School of Exercise and Nutritional Sciences, San Diego State University, CA.
Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ.
J Athl Train. 2024 Nov 1;59(11):1153-1162. doi: 10.4085/1062-6050-0567.23.
Medical disqualification (MDQ) following concussion is a challenging decision clinicians may encounter with little evidence-based guidance.
To (1) describe the MDQ following concussion cases athletic trainers (ATs) have been involved in, (2) describe beliefs about MDQ following concussion, and (3) explore factors that ATs believed should be involved in the MDQ following concussion process.
Mixed methods.
Online cross-sectional survey with follow-up semistructured interviews.
Athletic trainers (n = 502) employed at the collegiate setting completed a survey (completion rate = 82.3%, n = 413/502; men = 175, 34.9%; women = 235, 46.8%, prefer not to answer = 4, 0.8%; no response = 88, 17.5%; age = 35.3 ± 10.8 years). Twenty participants were also interviewed (men = 13, 65.0%; women = 7, 35.0%; average age = 40.7 ± 11.0 years).
Participants completed a cross-sectional survey comprised of 3 sections of MDQ experience and specific case information, MDQ beliefs, and demographic items. We also interviewed participants who completed the survey and indicated involvement in at least 1 MDQ following a concussion case. We addressed aims 1 and 2 using descriptive statistics and aim 3 with a 5-cycle content analysis.
Nearly half of respondents had been involved in an MDQ case following concussion (49.0%, n = 246; not involved = 51.0%, n = 256). Athletic trainers who had been involved in at least 1 MDQ case were involved in an average of 2.3 ± 1.9 cases (n = 241). Participants often described many factors that they believed should influence the MDQ decision, including sport type, concussion history and recovery, health-related quality of life, and academic performance.
Our findings highlight that nearly half of participants were involved in an MDQ case following concussion and navigated this process without guidelines. Given this, multiple factors were considered to evaluate the patient's well-being holistically. The number of ATs involved in MDQ cases following concussion and factors that guided this process warrant further research to develop evidence-based recommendations that assist clinicians in these difficult decisions.
脑震荡后的医疗淘汰（MDQ）是临床医生可能遇到的具有挑战性的决策，几乎没有基于证据的指导。
（1）描述运动训练师（ATs）参与的脑震荡后 MDQ 病例，（2）描述对脑震荡后 MDQ 的信念，以及（3）探讨 ATs 认为应参与脑震荡后 MDQ 过程的因素。
混合方法。
在线横断面调查，后续半结构化访谈。
在大学环境中工作的运动训练师（n = 502）完成了一项调查（完成率= 82.3%，n = 413/502；男性= 175，34.9%；女性= 235，46.8%，选择不回答= 4，0.8%；无回答= 88，17.5%；年龄= 35.3 ± 10.8 岁）。还对 20 名参与者进行了访谈（男性= 13，65.0%；女性= 7，35.0%；平均年龄= 40.7 ± 11.0 岁）。
参与者完成了一项横断面调查，包括 MDQ 经验和具体案例信息、MDQ 信念和人口统计项目的 3 个部分。我们还采访了完成调查并表示至少参与过 1 例脑震荡后 MDQ 病例的参与者。我们使用描述性统计数据解决了目标 1 和 2，使用 5 个周期的内容分析解决了目标 3。
近一半的受访者参与了脑震荡后的 MDQ 病例（49.0%，n = 246；未参与= 51.0%，n = 256）。至少参与过 1 例 MDQ 病例的运动训练师平均参与了 2.3 ± 1.9 例（n = 241）。参与者经常描述了他们认为应该影响 MDQ 决策的许多因素，包括运动类型、脑震荡史和恢复情况、健康相关生活质量和学业成绩。
我们的研究结果表明，近一半的参与者参与了脑震荡后的 MDQ 病例，并且在没有指导的情况下处理了这个过程。鉴于此，考虑了许多因素来全面评估患者的健康状况。参与脑震荡后 MDQ 病例的 AT 人数以及指导这一过程的因素值得进一步研究，以制定有助于临床医生做出这些困难决策的循证建议。
