The Influence of Concussion on Athletes’ Occupational Identity Presented by: Ruth Bakewell, Aldith...
Transcript of The Influence of Concussion on Athletes’ Occupational Identity Presented by: Ruth Bakewell, Aldith...
The Influence of Concussion on Athletes’ Occupational
Identity
Presented by: Ruth Bakewell, Aldith Dawson, Lizna Husnani, Erin McQuay, Christy Pickles and Keely Slessor
Agenda
TopicResearch ProcessDefinitionsInitial ModelCritical Review and Development of ModelFinal ModelRelevance to OS and OTGaps & Future Directions Facilitated Discussion
What is the influence of concussion on athletes’ occupational identity?
Research Process
Search interfaces: Ovid, Pubmed, Cambridge Scientific
Databases: PsychInfo, Medline, Sport Discus, Cinahl, ERIC
Keywords: concussions, mild traumatic brain injury, head injury, athletic injury, career-ending injury, athletes, elite athletes, athletic identity, athletic role, sports injury, depression, psychological effects
Research Process Cont’d…
Inclusion criteria for research articles Related to at least one component of the topic Well designed study Added new information to topic area
Shortfalls in research process General difficulty in finding relevant research topic Concussion specific literature Occupational identity and lack of participation in
sports
DefinitionsOccupational Identity “a composite sense of who one is and wishes to become as
an occupational being generated from one’s history of occupational performance”
shaped by capacities, interests, roles, relationships, obligations, routines, environment contexts and expectations
volition, habits and lived, bodily experiences combine to create an occupational identity that is a “means of self definition and a blueprint for upcoming action”
(Kielhofner, 2002)
Athletic Identity "degree to which an individual identifies with the athlete role"
(Brewer, Van Raalte & Linder, 1993)
Definitions Cont’d…
Post-concussion Syndrome• Personality changes• Headaches• Dizziness• Fatigue• Irritability• Depressed Mood• Anxiety
(Putukian, 2001)
Concussion• A violent shaking or jarring• An injury of a soft structure, as the brain, resulting from a blow or violent shaking
(stedmans.com)
Definitions Cont’d…
Occupational Deprivation “a state of prolonged preclusion from engagement in
occupations of necessity and/or meaning due to factors which stand outside of the control of the individual”
Occupational Disruption “a transient or temporary condition of being restricted
from participation in necessary or meaningful occupations such as that caused by illness, temporary relocation, or temporary unemployment”
(Townsend, 1996)
ATHLETIC
IDENTITY
Initial Model
“I think it just really bummed her out, because she had been doing it for so long and that becomes part of who she was. When that’s not who you are anymore, then you’re kind of lost”
(Female, Trainer, Age 21)(Granito, 2001)
Mainwaring, L. M., Bisschop, S. M., Green, E. A., Antoniazzi, M., Comper, P., Kristman, V., Provvidenza, C. & Richards, D. W. (2004). Emotional Reaction of Varsity Athletes to Sport- Related Concussion. Journal of Sport & Exercise Psychology, 26, 119-135.
CRITICAL ANALYSIS
Purpose To compare emotional functioning of university
athletes with MTBI (concussion) to that of uninjured teammates and physically active undergraduates.
Literature Previous studies lack pre-injury mood assessment
Design of Study Quantitative study
Methods Sample: Groups of U of T students: concussed athletes,
uninjured teammates of concussed athletes and healthy, physically active undergraduate students
Measured baseline mood state with a preseason medical and neuropsychological assessment
Following concussion, athletes completed a series of assessments for 4 weeks
Demographic questionnaire Short version of the Profile of Mood States (POMS)
ResultsNo difference in POMS ratings among the
three groups at pre-injury. Significant interactions were observed for
the POMS subscales of depression, confusion and total mood disturbance, which indicate that concussion and control groups respond differently in terms of mood across the 4 sessions.
Conclusions The three groups were not emotionally different
according to baseline testing. Concussed group showed higher ratings of
depression, confusion and total mood disturbance Emotional reactions may be the result of:
removal of play transient biochemical disturbances following brain injury.
TIME OUT OF PLAY
BIO-CHEMICALDISTUR-BANCE
PSYCHOLOGICAL/EMOTIONAL EFFECTS
CONCUSSION
Brock, S.C. & Kleiber, D.A. (1994). Narrative in Medicine: The stories of elite college athletes’ career-ending injuries. Qualitative Health Research, 4(4), 411-430.
CRITICAL ANALYSIS
Purpose To illustrate the relevance of narrative to medical
practice To demonstrate systematic method for assessing
illness narratives using the stories of elite college athletes who experienced career-ending injury
Literature Review Narrative has been used as an explanatory
complement to quantitative research Injured athletes are ideal to demonstrate the
general view of illness and how another approach would be helpful to understand the illness experience
Design of studyQualitative study
MethodsNarrative Analytic Method Individual interviews were conducted: face-
to-face or by phoneSample:17 former college athletes whose
sport careers were ended by injury Interviews assessed using core-narrative
approach
Results Injury interpreted as a disruption in the life
narrative had a negative impact on self-esteem and identity
Stories of injured athletes follow a clinically relevant pattern, like a book with 6 “chapters”.
The impact of sport culture: laminility - the experience of an ambiguous,
undefined, and invisible condition because of lack of role (on team);
stigma - feelings regarding the loss of a celebrated state and acquisition of a state of relative ordinariness.
Conclusion Information about the athlete’s personal
experiences with injury gives insight into the psychosocial impact of injury not just physiological impact.
It is important to include narrative in medical practice in order to get a holistic picture of the client and capture what the injury means to them.
The perspective derived from illness narratives would be an appropriate complement to the biomedical view.
FINAL MODEL
TIME OUT OF PLAY
BIO-CHEMICALDISTUR-BANCE
PSYCHOLOGICAL/EMOTIONAL EFFECTS
CONCUSSION
ATHLETICIDENTITY
Relevance to Occupational
Science and
OccupationalTherapy
Research
Relevance
Occupational ScienceSubstantiates the link between
occupational identity and occupational deprivation/disruption
Contributes to the understanding of athletic identity in relation to occupational identity
Relevance Cont’d…
Occupational TherapyThe extent to which an athlete identifies
with their athlete role may determine adherence to the rehabilitative process
Reinforces the importance of a holistic approach to clinical intervention (i.e., psychological/emotional effects of concussion)
ENVIRONMENTSocial Support
SEVERITY
OCCUPATIONAL IDENTITY
TIME OUT OF PLAY
BIO-CHEMI-CALDISTUR-BANCE
PSYCHOLOGICAL/EMOTIONAL EFFECTS
CONCUSSION
ATHLETICIDENTITY
Gaps and Future Research
TIME OUT OF PLAY
CONCUSSION
ATHLETICIDENTITY
BIOCHEMICAL DISTURBANCES
PSYCHOLOGICAL/EMOTIONALEFFECTS
PSYCHOLOGICAL/EMOTIONALEFFECTS
Discussion“I was disappointed. One, because you’re not in the spotlight anymore and I think that whenever you’re in the spotlight and then it’s shut off for you, I think there’s always some kind of identity crisis and I’m sure there was.”
“All the sudden you’re standing on the outside looking in. You feel kind of lost for a while. And I felt that way for a long time … It wasn’t so much a loss of self-esteem as maybe – I always felt like people were looking at me differently, like I was something less than I was before.”
(Brock & Kleiber, 1994)
Discussion Cont’d…
Tell us about your rehabilitation experience (with respect to concussion or other athletic injury)
How do you think seeing an OT could have contributed to the rehabilitation process?
Thank You!