• Gail A Kingston, Gary Williams, Jenni Judd, and Marion A Gray.
• 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.
• Aust J Rural Health. 2015 Apr 1; 23 (2): 112-21.

ObjectiveThe 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.DesignCross-sectional survey.SettingMetropolitan/regional and rural/remote public health facilities in Australia.ParticipantsOccupational therapists and physiotherapists who provide hand therapy to rural/remote patients.Main Outcome MeasureQuantitative and qualitative questionnaire responses analysed with descriptive statistics and inductive analysis.ResultsThere 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.ConclusionThe 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.© 2015 National Rural Health Alliance Inc.

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