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Rural Health Issues

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الكلية كلية التمريض     القسم قسم التخصصات التمريضية     المرحلة 7
أستاذ المادة امين عجيل ياسر الياسري       23/10/2017 06:00:37

Dr. Ameen Al Yassiry
Rural Health Issues
Introduction
Rural is defined as communities with fewer than 10,000 residents and a county population density of fewer than 1,000 people per square mile.
Rural clients are a unique aggregate. Community health nurses are key to ensuring the delivery of appropriate health services to this population.
The elderly are a rapidly growing population in rural communities. Rural clients generally have lower educational levels than urban clients, due in part to less access to higher education and lower-paying jobs. Income levels and housing costs are frequently lower than in larger cities.
Health concerns of populations in rural areas are related to the environment, occupations, injuries, and distance from health care providers. Environment issues particularly relate to agriculture and the health risks that accompany farming and other rural lifestyles.

Definition of rural health
Rural health : is the interdisciplinary study of health and health care delivery in rural environments.
• The concept of rural health have many fields, including geography, midwifery, nursing, sociology, economics, and telehealth or telemedicine.
• Research shows that the healthcare needs of individuals living in rural areas are different from those in urban areas, and rural areas often suffer from a lack of access to healthcare.

Communities of rural
• Rural communities have fewer resources ( roads, schools, hospitals)
• Mental Health Professionals who provide services report a persistent endemic level of depression among rural residents.
• Sometimes the community does not trust the professionals who provide services in local agencies.
• Some High risk industries in rural areas are: Lumber/forestry, mining, agriculture.
• Causes of death in rural areas include, machinery and vehicular accidents, trauma, cancer, respiratory disease, toxins such as herbicides, and pesticides.






Did you know?
Compared with urban Americans rural residents have the following:
• Higher infant and maternal morbidity rates
• Higher rates of chronic illness, including hypertension, cardiovascular disease, cancer, and diabetes.
• Unique health risks associated with occupations and the environment, such as machinery accidents, skin cancer from sun exposure, and respiratory problems associated with exposure to chemicals and pesticides.
• Stress-related health problems and mental illness, but the incidence of those conditions is not known.

Characteristics of rural life
• More space; greater distances between residents and services
• Cyclic/seasonal work and leisure activities
• Informal social/professional interactions
• Access to extended kinship systems
• Lack of anonymity
• Economic orientation to land and nature (e.g., agriculture, mining, lumbering, fishing)
• High-risk occupations are more prevalent
• Churches (Mosques) and schools are social organizations
• Preference for interacting with localities (insiders)
• Mistrust of newcomers to the community (outsiders)

Agriculture and Health
• Although farming is not characteristic of all rural areas, where agricultural production occurs, both direct and indirect effects on health can exist.
• Recently, note pesticides and fertilizers can affect water, air, and soil, and dust created from plowing for crops can affect the air quality.
• Many rural population depend on their own well water for drinking, and water quality is monitored only sporadically by well owners.
• About 30% of rural population obtain drinking water from very small water systems, without the monitoring and regulations associated with large urban water suppliers.
• There are many risk factor in rural area such as farming injuries can result from [tractor rollovers, suffocations in grain bins, exposure to harmful substances, falls, fires or explosions, accidents with other farm equipment...ets.]
• Because of the lack of mass transit, rural commuting increases air pollution and the incidence of injury or death from traffic accidents.


The Built Environment in Rural Areas
• Even with the advances of medicine not be able to significantly improve our overall health and quality of life without addressing how we plan our living spaces.
• The built environment can have effects on both physical and mental health outcomes, particularly adding to the burden of illness among ethnic minority populations and low-income communities.
• The built environment consists of the development of housing, highways, shopping areas, and other man-made features added to the natural environment.
• As populated areas expand, stresses are placed on natural habitats, water supplies, and air quality. The built environment is inextricably related to health.

Community Health Nursing in Rural area
• Nurses who work with rural people must assess each aggregate characteristics
• Rural nursing practice offers many opportunities.
• Nurses are respected from community members their judgment and opinions take into count.
• Rural nurses are key members of the health care team. They can make a change in the lives of their neighbors, friends, and community.

Difficulties in health care delivery
• Difficult in recruiting and retaining qualified health professionals in underserved communities
• Some factors that influence where health care providers work are:
1) geographic location.
2) population density.
3) distance from an urban center.
• Rural Health Care Providers are generalists.
• Despite an increased incidence of chronic health conditions, rural adults seek medical care less.










Characteristics of nursing practice in rural environments
• Variety of clinical experiences and broader scope of practice
• Generalist skills
• Flexibility and creativity in delivering care
• Sparse resources (materials, professionals, equipment, fiscal)
• Greater independence and more autonomy
• Interact with other disciplines
• Increased opportunity for informal interactions with patients and coworkers
• Opportunity for client follow-up upon discharge in informal community settings
• Planning allows for integration of formal with informal resources
• Opportunity for involvement the community in health education.

Work stressors of CHN in rural practice
• Political/bureaucratic problems
• Understaffing: overworked
• Intraprofessional/interpersonal conflicts
• Unsatisfactory work environment
• Relatives refuse to deliver needed care to client
• Patients who are hostile, apathetic, dependent, low intelligence
• Lack of communication
• Fear for personal safety
• Barriers to health care
• Great distances to obtain services
• Lack of personal transportation
• Unavailable public transportation
• Lack of telephone services
• Unavailable outreach services
• Unpredictable weather conditions
• Inability to pay for care
• Lack of "know how" to procure services
• Providers attitudes and knowledge levels about rural populations

Critical Care Needs
Critical Care Needs for rural areas include:
• Preventive services (health screening, nutrition counseling, wellness education, etc.)
• Services for frail elderly (Adult day care, hospice, respite care, meal deliveries)
• Services for children with special needs
• Emergency Care


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .
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