Department of Rural Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Docker St, Wangaratta, VIC 3677, Australia.
Int J Environ Res Public Health. 2020 Apr 14;17(8):2698. doi: 10.3390/ijerph17082698.
People living in rural places face unique challenges due to their geographic isolation and often experience poorer health outcomes compared to people living in major cities. The struggle to attract and retain an adequately-sized and skilled health workforce is a major contributing factor to these health inequities. Health professionals' decisions to stay or leave a rural position are multifaceted involving personal, organisational, social and spatial aspects. While current rural health workforce frameworks/models recognise the multidimensional and interrelated influences on retention, they are often highly complex and do not easily support the development of strategic actions. An accessible evidence-informed framework that addresses the complexity but presents the evidence in a manner that is straightforward and supports the development of targeted evidence- and place-informed retention strategies is required. The 'Whole-of-Person Retention Improvement Framework' (WoP-RIF) has three domains: Workplace/Organisational, Role/Career and Community/Place. The necessary pre-conditions for improving retention through strengthening job and personal satisfaction levels are set out under each domain. The WoP-RIF offers a person-centred, holistic structure that encourages whole-of-community responses that address individual and workforce level needs. It is a significant response to, and resource for, addressing avoidable rural health workforce turnover that rural health services and communities can harness in-place.
由于地理位置偏远，农村地区的居民面临着独特的挑战，其健康状况往往不如大城市的居民。吸引和留住足够数量且技能熟练的卫生工作队伍是造成这些健康不平等的一个主要因素。卫生专业人员选择留在或离开农村岗位的决定是多方面的，涉及个人、组织、社会和空间等方面。虽然现有的农村卫生人力框架/模式认识到了影响留用的多维度和相互关联的因素，但它们通常非常复杂，并且不容易支持制定战略行动。需要一个易于理解的、以证据为基础的框架，该框架既能解决复杂性问题，又能以简单明了的方式呈现证据，并支持制定有针对性的、基于证据和地点的留用策略。“全人保留改进框架”（Whole-of-Person Retention Improvement Framework，WoP-RIF）有三个领域：工作场所/组织、角色/职业和社区/地点。在每个领域下都列出了通过加强工作和个人满意度来提高保留率的必要前提条件。WoP-RIF 提供了一个以人为本的整体结构，鼓励整个社区做出响应，以满足个人和劳动力层面的需求。这是对可避免的农村卫生人力流失的一个重大应对措施，也是农村卫生服务和社区可以利用的资源。
