Middleton James W, McCormick Melissa, Engel Stella, Rutkowski Susan B, Cameron Ian D, Harradine Peter, Johnson Jennifer L, Andrews David
Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, Sydney, Australia.
Arch Phys Med Rehabil. 2008 Oct;89(10):1941-7. doi: 10.1016/j.apmr.2008.04.011.
To develop and implement a service model for people with spinal cord injury (SCI) living in rural regions.
Service development, pilot evaluation study.
Regional and remote areas of the state of New South Wales, Australia.
Persons with SCI, caregivers, and health professionals.
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.
Self-perception of confidence as a result of education as well as reported issues, adverse health events, and barriers to service provision.
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.
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.
为生活在农村地区的脊髓损伤患者开发并实施一种服务模式。
服务开发、试点评估研究。
澳大利亚新南威尔士州的区域和偏远地区。
脊髓损伤患者、护理人员和卫生专业人员。
第一阶段包括初步需求分析，随后针对农村卫生专业人员、护理人员和脊髓损伤患者的需求进行教育和资源开发。第二阶段包括由兼职农村关键工作者和驻大城市的项目官员进行协调、专业支持和网络开发，记录与健康和服务相关的问题。
教育后的自信心自我认知以及报告的问题、不良健康事件和服务提供的障碍。
教育后临床医生管理脊髓损伤患者的信心有所提高。报告了各种与健康、环境和社会心理相关的问题。资源和卫生基础设施的可用性有限，特别是在更偏远或较小的城镇，这对服务提供构成了挑战。农村关键工作者在支持当地临床医生和服务提供者、改善农村卫生专业人员与大城市脊髓损伤服务之间的沟通和服务协调方面发挥了核心作用。
对数量和能力可能有限的农村劳动力进行教育和支持，以及一种促进服务之间沟通和协调的模式，对于改善农村脊髓损伤患者的健康结局至关重要。
