Acceptance of Nurse Practitioners and Physician Assistants in Meeting the Perceived Needs of Rural Communities

Abstract

Nurse practitioners and physician assistants have provided a partial solution to the shortage of primary care services in medically underserved rural areas. This paper describes the results of a study exploring community acceptance of nurse practitioners and physician assistants in rural medically underserved areas. Community acceptance in the context of this study implies not only satisfaction with care received, but also willingness of the community to support NP/PA practice through its infrastructure and encourage members to initially seek and continue to receive care from an NP or PA. Five focus groups were conducted in each of five rural medically underserved communities. The two most pervasive findings were the lack of previous exposure to NPs and PAs and the general belief that NPs and PAs would be accepted in these communities if certain conditions could be met. The theme of conditional acceptance included both personal and system factors. Personal factors included friendliness, competence, willingness to enter into the life of the community, and the ability to keep information confidential. System factors considered critical for acceptance included service type, integration with the existing health care system, cost, geographic proximity, and availability. The results of this study offer insight into community attitudes and suggest marketing strategies for those who plan to introduce NP or PA services into rural communities.

Weaving a New Safety Net of Mental Health Care in Rural America: A Model of Integrated Practice

“…They need care that is integrated; integrated as a system and integrated within their communities (Baldwin et al, 1998;Roberts, Battaglia, & Epstein, 1999). Nursing in general, and psychiatric nursing in particular, is uniquely situated to respond to these needs but it will require approaching primary health care from a new perspective that re ects true integration of behavioral and physical health care.…”

What primary health‐care services are Australian consumers willing to accept from nurse practitioners? A National Survey

“…9,10 Furthermore, patients are as satisfied with the care provided at first contact by nurse practitioners as they are with that provided by doctors. 11 International evidence also suggests nurse practitioners would be appropriate and acceptable providers of care at the first point of contact, such as primary health care, 12,13 in rural areas underserved by medical practitioners 14 and for other specific populations, 12,15 as independent practitioners 16 and to enable timely access. 17 However, there is little Australian evidence about what care consumers are willing to accept from nurse practitioners working in primary health care.…”

Higher‐order factor analysis of an instrument with dichotomous data

“…One possible interpretation of these data is that, if clients had access to a physician, their trust in an NP or PA would be less. This conclusion was supported by Baldwin et al (1998) and Watts, Brockschmidt, Sisk, Baldwin, and McCubbin (1997) in their analysis of the focus group data that provided the basis for this instrument. The higher-order factor analysis also provided the researchers with implications for further research related to the initial acceptance of NPs and PAs into rural communities.…”