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Biomedical subjects

Ron Janes

Publications and source records attributed to Ron Janes.

7 recordsLinked to original sources
PubMed2005

Rural New Zealand health professionals' perceived barriers to greater use of the internet for learning.

INTRODUCTION: The purpose of this research was to investigate rural North Island (New Zealand) health professionals' attitudes and perceived barriers to using the internet for ongoing professional learning. METHODS: A cross-sectional postal survey of all rural North Island GPs, practice nurses and pharmacists was conducted in mid-2003. The questionnaire contained both quantitative and qualitative questions. The transcripts from two open questions requiring written answers were analysed for emergent themes, which are reported here. The first open question asked: 'Do you have any comments on the questionnaire, learning, computers or the Internet?' The second open question asked those who had taken a distance-learning course using the internet to list positive and negative aspects of their course, and suggest improvements. RESULTS: Out of 735 rural North Island health professionals surveyed, 430 returned useable questionnaires (a response rate of 59%). Of these, 137 answered the question asking for comments on learning, computers and the internet. Twenty-eight individuals who had completed a distance-learning course using the internet, provided written responses to the second question. Multiple barriers to greater use of the internet were identified. They included lack of access to computers, poor availability of broadband (fast) internet access, lack of IT skills/knowledge, lack of time, concerns about IT costs and database security, difficulty finding quality information, lack of time, energy or motivation to learn new skills, competing priorities (eg family), and a preference for learning modalities which include more social interaction. Individuals also stated that rural health professionals needed to engage the technology, because it provided rapid, flexible access from home or work to a significant health information resource, and would save money and travelling time to urban-based education. CONCLUSIONS: In mid-2003, there were multiple barriers to rural North Island health professionals making greater use of the internet for learning. Now that access to broadband internet is available in all rural towns in New Zealand, there is a clear need to address the other identified barriers, especially the self-reported lack of IT skills, which are preventing many in the rural health workforce from gaining maximum advantage from both computers and the internet.

Attitude of Health Personnel↗
PubMed2005

Few rural general practitioners use the Internet frequently in regard to patient care.

AIMS: To benchmark North Island rural general practitioner (GP) access to computers and the Internet, both at work and home, and assess whether rural GPs are using the Internet in regard to patient care. METHODS: Cross-sectional postal survey of all North Island rural GPs in mid-2003. RESULTS: 175 of 289 GPs (60.6%) returned useable questionnaires. Most (89.0%) reported computer availability at work when consulting, but even more had access to a computer at home (97.1%, p<0.01). Access to the Internet was also lower at work (68.6%) than at home (98.8%, p<0.01). Fewer GPs (p<0.05) reported ever using the Internet at work in regard to patients (56.5%) than at home (71.9%). Less than 10% of all GPs used the Internet three or more times a week at work (6.9%) or home (8.6%) in regard to patients. Of those with Internet access at work, 27.0% had broadband (fast Internet) access. Predictors of having (versus not having) work Internet access were computer availability in consultations (p=0.04). CONCLUSIONS: Few North Island rural GPs use the Internet frequently in regard to patient care, despite increasing access to computers and the Internet, both at work and home.

Computer Literacy↗
PubMed2005

New Zealand rural general practitioners 1999 survey part 4: analysis of specific sub-groups.

AIMS: To compare and contrast the demographics, working characteristics, and computer usage of 5 sub-groups of rural general practitioners (GPs) using data from the New Zealand Rural GPs 1999 Survey. METHODS: Anonymous postal questionnaires were mailed out to 559 rural and semi-rural GPs in November 1999. RESULTS: Of the 417 completed questionnaires returned (response rate = 75%), 338 were from GPs scoring >or= 35 points on the Rural Ranking Scale (RRS), and these 'rural' GPs formed the study group. Analysis of sub-groups showed that a significantly higher percentage of younger doctors (<45 years old) were vocationally trained, doing accreditation, working in group practices, or working part-time. A higher percentage of the more isolated rural GPs (RRS >or= 55) were working on the South Island, in solo practice, in areas with 3 or less GPs, working as rural hospital doctors, or doing intra-partum obstetrics. Of the vocationally trained GPs, a higher percentage expected to be in their current practice in 3 years, were doing accreditation or re-accreditation, were members of an Independent Practitioners' Association (IPA), or had email at the surgery. Compared to overseas graduates, New Zealand graduates were more likely to have been working in NZ rural general practice for >or= 10 years. CONCLUSIONS: The trend of younger doctors wanting to work part-time, in group practices, and not own their practice, has significant implications for the rural workforce shortage - especially as older, predominantly male rural GPs retire. This may be especially problematic for the South Island, where rural isolation appears to be a greater problem.

Accreditation↗
PubMed2004

Lifestyle screening: development of an acceptable multi-item general practice tool.

AIMS: To develop a short screening tool for lifestyle and mental-health risk factors that adults can self-administer, and to determine acceptability and feasibility of use of this tool in primary care settings. METHODS: The multi-item tool was designed to screen patients in rural and urban New Zealand general practices for smoking, alcohol and drug misuse, problem gambling, depression, anxiety, abuse, anger, sedentary lifestyle, and weight issues. Patients were offered help for identified risk factors. Fifty consecutive adult patients per practice (n=2,543) were recruited to participate from 20 randomly-selected urban general practitioners; 20 general practice nurses and 11 rural general practitioners. RESULTS: Patients came from diverse ethnic, geographical, and socioeconomic backgrounds. The sample prevalence of positive responses identified ranged from 2.8% (gambling) to 42.7% (depression). The number of patients requesting immediate assistance with these responses (0.5 to 13.5%) did not overwhelm clinicians. The tool was well accepted by patients, with few objections to specific questions (0.1-0.8%). Most practitioners stated they will use the screening tool once available. CONCLUSIONS: Screening for lifestyle and mental health risk factors is becoming increasingly important in primary health care. This screening tool was acceptable to patients and was not considered overly burdensome by practitioners.

Adult↗
PubMed2004

New Zealand Rural General Practitioners 1999 Survey--Part 2: gender issues.

AIMS: To compare and contrast the demographic and working characteristics of female and male rural general practitioners (GPs) in New Zealand, and to highlight issues specific to female rural GPs. METHODS: Anonymous postal questionnaires were sent to 559 rural GPs in November 1999. RESULTS: Completed questionnaires were returned by 417 rural GPs (75%). Of the 338 rural GPs who fulfilled the inclusion criteria, 93 (28%) were female. Eighty percent of female rural GPs were younger than 45 years of age compared with 53% of male rural GPs (p < 0.01). Women were less likely to be in full-time practice (45% vs 90%) or own their own practice (63% vs 83%) (p < 0.01). Concerns about locum scarcities, overwork, excessive on-call, bureaucratic demands, and GP shortages were equally important to both genders--while issues of security, accreditation, and combining work and family were mentioned by female GPs. CONCLUSIONS: Most of the quantitative gender differences could be explained by the female rural GPs being younger (80% in their child-bearing years). Recognising and addressing the specific difficulties faced by part-time female rural GPs, such as by providing more flexible work options, would create a more favourable environment, likely to retain and recruit more women.

Adult↗
PubMed2004

New Zealand Rural General Practitioners 1999 Survey--Part 3: rural general practitioners speak out.

AIMS: To describe themes about rural general practice from the written responses in the 'New Zealand Rural GPs 1999 Survey'. METHODS: A postal questionnaire surveyed all rural general practitioners (GPs) in New Zealand (NZ), who were asked for comments or suggestions about rural general practice. These responses were explored for themes about rural practice. RESULTS: Of 338 completed questionnaires (response rate--75%), 138 contained written responses. The positive themes of rural general practice included: forming strong relationships with patients and the community, and practising the full spectrum of general practice, including emergency medicine. The negative themes included: heavy workloads, frequent on-call, inability to get time off, and feeling undervalued and underpaid by funders. Retention solutions included: better pay to adequately reflect the skills and workload, more salaried positions with guaranteed working conditions, and better rural continuing education. Recruitment solutions included: reducing barriers for foreign doctors to enter NZ, establishing a rural GP career pathway, and increasing the number of rural registrars. CONCLUSIONS: This study highlights both the positive and negative features of NZ rural general practice, and makes it clear that further concerted and sustained action is required to improve retention and recruitment. The GPs' written comments provide detail on the challenges facing rural general practice, as well as informed comment about potential solutions.

Attitude of Health Personnel↗