The planning of rural health research: rurality and rural population issues.

Rurality and rural population issues require special consideration when planning both qualitative and quantitative health research in rural areas. The objective of this article was to explore the issues that require attention when planning the research. This is the first of two articles and focus on issues that require consideration when undertaking rural health research. The diversity of study populations, the feasibility of a research topic, the selection of a research team, and the cultural traditions of Indigenous communities, are all aspects of rural health research planning that require attention. Procedures such as identifying the characteristics of the population, the selection of measures of rurality appropriate for the research topic, the use of local liaison persons, decisions on the use of 'insider' or 'outsider' researchers, and the identification of skills resources available, increase the quality of the research outcomes. These issues are relevant to both qualitative and quantitative research. Procedures are available to address issues of particular concern in developing appropriate methods for rural health research. While we have concentrated on Australian issues and solutions, rural localities in other countries may face similar issues. Attention to rurality and rural situations when planning rural health research, results in studies that support the continued improvement of health in rural communities.

The conducting and reporting of rural health research: rurality and rural population issues.

Rurality and rural population issues require consideration when conducting and reporting on rural health research. A first article focused on the planning stage of the research. The objective of this article is to explore conducting and reporting issues that require attention when undertaking rural health research. The privacy of participants, the collection of data, the cultural traditions of Indigenous communities, the dissemination of results, and giving something back to the community, are all aspects of conducting and reporting rural health research that require attention. Procedures such as identifying the characteristics of the population, attention to safety issues when collecting data, the use of local liaison persons and acknowledging the ownership of intellectual property, increase the quality of the research outcomes. They are issues that are relevant to both qualitative and quantitative research methods. Procedures are available to address issues of particular concern in developing appropriate methods for rural health research. While we have concentrated on Australian issues, and possible solutions, rural localities in many other countries may face similar issues. In any rural setting, paying attention to issues that may affect the conducting and reporting of rural health research will hopefully result in studies that support the continued improvement of health in rural communities.

Disclosure of CAM use to medical practitioners: a review of qualitative and quantitative studies.

BACKGROUND: Many people use complementary or alternative medicine (CAM). It is estimated that over 50% of patients that require health care use CAM either in conjunction with, or separate from, conventional health care. Despite the popular use of CAM, patients do not always inform their conventional medicine health carers of their CAM use. The medical practitioner is in most cases the first health care professional a person contacts concerning a health care matter, and needs to have a full history of a health problem to understand and provide optimum care. This literature review aims to provide an understanding of the degree to which patients disclose their use of CAM to their medical practitioners, and their reasons for not doing so. METHOD: A comprehensive literature search identified 12 studies published between 1993 and 2002 that examined what percentage of consumers did not disclose to their medical practitioners their use of CAM, and their reasons for not doing so. RESULTS: The rate of non-disclosure of those using CAM is as high as 77% in some studies. The main reasons patients provided for not disclosing their use of CAM to their medical practitioners were concerns about a negative response by the practitioners, the belief that the practitioner did not need to know about their CAM use, and the fact that the practitioner did not ask. DISCUSSION: The pre-conceptions patients have that influence their non-disclosure may be based on three issues. First, beliefs and concerns that influence their decision-making, second personal experiences in their consultations with medical practitioners, and third, the desire for more control over their health care. Medical practitioners need to acknowledge the concerns and beliefs of patients in making their health care decisions, and work with patients so that the use of CAM is acknowledged and the patients' needs, beliefs and concerns respected.

Echidna: a Web-based community information database to assist students undertaking rural clinical placements.

The number of health-sciences students who spend time training in rural areas is increasing. Students undertaking rural placements have identified the need to be fully informed about the rural areas in which they are to be placed. To address this need, Echidna, a Web-based database containing rural-community information has been developed. The website brings fragmented information together in one easily navigable location for quick and accurate searching. Information provided in the website includes demographic data, health and community services information and relevant links. This paper examines the history of Echidna's development, data inclusion and data maintenance issues and discusses how students from medicine, nursing and other health disciplines, as well as other health professionals and organisations benefit from the resource.

Rural health resource databases: a little nurturing goes a long way.

Access to rural health research information together with the type and availability of educational resources in rural areas, are important to rural health care providers, community members, researchers, students, planners and policy makers. The Rural Health Research Register (RHRR) focuses on current and recent research activity being undertaken in Australia in the field of rural health, while the Health Education Rural Remote Resources Database (HERRD) focuses on education courses and resources relevant to the practice and professional development of rural and remote health professionals throughout Australia. Early versions of these databases were established between 1992 and 1997, and in the period 1998-2001 both information resources were systematically updated through targeted promotion, registrations and the creation of web-accessible search facilities. They continue to be maintained and updated. Detailed information is available by searching the RHRR and HERRD databases via the web or by contacting the relevant coordinator. This article examines some of the issues in developing and maintaining these resources and demonstrates the usefulness of their contents to rural healthcare workers.