Rural Men’s Health, Health Information Seeking, and Gender Identities: A Conceptual Theoretical Review of the Literature

Beginning as early as 2009, recent shifts in Canadian health care delivery indicate that access to health information is essential to promote and maintain a healthy population. It is important to understand how and where various populations, such as underresourced rural populations, access health information so that public health agencies can develop and deliver appropriate information with, for, and in these contexts. There is a paucity of research that specifically examines how rural Canadian men seek health information; therefore, this review aimed to conceptualize this process based on three dynamic key constructs: health patterns of rural Canadians, health information–seeking behaviors, and rural gender identities. This conceptual theoretical literature review included 91 articles at the intersection of these three constructs. Discussion focuses on how residing in a rural region influences men’s health and health care access. Health information–seeking behaviors are discussed in terms of social networks and framed with a rural context. Connell’s theory of masculinity provides a useful approach to dissecting how rural men’s gender identities influence their health attitudes, and how such attitudes are embedded in rural social and cultural norms. Each major construct—health in rural Canada, health information seeking, and rural gender identities—is discussed to highlight how specific embodiments of masculinity may promote and inhibit men’s health information–seeking and positive health behaviors

The transition experience of rural older persons with advanced cancer and their families: a grounded theory study

BACKGROUND: Transitions often occur suddenly and can be traumatic to both patients with advanced disease and their families. The purpose of this study was to explore the transition experience of older rural persons with advanced cancer and their families from the perspective of palliative home care patients, bereaved family caregivers, and health care professionals. The specific aims were to: (1) describe the experience of significant transitions experienced by older rural persons who were receiving palliative home care and their families and (2) develop a substantive theory of transitions in this population. METHODS: Using a grounded theory approach, 27 open-ended individual audio-taped interviews were conducted with six older rural persons with advanced cancer and 10 bereaved family caregivers. Four focus group interviews were conducted with 12 palliative care health care professionals. All interviews were transcribed verbatim, coded, and analyzed using Charmaz\u27s constructivist grounded theory approach. RESULTS: Within a rural context of isolation, lack of information and limited accessibility to services, and values of individuality and community connectedness, older rural palliative patients and their families experienced multiple complex transitions in environment, roles/relationships, activities of daily living, and physical and mental health. Transitions disrupted the lives of palliative patients and their caregivers, resulting in distress and uncertainty. Rural palliative patients and their families adapted to transitions through the processes of Navigating Unknown Waters . This tentative theory includes processes of coming to terms with their situation, connecting, and redefining normal. Timely communication, provision of information and support networks facilitated the processes. CONCLUSION: The emerging theory provides a foundation for future research. Significant transitions identified in this study may serve as a focus for improving delivery of palliative and end of life care in rural areas. Improved understanding of the transitions experienced by advanced cancer palliative care patients and their families, as well as the psychological processes involved in adapting to the transitions, will help health care providers address the unique needs of this vulnerable population

Evolving the theory and praxis of knowledge translation through social interaction: a social phenomenological study

Background: As an inherently human process fraught with subjectivity, dynamic interaction, and change, social interaction knowledge translation (KT) invites implementation scientists to explore what might be learned from adopting the academic tradition of social constructivism and an interpretive research approach. This paper presents phenomenological investigation of the second cycle of a participatory action KT intervention in the home care sector to answer the question: What is the nature of the process of implementing KT through social interaction? Methods: Social phenomenology was selected to capture how the social processes of the KT intervention were experienced, with the aim of representing these as typical socially-constituted patterns. Participants (n = 203), including service providers, case managers, administrators, and researchers organized into nine geographically-determined multi-disciplinary action groups, purposefully selected and audiotaped three meetings per group to capture their enactment of the KT process at early, middle, and end-of-cycle timeframes. Data, comprised of 36 hours of transcribed audiotapes augmented by researchers\u27 field notes, were analyzed using social phenomenology strategies and authenticated through member checking and peer review. Results: Four patterns of social interaction representing organization, team, and individual interests were identified: overcoming barriers and optimizing facilitators; integrating \u27science push\u27 and \u27demand pull\u27 approaches within the social interaction process; synthesizing the research evidence with tacit professional craft and experiential knowledge; and integrating knowledge creation, transfer, and uptake throughout everyday work. Achieved through relational transformative leadership constituted simultaneously by both structure and agency, in keeping with social phenomenology analysis approaches, these four patterns are represented holistically in a typical construction, specifically, a participatory action KT (PAKT) model. Conclusion: Study findings suggest the relevance of principles and foci from the field of process evaluation related to intervention implementation, further illuminating KT as a structuration process facilitated by evolving transformative leadership in an active and integrated context. The model provides guidance for proactively constructing a \u27fit\u27 between content, context, and facilitation in the translation of evidence informing professional craft knowledge

The value of community health nursing : a phenomenological study of the perceptions of community health nurses

This study explores and describes the value of community health nursing from the perspective of community health nurses. The phenomenological method as defined by Colaizzi (1978) guided this exploration. Eleven community health nurses from the health department of a large urban center participated in the study. Each nurse held a baccalaureate degree in nursing and had a minimum of two years of community health nursing experience in preventive health care programs. The researcher collected the data through a series of interviews. Each nurse was interviewed at least twice. Interviews were taped and transcribed verbatim. Interviews were analyzed to determine areas for clarification and exploration, to discover themes, and to determine data saturation. From continuous comparative analysis of the data, five themes emerged: (1) the value of activities in community health nursing, (2) the value of the purposes of community health nursing, (3) the value of prerequisites for community health nursing, (4) the value of the visibility of community health nursing, and (5) the value of community health nursing as the way to the future in health care. In the first theme, participants primarily valued multiple and varied activities which enabled and empowered clients to make informed health care decisions, choices, and actions. Subthemes included collaborative activities and autonomy. The second theme described the purposes of community health nursing as they relate to various clients, the context of practice, and the holistic vision of health. The third theme described the value of certain prerequisites for community health nursing. Participants identified two categories of prerequisites - knowledge, and certain personal qualities and attitudes. In the fourth theme, the value of the visibility of community health nursing, subthemes included: awareness, valuing, and effective use of community health nursing services by others, and political visibility. In the fifth theme, community health nursing as the way to the future in health care, subthemes included: the preventive focus and cost-effectiveness bases of community health nursing, and the value of research. The findings of this study have implications for community health nursing practice, administration, education, and research. In nursing practice, community health nursing roles and activities must be more clearly defined and promoted so that the value of community health nursing can be more fully realized. Administrators must support nursing staff and actively facilitate effective community health nursing practice. Nursing education must prepare professional nursing practitioners who have the knowledge and the ability to successfully practice community health nursing. All nurses must be encouraged In their education to appreciate the value of community health nursing so that the quality and quantity of community health care is facilitated in all nursing settings. All aspects of professional nursing - practice, administration, education, and research - must promote community health nursing research. Further research is required into the value of community health nursing from a variety of perspectives, such as the perspectives of nurses in other settings, clients, and colleagues. Research into these perspectives will likely achieve a clearer consensus of the value of community health nursing, and foster present and future community health nursing endeavors. As a consequence, the health care of Canadians could be addressed more effectively and efficiently.Applied Science, Faculty ofNursing, School ofGraduat

Factors That Influence Students In Choosing Rural Nursing Practice: A Pilot Study.

INTRODUCTION: Nursing shortages continue globally and are especially critical in rural and remote communities. Attracting nurses to work in less populated regions presents challenges that differ from those in urban areas. METHODS: This pilot study focused on self-identified factors of nursing students who expressed an interest in rural practice post-graduation. The sample included students from the USA and Canada, who were enrolled in graduate and under graduate programs of nursing, and were attending an international rural nursing conference. RESULTS: Findings from the pencil and paper short answer survey found those who have life experiences and connections in small communities are more likely to choose this setting. Post-graduation employment preference was reinforced by ongoing exposure to rural theory and practice settings in their programs of study. Nursing scholars may find this study useful to further examine students\u27 employment preferences, and to develop targeted strategies to better prepare those having an interest in rural practice. CONCLUSION: Evidence based findings are critically needed to recruit and retain nurses to address critical nursing shortages in rural regions in North America and globally

Determinants of Rural Women\u27s Health: A Qualitative Study in Southwest Ontario

Context: The influences of gender and geography are increasingly being acknowledged as central to a comprehensive understanding of health. Since little research on rural women\u27s health has been conducted, an in-depth qualitative approach is necessary to gain a better initial understanding of this population. Purpose: To explore the determinants of health and their influence on rural women\u27s health. Methods: From November 2004 to September 2005, 9 focus groups and 3 individual interviews were conducted in 7 rural southwestern Ontario communities. Sixty-five rural residents aged 26 years and older participated in the study. Semi-structured interview questions were used to elicit participants\u27 perceptions regarding determinants of rural women\u27s health. Findings: Four Health Canada determinants (employment, gender, health services, and social environments) and 3 new determinants (rural change, rural culture, and rural pride) emerged as key to rural women\u27s health. Conclusions: Although health determinants affect both urban and rural people, this qualitative study revealed that rural women experience health determinants in unique ways and that rural residents may indeed have determinants of their health that are particular to them. More research is needed to explore the nature and effects of determinants of health for rural residents in general, and rural women in particular