The experience of medical and rehabilitation intervention for traumatic hand injuries in rural and remote North Queensland: a qualitative study

Abstract

Introduction: This research explored the experience of receiving medical and rehabilitation intervention for rural and remote residents in North Queensland, Australia who had experienced a traumatic hand injury. This study contributes to larger project that seeks to propose a model of service delivery to rural and remote residents who have sustained a traumatic injury. Methods: Utilising an interpretive phenomenological research design, data was gathered through in-depth, semi-structured interviews. Fifteen participants were recruited into this study and questions were designed to explore the experience of receiving medical and rehabilitation intervention following a traumatic hand injury for residents in rural and remote areas of North Queensland. Results: The major themes that emerged were experience of medical intervention, experience of rehabilitation, travel, and technology. Participants felt that medical practitioners had a lack of local knowledge and were concerned that delays in medical intervention resulted in ongoing impairment. They reported following the exercise program they were given, often modifying it to fit with their daily routine. Metropolitan therapists appeared to have limited understanding of issues relevant to rural and remote lifestyles. There was, quite often, no occupational therapist or physiotherapist at their local facility due to staff turnover, and, when available, they had limited experience in hand injuries. The distance and cost of travel to appointments were of significant concern. The use of telehealth or telerehabilitation received a mixed response. Conclusion: Findings highlight the concerns regarding the provision of healthcare to rural and remote residents following a traumatic hand injury. These results provide the basis for recommendations surrounding the development of programs and service delivery models to address diverse needs in rural and remote areas.

Implications for Rehabilitation

• Timely medical and rehabilitation interventions for rural and remote residents with a hand injury will reduce the impact of a traumatic hand injury on function and livelihood.

• Rural and remote therapists with limited skills in hand injuries should identify a mentor or specialist in hand injuries to ensure clinical practice concerns can be addressed.

• Developing an appreciation of rural issues is vital to ensure effective communication and collaboration with rural and remote residents.

• Alternate models of care such as telehealth, shared care and “hub and spoke” or outreach services should be adapted to the skills of the local therapists and the needs and preferences of the patient.

• Australia
• hand injuries
• rural and remote

Declaration of interest

This research study was part funded by grants from the Australian Government Department of Health and Ageing Primary Health Care Research Evaluation and Development Program at James Cook University, Townsville and Mount Isa Centre for Rural and Remote Health. The authors report no conflict of interest.