Perspectives of major traumatic injury survivors on accessibility and quality of rehabilitation services in rural Australia

Abstract

Purpose

For the 30% of Australians who live in rural areas, access to rehabilitation services after sustaining a major traumatic injury can be challenging. This study aimed to explore the experience of rural major traumatic injury survivors accessing rehabilitation services.

Materials and methods

Semi-structured interviews were conducted with 21 rural major traumatic injury survivors (M_age = 47.86; SD = 11.35; Range: 21–61) who were an average of seven years post-injury (SD = 3.10; Range: 3.25–13.01). Transcribed interviews were thematically analysed.

Results

Four themes were identified: (1) Managing the transition back to local services, (2) Independence and determination to get better, (3) Rehabilitation is an ongoing process, and (4) Limited service access and quality. While injury-related symptoms persisted for many participants, they expressed strong determination for independence and self-management of their recovery. Barriers to accessing rehabilitation services included poor knowledge of local services, travel burden, financial costs, and a lack of local practitioners experienced in major traumatic injury rehabilitation. Facilitating factors included financial, psychological, community, and informal supports.

Conclusions

To support recovery, future rural service models should improve consideration of factors resulting from living at a distance to services and harness independence to self-manage.

IMPLICATIONS FOR REHABILITATION

• Rural major traumatic injury survivors need support to navigate numerous barriers to accessing rehabilitation services.

• Rural participants expressed their preference for greater involvement in planning their transition back home following hospitalisation and help to link with available services in their local area.

• Specialist training and support for rural rehabilitation practitioners is needed, to effectively treat impairments related to major traumatic injury, particularly psychological and cognitive difficulties.

• Future service delivery models should incorporate methods to locate rural services; facilitate telehealth access and client self-management; and provide financial and mental health support to both rural survivors of major traumatic injury and their carers.

Keywords:

• Major traumatic injury
• injury rehabilitation
• rural health
• community care
• qualitative research

Acknowledgements

The authors thank Aviva Lefkovits for assisting in cross-coding the transcripts in addition to all of the participants and the community representatives involved in this project who so generously gave their time.

Disclosure statement

No potential competing interest was reported by the author(s).

Additional information

Funding

This project was funded by the Transport Accident Commission, who also provided relevant data and assistance with recruitment. The Victorian State Trauma Registry (VSTR) is a Department of Health and Human Services, State Government of Victoria and Transport Accident Commission funded project. The Victorian State Trauma Outcome Registry and Monitoring (VSTORM) provided VSTR data and assistance with recruitment. Professor Lannin is the recipient of a Heart Foundation Fellowship (GNT 102055). Professor Ponsford is the recipient of an NHMRC Investigator Grant [#1174473]. Dr Melita Giummarra was supported by an Australian Research Council Discovery Early Career Researcher Award [DE170100726].