TY  - JOUR
PY  - 2008//
TI  - Issues and challenges for development of a sustainable service model for people with spinal cord injury living in rural regions
JO  - Archives of physical medicine and rehabilitation
A1  - Middleton, James W.
A1  - McCormick, Melissa
A1  - Engel, Stella
A1  - Rutkowski, Susan B.
A1  - Cameron, Ian D.
A1  - Harradine, Peter
A1  - Johnson, Jennifer L.
A1  - Andrews, David
SP  - 1941
EP  - 1947
VL  - 89
IS  - 10
N2  - 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.<p /> <p>Language: en</p>
LA  - en
SN  - 0003-9993
UR  - http://dx.doi.org/10.1016/j.apmr.2008.04.011
ID  - ref1
ER  -