title: Hand therapy services for rural and remote residents: Results of a survey of Australian occupational therapists and physiotherapists.
abstract: OBJECTIVE
  The aim of this study was to explore how interventions were provided to meet the needs of rural/remote residents who have had a traumatic hand injury, including the coordination of services between rural/remote and metro/regional therapists. Barriers to providing services, use of technology and professional support provided to therapists in rural/remote areas were also explored.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Metropolitan/regional and rural/remote public health facilities in Australia.
  
  
  METHODS
  Occupational therapists and physiotherapists who provide hand therapy to rural/remote patients.
  
  
  METHODS
  Quantitative and qualitative questionnaire responses analysed with descriptive statistics and inductive analysis.
  
  
  RESULTS
  There were 64 respondents out of a possible 185. Over half of rural/remote respondents provided initial splinting and exercise prescriptions, and over 85% reported that they continued with exercise protocols. Videoconferencing technology for patient intervention and clinical review was used by 39.1% respondents. Barriers to providing services in rural/remote locations included transport, travelling time, limited staff, and lack of expert knowledge in hand injuries or rural/remote health care. Four major themes emerged from the open-ended questions: working relationships, patient-centred care, staff development and education, and rural and remote practice.
  
  
  CONCLUSIONS
  The use of technology across Australia to support rural/remote patient intervention requires attention to achieve equity and ease of use. Flexible and realistic goals and interventions should be considered when working with rural/remote patients. A shared care approach between metropolitan/regional and rural/remote therapists can improve understanding of rural/remote issues and provide support to therapists. Further research is recommended to determine the suitability of this approach when providing hand therapy to rural/remote residents.
authors.affiliation: School of Public Health, Tropical Medicine and Rehabilitation Sciences, Anton Breinl Centre for Health Systems Strengthening James, Cook University, Townsville, Queensland, Australia; The Townsville Hospital, Townsville, Queensland, Australia.
authors.forename: Gail A
authors.initials: GA
authors.lastname: Kingston
authors.forename: Gary
authors.initials: G
authors.lastname: Williams
authors.forename: Jenni
authors.initials: J
authors.lastname: Judd
authors.forename: Marion A
authors.initials: MA
authors.lastname: Gray
mesh_terms: D001315:Australia; D003430:Cross-Sectional Studies; D005081:Exercise Therapy / Q000706:statistics & numerical data; D006230:Hand Injuries / Q000628:therapy*; D019538:Health Care Surveys; D006801:Humans; D000072087:Occupational Therapists / Q000706:statistics & numerical data*; D059825:Physical Therapists / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013685:Telecommunications; D049269:Videoconferencing
keywords: hand injury; model of service delivery; occupational therapy; physiotherapy; rural health