UBC Theses and Dissertations
Understanding rural rehabilitation practice : perspectives of occupational therapists and physical therapists in British Columbia Roots, Robin Katharine
Background: Providing rehabilitation services to meet the needs of rural residents and address poor health outcomes requires overcoming the challenges of geography, limited referral options and a shortage of occupational therapists (OTs) and physical therapists (PTs). However, little is known about how rehabilitation professionals in rural areas enact their practice to meet and overcome these challenges. To address this gap and contribute to enhancing health for rural residents, this research constructed an understanding of rural rehabilitation practice from the perspectives of OTs and PTs in rural British Columbia (BC). Methods: This qualitative study employed a purposive sample of OTs and PTs in rural communities (population < 15,000) in northern BC. Potential participants were recruited through a study information mail-out to workplaces and were selected according to inclusion criteria to ensure a variety of work experiences, roles and practice settings. In semi-structured interviews, participants were asked to describe the skills and knowledge they perceived as unique to rural and strategies used to overcome challenges. Guided by interpretive description, transcripts were analysed inductively using broad-level coding and findings collapsed into interpretive categories. Interpretations and implications for education, practice and policy were reviewed with participants to ensure relevancy for rural practice. Results: From interviews with 6 OTs and 13 PTs, serving a total of 15 rural communities, rehabilitation practice and participants’ definition of health was understood to be substantially shaped by rurality, or the contextual features of geography, determinants of health and access to services. Participants considered general practice ‘a specialty’ requiring advanced skills in assessment. They described ‘stretching their role’ and ‘participating and partnerships’ as means to overcome resource shortages. Reflective practice, networking and collaboration were deemed essential to maintaining competency. Rural clinical placements, mentoring and improving access to continuing education were regarded as central to recruitment and retention. Conclusion: This research illuminates the influence of rurality on the practice of OTs and PTs in rural BC. The findings asserted the importance of incorporating rural content in professional training programs and providing accessible professional development resources to addressing health human resource shortages and meeting the rehabilitation needs of rural residents.
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