School of Health Professions, University of Southern Mississippi, Hattiesburg, MS 39406, USA.
Sports Medicine and Community Health Research Lab, University of Southern Mississippi, Hattiesburg, MS 39406, USA.
Int J Environ Res Public Health. 2024 Jan 11;21(1):82. doi: 10.3390/ijerph21010082.
Concussions are a common sport-related injury that require appropriate initial care. Athletic trainers, often a primary source of healthcare for student-athletes, are key individuals involved in initial concussion diagnostic and management decisions. Challenges exist within the athletic environment that may hinder the consistency, efficacy, and/or effectiveness of concussion-related decision-making by athletic trainers, thereby impacting secondary concussion prevention and patient health. The purpose of this study was to identify factors that impact the intentions of athletic trainers to make appropriate concussion-related decisions under various circumstances. Overall, 1029 participants completed a survey examining educational precursors (quantity and quality of healthcare communication educational focus), demographic precursors (age, gender, educational degree, and employment setting), theory-based mediators (attitudes, perceived norms, and personal agency), and external mediators (knowledge, salience, and communication/collaboration practices) on appropriate concussion-related decision-making intentions. Data were analyzed using a two-step structural equation modeling approach. Quality of healthcare communication educational focus indirectly impacted appropriate concussion-related decision-making intentions via perceived behavioral control and communication/collaboration practices. Additionally, several factors impacted intentions to make appropriate concussion-related decisions directly including employment setting, self-efficacy, and general attitudes towards decision-making and concussions. Concussion prevention is aided by the initial and appropriate action taken by a healthcare professional to reduce immediate consequences; however, this action may be influenced by stakeholder relationships. These influential factors of decision-making may place athletes at further injury risk and negatively impact overall athlete health. As such, a sound theoretical framework incorporating the complexity of factors that may influence decision-making is needed.
脑震荡是一种常见的与运动相关的损伤，需要适当的初步护理。运动训练师通常是学生运动员的主要医疗保健来源，是参与初步脑震荡诊断和管理决策的关键人员。运动环境中存在挑战，可能会影响运动训练师在各种情况下做出适当脑震荡相关决策的一致性、效果和/或有效性，从而影响二次脑震荡预防和患者健康。本研究的目的是确定影响运动训练师在各种情况下做出适当脑震荡相关决策的意图的因素。总体而言，1029 名参与者完成了一项调查，该调查考察了教育前体（医疗保健沟通教育重点的数量和质量）、人口统计学前体（年龄、性别、教育程度和就业环境）、基于理论的中介因素（态度、感知规范和个人能动性）以及外部中介因素（知识、凸显性和沟通/协作实践）对适当脑震荡相关决策意图的影响。使用两步结构方程建模方法分析数据。医疗保健沟通教育重点的质量通过感知行为控制和沟通/协作实践间接影响适当的脑震荡相关决策意图。此外，几个因素直接影响做出适当脑震荡相关决策的意图，包括就业环境、自我效能感以及对决策和脑震荡的一般态度。通过医疗保健专业人员采取初步和适当的行动来减少即时后果，有助于预防脑震荡；但是，这种行动可能会受到利益相关者关系的影响。这些决策的影响因素可能会使运动员面临进一步受伤的风险，并对运动员的整体健康产生负面影响。因此，需要一个包含可能影响决策的因素的复杂的合理理论框架。
