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Interests towards wireless portable medical diagnostics and monitoring systems, which could be used outside hospital e.g. during pandemic or catastrophic situations, have increased recently. Additionally, portable monitoring solutions could partially address widely recognized challenges related to healthcare equality in rural areas. Microwave based sensing has recently been recognized as emerging technology for portable medical monitoring and diagnostics devices since they may enable development of safe, reliable, and low-cost solutions for future’s telemedicine. The aim of this paper is to present the basic idea of microwave -based medical monitoring and discuss its possibilities, advantages, and challenges. In particular, we show that microwaves could be exploited in three pre-diagnostics applications: 1) Detection of abnormalities in the brain with a helmet type of monitoring device, 2) Detection of breast cancer with a self-monitoring vest, 3) Detection of blood clots in leg with an antenna band. The technique is based on detecting differences in radio channel responses caused by the abnormalities having different dielectric properties than the surrounding tissues. Our results of realistic simulations and experimental measurements show that even small-sized abnormalities, e.g. tumors, can change channel characteristics in detectable level.

Introduction: Stoma complications are common and interfere with many aspects of everyday life. Stoma problems are usually managed by a specialised stoma nurse, a service not present in the rural areas of South Lapland in Sweden. The aim of this study was to describe how stoma patients in rural areas experience living with a stoma. Methods: A qualitative descriptive study with semi-structured interviews were conducted with 17 stoma patients living in rural municipalities and who received a part of their care at the local cottage hospital. Qualitative content analysis was employed. Results: Initially, the stoma was experienced as very depressing. Participants had difficulties in properly managing the dressing. Over time they learned how to properly care for their stoma, making their life easier. Both satisfaction and dissatisfaction with the healthcare were experienced. Those who were dissatisfied expressed a lack of competence in dealing with stoma-related problems. Conclusions: Living with a stoma in a rural area in northern Sweden is experienced as a learning process and acceptance of the stoma’s existence is important. This study emphasises the need for increased knowledge of stoma-related problems in rural primary healthcare in order to help patients cope with everyday life.

Aim: The aim of this study was to illuminate the meaning of being a nurse in the archipelago. Methodological Design and Justification: A phenomenological hermeneutical design was applied, as there is a need to understand the lifeworld and the meaning of being a nurse in the archipelago. Ethical Issues and Approval: Approval was granted by the Regional Ethical Committee and local management team. All participants provided consent to participate. Research Method: Individual interviews were conducted with 11 nurses (Registered Nurses or primary health nurses). The interviews were transcribed, and the text was analysed by means of phenomenological hermeneutical method. Results: The analyses ended in one main theme: Standing alone on the frontline, and three themes: 1. Combating sea, weather and the clock with the sub-themes: Fighting to give care to patients despite harsh conditions and Fighting against time; 2. Standing firm but wavering with the sub-themes: Embracing the unexpected and Calling out for support; and 3. Being a lifeline throughout the entire lifespan with the sub-themes: Having responsibility for the islanders and Having an intertwined private and work life. Study Limitations: The interviews may be considered few, but the textual data were rich and assessed suitable for the analysis. The text may be interpreted differently, but we deemed our interpretation as more probable than others. Conclusion: Being a nurse in the archipelago means standing alone on the frontline. Nurses, other health professionals and managers need knowledge and insight about working alone and the moral responsibilities thereof. There is a need to support the nurses in their lonely work. Traditional means of consultations and support could preferably be supplemented by modern digital technology.

Introduction: Stoma complications are common and interfere with many aspects of everyday life. Stoma problems are usually managed by a specialised stoma nurse, a service not present in the rural areas of South Lapland in Sweden. The aim of this study was to describe how stoma patients in rural areas experience living with a stoma. Methods: A qualitative descriptive study with semi-structured interviews were conducted with 17 stoma patients living in rural municipalities and who received a part of their care at the local cottage hospital. Qualitative content analysis was employed. Results: Initially, the stoma was experienced as very depressing. Participants had difficulties in properly managing the dressing. Over time they learned how to properly care for their stoma, making their life easier. Both satisfaction and dissatisfaction with the healthcare were experienced. Those who were dissatisfied expressed a lack of competence in dealing with stoma-related problems. Conclusions: Living with a stoma in a rural area in northern Sweden is experienced as a learning process and acceptance of the stoma’s existence is important. This study emphasises the need for increased knowledge of stoma-related problems in rural primary healthcare in order to help patients cope with everyday life.

Aim: The aim of this study was to illuminate the meaning of being a nurse in the archipelago. Methodological Design and Justification: A phenomenological hermeneutical design was applied, as there is a need to understand the lifeworld and the meaning of being a nurse in the archipelago. Ethical Issues and Approval: Approval was granted by the Regional Ethical Committee and local management team. All participants provided consent to participate. Research Method: Individual interviews were conducted with 11 nurses (Registered Nurses or primary health nurses). The interviews were transcribed, and the text was analysed by means of phenomenological hermeneutical method. Results: The analyses ended in one main theme: Standing alone on the frontline, and three themes: 1. Combating sea, weather and the clock with the sub-themes: Fighting to give care to patients despite harsh conditions and Fighting against time; 2. Standing firm but wavering with the sub-themes: Embracing the unexpected and Calling out for support; and 3. Being a lifeline throughout the entire lifespan with the sub-themes: Having responsibility for the islanders and Having an intertwined private and work life. Study Limitations: The interviews may be considered few, but the textual data were rich and assessed suitable for the analysis. The text may be interpreted differently, but we deemed our interpretation as more probable than others. Conclusion: Being a nurse in the archipelago means standing alone on the frontline. Nurses, other health professionals and managers need knowledge and insight about working alone and the moral responsibilities thereof. There is a need to support the nurses in their lonely work. Traditional means of consultations and support could preferably be supplemented by modern digital technology.

Aim: The aim of this study was to illuminate the meaning of being a nurse in the archipelago. Methodological Design and Justification: A phenomenological hermeneutical design was applied, as there is a need to understand the lifeworld and the meaning of being a nurse in the archipelago. Ethical Issues and Approval: Approval was granted by the Regional Ethical Committee and local management team. All participants provided consent to participate. Research Method: Individual interviews were conducted with 11 nurses (Registered Nurses or primary health nurses). The interviews were transcribed, and the text was analysed by means of phenomenological hermeneutical method. Results: The analyses ended in one main theme: Standing alone on the frontline, and three themes: 1. Combating sea, weather and the clock with the sub-themes: Fighting to give care to patients despite harsh conditions and Fighting against time; 2. Standing firm but wavering with the sub-themes: Embracing the unexpected and Calling out for support; and 3. Being a lifeline throughout the entire lifespan with the sub-themes: Having responsibility for the islanders and Having an intertwined private and work life. Study Limitations: The interviews may be considered few, but the textual data were rich and assessed suitable for the analysis. The text may be interpreted differently, but we deemed our interpretation as more probable than others. Conclusion: Being a nurse in the archipelago means standing alone on the frontline. Nurses, other health professionals and managers need knowledge and insight about working alone and the moral responsibilities thereof. There is a need to support the nurses in their lonely work. Traditional means of consultations and support could preferably be supplemented by modern digital technology.

Introduction: Stoma complications are common and interfere with many aspects of everyday life. Stoma problems are usually managed by a specialised stoma nurse, a service not present in the rural areas of South Lapland in Sweden. The aim of this study was to describe how stoma patients in rural areas experience living with a stoma. Methods: A qualitative descriptive study with semi-structured interviews were conducted with 17 stoma patients living in rural municipalities and who received a part of their care at the local cottage hospital. Qualitative content analysis was employed. Results: Initially, the stoma was experienced as very depressing. Participants had difficulties in properly managing the dressing. Over time they learned how to properly care for their stoma, making their life easier. Both satisfaction and dissatisfaction with the healthcare were experienced. Those who were dissatisfied expressed a lack of competence in dealing with stoma-related problems. Conclusions: Living with a stoma in a rural area in northern Sweden is experienced as a learning process and acceptance of the stoma’s existence is important. This study emphasises the need for increased knowledge of stoma-related problems in rural primary healthcare in order to help patients cope with everyday life.

Introduction: Stoma complications are common and interfere with many aspects of everyday life. Stoma problems are usually managed by a specialised stoma nurse, a service not present in the rural areas of South Lapland in Sweden. The aim of this study was to describe how stoma patients in rural areas experience living with a stoma. Methods: A qualitative descriptive study with semi-structured interviews were conducted with 17 stoma patients living in rural municipalities and who received a part of their care at the local cottage hospital. Qualitative content analysis was employed. Results: Initially, the stoma was experienced as very depressing. Participants had difficulties in properly managing the dressing. Over time they learned how to properly care for their stoma, making their life easier. Both satisfaction and dissatisfaction with the healthcare were experienced. Those who were dissatisfied expressed a lack of competence in dealing with stoma-related problems. Conclusions: Living with a stoma in a rural area in northern Sweden is experienced as a learning process and acceptance of the stoma’s existence is important. This study emphasises the need for increased knowledge of stoma-related problems in rural primary healthcare in order to help patients cope with everyday life.

Introduction: Stoma complications are common and interfere with many aspects of everyday life. Stoma problems are usually managed by a specialised stoma nurse, a service not present in the rural areas of South Lapland in Sweden. The aim of this study was to describe how stoma patients in rural areas experience living with a stoma. Methods: A qualitative descriptive study with semi-structured interviews were conducted with 17 stoma patients living in rural municipalities and who received a part of their care at the local cottage hospital. Qualitative content analysis was employed. Results: Initially, the stoma was experienced as very depressing. Participants had difficulties in properly managing the dressing. Over time they learned how to properly care for their stoma, making their life easier. Both satisfaction and dissatisfaction with the healthcare were experienced. Those who were dissatisfied expressed a lack of competence in dealing with stoma-related problems. Conclusions: Living with a stoma in a rural area in northern Sweden is experienced as a learning process and acceptance of the stoma’s existence is important. This study emphasises the need for increased knowledge of stoma-related problems in rural primary healthcare in order to help patients cope with everyday life.

Aim: The aim of this study was to illuminate the meaning of being a nurse in the archipelago. Methodological Design and Justification: A phenomenological hermeneutical design was applied, as there is a need to understand the lifeworld and the meaning of being a nurse in the archipelago. Ethical Issues and Approval: Approval was granted by the Regional Ethical Committee and local management team. All participants provided consent to participate. Research Method: Individual interviews were conducted with 11 nurses (Registered Nurses or primary health nurses). The interviews were transcribed, and the text was analysed by means of phenomenological hermeneutical method. Results: The analyses ended in one main theme: Standing alone on the frontline, and three themes: 1. Combating sea, weather and the clock with the sub-themes: Fighting to give care to patients despite harsh conditions and Fighting against time; 2. Standing firm but wavering with the sub-themes: Embracing the unexpected and Calling out for support; and 3. Being a lifeline throughout the entire lifespan with the sub-themes: Having responsibility for the islanders and Having an intertwined private and work life. Study Limitations: The interviews may be considered few, but the textual data were rich and assessed suitable for the analysis. The text may be interpreted differently, but we deemed our interpretation as more probable than others. Conclusion: Being a nurse in the archipelago means standing alone on the frontline. Nurses, other health professionals and managers need knowledge and insight about working alone and the moral responsibilities thereof. There is a need to support the nurses in their lonely work. Traditional means of consultations and support could preferably be supplemented by modern digital technology.

Aim: The aim of this study was to illuminate the meaning of being a nurse in the archipelago. Methodological Design and Justification: A phenomenological hermeneutical design was applied, as there is a need to understand the lifeworld and the meaning of being a nurse in the archipelago. Ethical Issues and Approval: Approval was granted by the Regional Ethical Committee and local management team. All participants provided consent to participate. Research Method: Individual interviews were conducted with 11 nurses (Registered Nurses or primary health nurses). The interviews were transcribed, and the text was analysed by means of phenomenological hermeneutical method. Results: The analyses ended in one main theme: Standing alone on the frontline, and three themes: 1. Combating sea, weather and the clock with the sub-themes: Fighting to give care to patients despite harsh conditions and Fighting against time; 2. Standing firm but wavering with the sub-themes: Embracing the unexpected and Calling out for support; and 3. Being a lifeline throughout the entire lifespan with the sub-themes: Having responsibility for the islanders and Having an intertwined private and work life. Study Limitations: The interviews may be considered few, but the textual data were rich and assessed suitable for the analysis. The text may be interpreted differently, but we deemed our interpretation as more probable than others. Conclusion: Being a nurse in the archipelago means standing alone on the frontline. Nurses, other health professionals and managers need knowledge and insight about working alone and the moral responsibilities thereof. There is a need to support the nurses in their lonely work. Traditional means of consultations and support could preferably be supplemented by modern digital technology.

Objective Remote area nurses provide primary health care services to isolated communities across Australia. They manage acute health issues, chronic illness, health promotion and emergency responses. This article discusses why their generalist scope of practice should be formally recognised as a specialist nursing practice area. Design Constructivist grounded theory, using telephone interviews (n = 24) with registered nurses and nurse practitioners. Setting Primary health care clinics, in communities of 150–1500 residents across Australia. Participants A total of 24 nurses participated in this study. Results Nurses' perceived their clinical knowledge and skill as insufficient for the advanced, generalist, scope of practice in the remote context, especially when working alone. Experience in other settings was inadequate preparation for working in remote areas. Knowledge and skill developed on the job, with formal learning, such as nurse practitioner studies, extending the individual nurse's scope of practice to meet the expectations of the role, including health promotion. Conclusion Remote area nursing requires different knowledge and skills from those found in any other nursing practice setting. This study supports the claim that remote area nursing is a specialist–generalist role and presents a compelling case for further examination of the generalist education and support needs of these nurses. Combined with multidisciplinary collaboration, developing clinical knowledge and skill across the primary health care spectrum increased the availability of health resources and subsequently improved access to care for remote communities. Further research is required to articulate the contemporary scope of practice of remote area nurses to differentiate their role from that of nurse practitioners.

Objective Remote area nurses provide primary health care services to isolated communities across Australia. They manage acute health issues, chronic illness, health promotion and emergency responses. This article discusses why their generalist scope of practice should be formally recognised as a specialist nursing practice area. Design Constructivist grounded theory, using telephone interviews (n = 24) with registered nurses and nurse practitioners. Setting Primary health care clinics, in communities of 150–1500 residents across Australia. Participants A total of 24 nurses participated in this study. Results Nurses' perceived their clinical knowledge and skill as insufficient for the advanced, generalist, scope of practice in the remote context, especially when working alone. Experience in other settings was inadequate preparation for working in remote areas. Knowledge and skill developed on the job, with formal learning, such as nurse practitioner studies, extending the individual nurse's scope of practice to meet the expectations of the role, including health promotion. Conclusion Remote area nursing requires different knowledge and skills from those found in any other nursing practice setting. This study supports the claim that remote area nursing is a specialist–generalist role and presents a compelling case for further examination of the generalist education and support needs of these nurses. Combined with multidisciplinary collaboration, developing clinical knowledge and skill across the primary health care spectrum increased the availability of health resources and subsequently improved access to care for remote communities. Further research is required to articulate the contemporary scope of practice of remote area nurses to differentiate their role from that of nurse practitioners.

Aims and objectives: To determine whether the current rural graduate programmes in Western Australia adequately support new graduate nurses transitioning into practice. Background: Graduate nurse's transition to employment is a time of significant change and challenge, often resulting in periods of transition shock. These challenges are magnified in rural areas where graduates have to relocate to commence their career with limited rural nursing experience. Graduate programmes were developed to smooth the transition for university trained bachelor's degree registered nurses into the workforce. Supportive graduate nursing programmes are essential for enabling transition to practice and reduce attrition rates. Design: Longitudinal convergent mixed method parallel design was informed by Duchscher's transition stage model. Method: Thematic analysis was applied to all interviews. COREQ checklist was completed. Descriptive statistics and content analysis were used to analyse the survey responses. Results: New graduates cycled through both transition shock and honeymoon periods on commencement of employment, reporting high levels of satisfaction in simultaneity with signs of transition shock. Satisfaction dropped within 7 months indicating a transition crisis before an adjustment period occurred at the end of their graduate year. Limited resources were highlighted as obstacles to providing adequate support to rural graduate nurses. Conclusion: The honeymoon stage of transition co-existed with transition shock at the commencement of graduate programmes, which may obscure the need for continuing adequate support. Inadequate and/or a lack of preceptorship was evident throughout the Western Australian rural graduate programmes. Graduate programmes need to be structured but flexible to allow for individual differences in graduates’ and clinical contexts. Relevance to clinical practice: Structured but flexible graduate programmes allow for individual differences in graduates and

Con el objetivo de develar la profesionalización de la enfermería rural, sus saberes y las políticas de salud en la Región de La Araucanía-Chile, años 1970-1990, se realiza una investigación histórica, descriptiva. Se trabaja historia oral, incluyendo 8 enfermeras y un enfermero. Los datos se analizan por codificación en base a criterio temático. Se trabaja rigor con triangulación por investigador y criterios de Guba y Lincoln. Se respetan los principios éticos de Ezekiel Emanuel. Como resultado surgen las metacategorías: Ejercicio profesional de enfermería rural marcado por necesidades sociales, Dualidad del ejercicio profesional, Formación de auxiliares rurales-capacitación, Liderazgo en programas de salud y Transformación de las condiciones de vida personal. Se concluye que los enfermeros desempeñaron su rol del cuidado de la salud, con abnegación y sacrificio, con destacada vocación en base a las necesidades enfrentadas, debiendo adaptarse a la ruralidad, viviendo realidades complejas en un entorno de pobreza y vulnerabilidad social, desarrollándose personal y profesionalmente., Aiming to reveal the rural nursing professionalization, knowledge circulation and state health policies in the Araucania region in Chile, from 1970 to 1990, a historical, descriptive investigation is carried out. Oral history is worked, including 9 nurses through snowball sampling. The data are analysed by coding based on thematic criteria. Rigor is worked by researcher triangulation and Guba and Lincoln criteria. Ezekiel Emanuel's ethical principles are respected. As a result, the following metacategories emerge: Professional rural nursing practice marked by social needs, Professional practice duality, Rural assistants training, Health programs leadership and Personal living conditions transformation. It is concluded that nurses performed their role as health care managers with abnegation and prominent vocation based on the needs they faced, adapting themselves to rurality, living complex realities in an environment of poverty and social vulnerability, thus, developing personally and professionally., Com o objetivo de desvelar a profissionalização da enfermagem rural, seus conhecimentos e políticas de saúde na região de La Araucanía-Chile, 1970-1990, é realizada uma investigação histórica, descritiva. A história oral é trabalhada, incluindo 8 enfermeiros e um enfermeiro. Os dados são analisados por codificação com base em critérios temáticos. Trabalhamos rigorosamente com a triangulação pelo pesquisador e pelos critérios de Guba e Lincoln. Os princípios éticos de Ezequiel Emanuel são respeitados. Como resultado, emergem as metacategorias: Prática profissional de enfermagem rural marcada por necessidades sociais, Dualidade de prática profissional, Capacitação de auxiliares rurais, Liderança em programas de saúde e Transformação das condições de vida pessoal. Conclui-se que os enfermeiros desempenharam seu papel na atenção à saúde, com auto-sacrifício e sacrifício, com uma vocação destacada com base nas necessidades enfrentadas, tendo que se adaptar à ruralidade, vivendo realidades complexas em um ambiente de pobreza e vulnerabilidade social, desenvolvendo pessoal e profissionalmente.

Aims and objectives: To determine whether the current rural graduate programmes in Western Australia adequately support new graduate nurses transitioning into practice. Background: Graduate nurse's transition to employment is a time of significant change and challenge, often resulting in periods of transition shock. These challenges are magnified in rural areas where graduates have to relocate to commence their career with limited rural nursing experience. Graduate programmes were developed to smooth the transition for university trained bachelor's degree registered nurses into the workforce. Supportive graduate nursing programmes are essential for enabling transition to practice and reduce attrition rates. Design: Longitudinal convergent mixed method parallel design was informed by Duchscher's transition stage model. Method: Thematic analysis was applied to all interviews. COREQ checklist was completed. Descriptive statistics and content analysis were used to analyse the survey responses. Results: New graduates cycled through both transition shock and honeymoon periods on commencement of employment, reporting high levels of satisfaction in simultaneity with signs of transition shock. Satisfaction dropped within 7 months indicating a transition crisis before an adjustment period occurred at the end of their graduate year. Limited resources were highlighted as obstacles to providing adequate support to rural graduate nurses. Conclusion: The honeymoon stage of transition co-existed with transition shock at the commencement of graduate programmes, which may obscure the need for continuing adequate support. Inadequate and/or a lack of preceptorship was evident throughout the Western Australian rural graduate programmes. Graduate programmes need to be structured but flexible to allow for individual differences in graduates’ and clinical contexts. Relevance to clinical practice: Structured but flexible graduate programmes allow for individual differences in graduates and

Con el objetivo de develar la profesionalización de la enfermería rural, sus saberes y las políticas de salud en la Región de La Araucanía-Chile, años 1970-1990, se realiza una investigación histórica, descriptiva. Se trabaja historia oral, incluyendo 8 enfermeras y un enfermero. Los datos se analizan por codificación en base a criterio temático. Se trabaja rigor con triangulación por investigador y criterios de Guba y Lincoln. Se respetan los principios éticos de Ezekiel Emanuel. Como resultado surgen las metacategorías: Ejercicio profesional de enfermería rural marcado por necesidades sociales, Dualidad del ejercicio profesional, Formación de auxiliares rurales-capacitación, Liderazgo en programas de salud y Transformación de las condiciones de vida personal. Se concluye que los enfermeros desempeñaron su rol del cuidado de la salud, con abnegación y sacrificio, con destacada vocación en base a las necesidades enfrentadas, debiendo adaptarse a la ruralidad, viviendo realidades complejas en un entorno de pobreza y vulnerabilidad social, desarrollándose personal y profesionalmente., Aiming to reveal the rural nursing professionalization, knowledge circulation and state health policies in the Araucania region in Chile, from 1970 to 1990, a historical, descriptive investigation is carried out. Oral history is worked, including 9 nurses through snowball sampling. The data are analysed by coding based on thematic criteria. Rigor is worked by researcher triangulation and Guba and Lincoln criteria. Ezekiel Emanuel's ethical principles are respected. As a result, the following metacategories emerge: Professional rural nursing practice marked by social needs, Professional practice duality, Rural assistants training, Health programs leadership and Personal living conditions transformation. It is concluded that nurses performed their role as health care managers with abnegation and prominent vocation based on the needs they faced, adapting themselves to rurality, living complex realities in an environment of poverty and social vulnerability, thus, developing personally and professionally., Com o objetivo de desvelar a profissionalização da enfermagem rural, seus conhecimentos e políticas de saúde na região de La Araucanía-Chile, 1970-1990, é realizada uma investigação histórica, descritiva. A história oral é trabalhada, incluindo 8 enfermeiros e um enfermeiro. Os dados são analisados por codificação com base em critérios temáticos. Trabalhamos rigorosamente com a triangulação pelo pesquisador e pelos critérios de Guba e Lincoln. Os princípios éticos de Ezequiel Emanuel são respeitados. Como resultado, emergem as metacategorias: Prática profissional de enfermagem rural marcada por necessidades sociais, Dualidade de prática profissional, Capacitação de auxiliares rurais, Liderança em programas de saúde e Transformação das condições de vida pessoal. Conclui-se que os enfermeiros desempenharam seu papel na atenção à saúde, com auto-sacrifício e sacrifício, com uma vocação destacada com base nas necessidades enfrentadas, tendo que se adaptar à ruralidade, vivendo realidades complexas em um ambiente de pobreza e vulnerabilidade social, desenvolvendo pessoal e profissionalmente.

Objective: to know the issues in evidence in rural nursing. Method: a six-stage integrative review. Data was collected from May to July 2017, in the SciELO, CUIDEN, PubMed, and ScienceDirect databases, with “Rural nursing” as descriptor. The analysis used was qualitative with the construction of subsets and topics. Results: of the 30 articles analyzed, 32% addressed professional training; 25% collective health-related practices; 12% hospital care; 10% job satisfaction; 7% were dedicated to telehealth and 3% of the studies addressed the following topics: nurses' recruitment and permanence in rural areas, continuing education, and professional practice in urgency and emergency regulation centers. Conclusion: working in rural areas demands that nurses face particularities such as isolation, difficulty of access, diverse socioeconomic conditions and specific epidemiological profiles, which influence the professional practice, making it a challenge., Objetivo: conocer los temas en evidencia en la enfermería en el territorio rural. Método: revisión integradora compuesta por seis etapas. Los datos se recolectaron de mayo a junio de2017 en las bases de datos SciELO, CUIDEN, PubMed y ScienceDirect, con el siguiente descriptor: “Rural nursing”. El análisis empleado fue el cualitativo con la elaboración de subconjuntos y temas. Resultados: de los 30 artículos analizados, el 32% abordaron la formación profesional; el 25%, acciones relacionadas con la salud colectiva; el 12%, la atención hospitalaria; el 10%, la satisfacción en el trabajo; el 7% estaban dedicados a la telesalud y el 3% de los estudios trataron dos temas: reclutamiento y permanencia de las enfermeras en el Espacio rural, educación permanente y desempeño profesional en la central de regulación de urgencias y emergencias. Conclusión: para desempeñarse profesionalmente en el territorio rural, una enfermera debe hacer frente a diversas particularidades como el aislamiento, la dificultad de acceso, condiciones socioeconómicas diversas y perfiles epidemiológicos específicos, que influyen sobre la práctica profesional, factores que la convierten en un desafío., Objetivo: conhecer os temas em evidência na enfermagem no território rural. Método: revisão integrativa composta por seis etapas. Os dados foram coletados no período de maio a julho de 2017, nas bases SciELO, CUIDEN, PubMed, ScienceDirect, com o descritor “Rural nursing”. A análise utilizada foi qualitativa com a construção de subconjuntos e tópicos. Resultados: dos 30 artigos analisados 32% abordavam a formação profissional; 25% ações relacionadas a saúde coletiva; 12% assistência hospitalar; 10% a satisfação no trabalho; 7% dedicaram a telessaúde e 3% dos estudos trataram dos temas: recrutamento e permanência das Enfermeiras no Espaço rural, educação permanente e a atuação profissional em central de regulação de urgência e emergência. Conclusão: a atuação no território rural demanda à enfermeira enfrentar particularidades como isolamento, dificuldade de acesso, condições socioeconômicas diversas e perfis epidemiológicos específicos, que influenciam a prática profissional, o que a torna um desafio.

Objective: to know the issues in evidence in rural nursing. Method: a six-stage integrative review. Data was collected from May to July 2017, in the SciELO, CUIDEN, PubMed, and ScienceDirect databases, with “Rural nursing” as descriptor. The analysis used was qualitative with the construction of subsets and topics. Results: of the 30 articles analyzed, 32% addressed professional training; 25% collective health-related practices; 12% hospital care; 10% job satisfaction; 7% were dedicated to telehealth and 3% of the studies addressed the following topics: nurses' recruitment and permanence in rural areas, continuing education, and professional practice in urgency and emergency regulation centers. Conclusion: working in rural areas demands that nurses face particularities such as isolation, difficulty of access, diverse socioeconomic conditions and specific epidemiological profiles, which influence the professional practice, making it a challenge., Objetivo: conocer los temas en evidencia en la enfermería en el territorio rural. Método: revisión integradora compuesta por seis etapas. Los datos se recolectaron de mayo a junio de2017 en las bases de datos SciELO, CUIDEN, PubMed y ScienceDirect, con el siguiente descriptor: “Rural nursing”. El análisis empleado fue el cualitativo con la elaboración de subconjuntos y temas. Resultados: de los 30 artículos analizados, el 32% abordaron la formación profesional; el 25%, acciones relacionadas con la salud colectiva; el 12%, la atención hospitalaria; el 10%, la satisfacción en el trabajo; el 7% estaban dedicados a la telesalud y el 3% de los estudios trataron dos temas: reclutamiento y permanencia de las enfermeras en el Espacio rural, educación permanente y desempeño profesional en la central de regulación de urgencias y emergencias. Conclusión: para desempeñarse profesionalmente en el territorio rural, una enfermera debe hacer frente a diversas particularidades como el aislamiento, la dificultad de acceso, condiciones socioeconómicas diversas y perfiles epidemiológicos específicos, que influyen sobre la práctica profesional, factores que la convierten en un desafío., Objetivo: conhecer os temas em evidência na enfermagem no território rural. Método: revisão integrativa composta por seis etapas. Os dados foram coletados no período de maio a julho de 2017, nas bases SciELO, CUIDEN, PubMed, ScienceDirect, com o descritor “Rural nursing”. A análise utilizada foi qualitativa com a construção de subconjuntos e tópicos. Resultados: dos 30 artigos analisados 32% abordavam a formação profissional; 25% ações relacionadas a saúde coletiva; 12% assistência hospitalar; 10% a satisfação no trabalho; 7% dedicaram a telessaúde e 3% dos estudos trataram dos temas: recrutamento e permanência das Enfermeiras no Espaço rural, educação permanente e a atuação profissional em central de regulação de urgência e emergência. Conclusão: a atuação no território rural demanda à enfermeira enfrentar particularidades como isolamento, dificuldade de acesso, condições socioeconômicas diversas e perfis epidemiológicos específicos, que influenciam a prática profissional, o que a torna um desafio.

Introduction and background The shortage of human resources in rural areas remains a crisis, especially in subSaharan Africa, affecting rural primary health centres. The purpose of this study was to identify and describe factors influencing the retention of health care workers in rural clinics, in order to develop strategies to improve retention in rural clinics. Methodology A quantitative research method and descriptive design was used in this study. The population was professional nurses and operational managers in rural clinics. Simple random sampling was used to select the clinics, the professional nurses and operational managers. The sample size were 210 professional nurses and operational managers. Only 170 professional nurses and operational managers participated in the study. Data were collected using a questionnaire, and all ethical principles were adhered to. The data was analysed using SPSS version 22.0. Results The study revealed that there are complex interconnecting factors that affect retention. It was further revealed that age is the core factor affecting retention (P= 0.001) with 19 (100%) of those aged < 30 years intending to leave rural practice. Furthermore, more than half of the respondents 118 (87.06%) were dissatisfied with the salary they earned. Only 1 (0.6%) of the respondents had a masters’ degree. Conclusion It is therefore concluded that both financial and non-financial incentives such as education, improving working conditions and relationship with colleagues needs to be incorporated in order to improve nurse retention. Key words: Retention, migration, rural health care workers, job satisfaction

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Objetivo: Conhecer o processo de formação em enfermagem rural internacional e as repercussões na formação e prática no Brasil. Métodos: Revisão integrativa composta por seis etapas. Os dados foram coletados no mês de março de 2018, nas bases PubMed, Direct Science, com o descritor “Rural nursing” e a palavra-chave “formation”, com a combinação dos operadores booleanos “AND” e “OR”. Foram elegíveis artigos dos últimos 10 anos, originais, nos idiomas: português, espanhol e inglês, coadunando aos critérios de inclusão e exclusão. Realizou-se análise qualitativa com a construção de subconjuntos e tópicos. Resultados: Totalizou-se 13 artigos abordando: graduação em enfermagem, cursos de graduação à distância; estágios curriculares em serviços de saúde rural e atividade simulada com casos de famílias rurais. Pós-graduação: estágio de pós-graduando em unidade de saúde rural, curso de prática de enfermagem avançada com ênfase no contexto rural e a necessidade de atividade de educação permanente em enfermagem rural. Conclusão: Os estudos analisados evidenciam que as estratégias de qualificação dos profissionais de saúde rural podem ser realizadas de diferentes formas, com a utilização de várias metodologias e tecnologias associadas, conforme a necessidade e disponibilidade dos profissionais, apresentando-se como um leque de possibilidades a serem discutidas e desenvolvidas pela enfermagem, para a qualificação e consolidação da prática da enfermagem rural no Brasil., Objective: To understand the formation process in international rural nursing and the repercussions on formation and practice in Brazil. Methods: Integrative review composed of six stages. Data were collected in March 2018 in PubMed and Direct Science with the descriptor ‘Rural nursing’ and the keyword ‘formation’ by combining the Boolean operators ‘AND’ and ‘OR’. Original articles from the previous ten years in in Portuguese, Spanish and English that met the inclusion criteria were eligible. Qualitative analysis was performed with the construction of subsets and topics. Results: Inclusion of 13 articles addressing: nursing undergraduate course, distance learning undergraduate courses; curricular internships in rural health services and simulated activity with cases of rural families. Post-graduation: postgraduate internship in rural health unit, advanced nursing practice (ANP) course with emphasis on the rural setting, and the need for continuing education activity in rural nursing. Conclusion: The analysis of studies demonstrated that strategies of qualification of rural health professionals can be applied in different ways, with use of several methodologies and associated technologies according to professionals’ needs and availability. A range of possibilities can be discussed and developed by nursing for the qualification and consolidation of rural nursing practice in Brazil., Objetivo: Conocer el proceso de formación en enfermería rural internacional y las repercusiones en la formación y práctica en Brasil. Métodos: Revisión integrativa compuesta por seis etapas. Los datos fueron recolectados en el mes de marzo de 2018, en las bases PubMed, Direct Science, con el descriptor “Rural” y la palabra clave “formation”, con la combinación de los operadores booleanos “AND” y “OR”. Eran artículos elegibles de los últimos 10 años, los documentos en los idiomas: portugués, español e inglés, conciliaron los criterios de inclusión y exclusión. Se realizó un análisis cualitativo con la construcción de subconjuntos y tópicos. Resultados: Un total de 13 artículos abordando: graduación en enfermería, cursos de graduación a distancia; las prácticas curriculares en servicios de salud rural y la actividad simulada con casos de familias rurales. Postgrado: etapa de postgrado en unidad de salud rural, curso de práctica de enfermería avanzada con énfasis en el contexto rural y la necesidad de actividad de educación permanente en enfermería rural. Conclusión: Los estudios analizados evidencian que las estrategias de calificación de los profesionales de salud rural pueden ser realizadas de diferentes formas, con la utilización de varias metodologías y tecnologías asociadas, según la necesidad y disponibilidad de los profesionales, presentándose como un abanico de posibilidades que podrán ser discutidas y desarrolladas por la enfermería, para la cualificación y consolidación de la práctica de la enfermería rural en Brasil.

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Few studies explore nurses’ experiences providing end-of-life care in the rural hospital setting and the implications of the rural setting on the delivery of care. The purpose of this qualitative study was to begin to address this gap. Two research questions guided this study: (a) What are the experiences of regulated nurses in providing end-of-life care in a rural hospital setting, and (b) How does the rural hospital setting influence regulated nurses’ experiences in providing end of life care? Data were collected by conducting individual interviews with rural nurses. Thematic analysis resulted in three themes: (a) end-of-life care as a relational matter, (b) an intimate affair, and (c) dying at home: hospital as home. Providing a description of how home is defined in the rural setting can inform how practical, human and professional resources are allocated and implemented for rural nurses and the communities that they provide care for.

Objetivo: Conhecer o processo de formação em enfermagem rural internacional e as repercussões na formação e prática no Brasil. Métodos: Revisão integrativa composta por seis etapas. Os dados foram coletados no mês de março de 2018, nas bases PubMed, Direct Science, com o descritor “Rural nursing” e a palavra-chave “formation”, com a combinação dos operadores booleanos “AND” e “OR”. Foram elegíveis artigos dos últimos 10 anos, originais, nos idiomas: português, espanhol e inglês, coadunando aos critérios de inclusão e exclusão. Realizou-se análise qualitativa com a construção de subconjuntos e tópicos. Resultados: Totalizou-se 13 artigos abordando: graduação em enfermagem, cursos de graduação à distância; estágios curriculares em serviços de saúde rural e atividade simulada com casos de famílias rurais. Pós-graduação: estágio de pós-graduando em unidade de saúde rural, curso de prática de enfermagem avançada com ênfase no contexto rural e a necessidade de atividade de educação permanente em enfermagem rural. Conclusão: Os estudos analisados evidenciam que as estratégias de qualificação dos profissionais de saúde rural podem ser realizadas de diferentes formas, com a utilização de várias metodologias e tecnologias associadas, conforme a necessidade e disponibilidade dos profissionais, apresentando-se como um leque de possibilidades a serem discutidas e desenvolvidas pela enfermagem, para a qualificação e consolidação da prática da enfermagem rural no Brasil., Objective: To understand the formation process in international rural nursing and the repercussions on formation and practice in Brazil. Methods: Integrative review composed of six stages. Data were collected in March 2018 in PubMed and Direct Science with the descriptor ‘Rural nursing’ and the keyword ‘formation’ by combining the Boolean operators ‘AND’ and ‘OR’. Original articles from the previous ten years in in Portuguese, Spanish and English that met the inclusion criteria were eligible. Qualitative analysis was performed with the construction of subsets and topics. Results: Inclusion of 13 articles addressing: nursing undergraduate course, distance learning undergraduate courses; curricular internships in rural health services and simulated activity with cases of rural families. Post-graduation: postgraduate internship in rural health unit, advanced nursing practice (ANP) course with emphasis on the rural setting, and the need for continuing education activity in rural nursing. Conclusion: The analysis of studies demonstrated that strategies of qualification of rural health professionals can be applied in different ways, with use of several methodologies and associated technologies according to professionals’ needs and availability. A range of possibilities can be discussed and developed by nursing for the qualification and consolidation of rural nursing practice in Brazil., Objetivo: Conocer el proceso de formación en enfermería rural internacional y las repercusiones en la formación y práctica en Brasil. Métodos: Revisión integrativa compuesta por seis etapas. Los datos fueron recolectados en el mes de marzo de 2018, en las bases PubMed, Direct Science, con el descriptor “Rural” y la palabra clave “formation”, con la combinación de los operadores booleanos “AND” y “OR”. Eran artículos elegibles de los últimos 10 años, los documentos en los idiomas: portugués, español e inglés, conciliaron los criterios de inclusión y exclusión. Se realizó un análisis cualitativo con la construcción de subconjuntos y tópicos. Resultados: Un total de 13 artículos abordando: graduación en enfermería, cursos de graduación a distancia; las prácticas curriculares en servicios de salud rural y la actividad simulada con casos de familias rurales. Postgrado: etapa de postgrado en unidad de salud rural, curso de práctica de enfermería avanzada con énfasis en el contexto rural y la necesidad de actividad de educación permanente en enfermería rural. Conclusión: Los estudios analizados evidencian que las estrategias de calificación de los profesionales de salud rural pueden ser realizadas de diferentes formas, con la utilización de varias metodologías y tecnologías asociadas, según la necesidad y disponibilidad de los profesionales, presentándose como un abanico de posibilidades que podrán ser discutidas y desarrolladas por la enfermería, para la cualificación y consolidación de la práctica de la enfermería rural en Brasil.

Introduction and background The shortage of human resources in rural areas remains a crisis, especially in subSaharan Africa, affecting rural primary health centres. The purpose of this study was to identify and describe factors influencing the retention of health care workers in rural clinics, in order to develop strategies to improve retention in rural clinics. Methodology A quantitative research method and descriptive design was used in this study. The population was professional nurses and operational managers in rural clinics. Simple random sampling was used to select the clinics, the professional nurses and operational managers. The sample size were 210 professional nurses and operational managers. Only 170 professional nurses and operational managers participated in the study. Data were collected using a questionnaire, and all ethical principles were adhered to. The data was analysed using SPSS version 22.0. Results The study revealed that there are complex interconnecting factors that affect retention. It was further revealed that age is the core factor affecting retention (P= 0.001) with 19 (100%) of those aged < 30 years intending to leave rural practice. Furthermore, more than half of the respondents 118 (87.06%) were dissatisfied with the salary they earned. Only 1 (0.6%) of the respondents had a masters’ degree. Conclusion It is therefore concluded that both financial and non-financial incentives such as education, improving working conditions and relationship with colleagues needs to be incorporated in order to improve nurse retention. Key words: Retention, migration, rural health care workers, job satisfaction

Nurse practitioners are an effective and appropriate health workforce for delivering health services to underserved and rural populations. Since 2001, New Zealand has been registering nurse practitioners through a robust educational, regulatory, and legislative framework, and from 2014, all nurse practitioners are authorised prescribers. However, the numbers of nurse practitioners working in rural primary health care have been slow to materialise. Despite an ageing demographic, the increasing prevalence of long term conditions, ongoing health inequalities, and a declining rural medical workforce, there remains a persistence to pursue the general practitioner-led model of care. The purpose of this study was to critically examine the work required to establish nurse practitioner services in rural primary health care in New Zealand. Institutional ethnography, developed by Dorothy Smith, provided the overall approach to the inquiry. The activities and experiences of people in local settings are textually organised by the institutional ruling relations. This inquiry explored the work and experiences that nurses undertook on their journey to become nurse practitioners and deliver services in rural primary health care, and how these were institutionally shaped and coordinated. Interviews were initially conducted with nurse practitioners and nurse practitioner candidates as the primary informants. The interviews were analysed using a mapping technique to identify text-based work processes and show connections, tensions, and contradictions with authoritative or ruling texts. Further data was collected through secondary informant interviews and the tracing and identification of texts. The findings revealed that there were multiple texts and discourses being enacted locally, which facilitated or hampered their work to become nurse practitioners. The ongoing institutional domination of medicine retained general practitioner-led primary care, despite policy and nursing professio

Purpose: The purpose of this project was to conduct an educational workshop among ICU nurses working in rural areas, to reduce risk of compassion fatigue. Background: Compassion fatigue is a job-related hazard unique to professionals in caring professions such as nursing. Rural ICU nurses represent a population that may encounter unique triggers for the risk of compassion fatigue due to professional isolation, less resources and more risk of knowing the patient as a community member. A review of literature reveals limited research related to compassion fatigue development in rural ICU nurses. Method: Two educational workshops were conducted among rural ICU nurses (N=3). Workshop content included discussion about symptoms, triggers, and outcomes of compassion fatigue, as well as positive coping strategies. Participants journaled physical and emotional responses to situations such as ethical or moral dilemmas, boundary issues, and aspects of self-care. Each workshop included time to discuss the educational content and participant experiences; the resulting narratives were analyzed for commonalities. Findings: Universally, burnout was viewed as inherent to the profession. All participants recounted past traumatic patient encounters that preoccupies their thinking when in similar situations. Symptoms identified as compassion fatigue included chronic, constant, generalized pain, symptoms of depression, isolation, withdrawal and lack of interest in enjoyable activities. Triggers were prolonged patient hospitalizations due to lack of resources, lack of supporting services, lack of leadership support, unexpected patient loss, witnessing patient trauma and grief, caring for patients who did not seem to really need ICU, social situations surrounding patients 10 and floating to different departments. Increased alcohol intake, sarcasm, and venting were the most reported mitigation strategies among participants. Implications: Compassion fatigue negatively impacts the lives of ru

BACKGROUND: Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. AIMS AND OBJECTIVES: This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. DESIGN: An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. METHOD: A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. FINDINGS: Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. CONCLUSIONS: Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. IMPLICATIONS FOR PRACTICE: Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers.

BACKGROUND: Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. AIMS AND OBJECTIVES: This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. DESIGN: An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. METHOD: A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. FINDINGS: Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. CONCLUSIONS: Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. IMPLICATIONS FOR PRACTICE: Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers.

BACKGROUND: Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. AIMS AND OBJECTIVES: This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. DESIGN: An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. METHOD: A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. FINDINGS: Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. CONCLUSIONS: Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. IMPLICATIONS FOR PRACTICE: Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers.

BACKGROUND: Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. AIMS AND OBJECTIVES: This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. DESIGN: An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. METHOD: A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. FINDINGS: Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. CONCLUSIONS: Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. IMPLICATIONS FOR PRACTICE: Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers.

BACKGROUND: Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. AIMS AND OBJECTIVES: This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. DESIGN: An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. METHOD: A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. FINDINGS: Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. CONCLUSIONS: Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. IMPLICATIONS FOR PRACTICE: Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers.

BACKGROUND: Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. AIMS AND OBJECTIVES: This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. DESIGN: An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. METHOD: A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. FINDINGS: Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. CONCLUSIONS: Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. IMPLICATIONS FOR PRACTICE: Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers.

While the use of simulation is gaining popularity as an educational and training method, little is known about its utility in supporting field research activities. To address this gap, the physical, psychological, and conceptual dimensions of a full-scale simulated multi-bed rural nursing unit that became the ‘field’ for a rural nursing practice study is presented. The advantages of using simulation in this manner are that it: 1) allows processes to unfold in a controlled but natural fashion; 2) supports the exploration of complex phenomena; 3) and provides comparable data sets for analysis. Items to consider prior to using a simulation environment are also discussed.

While the use of simulation is gaining popularity as an educational and training method, little is known about its utility in supporting field research activities. To address this gap, the physical, psychological, and conceptual dimensions of a full-scale simulated multi-bed rural nursing unit that became the ‘field’ for a rural nursing practice study is presented. The advantages of using simulation in this manner are that it: 1) allows processes to unfold in a controlled but natural fashion; 2) supports the exploration of complex phenomena; 3) and provides comparable data sets for analysis. Items to consider prior to using a simulation environment are also discussed.

While the use of simulation is gaining popularity as an educational and training method, little is known about its utility in supporting field research activities. To address this gap, the physical, psychological, and conceptual dimensions of a full-scale simulated multi-bed rural nursing unit that became the ‘field’ for a rural nursing practice study is presented. The advantages of using simulation in this manner are that it: 1) allows processes to unfold in a controlled but natural fashion; 2) supports the exploration of complex phenomena; 3) and provides comparable data sets for analysis. Items to consider prior to using a simulation environment are also discussed.

While the use of simulation is gaining popularity as an educational and training method, little is known about its utility in supporting field research activities. To address this gap, the physical, psychological, and conceptual dimensions of a full-scale simulated multi-bed rural nursing unit that became the ‘field’ for a rural nursing practice study is presented. The advantages of using simulation in this manner are that it: 1) allows processes to unfold in a controlled but natural fashion; 2) supports the exploration of complex phenomena; 3) and provides comparable data sets for analysis. Items to consider prior to using a simulation environment are also discussed.

While the use of simulation is gaining popularity as an educational and training method, little is known about its utility in supporting field research activities. To address this gap, the physical, psychological, and conceptual dimensions of a full-scale simulated multi-bed rural nursing unit that became the ‘field’ for a rural nursing practice study is presented. The advantages of using simulation in this manner are that it: 1) allows processes to unfold in a controlled but natural fashion; 2) supports the exploration of complex phenomena; 3) and provides comparable data sets for analysis. Items to consider prior to using a simulation environment are also discussed.

While the use of simulation is gaining popularity as an educational and training method, little is known about its utility in supporting field research activities. To address this gap, the physical, psychological, and conceptual dimensions of a full-scale simulated multi-bed rural nursing unit that became the ‘field’ for a rural nursing practice study is presented. The advantages of using simulation in this manner are that it: 1) allows processes to unfold in a controlled but natural fashion; 2) supports the exploration of complex phenomena; 3) and provides comparable data sets for analysis. Items to consider prior to using a simulation environment are also discussed.

While the use of simulation is gaining popularity as an educational and training method, little is known about its utility in supporting field research activities. To address this gap, the physical, psychological, and conceptual dimensions of a full-scale simulated multi-bed rural nursing unit that became the ‘field’ for a rural nursing practice study is presented. The advantages of using simulation in this manner are that it: 1) allows processes to unfold in a controlled but natural fashion; 2) supports the exploration of complex phenomena; 3) and provides comparable data sets for analysis. Items to consider prior to using a simulation environment are also discussed.

While the use of simulation is gaining popularity as an educational and training method, little is known about its utility in supporting field research activities. To address this gap, the physical, psychological, and conceptual dimensions of a full-scale simulated multi-bed rural nursing unit that became the ‘field’ for a rural nursing practice study is presented. The advantages of using simulation in this manner are that it: 1) allows processes to unfold in a controlled but natural fashion; 2) supports the exploration of complex phenomena; 3) and provides comparable data sets for analysis. Items to consider prior to using a simulation environment are also discussed.