DOI: 10.6084/m9.figshare.19593052.v1
title: Perspectives of major traumatic injury survivors on accessibility and quality of rehabilitation services in rural Australia

description: For the 30% of Australians who live in rural areas, access to rehabilitation services after sustaining a major traumatic injury can be challenging. This study aimed to explore the experience of rural major traumatic injury survivors accessing rehabilitation services. Semi-structured interviews were conducted with 21 rural major traumatic injury survivors (<i>M<sub>age</sub></i> = 47.86; <i>SD</i> = 11.35; Range: 21–61) who were an average of seven years post-injury (<i>SD</i> = 3.10; Range: 3.25–13.01). Transcribed interviews were thematically analysed. Four themes were identified: (1) <i>Managing the transition back to local services</i>, (2) <i>Independence and determination to get better</i>, (3) <i>Rehabilitation is an ongoing process</i>, <i>and</i> (4) <i>Limited service access and quality.</i> While injury-related symptoms persisted for many participants, they expressed strong determination for independence and self-management of their recovery. Barriers to accessing rehabilitation services included poor knowledge of local services, travel burden, financial costs, and a lack of local practitioners experienced in major traumatic injury rehabilitation. Facilitating factors included financial, psychological, community, and informal supports. To support recovery, future rural service models should improve consideration of factors resulting from living at a distance to services and harness independence to self-manage.IMPLICATIONS FOR REHABILITATIONRural major traumatic injury survivors need support to navigate numerous barriers to accessing rehabilitation services.Rural participants expressed their preference for greater involvement in planning their transition back home following hospitalisation and help to link with available services in their local area.Specialist training and support for rural rehabilitation practitioners is needed, to effectively treat impairments related to major traumatic injury, particularly psychological and cognitive difficulties.Future service delivery models should incorporate methods to locate rural services; facilitate telehealth access and client self-management; and provide financial and mental health support to both rural survivors of major traumatic injury and their carers. Rural major traumatic injury survivors need support to navigate numerous barriers to accessing rehabilitation services. Rural participants expressed their preference for greater involvement in planning their transition back home following hospitalisation and help to link with available services in their local area. Specialist training and support for rural rehabilitation practitioners is needed, to effectively treat impairments related to major traumatic injury, particularly psychological and cognitive difficulties. Future service delivery models should incorporate methods to locate rural services; facilitate telehealth access and client self-management; and provide financial and mental health support to both rural survivors of major traumatic injury and their carers.