Benefits and challenges of providing transitional rehabilitation services to people with spinal cord injury from regional, rural and remote locations

Objective: To identify the factors influencing participation and outline the benefits and challenges of providing transitional rehabilitation for people with spinal cord injury (SCI) from rural and regional locations. Design: Grounded Theory analysis of service records and policy documents. Setting: One transitional rehabilitation service for people with SCL Participants: Service records of 40 individuals with SCI from non-metropolitan locations who participated in transitional rehabilitation and 29 individuals with SCI who declined transitional rehabilitation over a two-year period. Interventions: Home-based transitional rehabilitation programs offered by a multidisciplinary team including physiotherapy, occupational therapy, nursing and social work. Measures: Participation was measured using the percentage of people from non-metropolitan locations who decline transitional rehabilitation. The benefits and challenges of transitional rehabilitation were identified using open, axial and selective coding of service records. Results: People with SCI from non-metropolitan areas were underrepresented among transitional rehabilitation participants, with 69% of those declining transitional rehabilitation coining from regional or rural areas. The study identified five functions of transitional rehabilitation that presented both benefits and challenges of this model in assisting people from non-metropolitan locations. These included: (1) the identification, education, coordination and funding of local care providers; (2) family involvement in rehabilitation; (3) contact with social and community supports;(4) specialist support to problem-solve discharge needs; and (5) skill acquisition and transfer in a community environment. Conclusions: The transitional rehabilitation model offers many advantages over traditional hospital-based rehabilitation but still faces challenges in offering an equitable model for people with SCI from non-metropolitan locations.