Rural-urban differences in use of health services before and after dementia diagnosis: a retrospective cohort study.

Background: Rural-urban differences in health service use among persons with prevalent dementia are known. However, the extent of geographic differences in health service use over a long observation period, and prior to diagnosis, have not been sufficiently examined. The purpose of this study was to examine yearly rural-urban differences in the proportion of patients using health services, and the mean number of services, in the 5-year period before and 5-year period after a first diagnosis of dementia.

Health service use before and after dementia diagnosis: a retrospective matched case-control study.

Objectives: This study investigated patterns in health service usage among older adults with dementia and matched controls over a 10-year span from 5 years before until 5 years after diagnosis.

Design: Population-based retrospective matched case-control study.

Setting: Administrative health data of individuals in Saskatchewan, Canada from 1 April 2008 to 31 March 2019.

A stakeholder engagement strategy for an ongoing research program in rural dementia care: Stakeholder and researcher perspectives.

Participatory research approaches have developed in response to the growing emphasis on translation of research evidence into practice. However, there are few published examples of stakeholder engagement strategies, and little guidance specific to larger ongoing research programs or those with a rural focus. This paper describes the evolution, structure, and processes of an annual Rural Dementia Summit launched in 2008 as an engagement strategy for the Rural Dementia Action Research (RaDAR) program and ongoing for more than 10 years; and reports findings from a parallel mixed-methods study that includes stakeholder and researcher perspectives on the Summit's value and impact.

'Staying strong': A constructivist grounded theory of how registered nurses deal with the impact of trauma-related events in rural acute care practice.

Aims And Objectives: This study explored how Registered Nurses (RNs) in rural practice deal with psychologically traumatic events when living and working in the same rural community over time.

Background: Rural RNs who are exposed to trauma may be at high risk for psychological distress (e.g.

The meaning of nursing practice for nurses who are retired yet continue to work in a rural or remote community.

Background: Although much research has focused on nurses' retirement intentions, little is known about nurses who formally retire yet continue to practice, particularly in rural and remote settings where mobilization of all nurses is needed to assure essential health services. To optimize practice and sustain the workforce stretched thin by the COVID-19 pandemic, it is necessary to understand what it means for retired registered nurses (RNs) and licensed practical nurses (LPNs) to work after retirement. This study explored what nursing practice means for RNs and LPNs who have formally retired but continue to practice in rural and remote communities.

A Scoping Review of Care Trajectories across Multiple Settings for Persons with Dementia.

Multiple transitions across care settings can be disruptive for older adults with dementia and their care partners, and can lead to fragmented care with adverse outcomes. This scoping review was conducted to identify and classify care trajectories across multiple settings for people with dementia, and to understand the prevalence of multiple transitions and associated factors at the individual and organizational levels. Searches of three databases, limited to peer-reviewed studies published between 2007 and 2017, provided 33 articles for inclusion.

The importance of organizational commitment in rural nurses' intent to leave.

Aims: To examine determinants of intention to leave a nursing position in rural and remote areas within the next year, for Registered Nurses or Nurse Practitioners (RNs/NPs) and Licensed Practical Nurses (LPNs).

Design: A pan-Canadian cross-sectional survey.

Methods: The Nursing Practice in Rural and Remote Canada II survey (2014-2015) used stratified, systematic sampling and obtained two samples of questionnaire responses on intent to leave from 1,932 RNs/NPs and 1,133 LPNs.

Exploring the Distressing Events and Perceptions of Support Experienced by Rural and Remote Nurses: A Thematic Analysis of National Survey Data.

Background: Exposure to traumatic events is an occupational hazard with potential adverse psychological consequences. Previous research has focused mainly on urban practice settings; therefore, this study explored the distressing experiences encountered by rural/remote nurses and their perception of organizational support.

Methods: Thematic analyses were conducted on open-ended data from a pan-Canadian survey of 3,822 regulated nurses, where 1,222 nurses (32%) reported experiencing an extremely distressing health care incident within the past 2 years.

The Mosaic of Primary Care Nurses in Rural and Remote Canada: Results from a National Survey.

Background|objective: Nurses provide essential primary care (PC) in rural and remote Canada. We examined the practice context and responsibilities of this little-known understudied workforce.

Method: Data from Nursing Practice in Rural and Remote Canada II, a 2014 to 2015 pan-Canadian survey, were analyzed.

Communication tools and sources of education and information: a national survey of rural and remote nurses.

Objective: This study examined accessibility of communication tools in the workplace, use of education to update nursing knowledge, and use of information to make specific decisions in practice among registered nurses (RNs) and licensed practical nurses (LPNs) in rural and remote communities in Canada.

Methods: Data were analyzed from the cross-sectional survey, "Nursing Practice in Rural and Remote Canada II," of regulated nurses practicing in all provinces and territories of Canada. Data were collected from April 2014 to August 2015.

Rural and Remote Registered Nurses' Perceptions of Working Beyond Their Legislated Scope of Practice.

Registered nurses (RNs) enact their scope of practice in everyday practice through the influences of client needs, the practice setting, employer requirements and policies and the nurse's own level of competence (Canadian Nurses Association 2015). A scope of practice is "dynamic and responsive to changing health needs, knowledge development and technological advances" (International Council of Nurses 2013). In Canada, RNs' scope of practice is set out through provincial and territorial legislation and provincial regulatory frameworks, which are broadly consistent, but vary across provinces (Schiller 2015).

Rural and Remote Licensed Practical Nurses' Perceptions of Working Below Their Legislated Scope of Practice.

Over the past two decades in Canada, licensed or registered practical nurses (LPNs) have experienced an extension of their educational preparation and scope of practice. Simultaneously, there has been an increase in the number of LPNs employed in rural and remote communities. These changes have influenced the practice environment and LPNs' perceptions of their work.

A five-step approach for developing and implementing a Rural Primary Health Care Model for Dementia: a community-academic partnership.

Aim: This study is aimed at developing a Rural Primary Health Care (PHC) Model for delivering comprehensive PHC for dementia in rural settings and addressing the gap in knowledge about disseminating and implementing evidence-based dementia care in a rural PHC context.

Background: Limited access to specialists and services in rural areas leads to increased responsibility for dementia diagnosis and management in PHC, yet a gap exists in evidence-based best practices for rural dementia care.

Methods: Elements of the Rural PHC Model for Dementia were based on seven principles of effective PHC for dementia identified from published research and organized into three domains: team-based care, decision support, and specialist-to-provider support.

Development and psychometric evaluation of the Job Demands in Nursing Scale and Job Resources in Nursing Scale: Results from a national study.

Aim: To develop and test the psychometric properties of the Job Resources in Nursing (JRIN) Scale and the Job Demands in Nursing (JDIN) Scale.

Design: Cross-sectional survey.

Methods: A three-phase process of instrument development and psychometric evaluation was employed: Phase 1: development of a 42-item JRIN Scale and 60-item JDIN Scale through extensive literature review, expert consultation and an iterative content evaluation; Phase 2: pilot survey of 89 nurses and use of item discrimination analysis to estimate the internal consistency reliability of each subscale and reduce the length of each scale; Phase 3: Modified scales were tested in a nationwide survey of 3,822 rural/remote nurses, including use of exploratory factor analysis.

Competence and confidence in rural and remote nursing practice: A structural equation modelling analysis of national data.

Aims And Objectives: To empirically test a conceptual model of confidence and competence in rural and remote nursing practice.

Background: The levels of competence and confidence of nurses practising in rural settings have been highlighted as essential to the quality of health outcomes for rural peoples. However, there is limited research exploring these constructs in the context of rural/remote nursing practice.

Exploratory factor analysis and reliability of the Primary Health Care Engagement (PHCE) Scale in rural and remote nurses: findings from a national survey.

Unlabelled: Aim The study purpose was to provide evidence of validity for the Primary Health Care Engagement (PHCE) Scale, based on exploratory factor analysis and reliability findings from a large national survey of regulated nurses residing and working in rural and remote Canadian communities.

Background: There are currently no published provider-level instruments to adequately assess delivery of community-based primary health care, relevant to ongoing primary health care (PHC) reform strategies across Canada and elsewhere. The PHCE Scale reflects a contemporary approach that emphasizes community-oriented and community-based elements of PHC delivery.

Nurses who work in rural and remote communities in Canada: a national survey.

Background: In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions.

Simultaneous temporal trends in dementia incidence and prevalence, 2005-2013: a population-based retrospective cohort study in Saskatchewan, Canada.

Background: Original studies published over the last decade regarding time trends in dementia report mixed results. The aims of the present study were to use linked administrative health data for the province of Saskatchewan for the period 2005/2006 to 2012/2013 to: (1) examine simultaneous temporal trends in annual age- and sex-specific dementia incidence and prevalence among individuals aged 45 and older, and (2) stratify the changes in incidence over time by database of identification.

Methods: Using a population-based retrospective cohort study design, data were extracted from seven provincial administrative health databases linked by a unique anonymized identification number.

Trajectories of Depressive Symptomatology in Rural Memory Clinic Patients between Baseline Diagnosis and 1-Year Follow-Up.

Background/aims: To investigate the prevalence and trajectories of depressive symptomatology at 1-year follow-up, and the severity of depressive symptoms, by dementia diagnostic group, as well as to determine the predictors of depressive symptomatology at 1-year follow-up.

Methods: In rural and remote patients of an interdisciplinary memory clinic between 2004 and 2014, 144 patients diagnosed with no cognitive impairment (NCI), mild cognitive impairment, dementia due to Alzheimer's disease (AD), or non-AD dementia completed the Center for Epidemiologic Studies of Depression Scale to assess depressive symptomatology at both time points.

Results: Among patients with data at both time points, persistence of depressive symptomatology at follow-up occurred in 22.

Availability and Primary Health Care Orientation of Dementia-Related Services in Rural Saskatchewan, Canada.

Community-based services are important for improving outcomes for individuals with dementia and their caregivers. This study examined: (a) availability of rural dementia-related services in the Canadian province of Saskatchewan, and (b) orientation of services toward six key attributes of primary health care (i.e.

Incidence and prevalence of dementia in linked administrative health data in Saskatchewan, Canada: a retrospective cohort study.

Background: Determining the epidemiology of dementia among the population as a whole in specific jurisdictions - including the long-term care population-is essential to providing appropriate care. The objectives of this study were to use linked administrative databases in the province of Saskatchewan to determine the 12-month incidence and prevalence of dementia for the 2012/13 period (1) among individuals aged 45 and older in the province of Saskatchewan, (2) according to age group and sex, and (3) according to diagnosis code and other case definition criteria.

Methods: We used a population-based retrospective cohort study design and extracted data from 10 provincial health databases linked by a unique health services number.

The influence of organizational context on best practice use by care aides in residential long-term care settings.

Objective: This study assessed individual and organizational context (work environment) factors that influence use of best practices by care aides (nursing assistants) in nursing homes. Little scientific attention has been focused on understanding best practice use in nursing homes and almost none on care aides.

Setting And Participants: A total of 1262 care aides in 25 nursing homes in the 3 Canadian prairie provinces.

Development and psychometric evaluation of the Primary Health Care Engagement (PHCE) Scale: a pilot survey of rural and remote nurses.

Aim: To report the development and psychometric evaluation of a scale to measure rural and remote (rural/remote) nurses' perceptions of the engagement of their workplaces in key dimensions of primary health care (PHC).

Background: Amidst ongoing PHC reforms, a comprehensive instrument is needed to evaluate the degree to which rural/remote health care settings are involved in the key dimensions that characterize PHC delivery, particularly from the perspective of professionals delivering care.

Methods: This study followed a three-phase process of instrument development and psychometric evaluation.

Degree of rurality is not related to dementia caregiver distress, burden, and coping in a predominantly rural sample.

Earlier research suggests that geographic location matters for informal caregivers of persons with dementia: rural caregivers tend to rely on more informal supports and may report more psychological distress and burden than urban caregivers. Differential access to services may underlie these findings, but degree of rurality is typically measured with population size. In contrast, the current article measured degree of rurality with standardized scale of access to metropolitan centers.