Citation

Middleton JW, McCormick M, Engel S, Rutkowski SB, Cameron ID, Harradine P, Johnson JL, Andrews D. Arch. Phys. Med. Rehabil. 2008; 89(10): 1941-1947.

Affiliation

Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, Sydney, Australia. j.middleton@usyd.edu.au

Copyright

(Copyright © 2008, Elsevier Publishing)

DOI

10.1016/j.apmr.2008.04.011

PMID

18929022

Abstract

OBJECTIVE: To develop and implement a service model for people with spinal cord injury (SCI) living in rural regions. DESIGN: Service development, pilot evaluation study. SETTING: Regional and remote areas of the state of New South Wales, Australia. PARTICIPANTS: Persons with SCI, caregivers, and health professionals. INTERVENTION: Phase 1 included initial needs analysis, followed by education and resource development tailored to needs of rural health professionals, caregivers, and persons with SCI. Phase 2 included coordination, professional support, and network development by part-time rural key worker and metropolitan-based project officer, documenting health- and service-related issues. MAIN OUTCOME MEASURES: Self-perception of confidence as a result of education as well as reported issues, adverse health events, and barriers to service provision. RESULTS: Clinician confidence in managing people with SCI improved after education. Various health-related, environmental, and psychosocial issues were reported. Limited availability of resources and health infrastructure, particularly in more isolated or smaller towns, challenged service provision. Rural key workers played a central role in supporting local clinicians and service providers, improving communication and service coordination between rural health professionals and metropolitan SCI services. CONCLUSION: Education and support for rural workforce that may be limited in numbers and capacity, and a model facilitating communication and coordination between services, are essential for improving health outcomes of rural people with SCI.

Language: en