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Patient-Centered Care in Sports Medicine Services

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: closed (15 February 2023) | Viewed by 20295

Special Issue Editor

Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
Interests: athletic training programs; tactical athletes; behavior concepts; telemedicine; patient-centered care

Special Issue Information

Dear Colleagues,

The Special Issue will be focused on the healthcare core competency of patient-centered care. Specifically, we are seeking submissions on the provision and delivery of patient-centered care in sports medicine, athletic training, physical medicine, physical therapy, and orthopaedics. The articles can be quantitative or qualitative reports. Priority will be placed on articles exploring the extent to which healthcare providers (e.g., physicians, athletic trainers, etc.) provide patient-centered care. The Special Issue will continue to explore and document best practices within sports medicine when delivering patient-centered care for work, life, and sport in the physically active.

Potential topics include, but are not limited to: Shared decision making; Fear and anxiety relief; Goal setting; Guidance and support for support systems; Self-management & care strategies; Health literacy and communication strategies; Social determinants of health & cultural considerations; Access to care; Patient education; Use of disablement models (e.g., Nagi, WHO ICF).

Dr. Zachary K. Winkelmann
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • goal setting
  • respect
  • comfort
  • continuity
  • access to care
  • family
  • emotional support
  • integration of care
  • advocacy

Published Papers (9 papers)

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Editorial

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6 pages, 293 KiB  
Editorial
Financial Health Literacy and the Shared Decision-Making Process in Healthcare
by Caitlin S. O’Mara, Justin P. Young and Zachary K. Winkelmann
Int. J. Environ. Res. Public Health 2022, 19(11), 6510; https://doi.org/10.3390/ijerph19116510 - 27 May 2022
Cited by 2 | Viewed by 1773
Abstract
Patient-centered care is the delivery of care that is unique to each patient, individualized to their needs, and established through a shared patient–clinician decision-making process [...] Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)

Research

Jump to: Editorial

11 pages, 1542 KiB  
Article
Athletic Trainers’ Perceptions of and Experience with Social Determinants of Health
by Kelsey J. Picha, Cailee E. Welch Bacon, R. Curt Bay, Joy H. Lewis and Alison R. Snyder Valier
Int. J. Environ. Res. Public Health 2023, 20(8), 5602; https://doi.org/10.3390/ijerph20085602 - 21 Apr 2023
Viewed by 1672
Abstract
The role that social determinants of health (SDHs) play in athletic healthcare is gaining attention, yet little is known about athletic trainers’ (ATs) perceptions of and encounters with the impact of SDHs. The purpose of this study was to evaluate ATs’ perceptions of [...] Read more.
The role that social determinants of health (SDHs) play in athletic healthcare is gaining attention, yet little is known about athletic trainers’ (ATs) perceptions of and encounters with the impact of SDHs. The purpose of this study was to evaluate ATs’ perceptions of various SDHs and their experience treating patients whose health and well-being were influenced by SDHs. This was a cross-sectional, web-based survey completed by 1694 ATs (completion rate = 92.6%; 61.1% female; age = 36.6 ± 10.8 years). The survey consisted of several multipart questions focusing on specific SDHs. Descriptive statistics were used to report frequencies and percentages. Results indicated widespread agreement that SDHs matter to patient health and are of concern in athletic healthcare. The SDHs that ATs most commonly reported encountering included lifestyle choices (n = 1306/1406; 93.0%), social support (n = 1185/1427; 83.0%), income (n = 1167/1502; 77.7%), and access to quality and timely healthcare (n = 1093/1420, 77.0%). The SDHs that ATs least commonly reported having experience with was governmental policy (n = 684/1411; 48%). The perceived importance of SDHs among ATs and their commonly reported experiences managing patient cases in which SDHs negatively influence patients’ health and healthcare suggest that efforts to assess these factors are needed so that strategies to address their influence on athletic healthcare can be identified. Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)
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10 pages, 597 KiB  
Article
Implementation of Patient-Centered Care by Athletic Training Students during Clinical Experiences: A Report from the Association of Athletic Training Education Research Network
by Julie M. Cavallario, Bonnie L. Van Lunen, Stacy E. Walker, R. Curtis Bay and Cailee E. Welch Bacon
Int. J. Environ. Res. Public Health 2023, 20(8), 5513; https://doi.org/10.3390/ijerph20085513 - 14 Apr 2023
Viewed by 1303
Abstract
Patient-centered care (PCC) is a core competency that should be required by all healthcare education programs, but little is known about its implementation in athletic training clinical experiences. Therefore, we examined characteristics of patient encounters documented by athletic training students implementing PCC behaviors. [...] Read more.
Patient-centered care (PCC) is a core competency that should be required by all healthcare education programs, but little is known about its implementation in athletic training clinical experiences. Therefore, we examined characteristics of patient encounters documented by athletic training students implementing PCC behaviors. A multisite panel design was used to recruit 363 students from twelve professional athletic training programs (five undergraduate, seven graduate). Over 1.5 years, clinical experience patient encounter data were logged in E*Value Case Logs, including student role during the encounter, length of encounter, and clinical site. Generalized estimating equations models characterized the likelihood students included PCC behaviors in 30,522 encounters. Discussing patient goals was associated with student role (χ2(2) = 40.6, p < 0.001) and length of encounter (χ2(4) = 67.6, p < 0.001). Using patient-reported outcome measures was associated with student role (χ2(2) = 21.6, p < 0.001), length of encounter (χ2(4) = 34.5, p < 0.001), and clinical site (χ2(3) = 17.3, p = 0.001). Implementing clinician-rated outcome measures was affected by length of encounter (χ2(4) = 27.9, p < 0.001) and clinical site (χ2(3) = 8.6, p = 0.04). PCC behaviors were largely associated with student role and length of encounters; clinical site had less impact. Athletic training educators should emphasize progressive autonomous supervision with preceptors and encourage students to facilitate slightly longer patient visits, when possible, to incorporate more PCC behaviors. Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)
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9 pages, 315 KiB  
Article
The Integration of Patient-Centered Care and the Biopsychosocial Model by Athletic Trainers in the Secondary School Setting
by Adriana M. Mendoza, Matthew J. Drescher and Lindsey E. Eberman
Int. J. Environ. Res. Public Health 2023, 20(8), 5480; https://doi.org/10.3390/ijerph20085480 - 12 Apr 2023
Viewed by 1428
Abstract
Our purpose was to explore the degree to which secondary school athletic trainers (SSATs) perceive they are integrating the principles of patient-centered care (PCC) and the biopsychosocial (BPS) model in their practice. We used a cross-sectional design to explore the primary research question. [...] Read more.
Our purpose was to explore the degree to which secondary school athletic trainers (SSATs) perceive they are integrating the principles of patient-centered care (PCC) and the biopsychosocial (BPS) model in their practice. We used a cross-sectional design to explore the primary research question. We used the Global Perceptions of Athletic Trainer Patient-Centered Care (GPATPCC) tool and the Biopsychosocial Model of Health (BPSMH) tool, both measured on a 4-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = agree, 4 = strongly agree, with an unscored “unsure” option). We sent the survey to 5665 SSATs through the National Athletic Trainers’ Association. Results indicate participants expressed strong agreement (mode = 4) with 7 of the 14 statements and agreement (mode = 3) with the remaining 7 statements of the GPATPCC tool (grand mean = 3.4 ± 0.8). Overall, participants rated their level of agreement on the BPSMH as agreeing (mode = 3) for each item (grand mean = 3.0 ± 1.0). SSATs perceive they are integrating the principles of PCC and the BPS model in clinical practice. These findings align with two previous studies concluding that patients, parents, and providers believe athletic trainers provide care that is focused on whole-person healthcare. Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)
13 pages, 323 KiB  
Article
The Role of Title 1 Secondary School Athletic Trainers in the Primary and Patient-Centered Care of Low Socioeconomic Adolescents
by Nicolette A. Harris and Michelle L. Odai
Int. J. Environ. Res. Public Health 2023, 20(7), 5411; https://doi.org/10.3390/ijerph20075411 - 05 Apr 2023
Cited by 2 | Viewed by 1579
Abstract
Athletic trainers (ATs) provide regular encounters with a healthcare provider for many Title 1 student–athletes with healthcare access and quality barriers. Thus, they are uniquely positioned to serve as a student–athletes’ first point of contact for general medical concerns. This study aimed to [...] Read more.
Athletic trainers (ATs) provide regular encounters with a healthcare provider for many Title 1 student–athletes with healthcare access and quality barriers. Thus, they are uniquely positioned to serve as a student–athletes’ first point of contact for general medical concerns. This study aimed to describe ATs’ experiences providing primary care for Title 1 student–athletes. This qualitative design employing an interpretative phenomenological analysis (IPA) approach used in-depth, virtual focus groups to examine the experiences of ATs practicing at Title 1 secondary schools. The findings reveal that ATs were called upon to evaluate, treat, and, when necessary, refer student–athletes with general medical conditions. However, Title 1 ATs encountered numerous complex social determinants of health (SDoH) preventing efficient and effective referral to specialty healthcare providers. Thus, ATs ultimately felt their most important roles in the primary care of low socioeconomic adolescents were as caregivers who mitigated avoidable healthcare barriers in addition to coordinators of integrated care that assisted student–athletes and their families with navigating the healthcare system. Title I ATs need to be aware of the SDoH affecting their student–athletes and the ability of those SDoH to affect health outcomes as well as overall student–athlete health and well-being. Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)
14 pages, 351 KiB  
Article
Examination of the Cumulative Risk Assessment and Nutritional Profiles among College Ballet Dancers
by Kenya Moore, Nancy A. Uriegas, Jessica Pia, Dawn M. Emerson, Kelly Pritchett and Toni M. Torres-McGehee
Int. J. Environ. Res. Public Health 2023, 20(5), 4269; https://doi.org/10.3390/ijerph20054269 - 28 Feb 2023
Viewed by 1347
Abstract
This study examined female collegiate ballet dancers’ (n = 28) Female Athlete Triad (Triad) risk via the Cumulative Risk Assessment (CRA) and nutritional profiles (macro- and micronutrients; n = 26). The CRA identified Triad return to play criteria (RTP: Full Clearance, Provisional [...] Read more.
This study examined female collegiate ballet dancers’ (n = 28) Female Athlete Triad (Triad) risk via the Cumulative Risk Assessment (CRA) and nutritional profiles (macro- and micronutrients; n = 26). The CRA identified Triad return to play criteria (RTP: Full Clearance, Provisional Clearance, or Restricted/Medical Disqualified) by assessing eating disorder risk, low energy availability, menstrual cycle dysfunction, and low bone mineral density. Seven-day dietary assessments identified any energy imbalances of macro- and micronutrients. Ballet dancers were identified as low, within normal, or high for each of the 19 nutrients assessed. Basic descriptive statistics assessed CRA risk classification and dietary macro- and micronutrient levels. Dancers averaged 3.5 ± 1.6 total score on the CRA. Based on these scores, the RTP outcomes revealed Full Clearance 7.1%, n = 2; Provisional Clearance 82.1%, n = 23; and Restricted/Medical Disqualification 10.7%, n = 3. Dietary reports revealed that 96.2% (n = 25) of ballet dancers were low in carbohydrates, 92.3% (n = 24) low in protein, 19.2% (n = 5) low in fat percent, 19.2% (n = 5) exceeding saturated fats, 100% (n = 26) low in Vitamin D, and 96.2% (n = 25) low in calcium. Due to the variability in individual risks and nutrient requirements, a patient-centered approach is a critical part of early prevention, evaluation, intervention, and healthcare for the Triad and nutritional-based clinical evaluations. Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)
12 pages, 349 KiB  
Article
An Examination of Depression, Anxiety, and Self-Esteem in Collegiate Student-Athletes
by Samantha R. Weber, Zachary K. Winkelmann, Eva V. Monsma, Shawn M. Arent and Toni M. Torres-McGehee
Int. J. Environ. Res. Public Health 2023, 20(2), 1211; https://doi.org/10.3390/ijerph20021211 - 10 Jan 2023
Cited by 6 | Viewed by 7124
Abstract
Mental health research exists for student-athletes in the areas of depression, anxiety, and self-esteem prevalence. However, updated prevalence rates and assessment of risks across sports, academic status, and genders are needed. Filling the gaps in research assists in the creation of patient-centered mental [...] Read more.
Mental health research exists for student-athletes in the areas of depression, anxiety, and self-esteem prevalence. However, updated prevalence rates and assessment of risks across sports, academic status, and genders are needed. Filling the gaps in research assists in the creation of patient-centered mental health screening and interventions designed for student-athletes. Therefore, the purpose is to examine the prevalence of depression, anxiety, and self-esteem in collegiate student-athletes and differences between sex, academic status, and sport type, and identify associations for risks. Using a cross-sectional design, collegiate student-athletes were surveyed to assess for risks of depression, anxiety, and self-esteem. With the use of SPSS, Chi-square analyses and multinomial logistic regressions were used. Student-athletes (22.3%) were at risk for depression, anxiety (12.5%), and low self-esteem (8%). No significant differences were found for sex, academic status, and sport type for depression or self-esteem; however, significant differences occurred for state and trait anxiety by sex. A significant association for depression and anxiety risk was found with females at risk. Depression and anxiety are present within student-athletes, regardless of sport type. Females are at a higher risk; however, all student-athletes would benefit from the creation of validated, patient-centered mental health screenings and psychotherapeutic interventions. Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)
14 pages, 499 KiB  
Article
Secondary School Athletic Trainers’ Navigation of Patient Socioeconomic Status Challenges in Care: A Qualitative Study
by Mayrena Isamar Hernandez, Elena Catherine Miller, Kevin Mark Biese, Luis Columna, Susan J. Andreae, Timothy McGuine, Traci Snedden, Lindsey Eberman and David Robert Bell
Int. J. Environ. Res. Public Health 2022, 19(24), 16709; https://doi.org/10.3390/ijerph192416709 - 13 Dec 2022
Cited by 5 | Viewed by 1744
Abstract
Secondary school ATs (SSATs) are uniquely positioned healthcare providers at an optimal public health intersection where they can provide equitable healthcare to low socioeconomic status (SES) adolescents. SSATs face similar challenges to physicians in treating low SES patients, but their strategies may be [...] Read more.
Secondary school ATs (SSATs) are uniquely positioned healthcare providers at an optimal public health intersection where they can provide equitable healthcare to low socioeconomic status (SES) adolescents. SSATs face similar challenges to physicians in treating low SES patients, but their strategies may be different compared to other medical professions. However, the consequences of low SES population healthcare delivery by SSATs have not been explored. SSATs were asked to share what challenges, if any, they encounter with providing care for their low SES patients and what strategies they find most effective to overcome these challenges. Data were collected via semi-structured interviews and reflective field notes and analyzed using a four-step, interpretative phenomenological analysis (IPA) guided theme development. Data saturation was met, and the sample size aligned with other IPA studies. Trustworthiness was established with research triangulation and Yardley’s four principles. Three interrelated themes emerged: (a) mechanisms for identifying SES, (b) the impact of SES on care, and (c) navigating SES challenges. SSATs described many strategies that were gained through their clinical experiences to overcome healthcare barriers. SSATs have the potential to decrease health disparities through their role as a liaison and advocates for their low SES patients. Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)
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22 pages, 728 KiB  
Article
Validation of a Script to Facilitate Social Determinant of Health Conversations with Adolescent Patients
by Emily M. Giorgi, Matthew J. Drescher, Zachary K. Winkelmann and Lindsey E. Eberman
Int. J. Environ. Res. Public Health 2022, 19(22), 14810; https://doi.org/10.3390/ijerph192214810 - 10 Nov 2022
Cited by 3 | Viewed by 1346
Abstract
Current social determinants of health (SDOH) tools exist to assess patient exposure; however, healthcare providers for the adolescent population are unsure of how to integrate SDOH knowledge into clinical practice. The purpose of this study was to validate a focused history script designed [...] Read more.
Current social determinants of health (SDOH) tools exist to assess patient exposure; however, healthcare providers for the adolescent population are unsure of how to integrate SDOH knowledge into clinical practice. The purpose of this study was to validate a focused history script designed to facilitate SDOH conversations between clinicians and adolescents through the use of the Delphi method. Six individuals (1 clinician, 5 educators/researchers) participated as expert panelists. Panelists provided critical feedback on the script for rounds 1 and 2. For rounds 3–7, panelists received an electronic questionnaire asking them to indicate agreement on a 6-point Likert scale (1 = strongly disagree, 6 = strongly agree). We defined consensus as mean item agreement ≥ 5.0 and percent agreement ≥ 80%. In round 7, panelists rated overall script level of agreement. After seven rounds of feedback, the focused history script achieved content validity with 100% of panelists agreeing on the final 40-item script. A focused history script for the SDOH was content validated to aid conversations between healthcare providers and adolescent patients on factors that affect their life, school, and play. Addressing social determinants of health with adolescent patients will improve cultural proficiency and family-centered care delivered by school healthcare professionals. Full article
(This article belongs to the Special Issue Patient-Centered Care in Sports Medicine Services)
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