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Marmura H, Bryant D, Getgood A, Webster F. 'It's just my knee': a qualitative study investigating the process of reframing and young athletes' perceived quality of life between anterior cruciate ligament injury and surgery. BMJ Open 2024; 14:e076799. [PMID: 38724051 PMCID: PMC11086484 DOI: 10.1136/bmjopen-2023-076799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES To understand the factors influencing young athletes' perceptions of quality of life (QOL) following an anterior cruciate ligament (ACL) rupture, prior to reconstructive surgery. DESIGN Qualitative descriptive study using semi-structured interviews and thematic analysis of data. SETTING Tertiary sports medicine clinic with patients recruited from the practices of three specialist orthopaedic surgeons. PARTICIPANTS Twenty athletes aged 14-25 provided consent to participate in the study and completed interviews prior to their ACL reconstruction surgery. Participants were eligible to participate if they were scheduled to undergo ACL reconstruction, were 25 years of age or younger, identified as athletes (participated in any level of organised sport), could communicate in English and agreed to be audio recorded. Participants were not eligible if they had experienced a multiligament injury or fracture. RESULTS Young athletes shared common factors that made up their QOL; social connections and support, sport, health, and independence. However, participants' perceptions of their current QOL were quite variable (13-95/100 on a Visual Analogue Scale). Participants who were able to reframe their injury experience by shifting focus to the positive or unaffected aspects of their lives tended to have more favourable perceptions of their QOL than participants who shifted focus to the losses associated with injury. CONCLUSIONS Young athletes who have experienced an ACL injury define their QOL based on social support, sport, health and independence. Individual processes of adaptation and cognitive reframing in response to an ACL injury may exert a greater influence on postinjury QOL than the physical ramifications of the injury itself. Understanding individual perceptions may help target potential interventions or supports to enhance athletes' adaptation to injury.
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Affiliation(s)
- Hana Marmura
- Faculty of Health Sciences, Western University, London, ON, Canada
- Fowler Kennedy Sport Medicine Clinic, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
- Lawson Research, London Health Sciences Centre, London, ON, Canada
| | - Dianne Bryant
- Faculty of Health Sciences, Western University, London, ON, Canada
- Fowler Kennedy Sport Medicine Clinic, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
- Lawson Research, London Health Sciences Centre, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Alan Getgood
- Faculty of Health Sciences, Western University, London, ON, Canada
- Fowler Kennedy Sport Medicine Clinic, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
- Lawson Research, London Health Sciences Centre, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Fiona Webster
- Faculty of Health Sciences, Western University, London, ON, Canada
- Bone and Joint Institute, Western University, London, ON, Canada
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Frerichs L, Smith C, Hoover S, Robinson-Ezekwe N, Khanna A, Ellerby B, Joyner L, Wynn M, Wrenn J, Stith D, Lindau S, Corbie G. Comparative Evaluation of 2 Work Experience Approaches for Predominantly Black Youth in a Rural Community: Implications for Public Health Workforce Development. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:21-32. [PMID: 36448755 PMCID: PMC9718253 DOI: 10.1097/phh.0000000000001661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
CONTEXT In order to create a more diverse workforce, there is a need to involve historically excluded youth in public health-related work. Youth involvement in asset-based work experience approaches is especially relevant for rural areas with workforce shortages. OBJECTIVE To explore the public health workforce development implications of community-based career exploration and asset mapping work experience from the perspective of Black youth. DESIGN We used qualitative in-depth interviews with youth, aged 14 to 22 years, who participated in a work experience program anchored in several rural counties in southeastern United States. A phenomenological lens was applied for qualitative analyses with iterative, team-based data coding. Participants were also surveyed pre- and postprogram to supplement findings. PROGRAM A rural community-based organization's work experience program consisted of 2 tracks: (1) Youth Connect-a career exploration track that included work placement within community agencies; and (2) MAPSCorps-a track that employs youth to conduct asset mapping for their community. RESULTS We interviewed 28 of 31 total participants in the 2 tracks. We uncovered 4 emergent profiles in how youth described shifts in their perceptions of community: (1) Skill Developers; (2) Community Questioners; (3) Community Observers; and (4) Community Enthusiasts. In comparing between tracks, youth who participated in work experience that involved asset mapping uniquely described increased observation and expanded view of community resources and had greater increases in research self-efficacy than youth who participated only in career exploration. CONCLUSION Asset mapping work experience that is directly placed in rural communities can expose Black youth to and engage them in essential public health services (assessing and mobilizing community assets) that impact their community. This type of program, directly integrated into rural communities rather than placed near academic centers, could play a role in creating a more diverse public health workforce.
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Affiliation(s)
- Leah Frerichs
- Gillings Global School of Public Health, Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina, Chapel Hill, NC
| | - Cambray Smith
- Gillings Global School of Public Health, Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina, Chapel Hill, NC
- School of Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - Stephanie Hoover
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina, Chapel Hill, NC
| | - Nicole Robinson-Ezekwe
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina, Chapel Hill, NC
| | - Anisha Khanna
- Gillings Global School of Public Health, Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina, Chapel Hill, NC
| | - Brian Ellerby
- Opportunities Industrialization Center, Inc., Rocky Mount, NC
| | - Linda Joyner
- Opportunities Industrialization Center, Inc., Rocky Mount, NC
| | | | - Jonina Wrenn
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina, Chapel Hill, NC
| | - Doris Stith
- Community Enrichment Organization, Tarboro, NC
| | - Stacy Lindau
- Department of OB/GYN, University of Chicago, Chicago, IL
- Department of Medicine, University of Chicago, Chicago, IL
| | - Giselle Corbie
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina, Chapel Hill, NC
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC
- Department of Medicine, University of North Carolina, Chapel Hill, NC
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Pieri M, Brilhante J. "The Light at the End of the Tunnel": Experiences of LGBTQ+ Adults in Portuguese Healthcare. Healthcare (Basel) 2022; 10:146. [PMID: 35052309 PMCID: PMC8775983 DOI: 10.3390/healthcare10010146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/29/2021] [Accepted: 01/02/2022] [Indexed: 11/25/2022] Open
Abstract
This work analyses experiences of LGBTQ+ people accessing healthcare in Portugal. A total of 32 semi-structured interviews were conducted with queer adults (18-59 years old). The thematic analysis and thematic networks brought to light how structural cis-heteronorms are compliant with the maintenance of invisibility regarding sexual and gender diversity. As a consequence, experiences of direct and indirect discrimination show us how crucial it is to have well prepared healthcare providers, capable of embracing diversity and creating safe spaces that allow us to shorten the path between Portugal's progressive legal frame and the people lived experiences.
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