Abstract
Providing data on the outcome of hand therapy intervention has become a critical part of treatment as government and private agencies place increasing emphasis towards quantifying ongoing care needs and the ability to return to paid occupation. Using data from tools, such as the Disabilities of the Arm, Shoulder and Hand (DASH), fails to acknowledge the impact that the environment, inequities in health care provision and differences in health attitudes within Australia have on outcomes. The International Classification of Functioning, Disability and Health (ICF) outlines that environmental and personal factors affect all aspects of function and disability. Factors relevant to rural and remote residents include isolation, limited infrastructure, stoicism, self sufficiency and the importance placed on hard work. Such issues are often ignored or taken for granted when measuring the success of therapy.