Self-determination in injury rehabilitation: designing a climate for promoting adherence

Abstract

The purpose of this dissertation was to use self-determination as a theoretical framework to investigate factors that influence college athletes’ adherence to injury rehabilitation programs. A two-part study, quantitative and qualitative approaches were used to gain insight into athletes’ motivation and decisions that they make regarding their engagement in injury rehabilitation. The focus of the quantitative study was to investigate the relationships between personal autonomy, levels of self-determination, perceived autonomy support, and perceived competence in injury rehabilitation. Participants (N=193 college athletes) completed surveys in a retrospective design. Autonomy orientations were positively related to higher levels of self-determination and the perception of an autonomy supportive environment. Findings suggested that a combination of autonomy and control orientations is associated with higher forms of motivation. In the qualitative study, 12 athletes, who had incurred a significant injury, and their athletic trainers, were interviewed about their perceptions of the injury rehabilitation program, health-care climate, and perceived competence. Three themes emerged that represent their views: (a) the powerful role that significant others play in the injury rehabilitation process; (b) the importance of maintaining an open dialogue; and (c) the utility of setting and achieving obtainable goals. Taken together, the results of these studies provide valuable information that can be used by researchers and practitioners to identify strategies that should enable athletic trainers to structure autonomy-supportive environments that will foster higher levels of self-regulation, motivation, and self-determination that ultimately will lead to improved adherence in treatment programs.