Rural Health Centers and Nursing Health Care

Afza.Malik GDA

Health Care System and Rural Health Centers

Rural Health Centers and Nursing Health Care

Rural Health,Purposes of Rural Health,Challenges and Complication of Rural Health Care,Poverty and Rural Health,How Get Maximum Health Outcomes,Rural Health Care  Centers and Nursing Concerns,Nursing Research and Journals About Rural Health Canters.

Rural Health

    Capturing the parameters of rural may appear quite simple, as each individual has a personal view of rural life. For some it is the place where, for generations, they have engaged in farming, ranching, mining, or logging, and for others it is an escape from urban tensions-a place to recreate and to relax. For those providing health care, there are unique challenges and opportunities in the rural setting.

Purposes of Rural Health

    Rural health requires an understanding of the clients being served. While rural America is still the site of our food production, it is also evolving into a new place with a new demographic profile and new opportunities. 

    The economic base is marked by increasing diversification, with consumer services accounting for 23% of rural earnings in 1999, along with manufacturing (21%), public sector (20%), recreational services (4%), and only 5% from agriculture. (Economic Research Services, 2000). 

    The increasing variety in occupations and rapid advances in technology are rapidly blurring differences within rural populations and between urban and rural residents.

Challenges and Complication of Rural Health Care 

    Sketching a rural health profile is complicated by the increasing diversity of the population, disparities in definition, inadequate measurement, and lack of adequate health statistics. Yet, from observation and statistical reports, it is clear that significant health disparities are present in certain segments of rural America.

    Rural dwellers often have limited access to health care, high rates of poverty, high rates of uninsured and underinsured, transportation problems, and high risks for chronic illness and accidental death. Among rural men, the suicide rate is 54% higher than in urban areas (Dotinga, 2002). 

    Rural women tend to have less access to health education, lower rates of cancer screening, fewer choices in insurance plans, fewer options for cancer treatment, and less access to oncologists than urban women (Hoekstra, 2001). The rural homeless need particular attention in terms of research and policy development (Bushy, 2000). 

    Among Native Americans and migrant workers, homelessness is largely a rural phenomenon (National Coalition for the Homeless, 1999). Rural residents have a greater likelihood of working in hazardous occupations, with exposure to chemicals, hearing loss from farm machinery noise, and serious farm equipment injuries. 

    Other health concerns are domestic violence, smokeless tobacco use, heavy drinking and smoking, unintentional firearms injuries, and suicide.

Poverty and Rural Health

    For small towns in the rural plains, loss is a defining characteristic. There has been a slow demographic collapse with the young moving out, businesses closing, factories emptying, and poverty increasing. Most alarmingly, polls show a “quiet crisis of confidence.” Rural people feel powerless to control their lives and are pessimistic about the future (Egan, 2003).

    The intention is not to create an exhaustive list of rural health problems. This sample of health disparities serves as an indicator of the complexity of social and health issues in rural areas and the challenges to those engaged in evidence-based rural nursing practice

    As noted in Rural Healthy People 2010, this type of discussion should not diminish the advantages and attractions that many rural areas already offer to residents and visitors, and to the successes in many communities that are a reflection of the hard work and commitment of rural people. unwilling to accept existing conditions (Gamm, Hutchison, Dabney, & Dorsey, 2003).

How Get Maximum Health Outcomes

    Optimal nursing care is provided when nurses and health care decision-makers have access to a synthesis of the latest research and a consensus of expert opinion as a basis for their judgment in planning and providing care. There are persistent deficits along with areas of optimism in rural nursing research that guide evidence-based care

    There continues to be a limited number of databased articles in the rural nursing literature. Continuing shortfalls in the literature include small sample sizes, lack of random sampling, cross sectional designs, problems with operationalization and measurement of rurality, and small specific populations. Studies lack clear descriptions of comparison groups and often fail to adequately account for key variables.

Rural Health Care  Centers and Nursing Concerns 

    Positive signs of the growth of rural nursing science are appearing. Among these are a new online rural nursing journal, programs of rural nursing research including multisite projects, a National Institute of Nursing Research funded exploratory research center focused on rural health, interest in doctoral preparation in rural health, and use of new technology for education and in nursing research (Weinert, 2002).

Nursing Research and Journals About Rural Health Canters 

    The Online Journal of Rural Nursing and Health Care, which focuses on dissemination of rural nursing research and health care information, is a sign of progress. There are now a cluster of projects addressing some of the pressing health issues such as women's health, children and adolescents, the elderly, caregiving, and issues associated with managing cancer, stroke, Alzheimer's disease, and end-of-life care in the rural setting. 

    Programs of rural nursing research are developing: Fahs and associates, at Binghamton University, on cardiovascular disease and rural women; Magilvy and colleagues, at the University of Colorado, on community health needs of elderly rural populations; and Weinert and colleagues, at Montana State University Bozeman, using computer-based technology to provide support and health information to isolated rural women living with a chronic health condition. 

    Cross-state studies are being designed to tease out which characteristics are somewhat universal across rural populations and which may be specific to a certain rural population. One example is the work of Shreffler Grant, at Montana State University Bozeman and her colleagues at the University of North Dakota, who are exploring the use of complementary therapy by rural older adults. 

    The launching of a nursing doctoral program at Binghamton University will increase the number of individuals prepared to conduct necessary rural research. 

    The Center for Research on Chronic Health Conditions in Rural Dwellers at Montana State University Bozeman, funded through the NINR Exploratory Centers Program, provides an opportunity to strengthen rural research and is forging research linkages between Montana nurse scientists and rural nurse investigators in Oregon, Iowa , Wyoming, North Dakota, and Nebraska. 

    The explosion of activity in the arena of telecommunications has been a boon to rural nursing education, brought current practice and research knowledge to the fingertips of nurses in the remotest of areas, extended the reach of the community health nurse through telehealth, and enhanced computer-based research designs. 

    There is progress in the development of the body of knowledge about rural health, with the crafting of more sophisticated and methodologically sound studies and an increase in the number of programs of nursing research. A foundation has been laid for expanding the field of rural nursing through a journal, doctoral program, and research center. 

    These advances in nursing science, along with better understanding of historical factors, changing demographics, health disparities, strengths, and resources of rural communities/individuals, enhance the delivery of evidence-based nursing care in the rural setting.

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