Wobbly Hub and Double Spokes Project, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
Disabil Rehabil. 2013 Aug;35(18):1564-70. doi: 10.3109/09638288.2012.720346. Epub 2012 Sep 26.
Throughout the world, people with a disability who live in rural and remote areas experience difficulty accessing a range of community-based services including speech-, physio- and occupational therapy. This paper draws on information gathered from carers and adults with a disability living in a rural area in New South Wales (NSW), Australia to determine the extent to which people living in rural areas may receive a person-centred therapy service.
As part of a larger study in rural NSW into the delivery of therapy services, focus groups and individual interviews were conducted with 78 carers and 10 adults with a disability. Data were analysed using constant comparison and thematic analysis.
Three related themes emerged: (i) travelling to access therapy; (ii) waiting a long time to get therapy; and (iii) limited access to therapy past early childhood. The themes overlaid the problems of recruiting and retaining sufficient therapists to work in rural areas.
Community-based rehabilitation principles offer possibilities for increasing person-centred therapy services. We propose a person-centred and place-based approach that builds on existing service delivery models in the region and involves four inter-related strategies aimed at reducing travel and waiting times and with applicability across the life course.
Therapy service delivery in rural and remote areas requires: Place-based and person centred strategies to build local capacity in communities. Responsive outreach programs working with individuals and local communities. Recognition of the need to support families who must travel to access remotely located specialist services. Innovative use of technology to supplement and enhance service delivery.
在世界各地,生活在农村和偏远地区的残疾人士在获得一系列社区服务方面存在困难,包括言语治疗、物理治疗和职业治疗。本文借鉴了澳大利亚新南威尔士州(NSW)农村地区的照顾者和残疾成年人的信息,以确定生活在农村地区的人们接受以人为中心的治疗服务的程度。
作为新南威尔士州农村地区治疗服务交付的更大研究的一部分,对 78 名照顾者和 10 名残疾成年人进行了焦点小组和个人访谈。使用恒比和主题分析对数据进行了分析。
出现了三个相关主题:(i)旅行以获得治疗;(ii)长时间等待治疗;以及(iii)幼儿期过后有限的治疗机会。这些主题与在农村地区招聘和留住足够治疗师的问题重叠。
基于社区的康复原则为增加以人为中心的治疗服务提供了可能性。我们提出了一种以人为中心和基于地点的方法,该方法建立在该地区现有的服务交付模式之上,涉及四项相互关联的策略,旨在减少旅行和等待时间,并在整个生命周期内具有适用性。
农村和偏远地区的治疗服务交付需要:基于地点和以人为中心的策略,在社区中建立本地能力。针对个人和当地社区的响应性外展计划。认识到必须支持必须旅行以获得远程专业服务的家庭的需求。创新使用技术来补充和增强服务交付。