Establishment of a sustainable connection between citizens and medical professionals in rural communities: A thematic analysis

Abstract Background A trustworthy relationship between medical institutions and people is important for effective community care. Dialogue between medical professionals and people has been lost owing to the coronavirus disease 2019 pandemic. To improve community care, dialogue among rural people regarding mutual help and connections to healthcare is essential. Therefore, this study aimed to clarify the health problems caused by social isolation and their solutions in rural contexts through interviews with community workers in rural communities. Methods This qualitative study used thematic analysis of community workers in rural communities to investigate the health problems caused by social isolation and their solutions. Semi-structured interviews were conducted among participants using purposive sampling. In total, 57 community workers participated in this study. Results Through thematic analysis, four themes were identified: social changes due to aging, relational changes in communities, community-specific networking, and connections driving community health. Social changes due to aging that cause social isolation include the dilution of human relationships, lack of diverse generations, and distance to medical care facilities. Relational changes in communities were explained by excessive consideration of privacy, lack of intimacy with one’s surroundings, and hesitance to depend on others. Rural communities have specific networking strategies, such as involvement of people well known in communities, localization of community information, and specific lay care in communities. For the sustainability of rural healthcare, solving social isolation issues through connections driving community health, including respect for community culture, smooth collaboration with healthcare providers, and active engagement of physicians, are demanded. Conclusions Challenges to the sustainability of rural communities were caused by the social and relational changes that led to social isolation. Excessive consideration of privacy and lack of intimacy with one’s surroundings caused hesitance to depend on others. Moreover, social and relational changes in rural communities have increased the number and variation of health issues, and previous support systems cannot deal with the present changes. Established community cultures should be respected to ensure the sustainability of rural healthcare. Relationships between rural communities and medical institutions for health promotion must be established, for which friendly and open-minded engagement of physicians is required.