scholarly journals Pressure on Sports Medicine Clinicians to Prematurely Return Collegiate Athletes to Play After Concussion

2015 ◽  
Vol 50 (9) ◽  
pp. 944-951 ◽  
Author(s):  
Emily Kroshus ◽  
Christine M. Baugh ◽  
Daniel H. Daneshvar ◽  
Julie M. Stamm ◽  
R. Mark Laursen ◽  
...  

Context  Anecdotal and qualitative evidence has suggested that some clinicians face pressure from coaches and other personnel in the athletic environment to prematurely return athletes to participation after a concussion. This type of pressure potentially can result in compromised patient care. Objective  To quantify the extent to which clinicians in the collegiate sports medicine environment experience pressure when caring for concussed athletes and whether this pressure varies by the supervisory structure of the institution's sports medicine department, the clinician's sex, and other factors. Design  Cross-sectional study. Setting  Web-based survey of National College Athletic Association member institutions. Patients or Other Participants  A total of 789 athletic trainers and 111 team physicians from 530 institutions. Main Outcome Measure(s)  We asked participants whether they had experienced pressure from 3 stakeholder populations (other clinicians, coaches, athletes) to prematurely return athletes to participation after a concussion. Modifying variables that we assessed were the position (athletic trainer, physician) and sex of the clinicians, the supervisory structure of their institutions' sports medicine departments, and the division of competition in which their institutions participate. Results  We observed that 64.4% (n = 580) of responding clinicians reported having experienced pressure from athletes to prematurely clear them to return to participation after a concussion, and 53.7% (n = 483) reported having experienced this pressure from coaches. Only 6.6% (n = 59) reported having experienced pressure from other clinicians to prematurely clear an athlete to return to participation after a concussion. Clinicians reported greater pressure from coaches when their departments were under the supervisory purview of the athletic department rather than a medical institution. Female clinicians reported greater pressure from coaches than male clinicians did. Conclusions  Most clinicians reported experiencing pressure to prematurely return athletes to participation after a concussion. Identifying factors that are associated with variability in pressure on clinicians during concussion recovery can inform potential future strategies to reduce these pressures.

2014 ◽  
Vol 49 (1) ◽  
pp. 83-88 ◽  
Author(s):  
James W. Brenner ◽  
Stacie M. Metz ◽  
Jack Entriken ◽  
Christina J. Brenner

Context: Alcohol-related unintentional injury (ARUI) has been an unexamined consequence of alcohol consumption by collegiate athletes. It has a potentially devastating effect on their athletic performances and careers. Awareness of this problem in athletes could have a huge effect on what athletic trainers (ATs) do to recognize, treat, and prevent it in a collegiate athlete population. Objective: To examine the experiences and attitudes among collegiate and university ATs about ARUI in the athletes in their care. Design: Cross-sectional study. Setting: Web-based survey. Patients or Other Participants: A total of 1767 e-mail addresses for collegiate and university ATs within National Athletic Trainers' Association Districts 1, 2, 3, and 9. Main Outcome Measure(s): We calculated frequencies, percentages, and attitudes of ATs regarding ARUI in collegiate athletes during the 2010–2011 academic year. Results: The resulting sample size for the analysis was 459 (26.0%) participants of the initial total sample. More than 56% (n = 260) of the ATs reported that they had evaluated, treated, or referred if needed at least 1 ARUI in a collegiate athlete. On average, these ATs had evaluated, treated, or referred if needed 3 alcohol-related unintentional injuries within the 2010–2011academic year. About 73% (n = 331) of ATs agreed that ARUI is a serious problem. Nearly 80% (n = 358) indicated they believe ATs should receive more training to identify student–athletes with alcohol-related problems. Conclusions: Alcohol-related unintentional injury is a common and serious consequence of alcohol use among collegiate athletes. Many ATs also view it as a serious problem yet would like more training in how to address it. Alcohol-related unintentional injury may have important negative effects on the careers and athletic performances of athletes. Researchers need to determine how prevalent ARUI is in the collegiate athlete population and what ATs can do to address it.


2019 ◽  
Vol 54 (7) ◽  
pp. 822-830 ◽  
Author(s):  
Lindsey E. Eberman ◽  
Elizabeth R. Neil ◽  
Sara L. Nottingham ◽  
Tricia M. Kasamatsu ◽  
Cailee E. Welch Bacon

Context Medical documentation is a required component of patient care in all health care professions. Objective To evaluate athletic trainers' perceived behaviors toward, barriers to, and confidence in their medical documentation. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants We purchased a list of randomly selected e-mails from the National Athletic Trainers' Association. Of the 9578 participants, 1150 accessed our questionnaire (12.0% access rate), 1053 completed at least 1 portion, and 904 completed the questionnaire in its entirety (85.8% completion rate). Of the participants, 60.1% (n = 569/947) were female, 66.6% (n = 632/949) held a master's degree, 39.3% (n = 414/1053) worked in a collegiate or university setting, and 36.1% (n = 381/1053) worked in a secondary school setting. Main Outcome Measure(s) We used a 31-item questionnaire with demographics (12 items), medical documentation behaviors (16 items), barriers (2 items), and perceptions (1 multipart item) sections. The questionnaire explored athletic trainers' behaviors as well as confidence in, comfort with, and concerns about their documentation practices (Cronbach α = 0.887). We used descriptive statistics to identify characteristics of central tendency (mean, standard deviation, mode, frequency). Results Participants always (45.7%, n = 478/1046) or very frequently (39.0%, n = 408/1046) used a double documentation system consisting of electronic and paper records (50.4%, n = 523/1038). They most often documented to provide legal protection (86.8%, n = 914/1053), because it is a legal obligation (79.1%, n = 833/1053), or to track patient progress (83.9%, n = 883/1053). The most frequently cited barriers to medical documentation were time (76.5%, n = 806/1053), managing too many patients (51.9%, n = 547/1053), technological concerns (17.2%, n = 181/1053), and software limitations (17.2%, n = 181/1053). Respondents believed they were competent, comfortable, and confident in their documentation practices. Conclusions We were able to evaluate the generalizability of previous research while adding to the understanding of the behaviors toward, barriers to, and perceptions about medical documentation. We confirmed that time and patient load affected the ability to perform high-quality medical documentation.


Author(s):  
Melissa T. Lodge ◽  
Kathryn E Ackerman ◽  
Jessica Garay

ABSTRACT CONTEXT: Female endurance athletes exhibit an increased risk of Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S). Triad and RED-S are conditions that explore the health and performance consequences of low energy availability (LEA). Few studies to date have assessed the knowledge that athletes, coaches, and athletic trainers (ATs) have regarding Triad/RED-S. Proper education has been shown to be effective in increasing knowledge of sports medicine concerns for athletes. Yet, there are no known continuing education programs for Triad/RED-S at collegiate institutions. OBJECTIVE: The primary purpose of this study was to assess the knowledge, confidence, and impact of identifying, screening, treating, and preventing Triad/RED-S. DESIGN: Cross-sectional study. SETTING: An evidence-based online survey was developed and administered via QualtricsTM. PARTICIPANTS: Female collegiate cross-country athletes (n = 275; 20 ± 1 yrs.), collegiate cross-country coaches (n = 55, 34 ± 9 yrs.), and ATs working with cross-country teams (n = 30, 36 ± 11 yrs.). MAIN OUTCOME MEASURE: Knowledge, confidence, and impact scores were assessed between groups using ANOVA. Independent t-tests were used to determine differences in impact scores between people who had or had not received education. RESULTS: Female cross-country athletes' total knowledge, confidence, and impact scores (mean scores of 25.00 ± 5.27, 95.42 ± 28.83, 18.81 ± 7.05 respectively) were significantly different from scores of coaches (mean scores of 26.92 ± 5.02, 111.35 ± 24.14 and 22.41 ± 6.33) and ATs (mean scores of 28.66 ± 4.02, 117.67 ± 22.53, and 23.93 ± 5.69) (p < 0.05). CONCLUSIONS: Knowledge, confidence, and impact scores of Triad/RED-S were lowest in female cross-country athletes and highest in ATs. These findings support the call for education, which should be regarded as the primary tool to increase knowledge to improve the prevention and treatment of Triad/RED-S.


2016 ◽  
Vol 51 (6) ◽  
pp. 454-459 ◽  
Author(s):  
Jessica Barrett ◽  
Christianne M. Eason ◽  
Rhyan Lazar ◽  
Stephanie M. Mazerolle

Context: Burnout, a psychological state of mental weariness that occurs when work stresses become overwhelming, has frequently been documented in athletic trainers and has been hypothesized to affect professional retention. Experiences of burnout may be influenced by individual-level factors such as gender or personality, though few researchers have investigated such interactions in athletic trainers.Objective: To investigate the relationship between personalities, as measured by the Big Five Personality Inventory, and burnout.Design: Cross-sectional study.Setting: Online Web-based survey.Patients or Other Participants: A total of 189 athletic trainers working in the collegiate setting, 65 men (34.4%) and 124 women (65.6%), with an average of 5 ± 3 years certified and 2.5 ± 2 years working in their current position.Main Outcome Measure(s): Data were collected using a Web-based survey instrument consisting of 3 sections: (1) demographics, (2) burnout survey, and (3) Big Five Personality Inventory. Likert responses for the burnout score were summed. Independent t tests, Pearson correlations, and multiple regressions were calculated to evaluate the relationships between demographics and burnout and between burnout and personality.Results: This group of athletic trainers experienced moderate burnout, regardless of gender. A weak negative correlation was present between burnout score and both agreeableness and extraversion. A weak positive correlation existed between burnout and neuroticism. These variables did not predict burnout scores; only neuroticism added significantly to the weak predictive value. Personality explained only 17.3% of the variability in burnout scores.Conclusions: Our study confirms the findings of previous researchers highlighting moderate burnout in athletic trainers employed in the collegiate setting. We did not find that personality significantly predicted burnout, though it did account for a small amount of the variance in burnout scores. Thus, organizational-level factors may play a greater role in determining burnout in athletic trainers than individual-level factors such as personality.


2014 ◽  
Vol 49 (5) ◽  
pp. 674-683 ◽  
Author(s):  
Alison R. Snyder Valier ◽  
Amy L. Jennings ◽  
John T. Parsons ◽  
Luzita I. Vela

Context: Patient-rated outcome measures (PROMs) are important for driving treatment decisions and determining treatment effectiveness. However, athletic trainers (ATs) rarely use them; understanding why may facilitate strategies for collection of these outcomes. Objective: To identify the benefits of and barriers to using PROMs in athletic training. Design: Cross-sectional study. Setting: Web-based survey. Patients or Other Participants: A total of 1469 randomly sampled ATs (age = 36.8 ± 9.8 years; 48% female) working in the college/university, 2-year institution, secondary school, clinic, hospital, or industrial/occupational setting. Intervention(s): An e-mail was sent to ATs inviting them to complete a survey regarding the use, benefits, and barriers of PROMs. Athletic trainers who indicated they used PROMs (AT-PRs) completed 65 questions about the benefits of and barriers to their use. Athletic trainers who indicated no use of PROMs (AT-NONs) completed 21 questions about barriers of use. Main Outcome Measure(s): Dependent variables were the endorsements for the benefits of and barriers to the use of PROMs. Results: A total of 458 ATs initiated the survey and 421 (AT-PR = 26%, AT-NON = 74%) completed it (response rate = 28.7%). The most frequently endorsed benefits by AT-PRs were enhancing communication with patients (90%) and other health care professionals (80%), directing patient care (87%), and increasing examination efficiency (80%). The most frequently endorsed barriers by AT-PRs were that PROMs are time consuming (44%), difficult (36%), and confusing (31%) for patients and time consuming for clinicians to score and interpret (29%). The most frequently endorsed problems by AT-NONs were that PROMs are time consuming for clinicians to score and interpret (31%), time consuming (46%) and irrelevant to patients (28%), and lacking a support structure for clinicians (29%). Conclusions: These results suggest that, although benefits to using PROMs exist, there are also barriers. Barriers are similar for AT-PRs and AT-NONs. Strategies to decrease barriers and facilitate the use of PROMs warrant investigation.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1144-1150
Author(s):  
Muralidharan V A ◽  
Gheena S

Covid -19 is an infectious disease caused by the newly discovered strain of coronavirus. As there is no vaccine discovered, the only way to prevent the spread is through following the practice of social isolation. But prolonged isolation may also lead to psychological stress and problems. The objective of the survey was to assess the knowledge and awareness of preventive measures against Covid 19 amongst small shop owners. A web-based cross-sectional study was conducted amongst the small shop owners.  A structured questionnaire comprising 15-17 questions had been put forth to assess the Covid 19 related knowledge and perception. The shopkeepers were contacted telephonically and responses recorded. The data analysis was performed using IBM SPSS statistics. Although the majority of the population had a positive perception about the preventive measures against the Covid spread, 36% of the shopkeepers were not aware of the preventive measures against the Covid spread. This study found optimal knowledge and perception of the preventive measures against Covid spread among the shopkeepers but misinformation and misunderstanding still prevailing. The shopkeepers are crucial in the prevention of the spread of Covid 19 and educating them might aid us in the fight against Covid- 19. 


2021 ◽  
pp. 002076402110001
Author(s):  
Esra’ O Taybeh

Background: The magnitude of postpartum depression in Jordan is under documented, and little is known about its potential sociodemographic and clinical correlates. Purpose: The aim of this study was to explore the prevalence and risk factors associated with postpartum depression among Jordanian mothers in the first 18 months after delivery. Method: This descriptive cross-sectional study was carried out from April to June 2020 in Jordan. A web-based survey was used for recruiting eligible participants. An Arabic version of the validated self-administered Edinburgh Postnatal Depression Scale questionnaire was used to measure postpartum depression with a cut-off score of ⩾12 which indicates probable depression. Results: A total of 1,071 Jordanian women participated in the study. Of those, 567 women had postpartum depression (52.9%). Multivariate logistic regression analysis revealed that postpartum depression was significantly associated with marital conflict (OR: 4.91; 95% CI: 2.36–10.20), negative attitude from the pregnancy (OR: 0.67; 95% CI: 0.45–0.99), unplanned pregnancies (OR: 1.73; 95% CI: 1.16–2.60), lack of social support (OR: 1.93; 95% CI: 1.12–3.32), time from last delivery (OR: 0.99; 95% CI: 0.98–1.00), insomnia (OR: 0.53; 95% CI: 0.35–0.82), and depression during the pregnancy (OR: 0.51; 95% CI: 0.33–0.78). Most of the participants (65.7%) sought social support to avoid, reduce, or treat postpartum depression. Conclusions: Postpartum depression among Jordanian women was the highest in comparison to that of women in other countries in the region. Therefore, screening for the presence of depressive symptoms should be implemented during regular pregnancy care visits. Social support should be encouraged in order to avoid, reduce, or treat postpartum depression.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Angela Brenton-Rule ◽  
Daniel Harvey ◽  
Kevin Moran ◽  
Daniel O’Brien ◽  
Jonathon Webber

Abstract Background Podiatrists in New Zealand have a duty of care to assist patients in an emergency, and current cardiopulmonary resuscitation (CPR) certification is a requirement for registration. However, it is unknown how competent and confident podiatrists are in administering CPR and how they would respond in an emergency. Having a health professional who has a competent knowledge of CPR and skills in basic life support, can improve survival rates from sudden cardiac arrest. Therefore, the aim of this study was to survey New Zealand podiatrists to determine their CPR knowledge and qualifications; beliefs about the application of CPR; and perceptions of their competency in CPR. Methods This cross-sectional study used a web-based survey. Participants were New Zealand registered podiatrists with a current annual practising certificate. The 31-item survey included questions to elicit demographic information, CPR practice and attitudes, and CPR knowledge. Responses were collected between March and August 2020. Results 171 podiatrists responded to the survey. 16 % of the podiatrists (n = 28) had performed CPR in an emergency, with a 50 % success rate. Participants were predominantly female (n = 127, 74 %) and working in private practice (n = 140,82 %). Nearly half of respondents were younger than 40 years (n = 75,44 %) and had less than 10 years of clinical experience (n = 73, 43 %). Nearly all (n = 169,97 %) participants had received formal CPR training in the past two years, with 60 % (n = 105) receiving training in the past 12 months. Most respondents (n = 167,98 %) self-estimated their CPR ability as being effective, very effective, or extremely effective. Participants’ knowledge of CPR was variable, with the percentage of correct answers for CPR protocol statements ranging between 20 and 90 %. Conclusions This study provides the first insight into New Zealand podiatrists’ CPR knowledge and perceptions. Podiatrists were found to have high levels of CPR confidence but demonstrated gaps in CPR knowledge. Currently, New Zealand registered podiatrists require biennial CPR re-certification. However, resuscitation authorities in New Zealand and overseas recommend an annual update of CPR skills. Based on this study’s findings, and in line with Australia and the United Kingdom, the authors recommend a change from biennial to annual CPR re-certification for podiatrists in New Zealand. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620001144909).


2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098700
Author(s):  
Jordan L. Liles ◽  
Richard Danilkowicz ◽  
Jeffrey R. Dugas ◽  
Marc Safran ◽  
Dean Taylor ◽  
...  

Background: The COVID-19 (SARS-COV-2) pandemic has brought unprecedented challenges to the health care system and education models. The reduction in case volume, transition to remote learning, lack of sports coverage opportunities, and decreased clinical interactions have had an immediate effect on orthopaedic sports medicine fellowship programs. Purpose/Hypothesis: Our purpose was to gauge the response to the pandemic from a sports medicine fellowship education perspective. We hypothesized that (1) the COVID-19 pandemic has caused a significant change in training programs, (2) in-person surgical skills training and didactic learning would be substituted with virtual learning, and (3) hands-on surgical training and case numbers would decrease and the percentage of fellows graduating with skill levels commensurate with graduation would decrease. Study Design: Cross-sectional study. Methods: In May 2020, a survey was sent to the fellowship directors of all 90 orthopaedic sports medicine fellowships accredited by the Accreditation Council for Graduate Medical Education; it included questions on program characteristics, educational lectures, and surgical skills. A total of 37 completed surveys (41%) were returned, all of which were deidentified. Responses were compiled and saved on a closed, protected institutional server. Results: In a majority of responding programs (89%), fellows continued to participate in the operating room. Fellows continued with in-person clinical visits in 65% of programs, while 51% had their fellows participate in telehealth visits. Fellows were “redeployed” to help triage and assist with off-service needs in 21% of programs compared with 65% of resident programs having residents rotate off service. Regarding virtual education, 78% of programs have used or are planning to use platforms offered by medical societies, and 49% have used or are planning to use third-party independent education platforms. Of the 37 programs, 30 reported no in-person lectures or meetings, and there was a sharp decline in the number of programs participating in cadaver laboratories (n = 10; 27%) and industry courses (n = 6; 16%). Conclusion: Virtual didactic and surgical education and training as well as telehealth will play a larger role in the coming year than in the past. There are effects to fellows’ exposure to sports coverage and employment opportunities. The biggest challenge will be how to maintain the element of human interaction and connect with patients and trainees at a time when social distancing is needed to curb the spread of COVID-19.


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