title: Interventions for supporting nurse retention in rural and remote areas: an umbrella review.
abstract: BACKGROUND
  Retention of nursing staff is a growing concern in many countries, especially in rural, remote or isolated regions, where it has major consequences on the accessibility of health services.
  
  
  OBJECTIVE
  This umbrella review aims to synthesize the current evidence on the effectiveness of interventions to promote nurse retention in rural or remote areas, and to present a taxonomy of potential strategies to improve nurse retention in those regions.
  
  
  METHODS
  We conducted an overview of systematic reviews, including the following steps: exploring scientific literature through predetermined criteria and extracting relevant information by two independents reviewers. We used the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) criteria in order to assess the quality of the reports.
  
  
  RESULTS
  Of 517 screened publications, we included five reviews. Two reviews showed that financial-incentive programs have substantial evidence to improve the distribution of human resources for health. The other three reviews highlighted supportive relationships in nursing, information and communication technologies support and rural health career pathways as factors influencing nurse retention in rural and remote areas. Overall, the quality of the reviews was acceptable.
  
  
  CONCLUSIONS
  This overview provides a guide to orient future rural and remote nurse retention interventions. We distinguish four broad types of interventions: education and continuous professional development interventions, regulatory interventions, financial incentives, and personal and professional support. More knowledge is needed regarding the effectiveness of specific strategies to address the factors known to contribute to nurse retention in rural and remote areas. In order to ensure knowledge translation, retention strategies should be rigorously evaluated using appropriate designs.
authors.affiliation: Hôpital St-François d'Assise, Research Center of the Centre Hospitalier Universitaire de Québec, 10 rue de l'Espinay, D6-727, G1L 3L5, Québec, QC, Canada. marie-pierre.gagnon@fsi.ulaval.ca.
authors.forename: Gisèle
authors.initials: G
authors.lastname: Mbemba
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gagnon
authors.forename: Guy
authors.initials: G
authors.lastname: Paré
authors.forename: José
authors.initials: J
authors.lastname: Côté
mesh_terms: D006801:Humans; D002321:Career Choice; D002322:Career Mobility; D004509:Education, Nursing, Continuing; D007588:Job Satisfaction; D009042:Motivation; D009740:Nursing Staff; D019035:Rural Health Services; D012456:Salaries and Fringe Benefits; D000078329:Workforce; D000078202:Systematic Reviews as Topic
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