scholarly journals United States Air Force Academy Cadets' Unprompted Knowledge of Concussions and Bell-Ringers/Dings: Perceived Differences and Similarities

2021 ◽  
Author(s):  
Michelle L. Weber Rawlins ◽  
Brian R. Johnson ◽  
Johna K. Register-Mihalik ◽  
Karin DeAngelis ◽  
Julianne D. Schmidt ◽  
...  
Keyword(s):  
United States ◽  
Air Force ◽  
Health Care Providers ◽  
United States Air Force ◽  
Memory Loss ◽  
Signs And Symptoms ◽  
Educational Interventions ◽  
Care Providers ◽  
Air Force Academy ◽  
Concussion Knowledge

Context: After a potential concussion mechanism, a cadet is unlikely to have a list of concussion signs and symptoms at their disposal. As such, unprompted concussion knowledge may be an essential factor in personal recognition. Objective: The primary purpose of an overall study was to explore determinants that contributed to United States Air Force Academy (USAFA) cadets to disclose a concussion. This manuscript focuses on one of the eight overall themes discovered of unprompted concussion knowledge. Design: Qualitative study. Setting: Military academy. Patients or Other Participants: USAFA cadets (males=23, females=11, age=19.91±1.14 years). Main Outcome Measure(s): We conducted 34 semi-structured interviews. The transcribed text was analyzed in a five-cycle process. From this process eight overall themes were discovered including unprompted concussion knowledge. Subthemes were also discovered of concussion definition, concussion symptoms, bell-ringer/ding definition, bell-ringer/ding symptoms, and concussion vs. bell-ringer/ding. Results: Many participants were able to largely accurately describe a concussion. The most commonly listed concussion signs and symptoms were dizziness (n=22/34, 64.7%), “can't remember”/“memory loss”/“forgetful” (n=19/34, 55.9%), and headache (n=16/34, 47.1%). USAFA cadet participants identified the most common bell-ringer/ding signs and symptoms as dizziness (n=2/34, 5.9%) and headache (n=2/34, 5.9%). Lastly, cadets described how a bell-ringer/ding differs from a concussion, often describing that concussions are more severe than bell-ringers/dings. Conclusions: Overall, USAFA cadet participants listed common concussion signs and symptoms. However, cadet participants perceived differences between concussion and bell-ringer/ding. While decreasing use of colloquial terms for concussion is recommended, using these terms when examining concussion history may be useful. Concussion educational interventions should continue to focus on describing concussion signs and symptoms using cadets' own words to describe the injury such as “forgetful”, but also differentiating between what may and may not be a concussion, and encourage individuals to seek the care of health care providers to discern concussion symptoms.

The Role of Social Support in Concussion Disclosure in United States Air Force Academy Cadets: A Mixed Methods Approach

2021 ◽  
Author(s):  
Michelle L Weber Rawlins ◽  
Brian R Johnson ◽  
Emily R Jones ◽  
Johna K Register-Mihalik ◽  
Craig Foster ◽  
...  
Keyword(s):  
United States ◽  
Social Support ◽  
Mixed Methods ◽  
Air Force ◽  
Medical Staff ◽  
United States Air Force ◽  
Medical Attention ◽  
Air Force Academy ◽  
Mixed Methods Approach

ABSTRACT Introduction United States Air Force Academy (USAFA) cadets are at risk for sustaining concussions; however, several factors inhibit disclosure. We aimed to better understand the role of social support in concussion disclosure. Methods and Materials We used a mixed methods approach with an electronic survey and interviews. The survey used a 9-point Likert scale (1 = strongly disagree and 9 = strongly agree) to assess concussion disclosure. Survey items asked cadets whom they felt most comfortable disclosing a concussion or bell-ringer/ding to, how quickly they would seek medical attention for a suspected concussion or bell-ringer/ding, whether cadets would be generally supportive/unsupportive of another cadet disclosing a concussion to medical staff, and whether other cadets important to them would be generally supportive/unsupportive if they reported a concussion to medical staff. Two multivariate linear regressions, one for concussion and one for bell-ringers/dings, were calculated to determine whether cadet choice of the person they felt most comfortable disclosing a concussion or bell-ringer/ding to predicted whether they would immediately seek medical attention for either condition. Choice of person included Air Officer Commanding (AOC)/Academy Military Trainer (AMT), upper classmen, cadet who had recovered from a concussion, cadet, closest friend, teammate, and squadmate. Descriptive analyses assessed whether cadets felt supported or unsupported by other cadets and by those who were important to them concerning concussion reporting. Thirty-four semi-structured interviews were conducted with cadets to explore their views on concussion disclosure. Results Increased comfort with disclosing a suspected concussion to an AOC/AMT had higher agreement seeking medical attention (β = 0.28, P < .001). For every 1-point increase in being comfortable disclosing a potential bell-ringer/ding to an AOC/AMT (β = 0.272, P < .001), squadmate (β = 0.241, P = .002), and teammate (β = −0.182, P = .035), agreement for seeking medical attention immediately increased 0.27, increased 0.24, and decreased 0.18, respectively. Interviews indicated cadets would often speak to a peer before seeking medical attention. Conclusions Our results suggested that cadets felt comfortable reporting a suspected concussion or bell-ringer/ding to various peers and that those peers would be supportive of that choice, indicating social support. Future interventions should include educating cadets that peers may come to them, especially if they are AOCs/AMTs or squadmates.

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