title: The experience of medical and rehabilitation intervention for traumatic hand injuries in rural and remote North Queensland: a qualitative study.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University , Townsville , Australia .
authors.forename: Gail A
authors.initials: GA
authors.lastname: Kingston
authors.forename: Jenni
authors.initials: J
authors.lastname: Judd
authors.forename: Marion A
authors.initials: MA
authors.lastname: Gray
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care; D005260:Female; D006230:Hand Injuries / Q000534:rehabilitation*; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D059825:Physical Therapists; D036301:Qualitative Research; D011793:Queensland; D019035:Rural Health Services; D012424:Rural Population; D017216:Telemedicine; D014195:Travel / Q000191:economics*; D014937:Work; D055815:Young Adult
keywords: Australia; hand injuries; rural and remote