Rural Experience Research Articles

Improving Patient Experience and Team Engagement with Environmental Services: Application of Watson's Theory of Human Caring.

Patient experience and team engagement are key performance indicators in organizational strategic planning. Health-care organizations have a seldom-used resource within acute care settings that expands the ability to improve patients' experiences of their care as well as their own team engagement. Environmental services (ES) staff, the second largest health-care workforce, spend an average of 10 min per patient day interacting with patients and families. Few studies highlight how nursing theory may influence patient experience outside of the nursing role. This paper explores how ES staff at a non-profit rural 974-bed academic medical center impacted patient experience using nursing theory to promote a caring environment. Applying Watson's Theory of Human Caring and Caritas Processes© with ES team members beginning at leadership levels increased team engagement and improved patient experience. ES team members benefited from a professional nursing framework and from being integrated as a valued partner in advancing human caring.

A structural model of customer experience in rural tourism

Purpose The purpose of this study is to explore the diversification of agricultural management for development in rural tourism. Excellent service has been standardized in response to society becoming more service-oriented. However, the structure of customer evaluations of services in rural tourism and their association with customer satisfaction and customer delight remain under-investigated. Design/methodology/approach This study used survey data from the general consumer population in Japan and used SERVPERF to measure service quality post-service, focusing on rural tourism experiences. The author analyzed the mechanisms of service quality leading to customer satisfaction and value co-creation, and value co-creation leading to customer delight and the effects of customer delight compared with those of customer satisfaction, using structural equation modeling. Findings Enhancing services strongly influenced excellent services, which were considered to generate customer delight. Compared with customer satisfaction, customer delight was inferred to lead to higher customer loyalty. The results indicated that core services generated customer satisfaction, whereas enhancing services generated customer delight. Practical implications These findings provide important insights into the provision of services in rural tourism, which is becoming prevalent in society, and contribute to the diversification of agricultural management. Originality/value The originality of this study lies in the adoption of rural tourism to diversify farm management, revealing its structure as an experience that leads to customer delight through value co-creation. The author showed that customer experience as a form of value co-creation in rural tourism can lead to the creation of excellent services.

Everyday reality of children in rural Catalonia (Spain): experiences and emotions

ABSTRACT The pandemic has been the catalyst for many families with young children to leave the urban environment and settle in rural areas, attracted by discourses that are in tune with the imported and classic ‘ideal of rural childhood’: natural environment, freedom, autonomy, mutual help, peace and quiet. However, we do not know to what extent this ideal construction of childhood in rural areas corresponds nowadays to the everyday reality of children. In this article we analyse the daily experiences and emotions of children in rural areas of Catalonia (Spain). By applying a qualitative methodology that allows children to express themselves, we provide a critical reading of the current rural areas based on children’s lived experiences. The use of the relief map as a methodological tool makes possible to graphically capture children’s emotions related to places. The research fills a gap on the current rural childhood experiences in non-Anglo-Saxon contexts, places the concept of the rural ideal in the Catalan environment and provides insight into the diversity of rural childhoods based on children’s experiences and emotions.

Understanding values in summer farm tourism

ABSTRACT This study aims to analyze the main drivers behind summer farm tourism and the elements of summer farms and the summer farm experience that create value for tourists. The study contributes to the conceptualization of summer farm food consumption. By combining concepts used in the analysis of rural tourism, such as postmodernity and cultural heritage, with the hospitality-oriented Five Aspects Meal Model, we offer a new avenue to understand the drivers behind summer farm tourism. Empirically, the study contributes by bringing a hospitality perspective into research about rural tourism, thus offering new avenues for future research. The results show that intrinsic and extrinsic values (e.g. product-specific and non-product-specific characteristics) of summer farm products, along with a welcoming atmosphere, aspects related to the cultural and biological heritage of summer farms, the scenery, and the possibility of encountering real-life animals, are appreciated elements in creating consumer and tourist value. Tourists appreciate the simple rural experience and wish to preserve the cultural heritage embedded in summer farms. Furthermore, traditional elements of hospitality are highly conditioned by postmodern and cultural heritage values.

Multifaceted Interventions to Enable Elimination of Clinician-ordered Blood Smear Reviews: A Rural Academic Medical Center Experience

Abstract Introduction/Objective Blood smears (BS) evaluate a variety of clinical disorders. At Geisinger, clinician ordered pathologist review of blood smears (CBS) have increased despite usage of highly sophisticated hematology analyzers and automatic blood smear (ABS) review criteria. We hypothesized that CBS impact pathologists’ and technologists’ workloads and increase costs and turn-around times, with rare improvement in value-based patient care. This study aimed to analyze CBS ordering practices and improve the utilization of BS review. Methods/Case Report In October 2020, a prospective CBS utilization study was completed by 8 clinical pathologists for 172 CBS. Subsequently, a clinical question was required for CBS orders from January 1, 2022, to January 1, 2023, to investigate clinician ordering practices based on campus, department, and indications. Findings were used to support new interventions including: clinician education; cancellation of repeat BS ordered within 24 hours, creation of alternative tests (schistocyte technologist smear review, clinician order for independent slide review), standardization of morphology reporting, ABS audits, and elimination of orderable CBS replaced by an electronic BS review request, that is reviewed by a clinical pathologist prior to determine if a BS is indicated. Results (if a Case Study enter NA) Part of the Conclusions section for Lab Practice abstract. Conclusion Prospective utilization audit of 172 CBS orders showed 17% changed clinical management. Audit of 3,693 CBS orders demonstrated common reasons for review included tick-borne illness, hemolysis, erythrocytosis, thrombocytosis, and iron deficiency anemia. Systematic implementation of multiple interventions enabled the elimination of CBS, with no known adverse effect on patient management to date. The streamlined BS review guidelines allowed for better-allocation of resources, appropriate patient turn-around times, empowerment of laboratory technologists and reduced hospital costs. We propose maximizing the incorporation of technologist skills to improve the utilization and efficiency of BS reviews and establishing standardized, evidence-based, and institutional- specific guidelines to determine BS reviews.

Rural residency, rural resentment, and attitudes toward public land management in the United States

ABSTRACT Disparate urban and rural lived experiences contribute to the geographic divide in American politics. We expect this to be especially true for environmental politics because of urban-rural differences in exposure to natural resources. We demonstrate that Americans are broadly supportive of public lands and that ruralites are slightly more supportive of public land management compared to the non-rural. However, a crucial exception to general rural attitudes is highly resentful ruralites are uniquely and dramatically unsupportive of public lands and direct their resentment at the federal government especially. This research clarifies the nationalized nature of the urban-rural divide by highlighting that the preferences of resentful rural Americans are in stark contrast to the rest of society, even the rest of rural America. Nevertheless, when a minority’s unpopular opinions on the management of America’s natural resources overshadow more moderate and modal positions it fuels fringe movements like the Sagebrush Rebellion.

Transitioning to rural practice together: a rural fellowship model (in 6 Ps).

Maintaining a robust healthcare workforce in underserved rural communities continues to be a challenge. To better meet healthcare needs in rural areas, training programs must develop innovative ways to foster transition to, and integration into, these communities. Mountain Area Health Education Center designed and implemented a 12-month post-residency Rural Fellowship program to enhance placement, transition, and retention in rural North Carolina. Utilizing a '6 Ps' framework, the program targeted physicians and pharmacists completing residency with the purpose of recruiting and supporting their transition into the first year of rural practice. To better understand Rural Fellows' experiences and the immediate impact of their Fellowship year, we conducted a semi-structured interview using a narrative technique and evaluated retention rates over time. Interviews with the eight participants, which included Fellowship alumni and current Fellows, demonstrated the impact and influence of the key curricular '6 Ps' framework. An early retention rate of 100% and a long-term retention rate of 87%, combined with expressed clarity of curricular knowledge, skills, and attitudes related to the '6 Ps', demonstrate the potential and effectiveness of this Rural Fellowship model. Participants indicated the Rural Fellowship experience supports the transition to rural practice communities and expands their clinical skills. The Rural Fellowship program demonstrates an effective model to support early career healthcare providers as they begin practice in rural communities in western North Carolina through academic opportunities, personal growth, and professional development. Implementation of this model has demonstrated the success of a rural retention model over a 6-year period. This model has the potential to target an array of clinical providers and disciplines. We started with family medicine and have expanded to psychiatry, obstetrics, pharmacy, and nursing. This study demonstrated that this model supports clinical providers during the critical transition period from residency to practice. Targeting the most important stage of one's medical training, the commencement of professional practice, this is a scalable model for other rural-based health professions education sites where rural recruitment and retention remain a problem.

Rural unpaid caregivers' experiences in northern Aotearoa, New Zealand during the Covid-19 pandemic: A qualitative study.

Rural unpaid caregivers experience different opportunities and challenges than their urban counterparts. Our aim was to understand rural unpaid caregivers' experiences of challenges and opportunities during the Covid-19 pandemic in New Zealand. Rural northern New Zealand during the Covid-19 pandemic. A convenience sample of 10 unpaid rural caregivers, most supporting an older person living with dementia. A qualitative descriptive design. Data included interviews and online workshops, and a thematic analysis. Rural unpaid caregivers observed that some aspects of living in a rural context were helpful during the Covid-19 pandemic. However, tasks such as shopping and long-distance travel and communication (both telephonic and digital) became more complex. Abrupt changes to routine and closure of resources and support groups created challenges. Unpaid caregivers worried about what would happen if they were hospitalised themselves. There was a diversity of experience both across caregivers, of familiar routines and rural context as resources, increased challenges requiring resourcefulness to adapt, and experiences of crisis. Many experienced all three states at different times. This research provides valuable insights into challenges and opportunities experienced by rural unpaid caregivers during the Covid-19 pandemic and may help policy-makers and healthcare professionals develop improved emergency preparedness. Multilevel, multisector responses are needed to ensure effective health and social support and access to resources including health care, access to groceries and medication, transport, and communications (telephone and digital). Enhancing rural access to effective and inexpensive online services is particularly important, as is recognition of the value of rural sites or hubs of connection and social interaction.

Reviving the poppy seed test for the diagnosis of colovesical fistula: A case report from a single rural center experience.

The poppy seed test is a valuable, cost-effective, and sensitive initial diagnostic investigation to identify the presence of colovesical fistula, particularly for clinicians in remote or rural areas with lack of access to specialist radiologic, endoscopic, surgical, or urological support. The poppy seed test therefore may act as a bridge toward the commencement of appropriate referral pathways for the management of colovesical fistula. The diagnosis of colovesical fistula is resource intensive, often requiring a combination of radiological investigation and endoscopy. The poppy seed test is a non-invasive and cost-effective alternative that has been demonstrated to identify presence of colovesical fistula with high sensitivity. There is however a noticeable paucity of recommendations for the poppy seed test in the diagnostic approach to colovesical fistula due to significant advancements in alternative radiologic and endoscopic technologies. Despite this, in resource-challenged areas with lack of specialist support, the poppy seed test is a cost-effective, accessible and safe test that can be performed to confirm the presence of colovesical fistula. We report a case of a 79-year-old man with a past history of colorectal cancer managed surgically with adjuvant chemoradiotherapy who develops noisy micturition, pneumaturia, and fecaluria 22 years after treatment. Given the suspicion of colovesical fistula, computed tomography imaging and cystoscopy were performed which was unable to demonstrate an overt fistula. The poppy seed test was utilized and demonstrated presence of poppy seeds in the urine, confirming the presence of a fistula. The patient was referred to a specialist surgical center for consideration of further management. The poppy seed test is a valuable initial diagnostic investigation for clinicians in remote or rural areas with lack of access to specialist radiologic, endoscopic, surgical, or urological support in confirming the presence of a colovesical fistula and initiating referral pathways for the management of this condition.

Analysis of MZ Generation's Participation Motives in Rural Experience Tourism Programs through Goal Framing Theory

Analysis of MZ Generation's Participation Motives in Rural Experience Tourism Programs through Goal Framing Theory

"I Couldn't Leave the Farm": Rural Women's Experiences of Intimate Partner Violence and Coercive Control.

Intimate partner violence (IPV) and coercive control are prevalent across Canada; these experiences are exacerbated by regionality with women in rural areas disproportionately affected. This study explores rural women's experiences of IPV and coercive control, drawing on qualitative interviews with rural women in Saskatchewan who experienced IPV and focus groups with service providers who work with survivors. Our findings suggest rurality magnifies conditions of coercive control through physical elements of normative rurality, such as isolation that restrict women's space for action. Our participants' experiences of coercive control were exacerbated by the geographic reality of living in a rural/remote location.

Taking the car out of the countryside: Understanding opposition to climate policy in rural Finland

There is an urgent need to decarbonize mobility. Yet, the necessary policies risk compounding existing vulnerabilities and controversies and creating new ones, potentially leading to political polarization. One affected population consists of people living in rural peripheries. Drawing from a Finnish public consultation survey (n = 18,378), we explore how rural participants (n = 4995) experience policies and proposals to decarbonize mobility: how they perceive the problem and what they propose as solutions. We draw on Noortje Marres' concept of attachments to understand the socio-material, discursive and subjective attachments that coalesce in rural experiences of policies and proposals to decarbonize mobility. We contribute to previous research on spatial inequalities in the mobility transition by showing how electric vehicles might not simply replace internal combustion engines in rural areas. We also show how distributive policies, i.e. subsidies, might not solve the problems, because different dimensions of attachments are intertwined and serve to maintain each other and thus reinforce existing experiences of inaccessibility and injustice. We conclude with suggestions for how to better address just and acceptable mobility transitions for rural dwellers.

Reflections on ethnic diversity within a dental desert.

The demographics of the dental workforce have changed significantly in recent years, with regard to both gender and ethnicity. Ethnic diversity within dentistry does not align with UK population data, with some groups less well-represented than others, such as those of Black or Afro-Caribbean heritage. Although multiculturalism has developed throughout the UK, it is much less advanced within rural areas. Rural communities have a less ethnically diverse population and this has been identified as a challenge when looking to recruit dentists and other dental care professionals from a Black, Asian or minority ethnic (BAME) background.Recruitment and retention of dentists to rural areas is a major issue and it is vitally important to ensure that all members of the dental profession feel adequately supported and welcome. Addressing the shortage of dental professionals in rural areas is crucial in improving dental access. However, this task becomes more complex when considering the increasing number of BAME students and graduates from a metropolitan background, and a continuing lack of multi-culturalism within rural communities. Identifying and understanding the factors which influence BAME dental professionals' decisions to relocate to rural areas is vital for developing effective strategies to attract and retain diverse talent within these communities.This opinion article considers existing literature, while drawing upon personal experiences as a Black student in the South West of England, in order to explore the barriers to working in rural areas as an individual from a minority ethnic group. Socioeconomic challenges, cultural isolation and limited rural experience are identified as factors that can deter Black and other minority ethnic dentists from living and working in rural areas.

It's not just about the sun, it's about a living: Rural older farmers' experience of skin cancer risk and prevention.

To understand rural older farmers' perspectives and attitudes toward skin cancer risk and prevention. This study used a grounded theory approach and semi-structured interviews with 12 rural older farmers (farm owners, farmworkers ages 50 years or older) in Washington. Participants' perspectives were explored relative to Health Belief Model constructs. Inductive and deductive analyses were used to generate relevant themes. COREQ guidelines were followed. The findings fit well and extended the Health Belief Model, which was used to arrange key themes identified in relation to skin cancer risk and prevention, specifically participants' perceived barriers to accessing primary care and protection when outdoors, perceived benefits of sun-protective behaviors, perceived hereditary susceptibility to skin cancer, perceived severity of the increased skin cancer risk, and cues to action for skin checks. A new construct of hope was identified to emphasize the importance of establishing emotional, instrumental, and informational support systems for promoting skin cancer prevention. Participants also indicated their hope of raising awareness of skin cancer prevention among all ages. Findings highlighted the importance of integrating skin cancer prevention services for rural older farmers and across the lifespan. Public health approaches are needed to enhance the awareness of and access to preventive care in these underserved populations.

Rural songs for COVID‐19 times? UK folk music's resurgent engagement with the countryside

AbstractThe COVID‐19 pandemic somewhat unexpectedly promoted resurgent interest in the attractions of rural places, not least associated with nature, in many countries for especially urban people. The paper argues that this link was very fecund for many within the broad UK ‘folk music’ community specifically. After introducing COVID‐19's pro‐rural turn, the paper gives a brief overview of now substantial music geography scholarship, paying particular attention to what has been studied in respect of folk music, not least its examination of the latter's problematic links to English identities. It argues that folk music's resurgent rural links call for attention. It then introduces how the rural‐folk music COVID‐19 experience worked at three non‐exclusive levels. First, there was rural influence on the music being produced. Second, some musicians were also personally impacted strongly by rural experiences, evident not solely through their music. Third, some musicians developed original rural initiatives that saw audience members also gaining direct rural inspiration, not just via the strong growth in internet‐facilitated connections but through direct in‐place encounters with the musicians in the rural. Each reading is illustrated by two brief case studies, with the rural‐folk combination becoming increasingly alive and more‐than‐representational. It is suggested in conclusion that there remains a strong ‘life’ to these rural‐folk music connections in less predominant COVID‐19 times.

Rural Natural Disaster Stress: A Survey of Community Resource Use and Effect

ABSTRACT Objective This study identified rural community experiences and preferences related to available resources and their effects on stress following tornadoes and floods. Methods The Rural Natural Disaster Stress and Recovery survey was distributed from December 2021 to February 2022 in rural disaster-affected communities. Within the analysis sample (N = 159) of self-selected participants representing both agricultural and non-agricultural occupations, 125 responded to the Resource Use and Effect survey component that evaluated the effects of 22 resources on post-disaster stress. Additional qualitative questions provided further data. Results The most frequently used resources post-disaster were found to be talking about the event (98.3%), friends and neighbors (97.6%) and family (97.6%). Using a derived Impact per Use score, groups from the neighboring community and personal faith activities most often reduced stress. Resources that increased stress were identified as FEMA or other government organizations; repairing, replacing, or rebuilding property; and following news or social media. Participants reported help from their community (35.8%) or things they did for themselves (31.2%) most effectively decreased disaster stress. Family, friends, faith, neighbors, and community were top choices to decrease stress in a future disaster. Conclusion Rural residents identified available resources for reducing disaster stress, but some common post-disaster activities were found to increase stress. Rural emergency management should adapt response and recovery plans and activities to leverage readily accessible people, groups, and activities to mitigate negative mental and emotional health effects.

Who you travel with matters: the influence of intimacy experience on the stickiness of rural tourism activities – travel companion as the moderator

ABSTRACT This study examines the mediating effect of tourists’ perceived value between four dimensions of rural intimacy – physical, verbal, intellectual, and spiritual – and the stickiness of rural tourism activities It further scrutinises the moderating impact of travel companions, posing the pivotal question, ‘Who do you travel with matters the most?’ Analyzing a sample of 649 Chinese tourists, the research finds that each dimension of rural intimacy significantly enhance tourists’ perceived value and the stickiness of rural tourism. The study concludes that ‘growth-oriented’ intimate experiences are more effective in enhancing stickiness than ‘instrumental-oriented’ intimate experiences. The presence of friends as travel companions does not notably elevate tourists’ perceived value. In contrast, travelling with family, either with parents or children, substantially enhances tourists’ perceived value. Couples perceive increased value through verbal and spiritual intimacy. Tourists who travel alone gain heightened value and activity stickiness through verbal and intellectual interactions. These findings provide strategic insights for enhancing rural tourism experiences and strengthening customer engagement and loyalty.

Rural Suicide: Demographics, Causes, and Treatment Implications.

Suicide rates in rural areas are higher than urban areas and growing, with current treatment developments only exacerbating this discrepancy. Within individual factors, both age and gender relate to and intersect with personal values related to self-reliance and attitudes toward mental health difficulties and treatment to increase suicide risk. The lethality ubiquitous in rural environments and occupations is a leading factor in rural suicide rates, with other factors such as race alternately noted to be a key factor but with more mixed findings. The cultural values of rural communities as typically negative toward mental health disclosure and treatment contribute to the disengagement of rural communities from treatment that may otherwise prevent suicides, exacerbating the physical lack of treatment access many rural communities experience. Working within the primary care system alongside increased telehealth utilization are suggested to reduce rural suicide rates.

Possibilities for Rural Queer Liberation: Toward a Queer Rural Place-Based Pedagogy

Combining queer pedagogy and critical pedagogy of place, a queer rural place-based pedagogy centers rural queer student experiences to foster rural queer liberation.

Queerly Rural, Rurally Queer

Recently, the number of books featuring both queer and rural youth experiences has increased (Kedley et al., 2022), including Jamison’s (2021) Hillbilly Queer: A Memoir. The present study examined how this book functions as a memoir about young adult experiences and analyzed the possibilities it offers rural queer students as well as rural and/or queer educators. Through a queer autoethnographic literary analysis, the authors draw upon their experiences as once closeted rural queer youth and former openly queer secondary English language arts educators teaching in rural and rural-serving public schools. This study found important benefits for rural queer adolescents and significant implications for the English language arts classroom.