title: What stresses remote area nurses? Current knowledge and future action.
abstract: OBJECTIVE
  Review and synthesise the literature identifying the stresses experienced by remote area nurses (RANs). Identify interventions implemented to address identified stresses. Explore the use of the job demands-resources (JD-R) model.
  
  
  METHODS
  A comprehensive literature review was conducted using the meta-databases Ovid and Informit.
  
  
  METHODS
  Remote Australian primary health care centres.
  
  
  RESULTS
  The reported demands experienced by RANs can be grouped into four themes: (i) the remote context; (ii) workload and extended scope of practice; (iii) poor management; and (iv) violence in the workplace and community. In this high-demand, low-resource context, the JD-R model of occupational stress is particularly pertinent to examining occupational stress among RANs. The demands on RANs, such as the isolated geographical context, are immutable. However, there are key areas where resources can be enhanced to better meet the high level of need. These are: (i) adequate and appropriate education, training and orientation; (ii) appropriate funding of remote health services; and (iii) improved management practices and systems.
  
  
  CONCLUSIONS
  There is a lack of empirical evidence relating to stresses experienced by RANs. The literature identifies some of the stresses experienced by RANs as unique to the remote context, while some are related to high demands coupled with a deficit of appropriate resources. Use of models, such as the JD-R model of occupational stress, might assist in identifying key areas where resources can be enhanced to better meet the high level of need and reduce RANs' levels of stress.
authors: Centre for Remote Health, Flinders University and Charles Darwin University, PO Box 4066, Alice Springs, Northern Territory, 0871, Australia. sue.lenthall@flinders.edu.au
authors: Sue
authors: S
authors: Lenthall
authors: John
authors: J
authors: Wakerman
authors: Tess
authors: T
authors: Opie
authors: Maureen
authors: M
authors: Dollard
authors: Sandra
authors: S
authors: Dunn
authors: Sabina
authors: S
authors: Knight
authors: Martha
authors: M
authors: Macleod
authors: Colin
authors: C
authors: Watson
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D006801:Humans; D008507:Medically Underserved Area; D009726:Nurses / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D013315:Stress, Psychological / Q000209:etiology*; D000078329:Workforce