Abstract:
AIMS:To identify significant patient and system access barriers and facilitators to dermatology care in one rural health system with limited dermatology appointment availability. DESIGN:Mixed methods study using data from electronic medical records, patient surveys, stakeholder semi-structured interviews, and service area dermatologist demographics. Retrospective data were collected between 1 January 2017-1 March 2018, and interviews and surveys were conducted between June 1-August 31, 2018. Participants were recruited from two primary care practices in one rural Maine regional health system. METHODS:Findings from thematic analyses, descriptive statistics, and statistical modelling were integrated using Chi-square tests for homogeneity to develop a unified understanding. Statistical modelling using odd-ratio logistic and linear regression were performed for each outcome variable of interest. RESULTS:Urgent referrals by primary care increased the likelihood of dermatology care overall (OR: 6.771; p = .007) and at nearby sites with limited availability (OR: 4.024; p = .024), but not at geographically further sites with higher capacities (p = .844). Referral under-diagnosis occurred in 20.8% of those biopsied. Older (p = .041) or non-working (p = .021) patients were more likely to remain unevaluated than seek more available but geographically further care. CONCLUSIONS:In rural areas with scarce appointment availability, primary care provider diagnostic accuracy may be an important barrier of dermatology care receipt and health outcomes, especially among at-risk populations. IMPACT:Although melanoma mortality rates are decreasing throughout the US, little is known about why rates in Maine continue to rise. This study applied a comprehensive approach to identify several patient and system access barriers to dermatology care in one underserved rural regional health system. While specific to this population and large service area, these findings will inform improvement efforts here and support broader future research efforts aimed at understanding and improving health outcomes in this rural state.
journal_name
J Adv Nursjournal_title
Journal of advanced nursingauthors
Cyr ME,Boucher D,Korona SA,Guthrie BJ,Benneyan JCdoi
10.1111/jan.14604subject
Has Abstractpub_date
2020-10-24 00:00:00eissn
0309-2402issn
1365-2648pub_type
杂志文章abstract:AIMS:To gather, quality assess, synthesize and interpret the views, feeling, and experiences of women who used water immersion during labour and/or birth. DESIGN:A systematic meta-thematic synthesis and GRADE-CERQual. DATA SOURCES:We searched MEDLINE, CINHAL, PsychINFO, AMED, EMBASE (MIDIRS only), LILACS, AJOL. Addit...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,评审
doi:10.1111/jan.14720
更新日期:2021-01-19 00:00:00
abstract::Perinatal substance use disorders, and all of the associated sequelae, continue to be a national health crisis that is further impacted by shifts in access to obstetrical care, particularly in rural areas. Opioid Use Disorder (OUD) specifically presents as a medical condition for which evidence-based guidelines suppor...
journal_title:Journal of advanced nursing
pub_type: 社论
doi:10.1111/jan.14544
更新日期:2020-09-25 00:00:00
abstract::This study forms part of the International Family Dynamics Project. Its purpose was describe the family functioning of families with mental health problems on the basis of Barnhill's framework for healthy family systems. The sample consisted of 160 families in which one family member had mental health problems. Both t...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2648.1997.tb00802.x
更新日期:1997-12-01 00:00:00
abstract::In this paper the author discusses her experiences as a feminist, nurse and sociologist carrying out a study of hysterectomy. Difficulties in setting up the research, carrying out interviews and publishing reports result from masculine models of sociological research and from the fact that nursing work, including rese...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2648.1984.tb00368.x
更新日期:1984-05-01 00:00:00
abstract:AIM:To examine the effect of a self-help psychoeducation program for people with coronary heart disease in Singapore. BACKGROUND:Cardiac rehabilitation has shown benefits for mitigating many cardiac risk factors and can lead to improvement in health-related quality of life and psychological well-being in people with h...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,随机对照试验
doi:10.1111/jan.13793
更新日期:2018-10-01 00:00:00
abstract:AIM:This paper is a report of a study to examine the operational impact of a police custody nursing service on healthcare delivery in one police service in the north of England. BACKGROUND:Medical practitioners, trained specifically for the role of forensic medical examiner, have traditionally provided forensic and cu...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2648.2007.04403.x
更新日期:2007-10-01 00:00:00
abstract:AIM:This paper reports a study exploring how Iranian women coped with newly diagnosed breast cancer and provides a foundation for cultural-based care. BACKGROUND:Although research has indicated that coping strategies are associated with adaptation to breast cancer, and despite the number of women with newly diagnosed ...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2648.2006.03808_1.x
更新日期:2006-05-01 00:00:00
abstract:AIM:This paper identifies the characteristics of Greek patients with acute myocardial infarction who have long prehospital delays and identifies the factors that are specifically associated with these delays. BACKGROUND:The time between the first appearance of symptoms until the hospitalization of the patient with myo...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2648.2010.05301.x
更新日期:2010-07-01 00:00:00
abstract:AIMS:To report a secondary analysis of data collected from the case study phase of a national study of advanced practitioners and to develop leadership outcome-indicators appropriate for advanced practitioners. BACKGROUND:In many countries, advanced practitioners in nursing and midwifery have responsibility as leaders...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/jan.12262
更新日期:2014-05-01 00:00:00
abstract::Hospital noise pollution: an environmental stress model to guide research and clinical interventions This commentary provides an expanded environmental stress model. Conceptual relationships between ambient stressors, ambient stress, and health are detailed. A three-part intervention, enhancement of person-environment...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2648.2000.01307.x
更新日期:2000-03-01 00:00:00
abstract::Eight first-time and eight second-time working class mothers were observed interacting with their newborn babies during the first half-hour of life. In all cases the father was present for at least some of this period. The interactions were notable for their passivity, mothers looked for long periods at their babies a...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2648.1981.tb03222.x
更新日期:1981-07-01 00:00:00
abstract:BACKGROUND:In most parts of the world, nursing historically has been considered an occupation for women. Gender stereotypes are associated with the nursing profession. AIM:The aim was to describe and compare the self-reported competence in female and male nursing students. The students were also compared according to ...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/jan.14220
更新日期:2020-01-01 00:00:00
abstract:AIMS:The aims of this paper are to explore the role of cross-disciplinary knowledge exchange and integration in advancing the science of unfinished nursing care and to offer preliminary guidance for theory development activities for this growing international community of scholars. BACKGROUND:Unfinished nursing care, ...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/jan.13948
更新日期:2019-04-01 00:00:00
abstract:AIM:To report a novel review to develop a health systems model of successful transition of children with complex healthcare needs from hospital to home. BACKGROUND:Children with complex healthcare needs commonly experience an expensive, ineffectual and prolonged nurse-led discharge process. Children gain no benefit fr...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,评审
doi:10.1111/jan.12278
更新日期:2014-05-01 00:00:00
abstract::This paper reports the findings of one stage of an ongoing project to evaluate a problem-based learning (PBL) curriculum. Focusing on the students themselves, the ethnographic study explored how undergraduate nursing students (n=17) managed and made sense of a PBL programme. Fieldwork and ethnographic interviews revea...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1046/j.1365-2648.1999.01188.x
更新日期:1999-11-01 00:00:00
abstract::Historical and contemporary conceptualizations of caregiving have not addressed the active role of care recipients within caregiver-care-recipient relationships. Using an interpretive synthesis method, the authors developed the concept of protective care-receiving from three qualitative studies of different groups of ...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2648.1997.1997025532.x
更新日期:1997-03-01 00:00:00
abstract::Undergoing diagnostic investigations for symptoms of breast disease constitutes an intensely stressful experience for any woman. The widespread use of contemporary fine-needle techniques throughout specialist breast clinics, whilst removing the necessity of hospitalization and general anaesthesia for many women, has i...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2648.1997.1997025273.x
更新日期:1997-02-01 00:00:00
abstract:AIM:The aim of this paper was to report the experience of in-depth interviewing about emotive topics from the perspectives of participants. BACKGROUND:We both undertook qualitative, longitudinal studies investigating emotive topics using repeated in-depth interviews as the data collection method. Recruitment and some ...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2648.2006.03950.x
更新日期:2006-09-01 00:00:00
abstract::This study examined the use of nursing practice standards in British Columbia in labour arbitrations related to patient care for the years 1987-1994. Retrospective secondary content analysis was the method used to analyse the cases. Although practice standards were referred to in some of the cases, the nature and clar...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1046/j.1365-2648.1998.00561.x
更新日期:1998-03-01 00:00:00
abstract:AIM:The aim of this paper was to report the process evaluation of facilitators' delivery of a psychosocial intervention (called CONNECT), in a randomized controlled trial, to men with prostate cancer and their partners. BACKGROUND:There is a lack of information on the process of implementing psychosocial interventions...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,随机对照试验
doi:10.1111/jan.13248
更新日期:2017-07-01 00:00:00
abstract:AIMS:This study aimed to provide an in-depth understanding of the process of hospital discharge experienced by the carers of patients 'at risk' of unsuccessful discharge from medical wards in three hospitals in the North of England. BACKGROUND:The Community Care Act and the Carers Recognition and Services Act placed r...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1365-2648.2001.01838.x
更新日期:2001-07-01 00:00:00
abstract:AIM:This paper reports a literature review identifying and categorizing client system stressors in Neuman systems model-based studies. BACKGROUND:To date, literature reviews related to the Neuman systems model have focused broadly on all concepts of the model. The concept of stressors has been selected by the Neuman S...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2648.2006.03981.x
更新日期:2006-10-01 00:00:00
abstract::The use of reflective journal writing has become popularized in the past decade. This paper uses the experience of two university lecturers to problematize this practice. The practice of journal writing in nursing courses is explored firstly through the lens of critical theory and secondly that of post-structuralism. ...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2648.1996.tb02946.x
更新日期:1996-11-01 00:00:00
abstract::The purpose of this study was to identify the relationship between the number and quality of nursing diagnoses generated by public health nurses (PHNs), and the use of different assessment databases (nursing or medical). In addition, the effect of experience with theory-based nursing practice on the number and quality...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1046/j.1365-2648.1995.21040800.x
更新日期:1995-04-01 00:00:00
abstract:AIM:To explore experiences of the diagnosis and management of tuberculosis from the perspective of Somali patients and healthcare professionals involved in their care. BACKGROUND:The Somali population has the third highest incidence of tuberculosis occurring in persons born outside the UK. Tuberculosis is a disease wi...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/jan.12112
更新日期:2013-10-01 00:00:00
abstract::To be or to parent a chronically-ill child is a difficult experience. Parents can initiate 'normalizing' tactics that alleviate the child's feeling of being different and enable a sense of control with the possibility to influence the quality of life of the child and the family. Following up among 20 parents of chroni...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/j.1365-2648.1980.tb03188.x
更新日期:1980-11-01 00:00:00
abstract::Towards an aesthetics of nursing This paper re-appraises the work of Barbara Carper on aesthetics and the art of nursing. It identifies serious flaws in Carper's original arguments and the way in which she and subsequent authors have conflated the concepts of art and aesthetics in nursing. The paper explores a broader...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2648.2000.01536.x
更新日期:2000-09-01 00:00:00
abstract:AIM:To systematically review the effectiveness of vinegar consumption in improving glycaemic control in adults with type 2 diabetes mellitus. DESIGN:A systematic review and meta-analysis. REVIEW SOURCES:The CINAHL, Excerpta Medica database (EMBASE), Medline, PubMed, Scopus and Cochrane databases were searched in Apri...
journal_title:Journal of advanced nursing
pub_type: 杂志文章,meta分析
doi:10.1111/jan.14255
更新日期:2020-02-01 00:00:00
abstract:AIMS:To explore functional exercise adherence, coping styles, and illness perception and to examine the relationships between functional exercise adherence and coping styles with illness perception among Chinese breast cancer survivors. BACKGROUND:Although the relationships between functional exercise adherence with c...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/jan.13832
更新日期:2019-01-01 00:00:00
abstract:AIM:To develop and psychometrically test the Italian-language Nurse Caring Behaviours Scale, a short measure of nurse caring behaviour as perceived by inpatients. BACKGROUND:Patient perceptions of nurses' caring behaviours are a predictor of care quality. Caring behaviours are culture-specific, but no measure of patie...
journal_title:Journal of advanced nursing
pub_type: 杂志文章
doi:10.1111/jan.13384
更新日期:2017-12-01 00:00:00