Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
Northwestern University Health Services, Evanston, Illinois.
Clin J Sport Med. 2021 Sep 1;31(5):453-454. doi: 10.1097/JSM.0000000000000835.
Recommendations for addressing sporting eligibility and disqualification in athletes with heart disease have traditionally used a paternalistic approach with cardiologists making a binary "yes-no" decision. This paradigm has recently evolved to a shared decision-making model recognizing and respecting the autonomy of the athlete while instituting safeguards to mitigate risk where possible. How well this paradigm is understood or has been integrated into the athletic trainer (AT) community is unknown.
Athletic trainers from the Ohio High School Athletic Association were surveyed.
Of 107 ATs who responded, we found that the majority had not heard of the term "shared decision-making" in the context of sporting participation [62.6%, confidence interval (CI) 0.53-0.72 vs 37.4%, CI 0.28-0.47]. Furthermore, we found large discrepancies as to how ATs would interpret and implement recommendations from cardiologists.
This study highlights the need to educate and improve communication between AT, sports medicine physicians, and sports cardiologists if shared decision-making strategies are to become widely implemented.
传统上，心脏病运动员的运动资格和取消资格的建议采用家长式方法，由心脏病专家做出“是或否”的二元决策。这种模式最近已经发展为一种共同决策模式，承认并尊重运动员的自主权，同时在可能的情况下采取保护措施来降低风险。这种模式的理解程度或已经融入运动训练师（AT）群体的程度尚不清楚。
对俄亥俄州高中体育协会的运动训练师进行了调查。
在 107 名做出回应的 AT 中，我们发现大多数人没有听说过“共同决策”这个术语在运动参与中的含义[62.6%，置信区间（CI）0.53-0.72 与 37.4%，CI 0.28-0.47]。此外，我们发现 AT 对如何解释和实施心脏病专家的建议存在很大差异。
如果要广泛实施共同决策策略，本研究强调需要教育和改善 AT、运动医学医生和运动心脏病专家之间的沟通。
