S.TRUEMAN PhD THESIS 2016

5

Alliance, 2005). It is clear that the notion of remoteness has shifted from one based solely on geographical location to one that includes considerations of social, economic and demographic factors. Early nursing scholars and conference proceedings did not differentiate between the issues and concerns of ‘rural’ and ‘remote’ nursing; both were simply referred to as ‘rural’, irrespective of geographical location (Courtney, 1992; Hegney, Pearson & McCarthy, 1997; ‘remote nurses’ qua Remote Area Nurses National Conference, 1983). This study differentiates between ‘rural’ and remote’ as distinct types of area with their own workforce issues and concerns, unless otherwise stipulated. However, the study does use the terms ‘remote’ and ‘very remote’ interchangeably. The Accessibility/Remoteness Index of Australia (ARIA+) is a means of measuring the accessibility of service centres from a given place, or conversely of remoteness of a place (Australian Bureau of Statistics [ABS], 2014). Geographical areas are given a score (continuous 0–15) based on the road distance to service towns of different sizes. Scores for regions are derived by averaging scores within squares of a 1 km 2 grid (Australian Bureau of Statistics, 2015). The index scores can be classified into various categories. These remoteness categories and their ARIA+ scores are detailed below: 1. Major Cities (ARIA+ score > 0 to ≤ 0.20): relatively unrestricted accessibility to a wide range of goods and services and opportunities for social interaction. 2. Inner Regional (ARIA+ score > 0.20 to ≤ 2.40): some restrictions to accessibility to some goods, services and opportunities for social interaction.