Partnerships in specialty care: Exploring rural haemophilia provider resource needs


Andrea M. Pritchard, Faculty, Undergraduate Nursing Department, Faculty of Health and Community Studies, Mount Royal College, 4825 Mount Royal Gate SW, Calgary, Alberta, Canada T3E 6K6. Email:



Objective: The purpose of this study was to determine whether rural providers have adequate preparation for safe and effective haemophilia care.

Design: This qualitative study proceeded in two phases: focus group (phase I) and telephone (phase II) interviews.

Setting: Five Canadian rural hospitals served by one urban haemophilia treatment centre and providing service to at least one haemophilia family.

Participants: Phase I: focus groups of rural health professionals (site 1:= 5; site 2:= 6), including nursing, medicine and lab technology. Phase II: telephone interviews with nine participants from nursing, medicine, lab technology, social work and physiotherapy across three sites.

Main outcome measures: Qualitative content analysis yielded categorical themes for specialty care resource requirements in a rural context.

Results: Resource needs reflected five main categories: communication network, subjective knowledge, team roles, objective knowledge and partnerships (C-STOP).

Conclusions: The five C-STOP categories require resources and alignment of urban specialist, rural provider and family expertise. Specialty clinic efforts promoting self-care are incomplete without matched resources for rural providers.

Key Terms:

 Haemophilia (A and B) refers to a deficiency in factor VIII or IX, with associated bleeding of post-traumatic or spontaneous origin as potentially life or limb threatening1

 Rural refers to those communities beyond a 30-min commuting distance2 to the tertiary-based haemophilia treatment centre.