory and with admission rights to local hospitals, can often manage much of this locally.
The palliative care services in rural areas also have unmet needs in terms of their own support, educational requirements, access to specialist symptom management and ways to facilitate communication between service providers (3). Primary healthcare providers in the absence of a palliative care service will also face many of the same issues.
What does the literature say?
- Evans R, Stonea D, Elwyn G. Organizing palliative care for rural populations: a systematic review of the evidence. Family Practice 2003;20(3):304-310.
- Reymond L, Charles M, Israel F, Read T, Treston P. A strategy to increase the palliative care capacity of rural primary health care providers. Aust J Rural Health. 2005 Jun;13(3):156-61.
- Rosenberg JP, Canning DF. Palliative care by nurses in rural and remote practice. Aust J Rural Health. 2004 Aug;12(4):166-71.
- Buikstra E, Pearce S, Hegney D, Fallon T. SEAM--improving the quality of palliative care in regional Toowoomba, Australia: lessons learned. Rural Remote Health. 2006 Jan-Mar;6(1):415. Epub 2006 Feb 22
- Phillips JL, Davidson PM, Jackson D, Kristjanson L, Bennett ML, Daly J. Enhancing palliative care delivery in a regional community in Australia. Aust Health Rev 2006;30(3):370-79.
- There is also an evidence briefing from the Social Care Institute for Excellence on Obstacles to using and providing social rural care.
Models of care
Policies & resources
A resource kit developed by the Australian General Practice Network has information to support rural divisions of general practice to develop and implement collaborative models of care. This could significantly improve rural community access to timely, quality and coordinated palliative care.
References
- Moorhouse. C, George. M and Smith. B (2000) Palliative care in rural Australia: Involving the community in multidisciplinary coordinated care. Australian Journal of Primary Health – Interchange. Vol.6 No’s 3 & 4:141-6.
- White, K (2007) Rural palliative care: exploration of the pivotal role of primary healthcare providers. Cancer Forum Vol 31, No.1 :22-25.
- Reymond L, Charles M, Israel F, Read T, Treston P.A strategy to increase the palliative care capacity of rural primary health care providers.Aust J Rural Health. 2005 Jun;13(3):156-61.
This page was created on 20 June 2008 and is due for review in June 2010
Last updated 20 June 2008