Julie A. George

Bio: Julie A. George is an academic researcher from University of Western Ontario. The author has contributed to research in topics: Population & Focus group. The author has an hindex of 1, co-authored 1 publications receiving 62 citations.

Determinants of Rural Women's Health: A Qualitative Study in Southwest Ontario

Abstract: Context The influences of gender and geography are increasingly being acknowledged as central to a comprehensive understanding of health. Since little research on rural women's health has been conducted, an in-depth qualitative approach is necessary to gain a better initial understanding of this population. Purpose To explore the determinants of health and their influence on rural women's health. Methods From November 2004 to September 2005, 9 focus groups and 3 individual interviews were conducted in 7 rural southwestern Ontario communities. Sixty-five rural residents aged 26 years and older participated in the study. Semi-structured interview questions were used to elicit participants' perceptions regarding determinants of rural women's health. Findings Four Health Canada determinants (employment, gender, health services, and social environments) and 3 new determinants (rural change, rural culture, and rural pride) emerged as key to rural women's health. Conclusions Although health determinants affect both urban and rural people, this qualitative study revealed that rural women experience health determinants in unique ways and that rural residents may indeed have determinants of their health that are particular to them. More research is needed to explore the nature and effects of determinants of health for rural residents in general, and rural women in particular.

Farmwomen's emotional geographies of care: a view from rural Ontario

Abstract: This article contributes to geographies of rural women's health by investigating farmwomen's perceptions of their caring roles and responsibilities, which are crucial to the wellbeing and sustainability of rural people and their communities. Featuring a thematic analysis of interviews and a focus group with farmwomen from Ontario, Canada, the research examines farms and farming as unique places and spaces of care. Informed by the literature on emotional geographies, the article examines how care is situated and performed through farmwomen's negotiation of multiple, overlapping identities and how these are embodied and affective in emotional work. The findings not only confirm the paramount role of women in rural care, they demonstrate the interdependence of family, community and work as central to the challenges of rural women's health. The article argues that the link between health and productivity on the farm is crucial to understanding farmwomen's caring, and highlights the paradox that their emotiona...

When Self-Presentation Trumps Access: Why Older Adults with Low Vision Go without Low Vision Services

Abstract: Reasons were sought for low-vision service nonuse in a group of Canadian seniors with self-reported low vision. Audio-recorded semistructured interviews were completed with 34 seniors with low vision: age range (70 to 94 years; mean: 82 years); 16 urban dwellers (12 women); 18 rural dwellers (14 women). Qualitative content analysis and template analytic techniques were applied to transcriptions. Informant nonuse of low-vision services involved: insufficient knowledge, managing for now, and practitioner behavior (inadequate rehabilitation education and management). Underlying seniors’ attitudes that shaped their self-presentation and service nonuse included a strong need for independence, a contextualization of vision loss relative to other losses, and an acceptance of vision loss in life. Service delivery strategies should consider not only knowledge access and healthcare practitioner behavior but also senior self-presentation strategies (e.g., viewing aids as counterproductive to independence). Subtle rural-urban attitudinal differences may further delay access for rural seniors; further research is advised.

The Association between Rural-Urban Continuum, Maternal Education and Adverse Birth Outcomes in Quebec, Canada.

Abstract: Context Rural relative to urban area and low socioeconomic status (SES) are associated with adverse birth outcomes. Whether a graded association of increasing magnitude is present across the urban-rural continuum, accounting for SES, is unclear. We examined the association between rural-urban continuum, SES and adverse birth outcomes. Methods Singleton births from 1999 to 2003 (n = 356,147) were linked to Quebec municipalities ranked on a continuum of 3 urban and 4 rural areas based on population and economic base. Maternal education was used to represent SES. Odds ratios (OR) were calculated for preterm birth (PTB), low birth weight (LBW), and small-for-gestational-age (SGA) birth, accounting for municipality and individual-level covariates. We used stratified analyses to examine interaction between SES and rural-urban continuum. Findings Relative to metropolitan area residence, living in small urban or rural areas was associated with adverse birth outcomes. Living in rural areas was associated with SGA birth (OR 1.11, 95% CI 1.05-1.17) and LBW (OR 1.15, 95% CI 1.05-1.26), and living in small urban areas was associated with PTB (OR 1.14, 95% CI 1.08-1.20). Upon stratification by education, living in remote rural relative to metropolitan areas was associated with adverse birth outcomes among university educated mothers only, and living in small urban areas was associated with adverse birth outcomes among mothers with lesser but not higher education. An SES gradient was present in all rural-urban areas, particularly for SGA birth. Conclusion Differences in perinatal health exist across the rural-urban continuum, and maternal education has a modifying influence.

What does quality care mean to nurses in rural hospitals

Abstract: baernholdt m., jennings b.m., merwin e. & thornlow d. (2010) What does quality care mean to nurses in rural hospitals? Journal of Advanced Nursing 66(6), 1346–1355. Abstract Title. What does quality care mean to nurses in rural hospitals? Aim. This paper is a report of a study conducted to answer the question: ‘How do rural nurses and their chief nursing officers define quality care?’ Background. Established indicators of quality care were developed primarily in urban hospitals. Rural hospitals and their environments differ from urban settings, suggesting that there might be differences in how quality care is defined. This has measurement implications. Methods. Focus groups with staff nurses and interviews with chief nursing officers were conducted in 2006 at four rural hospitals in the South-Eastern United States of America. Data were analysed using conventional content analysis. Findings. The staff nurse and chief nursing officer data were analysed separately and then compared, exposing two major themes: ‘Patients are what matter most’ and ‘Community connectedness is both a help and a hindrance’. Along with conveying that patients were the utmost priority and all care was patient-focused, the first theme included established indicators of quality such as falls, pressure ulcers, infection rates, readmission rates, and lengths of stay. A new discovery in this theme was a need for an indicator relevant for rural settings: transfer time to larger hospitals. The second theme, Community Connectedness, is unique to rural settings, exemplifying the rural culture. The community and hospital converge into a family of sorts, creating expectations for quality care by both patients and staff that are not typically found in urban settings and larger hospitals. Conclusion. Established quality indicators are appropriate for rural hospitals, but additional indicators need to be developed. These must include transfer times to larger facilities and the culture of the community.