International declaration on rural mental health research: 10 guiding principles and standards.

Rural communities have unique mental health needs and challenges which are often related to the uniqueness of the community itself. On a per-capita basis, the investment in rural mental health research is far less than that in urban communities. Added to this, rural communities are often at risk of researchers, based in large urban universities, visiting, conducting the research with minimal engagement with local stakeholders and limited understanding of the community's social-service-environmental context.

Bridging the divide: exploring the relationship between mental and physical health in rural areas.

Those living in rural settings may experience particular challenges to their mental as well as physical health, which together with issues relating to healthcare access can lead to disparities in outcomes. This commentary looks at the relationship between mental and physical health in rural areas and highlight the urgent need for a holistic approach to healthcare in these regions.

Brief Digital Interventions to Support the Psychological Well-being of NHS Staff During the COVID-19 Pandemic: 3-Arm Pilot Randomized Controlled Trial.

Background: Health and social care staff are at high risk of experiencing adverse mental health (MH) outcomes during the COVID-19 pandemic. Hence, there is a need to prioritize and identify ways to effectively support their psychological well-being (PWB). Compared to traditional psychological interventions, digital psychological interventions are cost-effective treatment options that allow for large-scale dissemination and transcend social distancing, overcome rurality, and minimize clinician time.

The mental health of NHS staff during the COVID-19 pandemic: two-wave Scottish cohort study.

Background: Health and social care workers (HSCWs) are at risk of experiencing adverse mental health outcomes (e.g. higher levels of anxiety and depression) because of the COVID-19 pandemic.

We've got what the NHS ultimately intended for us: Experiences of community engagement in rural primary care services change.

Policy promotes service user engagement in health services design and delivery. Various tools exist to support the engagement of citizens within health services design. We consider community engagement within the context of primary care delivery in remote and rural areas of Scotland.

A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being.

Background: Health and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and, in the challenge to control the virus, have directly faced its consequences. Supporting their psychological wellbeing continues, therefore, to be a priority. This rapid review was carried out to establish whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis.

Using micro-geography to understand the realisation of wellbeing: A qualitative GIS study of three social enterprises.

Social enterprises are promoted as a method of welfare reform, to transition people out of disadvantage by addressing poverty, unfulfilled capabilities and social exclusion. This study explores how three Work Integration Social Enterprises (WISEs) in Australia help to realise wellbeing for their employees by mapping their micro-geographical experience of wellbeing. By mapping the sites within a social enterprise where wellbeing is realised, we provide a practical, empirical and replicable methodology that is useful for gaining insights into where and how wellbeing realisation occurs.

Co-production of "nature walks for wellbeing" public health intervention for people with severe mental illness: use of theory and practical know-how.

Background: Interventions need to be developed in a timely and relatively low-cost manner in order to respond to, and quickly address, major public health concerns. We aimed to quickly develop an intervention to support people with severe mental ill-health, that is systematic, well founded both in theory and evidence, without the support of significant funding or resource. In this article we aim to open and elucidate the contents of the 'black box' of intervention development.

Barriers and facilitators to participating in cardiac rehabilitation and physical activity in a remote and rural population: A cross-sectional survey.

Background: Cardiac disease requires ongoing active management which may include attendance at formal cardiac rehabilitation (CR) and increased physical activity (PA). However, uptake rates are sub-optimal. This study aimed to identify factors associated with attendance at CR and PA in a rural Scottish population.

Does the Mode of Exercise Influence the Benefits Obtained by Green Exercise?

Green exercise studies have tended to use walking as a modality of exercise to establish benefits to mental health. Whether green exercise benefits translate into different forms of green exercise has been deemed an important research gap. A mixed-methods study design was used to compare psychological responses between two forms of green exercise; golf and walking.

Psychological effects of outdoor activity in type 2 diabetes: a review.

Previous research has shown individuals living with type 2 diabetes are more likely to experience depression, anxiety and reduced quality of life (QoL) in comparison to those without the disease. Physical activity has been highlighted as an important factor in improving physiological and psychological parameters in this population. Previous systematic reviews have found mixed results regarding the effects of exercise on psychological problems.

What Motivates Participants to Adhere to Green Exercise?

There is a lack of research into green exercise which investigates and compares motivational drivers between the different types of outdoor activities. The current paper addressed this gap by classifying and comparing three types of green exercise: (i) Recreational physical activity, (ii) competitive sport, and (iii) outdoor adventure sport. Using a mixed methodological approach, the present study investigated the motivations for adhering to green exercise and directly compared the differences between these three forms of green exercise.

The personal and community impact of a Scottish Men's Shed.

Social isolation and loneliness are known to be associated with increased morbidity and mortality. Therefore, reducing social isolation and loneliness may improve such outcomes. In relation to men's health, "Men's Sheds" have been shown as one mechanism to achieve this.

Learning and unlearning dignity in care: Experiential and experimental educational approaches.

Guarding against loss of human dignity is fundamental to nursing practice. It is assumed in the existing literature that 'dignity' as a concept and 'dignity in care' as a practice is amenable to education. Building on this assumption, a range of experiential and experimental educational approaches have been used to enhance students' understanding of dignity.

Student nurses' perceptions of dignity in the care of older people.

Aim: The aim of this research was to investigate student nurses' perceptions of the concept of dignity in the care of older people. Student nurses regularly move between the classroom and the clinical setting and are thus ideally placed to cast light on the barriers that exist to providing dignity in care and the way in which their theoretical understanding of dignity is shaped by exposure to the practice setting.

Method: All student nurses on a three-year undergraduate nursing programme at one university were invited to participate in an online questionnaire survey and focus groups.

Revealing student nurses' perceptions of human dignity through curriculum co-design.

Dignity is a slippery concept to define - yet it has been at the heart of media and policy debates around the provision of health and social care in recent years; particularly in the United Kingdom following the Mid-Staffordshire scandal and subsequent Francis Inquiry. This paper considers the concept of dignity in care from the perspective of student nurses. Thus, it allows us to discuss how professional nurses-to-be conceptualise dignity and also how they consider it should/could be taught at undergraduate and postgraduate levels of training, and as part of their Continuing Professional Development.

An exploration of the longer-term impacts of community participation in rural health services design.

This article explores what happened, over the longer term, after a community participation exercise to design future rural service delivery models, and considers perceptions of why more follow-up actions did or did not happen. The study, which took place in 2014, revisits three Scottish communities that engaged in a community participation research method (2008-2010) intended to design rural health services. Interviews were conducted with 22 citizens, healthcare practitioners, managers and policymakers all of whom were involved in, or knew about, the original project.

Community participation for rural healthcare design: description and critique of a method.

This paper outlines a community participation process that was developed to engage rural community stakeholders in designing new health services. The paper explains what led up to the process and provides critique around applying the process for other health services and in other communities. Internationally, community participation is widely invoked, but it is only broadly explained in the literature, other than reviews of outcomes or descriptions of problems.

Theory in rural health.

Objective: This paper offers theories to explain persistent rural health challenges and describes their application to rural health and research.

Methods: Review of theories from several disciplines.

Findings: Key issues in rural health are poorer health status and access to health care, staff shortages, relationship-based health provision and the role of health services in community sustainability.

Being rural in rural health research.

This paper explores ways that being from a rural background might influence the health research process and why this might occur. It draws on the research experiences of three 'generations' of rural health researchers to suggest rural background affects how researchers approach and conduct study, and how they interpret findings. Concepts of positionality, habitus, performance and 'othering' are explored to suggest how existing sociological and philosophical ideas can explain why rural researchers possess a particular worldview that may influence their research outputs.

Is a global rural and remote health research agenda desirable or is context supreme?

Objective: This paper proposes that there is value in international comparison of rural and remote health-care service delivery models because of practical reasons - to find ideas, models and lessons to address 'local' delivery challenges; and for theoretical reasons - to derive a conceptual framework for international comparison.

Methods: Literature review and commentary.

Findings: There are significant challenges to international comparative research that have been highlighted generically; for example, equivalence of terminology, datasets and indicators.