Wilkinson Amanda, Higgs Chris, Stokes Tim, Dummer Jack, Hale Leigh
Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand.
Front Rehabil Sci. 2022 Jun 21;3:904007. doi: 10.3389/fresc.2022.904007. eCollection 2022.
People living rurally frequently experience health disparities especially if living with a long-term condition (LTC) or multi-morbidity. Self-management support is a key component of LTC management and commonly included in rehabilitation programmes to enhance ability to self-manage health and encourage physical activity. Such programmes are however often condition focussed and despite evidence for their effectiveness, are not always feasible to deliver in rural settings. Generic programmes are arguably more optimal in the rural context and delivery can be face to face or remotely (via telehealth). The aim of this explorative integrative review was to collate and present international evidence for development, delivery, integration, and support of community-based, generic LTC group rehabilitation programmes delivered rurally in person, or remotely using telehealth. Electronic databases were systematically searched using MeSH terms and keywords. For inclusion, articles were screened for relevance to the aim, and practical information pertaining to the aim were extracted, charted, and organized deductively into themes of Development, Delivery, Integration, and Support. Within each theme, data were synthesized inductively into categories (Theory, Context, Interpersonal aspects, and Technology and Programme aspects). Fifty-five studies were included. Five studies contributed information about community based programmes delivered the internet. was the only theme populated by information from all categories. The theme of was only populated with information from one category. Our review has drawn together a large body of diverse work. It has focused on finding practical information pertaining to the best ways to develop, deliver, integrate, and support a community-based generic rehabilitation programme for people living with long-term health conditions, delivered rurally and/or potentially the internet. Practical suggestions were thematically organized into categories of theory, context, interpersonal aspects, and technology and programme aspects. While the findings of this review might appear simple and self-evident, they are perhaps difficult to enact in practice.
生活在农村的人经常面临健康差异，尤其是患有长期疾病（LTC）或多种疾病的人。自我管理支持是长期疾病管理的关键组成部分，通常包含在康复计划中，以提高自我管理健康的能力并鼓励体育活动。然而，此类计划往往以疾病为重点，尽管有证据表明其有效性，但在农村地区实施并不总是可行的。一般来说，通用计划在农村环境中可能更具优势，其实施方式可以是面对面的，也可以是远程的（通过远程医疗）。本探索性综合综述的目的是整理并呈现国际上关于在农村地区亲自或通过远程医疗提供的基于社区的通用长期疾病群体康复计划的开发、实施、整合和支持的证据。使用医学主题词（MeSH）和关键词对电子数据库进行系统检索。为了纳入研究，筛选文章与该目的的相关性，并提取、绘制与该目的相关的实用信息，并将其演绎性地组织成开发、实施、整合和支持等主题。在每个主题中，数据被归纳性地综合为类别（理论、背景、人际方面以及技术和计划方面）。共纳入55项研究。五项研究提供了关于通过互联网提供的社区计划的信息。是唯一由所有类别信息构成的主题。主题仅由来自一个类别的信息构成。我们的综述汇集了大量不同的研究。它专注于寻找与为患有长期健康状况的农村居民开发、实施、整合和支持基于社区的通用康复计划的最佳方式相关的实用信息，该计划可以在农村地区亲自实施和/或可能通过互联网实施。实用建议按主题组织成理论、背景、人际方面以及技术和计划方面等类别。虽然本综述的结果可能看起来简单明了，但在实践中可能难以实施。
