In return-to-sport decision making, a preventive RDO for the medically risky alternative (playing hurt) could be the use of additional protective gear, while a compensating one might be the availability of excellent health insurance. The main goals were to identify different information acquisition patterns and to analyze the influence of varying sporting consequences on decision making. However, this difference is not significant (Fishers exact test, n.s.). Thus, participants dynamically construct and elaborate a mental representation of the decision-making situation (Huber, 2012). Obviously, players refer to implicit anecdotal RDOs and do not need to actively search for this type of information. Br J Gen Pract 2013;63:3423. and transmitted securely. A question did not necessarily have to contain the word probability to be classified as a probability question. It is characterized by a search including sports related information categories and an average of 2.94 (SD: 1.92) questions asked. For almost two thirds of the athletes, playing hurt is the most promising alternative, as medical background and is of initial importance for 57.4 and 6.4% respectively. Interactionist research indicates that sport participation is related to 1) ongoing processes in peoples lives 2) decision making processes in which decisions: change as social circumstances change and are not made one and for all time Stevensons findings 1999: Becoming an elite athlete involves sharing sensitive information, make sure youre on a federal Against this background we hypothesize, that the severity of perceived sporting consequences of being absent affects the information search patterns and consequently influences athletes mental representation about their most promising option. Therefore, return-to-play decisions have to be considered as risky decisions (Huber, 2012), which are generally defined by at least one uncertain negative outcome in at least one of the alternatives. JM wrote the initial draft of the manuscript. Compete or rest? Neither sports discipline (2(2, N = 33) = 2.35, p > 0.05) nor gender (2(1, N = 33) = 0.503, p > 0.05) is significantly associated with a search for SC information. In other experiments where people were told to justify their decision afterward, an intensified search for information could be observed (Huber et al., 2009). Before By manipulating the answers to specific questions, the effects of particular kinds of information on search processes and final decisions can be analyzed using experimental study designs. On the other hand, we see athletes who base their choice solely on medical information. The impact of sports participation on mental health and social outcomes Here, it needs also to be evaluated, under which personal (e.g., ones injury experiences) and social circumstances (e.g., leadership style of the coach or position within the team) specific RDOs are considered as acceptable. In the following, we will focus on the question of how athletes proceed when confronted with risky return-to-play decisions. Objective: As the subgroup analyses including the 33 athletes requesting SC-information reveal, decisions to play hurt almost always refer to the detection of an RDO. If athletes are perceived as fully competent, they are supposed to make an informed decision (Dijkstra et al., 2017). Policy and politics of women's sport and women in sport Since the late 1980s an increasing number of studies related to sports and sport culture have viewed socialization as a community and cultural process. Overall relevance of categories info search, Ill play although it hurts / even if this is bad for my health (2), For this game, it is not worth risking a more severe injury (10); I do not want to take the risk of a long-term injury/sports invalidity (10); If I play, the risk of a long lay-off due to a more severe injury/rupturing the tendon is too high (8); If I rest, I am out for just a few weeks which is better than having to rest months with a tendon rupture (3); High Risk (1), To support the team, I am going to play for just a few minutes/at less than 100%/stop playing when pain increases during the match (10); To support the team, I postpone the lay-off until the next match is over (4); I will get my shoulder tape bandaged before the match (4); Take painkillers to be ready to support team (3); The doctor does not categorically exclude the option to play (2); Excellent treatment options after a potential tendon-rupture leads me to play (1), An adequate substitute is available so I can rest to be back soon (3), I want to support the team/I dont want to abandon the team (4); The upcoming match is very important and the team needs me (1), It is reasonable to fully recover from an injury before practicing sports again (3), It is highly probable that severe long-term damage occurs if I play, and that I am also not 100% fit to play (1); There is a 50/50 percent chance that the tendon ruptures, so the risk of a 6-month recovery time is too high (1), The probability of tendon rupture is disproportional to the predicted lay-off time of 6 weeks (1), Information search and information type condition (n), Decision heuristic by alternative (based on justification texts). FOIA doi: 10.5694/mja2.50881. Bethesda, MD 20894, Web Policies Eligibility criteria: The same applies to potential gender effects, which too are the subject of controversy. , Determining the information participants need: methods of active information search. This study presents the results of an updated systematic review of the mental health and social outcomes of community and elite-level sport participation for adults. Although justification pressure was applied, one-third of all athletes decided without actively searching for additional information at all. For this, the basic procedure of the method of active information search (Huber et al., 2011a) was adjusted to the aims of our study and combined with scientific knowledge about return-to-play issues and practical knowledge taken from expert interviews with doctors and physiotherapists working in team sports settings. Transferred to athletes, negative medical consequences are likely to come into focus if the alternative to return-to-play hurt is closely inspected as the most promising one. Finally, as soon as an RDO has been explicitly detected or implicitly identified, it has to be decided whether it is acceptable in terms of cost-benefit ratio (Huber, 2012). Those who actively searched for SC information and who got confronted with low SC all chose the medically safe alternative to rest (100%). Available: Verstegui EL. When using Maximax, the best outcome of each alternative is first identified, then the best outcomes are compared, and finally, the alternative with the best of the best outcomes is chosen. Sports Participation and Academic Success - Phdessay How do varying sporting consequences (SC) affect information acquisition strategies and RDO-inclusion within the return-to-play decision-making process? In the current study, physical self-concept is tested as a mediator of the association between social . It was assumed that sports taught young people lessons about teamwork, competition, achievement, productivity, conformity to rules, and obedience to authority. This means that if athletes detect severe SC, they subjectively minimize the risks of playing hurt by an additional action. Gender did not affect information search and decision making in our study. Indications for risk calculations involving probabilities and outcome values as characteristic for SEU can only be found in one of the three texts including probabilities at all. Playing hurt: managing injuries in English professional football. 1 P articipation in physical activity holds a variety of significant physical and mental benefits. Only three athletes (3.2%) mention probabilities in their justifications at all. Therefore, their studies missed the tension, negotiation, misunderstand ing, and resistance that characterize lived sport experiences. At the same time, there is social pressure on team doctors in order to minimize lay-off times and clear athletes for competitions (Malcolm, 2006). Another defining aspect of the decision-making situation is the characteristic sports context surrounding the individual athlete who is confronted with a health issue. Syst Rev. The meanings that people give to their sport experiences vary by context in connection with gender, race/ethnicity, social class, age, and (dis)ability, and they change through the life course as people redefine themselves and their connections with others. There is a long tradition of research on sports and socialization. Additionally, many parents in the 1970s had come to define participation in organized sports as important for the development and social status of their children. Quantitative content analysis reveals that athletes refer to distinct justification strategies when explaining their decisions (see Table 2). Other research analyzing NELS data shows that high school participation in extracurricular school activities (ESAs) are more strongly related to positive school outcomes than out-of-school extracurricular activities. Received 2019 Dec 20; Accepted 2020 Apr 23. Influence of the Coach's Method and Leadership Profile on the Positive To justify recovery, 44% of the athletes mention the risk of severe medical consequences (e.g., aggravation of injury, long-term injury, or sports invalidity) as too high compared to the potential negative outcomes of not being part of the team. This could also help to reduce the activation of potential medical background knowledge, to get a clearer picture of participants fundamental information needs. The participating athletes were randomly assigned to one of the two sporting consequences groups (high sporting consequences vs. low sporting consequences). Additionally, most of these correlational studies simply divided all respondents into so called athletes and nonathletes, thereby ignoring their participation histories and the confounding effects of participation in a wide range of activities offering experiences closely resembling those offered by playing on school sponsored varsity teams. Neither types of sports (2(2, N = 26) = 1.21, p > 0.05) nor gender (2(1, N = 26) = 1.16, p > 0.05) is associated with this kind of information request. Still, 13.33% within this group found some RDOs to defuse the risk of SC induced by having a break. Funding. Each answer was printed on an index card. They are further characterized by the need to justify them to significant others like coaches, managers, team members, or even the public. Empirical studies of socialization and sport were initiated in the 1950s as the first cohort of baby boomers in North America inspired parents as well as developmental experts to seek optimal conditions for teaching children, especially boys, the skills needed to succeed as adults in rapidly expanding, competitive, national and global economies. Coping with growth in adolescent elite sport. Creighton D. W., Shrier I., Shultz R., Meeuwisse W. H., Matheson G. O. If an acceptable RDO for medical consequences is identified, the chances of playing hurt are extremely high, particularly if high SC are perceived. In the following section, the choices are further analyzed in terms of underlying decision heuristics with regard particularly to the influence of high and low SC. People who choose to play sports are selected to participate by coaches, and those who remain on teams generally differ from others in terms of their characteristics and relationships. The Health Survey for England (HSE) [ 13] found that the number of physically inactive people (less than one occasion of 30-min activity per week) was increasing and that this trend was consistent for both genders and across all age groups [ 14 ]. Introduction: Girls are often less motivated to participate in community sport compared to boys. A supportive research environment would facilitate their involvement in research only if the research agenda fit with their social environment. In the following paragraphs, the resulting introductory scenario description and further information about data generation and statistical procedures are presented. In both conditions, the most relevant category before the final decision is SC, as 27 out of 33 athletes (81.8%) make their choice after getting this kind of information. Although the decision-making process of research participation in Fig 1 appears to lead from one stage to another, all three factors operated simultaneously. Although we ruled out that the participants had sustained an injury like the one we used in our scenario, it is still possible that knowledge from past injuries and/or shared experiences with teammates pre-structured the mental representations of the participants. Sport, physical danger and injury: the experiences of elite women athletes. McCormack and Chalip published a key article in 1988 in which they critiqued the methodological premises of research on socialization through sports. Thus, a sufficient number of alternate players in a team can be interpreted as a social resource that fosters health oriented decision making. In this regard, the active interest of the participants in certain contents is taken as an indicator of the importance of specific kinds of information for deciding. The alternative with the best subjective outcome is chosen, whereas no probabilities or no negative consequences are mentioned. Leisure participation: modelling the decision to engage in sports and This research acknowledges that sports and the discourses that constitute them have become one of the more influential narratives in twenty first century culture. & Donnelly, P. Within the low SC group, the Maximin heuristic is mostly used when the choice to rest is made (86.7%). However, this holds true only for situations with SC of having a break. Kostopoulou O., Mousoulis C., Delaney B. Decisions about whether to return to play or rest when having an acute health problem are typical of all kinds of sports. In order to capture potential effects of sports discipline specific risk cultures, athletes from distinct team sports were recruited for the study, including a typical high contact sport (handball), a medium contact sport (basketball) and a non-contact sport (volleyball). Design: This site needs JavaScript to work properly. The dependent variables in these studies included academic achievement, occupational mobility, prestige and status in school cultures, political orientations, rates of delinquency and deviance, and various character traits such as moral development. However, most interest was also shown in questions about sporting consequences (M: 1.36, SD: 0.5), whereas questions about the sporting situation were only asked occasionally (M: 0.29, SD: 0.73). Example: I chose not to play because it is better to fully recover from an injury before practicing sports again. For children to participate in research, both parental permission and child assent, defined as agreement to participate, must be obtained. Those who chose to withdraw from competition primarily referred to maximin heuristic, particularly when social pressure to play was reduced. However, the analysis shows that RDOs become particularly relevant when the SC are high and consequently, social pressure to compete is increased. Other common RDOs are to postpone the recovery (N = 4), getting ones shoulder taped (N = 4), and taking pain killers (N = 3). For nearly a century the validity of these beliefs was taken for granted and promoted by those associated with organized competitive sports in these countries. If no decision code could be assigned. The coach also tells you that he needs to be immediately informed about whether he can count on your participation in the upcoming competition. Consequently, painkillers are often used and medical treatments are timed in accordance to the relevance of upcoming games and the seasonal stage (Murphy and Waddington, 2007; Roderick, 2006). A central goal of the study was to investigate which types of information team sport athletes need for return-to-play decision making. These strategies are applied to justify both choices. Information on adaptive sport has to be incorporated in future research as a possible factor that may explain why some learners participate in sport and others not. On the contrary, volleyball players most often showed search strategies including medical consequences and background information (Volleyball: 46.2% vs. Handball: 38.5% vs. Basketball: 15.4%) as well as sports related information (Volleyball: 41.2% vs. Handball: 35.3% vs. Basketball: 23.5%). On the other hand, given the same acute illness or injury, it can be assumed that those athletes who only perceive minor sporting consequences can easily prioritize health referring to heuristics such as Maximax. Research indicates that many people with serious mental illnesses, at least outside the context of the most acute phases of illness, retain the capacity to understand, appreciate, reason and to make and express a choice about participating in research protocols (Appelbaum, 2006; Jeste, Depp, & Palmer, 2006). Thus, the precondition for a team sport to be included within this study was the shared characteristic, wherein a functioning shoulder joint is essential for the shooting movements and overall sports performance. However, the only difference we found was that basketball players were less interested in additional medical and sports related information acquisition than volleyball and handball players. However, your teams next game is scheduled for the following Saturday. Frontiers | Understanding Girls' Motivation to Participate in Sport The findings can be used to improve rehabilitation-related communication and shared return-to-play decision making in sports. Socialization through sport is tied to issues of identity and identity development. Such RDOs were included in 77.7% of all justification texts of those athletes who chose to play, while no such information was referred to when taking the alternative to rest. After an in-depth examination, the team doctor diagnoses a partial tear of the supraspinatus tendon. specifically on sport played by women, e.g. government site. Clinical practice and empirical research show that return-to-play decision authority varies to a relevant extent and stakeholder groups often have heterogeneous opinions on which criteria should be considered when deciding (Shultz et al., 2013; Shrier et al., 2014). The athlete group which requested sports related infomation only, in particular, obviously shows no interest in potential medical consequences or medical background information about the condition. When does information about probability count in choices under risk? State University of New York Press, Albany. Witham MD, Anderson E, Carroll C, et al. Inclusion in an NLM database does not imply endorsement of, or agreement with, False The statement that "sports are reflections of society" ignores the capacity of people to participate in the process of cultural production. Further analysis reveals that those who search for SC-information are mostly interested in the relevance of the game (26 out of 44 questions asked), followed by questions about the players position within the team (10 out of 44), and the specific advice of the team doctor (4 out of 44). The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Against this background, we were looking for a suitable theoretical and methodical approach to research athletes return-to-play decision making procedures. All questions asked by the participants during the decision process were categorized by the experimenter and answered non-verbally using the prepared index cards. Against this background, we assume the social context of sports with its particular social expectations (e.g., performance orientation, sports culture of risk) to fundamentally influence the decision-making processes. The next step included an introduction to the scenario method. Those main categories were developed in accordance to previous studies using the method of active information search (e.g., Br and Huber, 2008) and adjusted to the case of return-to-play decisions: All questions about the medical situation or medical background information. Coming back to the case at hand, assuming that Dr T has not done so already, she should start with the first step in shared decision making for informed consent: the assessment of Mr X's health and research literacy. What are the effects of RDO-inclusion and use of other heuristics on return-to-play decisions in relation to varying SC? Given the great importance of morality and values in modern sports, especially among young athletes, in this pilot study, we sought to broaden the exploration of the factors that may play role in these contexts, which have not been widely researched to date. Participants assigned to the condition high sporting consequences were confronted with strong social pressure to compete. Arajo D., Hristovski R., Seifert L., Carvalho J., Davids K. (2019). People obviously do not rely on probabilities, they rather orientate themselves on their own experience (Huber and Macho, 2001). Singapore Statement on Research Integrity - WCRIF RDOs are mainly included to justify the alternative to play hurt (33%, N = 24). Sports participation in sport clubs, gyms or public spaces: How users Maximin compares the worst outcomes of alternatives and chooses the alternative with the least bad outcome. Willingness to compete hurt among adolescent elite athletes. Return to play in elite sport: a shared decision making process. RDO or probability information are not of initial importance. Decision heuristic used in relation to information search type and sporting consequences condition. Against this background, the developed study design and procedure for analyzing athletes return-to-play decisions are presented in the following sections. This step was realized by matching the question to one of the 95 prepared answers. The criteria for inclusion were: age 1835, at least two training units per week, active participation in competitions within a team playing in the German league system (3rd to 6th league level), and no professional athletic experience. Perceiving higher social consequences also does not lead to an increased active information search for RDOs, which further underlines the fundamental role implicit RDOs must have in expert decision making. Against this background, the following theoretical considerations will focus on those typical risky return-to-play decision scenarios which arise, whenever an acute health event is detected in competitive sports irrespective of an athletes performance level, type of sport, age, or sex. A central goal was to develop a scenario which allowed the inclusion of performance oriented amateur athletes from different team sports. RDOs are mostly used in the written explanations of those athletes who chose the playing hurt alternative. Results: This indicates that the alternative to rest is most thoroughly evaluated. In line with general RMD-theory, such explicit and implicit RDOs are supposed to play the decisive role within decision-making processes: If an acceptable RDO is found, then usually the associated risky alternative is chosen. However, the results about initially requested information reveal that most athletes consider the medically risky alternative to play as the most promising one and stop searching to decide after SC-information is retrieved. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Only 2.8% of the players mention that the negative health consequences are considered at least as bad as the negative sporting ones. Those who asked these questions were often associated with organized sport programs, and they usually had vested interests in recruiting participants and promoting their programs by linking sport participation to positive developmental outcomes. Patients information needs and decision making processes: what can be learned from genetic counselees?
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