Abstract
BackgroundSignificant efforts have been made to address the shortage of health professionals in rural communities. In the face of increasing demand for rehabilitation services, strategies for recruiting and retaining occupational therapists (OTs) and physiotherapists (PTs) have yielded limited success. This study aims to broaden the understanding of factors associated with recruitment and retention of OTs and PTs in rural regions, through a synthesis of evidence from qualitative studies found in the literature.MethodsA systematic search of three databases was conducted for studies published between 1980 - 2009 specific to the recruitment and retention of OTs and PTs to rural areas. Studies deemed eligible were appraised using the McMaster Critical Review Form. Employing an iterative process, we conducted a thematic analysis of studies and developed second order interpretations to gain new insight into factors that influence rural recruitment and retention.ResultsOf the 615 articles retrieved, 12 qualitative studies met the eligibility criteria. Our synthesis revealed that therapists’ decision to locate, stay or leave rural communities was influenced to a greater degree by the availability of and access to practice supports, opportunities for professional growth and understanding the context of rural practice, than by location. The second-order analysis revealed the benefits of a strength-based inquiry in determining recruitment and retention factors. The themes that emerged were 1) support from the organization influences retention, 2) with support, challenges can become rewards and assets, and 3) an understanding of the challenges associated with rural practice prior to arrival influences retention.ConclusionsThis meta-synthesis illustrates how universally important practice supports are in the recruitment and retention of rehabilitation professionals in rural practice. While not unique to rural practice, the findings of this synthesis provide employers and health service planners with information necessary to make evidence-informed decisions regarding recruitment and retention to improve availability of health services for rural residents.
Highlights
Significant efforts have been made to address the shortage of health professionals in rural communities
With the exception of one study set in northern British Columbia [36], the research included in this synthesis originated from Australia where the issue of health human resource shortages in rural areas is a focus of much rural health research
A number of studies in this review suggest that occupational therapists (OTs) and PTs who participated in these studies felt that their colleagues, other health care professionals or organizations did not understand the nature of rural practice, or recognize the distinct features of rural practice [38,39,42,45]
Summary
In Canada, rural health is characterized by a higher prevalence of chronic diseases and traumatic injuries [1] as compared with urban areas, as well as higher rates of overweight and Occupational therapists (OTs) and physiotherapists (PTs) are critical members of the health care team, providing direct patient care, education, and advocacy in the community. To address the disparity between the need for and supply of health services, there has been a growth in research on recruitment and retention of health care workers in rural and remote areas. Despite the wealth of studies in this field, the shortage of health care professionals from all disciplines in rural communities does not seem to have abated signalling the need for a better understanding of the strategies necessary to improve the situation
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