Hand therapy services for rural and remote residents: Results of a survey of Australian occupational therapists and physiotherapists

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. Design: Cross-sectional survey. Setting: Metropolitan/regional and rural/remote public health facilities in Australia. Participants: Occupational therapists and physiotherapists who provide hand therapy to rural/remote patients. Main outcome measure: 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. Conclusion: 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.