Higher Order Themes Research Articles

Psychological support for the talent pathway: Qualitative process evaluation of a state sport academy’s psychology service

Sport psychologists provide their services in complex settings, with numerous competing demands, resource constraints, and aims/goals for the psychology support service. Research in sport psychology often struggles to characterize the unique challenges of applied practice as it occurs in context. This research examined the delivery of a year-round sport psychology support service in a relatively small state sports academy, which serviced approximately 100 talented and high-potential athletes across multiple sports and levels. A qualitative process evaluation was undertaken. Eight semi-structured interviews were conducted with key stakeholders, including: two current psychologists, one former psychologist, two senior managers, one full time coach and three athletes. After deductively coding content into six higher-order themes, based on process-evaluation approaches, quotes were inductively analyzed using thematic content analysis. Dense and rich category clusters were identified within each higher-order theme: (a) aims and objectives; (b) context and environment; (c) implementation (i.e., what is done by the sport psychologists?); (d) attributes of the sport psychologists; (e) mechanisms of impact; and (f) outcomes generated. The themes extended beyond what is articulated in many current models of service delivery. Analysis suggested that not only are there numerous concepts “in play” when delivering sport psychology services, but that they are deeply interdependent and interconnected. There were notable discrepancies between the assumed aims of the service and the outcomes that were most valued by participants. The study identifies several key strengths and threats for the sport psychology service, and insights that can be applied in diverse service delivery settings.

Parental Experiences of Adolescent Cancer-Related Fatigue: A Qualitative Study.

Cancer-related fatigue is common, disabling, and chronic, but professional help is not necessarily sought. Parents can support symptom management and facilitate help-seeking. This study explored parental experiences of their adolescent's cancer-related fatigue and what they do to help. Qualitative semi-structured interviews were conducted with 21 parents of 17 adolescents aged 12-18 who were previously diagnosed with cancer. Reflexive thematic analysis was used to analyze the data. Three high-order themes were generated. Firstly, "fatigue is inevitable and unpredictable." This encompassed parental perceptions of fatigue as variable, distinct from normal tiredness, and linked to sleep and mood. Fatigue was seen as arising from cancer, which rendered parents helpless. Secondly, "fatigue is disruptive to normal life" beyond cancer treatment, which is contrary to expectations. Thirdly, parents managed fatigue by trying to balance the adolescent's desires for normality and their own perception of what is realistic with encouraging activities, and by seeking support from others. Parents see adolescent cancer-related fatigue as multi-faceted and experience it as unpredictable and attributed to cancer. They struggle to distinguish normal adolescent behavior from problematic fatigue, and to balance supporting and empowering the adolescent to live life to the fullest whilst also being realistic about the limitations imposed by fatigue and the benefits of activity. Parents try to manage fatigue practically but want more information about adolescent cancer-related fatigue to help establish their own and their adolescent's expectations.

The triple helix of clinical, research, and education missions in academic health centers: A qualitative study of diverse stakeholder perspectives.

IntroductionAcademic health centers are poised to improve health through their clinical, education, and research missions. However, these missions often operate in silos. The authors explored stakeholder perspectives at diverse institutions to understand challenges and identify alignment strategies.MethodsAuthors used an exploratory qualitative design and thematic analysis approach with data obtained from electronic surveys sent to participants at five U.S. academic health centers (2017‐18), with four different types of medical school/health system partnerships. Participants included educators, researchers, system leaders, administrators, clinical providers, resident/fellow physicians, and students. Investigators coded data using constant comparative analysis, met regularly to reconcile uncertainties, and collapsed/combined categories.ResultsOf 175 participants invited, 113 completed the survey (65%). Three results categories were identified. First, five higher‐order themes emerged related to aligning missions, including (a) shared vision and strategies, (b) alignment of strategy with community needs, (c) tension of economic drivers, (d) coproduction of knowledge, and (e) unifying set of concepts spanning all missions. Second, strategies for each mission were identified, including education (new competencies, instructional methods, recruitment), research (shifting agenda, developing partnerships, operations), and clinical operations (delivery models, focus on patient factors/needs, value‐based care, well‐being). Lastly, strategies for integrating each dyadic mission pair, including research‐education, clinical operations education, and research‐clinical operations, were identified.ConclusionsAcademic health centers are at a crossroads in regard to identity and alignment across the tripartite missions. The study's results provide pragmatic strategies to advance the tripartite missions and lead necessary change for improved patient health.

Comparison of the Perspectives of Medical Students and Residents on the Surgery Learning Environment

BackgroundThe learning environment plays a critical role in learners' satisfaction and outcomes. However, we often lack insight into learners' perceptions and assessments of these environments. It can be difficult to discern learners' expectations, making their input critical. When medical students and surgery residents are asked to evaluate their teachers, what do they focus on? Materials and methodsOpen-ended comments from medical students' evaluations of residents and attending surgeons and from residents' evaluations of attendings during the 2016-2017 academic year were analyzed. Content analysis was used, and codes derived from the data. A matrix of theme by learner role was created to distinguish differences between medical student and resident learners. Subthemes were grouped based on similarity into high-order themes. ResultsTwo overarching themes were Creating a positive environment for learning by modeling professional behaviors and Intentionally engaging learners in training and educational opportunities. Medical students and residents made similar comments for the subthemes of appropriate demeanor, tone and dialog, respect, effective direct instruction, feedback, debriefing, giving appropriate levels of autonomy, and their expectations as team members on a service. Differences existed in the subthemes of punctuality, using evidence, clinical knowledge, efficiency, direct interactions with patients, learning outcomes, and career decisions. ConclusionsFaculty development efforts should target professional communication, execution of teaching skills, and relationships among surgeons, other providers, and patients. Attendings should make efforts to discuss their approach to clinical decision making and patient interactions and help residents and medical students voice their opinions and questions through trusting adult learner-teacher relationships.

The Professionalization of Women’s Football in England and its Impact on Coaches’ Philosophy of Practice

Women’s elite football is in a transitional phase where coaches and players are increasingly offered professional contracts. The current study examined the stories of coaches currently operating in a women’s football academy in England to understand whether and how the professionalization of women’s football has influenced their coaching philosophy. Narrative interviews with 10 coaches (aged 23–60 years, two women) were carried out and analyzed using thematic narrative analysis. Observational data were also obtained while the authors were immersed within the environment. Two high-order themes were identified: (a) the coaches adapted their philosophy to meet the new needs of professionalization and (b) there were novel moral challenges surrounding the coaches’ approach to a dual career. The findings illustrated that the individuals developed a coaching philosophy that was adapted according to the coaching environment, which was largely informed from their previous experiences in men’s football. Player’s stories highlighted conflicting expectations surrounding dual careers.

Next One Up! Exploring How Coaches Manage Team Dynamics Following Injury

Injuries are commonplace in high-intensity sport, and research has explored how athletes are psychologically affected by such events. As injuries carry implications for the group environment in sport teams, the authors explored what occurs within a team during a time period of injury from a coach perspective and how high-performance coaches manage a group at this time. Semistructured interviews were conducted with 10 Canadian university basketball head coaches. Thematic analysis revealed four high-order themes in relation to how coaches managed group dynamics from the moment of the injury event to an athlete’s reintegration into the lineup. Strategies to mitigate the negative effects of injury on the group environment while prioritizing athlete well-being involved remaining stoic at the time of an injury event, maintaining the injured athlete’s sense of connection to the team, and coordinating with support staff throughout the recovery and reintegration process.

Staff experience of the implementation of intensive interaction within their places of work with people with learning disabilities and/or autism

Intensive interaction is an approach used to develop the communication and social inclusion of those who are pre-verbal. It is used in a variety of settings by healthcare and educational staff. A systematic search was conducted to identify and review the literature which explores staff experiences of intensive interaction being implemented within their places of work. Thematic synthesis was utilized to synthesize the findings. Nine papers were included. Three higher-order themes were generated: "Personal Doubt, Discordance & Discomfort," "A Turning Point" and "Needing Implementation at All Levels." There were consistent findings across a range of settings. Findings suggest that intensive interaction is rewarding for staff and beneficial to those that they work with. Implementation was sometimes perceived to be challenging and this review attempts to highlight solutions with guidance of the literature. Limitations largely relate to heterogeneity of the papers and methodological limitations are discussed.

Exploring how Chinese adults living with spinal cord injury viewed the prospect of inpatient peer support programs within a hospital-based rehabilitation setting.

Generic qualitative design. To explore how Chinese adults living with spinal cord injury (SCI) viewed the prospect of inpatient peer support programs within a rehabilitation setting. Hospital in China. A purposive sample of adult inpatients with SCI (N = 6) currently undergoing rehabilitation was recruited. Each participant was interviewed twice. Twelve interview transcripts were analyzed using a thematic method. Five higher-order themes were developed. First, participants had unique backgrounds and personal lives before and after their SCI and reported frustrations about their lives resulting from their SCI. Second, participants reported varying degrees of satisfaction with their rehabilitation and identified the facilitators and barriers to their rehabilitation. Third, their perspectives on peer support were shaped by their rehabilitation goals. For example, participants who solely focused on the recovery of physical functioning noted that peers could help to supplement existing rehabilitation programming by guiding their rehabilitation exercises. Participants who concentrated on their future lives believed peers could teach them new skills to facilitate their integration in the community. However, some participants felt they could not trust peers' advice because peers are not healthcare providers. Fourth, peer support delivery options varied from online chat groups (i.e., WeChat), in-person conversations, and mentoring lectures. Finally, anticipated outcomes were related to obtaining practical and emotional support from peers, being motivated, and feeling understood. Participants harbored mixed views on potential use-value and necessity of hospital-based peer support programs, which could inform future utilization of SCI peer support within Chinese hospitals.

Exploring sports coaches’ experiences of using a contemporary pedagogical approach to coaching: an international perspective

ABSTRACT Nonlinear contemporary coaching approaches are becoming more prominent in academic research, although there is still limited take-up by sports practitioners. Research has investigated why coaches continue to use traditional reproductive pedagogical approaches. However, there is limited understanding of insights and experiences of sports coaches who have switched to contemporary approaches in practice. This study aimed to: (i) explore insights of coaches who are adopting contemporary approaches to understand why they eschewed more traditional approaches and (ii) gain information on their experiences when implementing these contemporary approaches into their practice. To address these aims, 15 experienced professional individual and team sports coaches from a range of countries (i.e. Australia, Netherlands, Portugal, Sweden, UK, USA), were interviewed. Thematic analysis revealed 59 lower-order themes and 10 higher-order themes, organised into 3 dimensions; (i) factors underpinning the coaches’ approach to athlete learning; (ii) learning approaches; and (iii), responses to contemporary pedagogical approaches. Coaches reported a typical culture of traditional methods of learning within their sports, which they believed were not effective in developing athlete performance. Hence, they elected to adopt a contemporary non-linear, individualised, adaptive approach, emphasising representative learning designs. Results suggested that typical reactions to this approach included resistance from stakeholders. However, coaches continued to use this approach and expressed the importance of effective communication with stakeholders to enable acceptance of the contemporary approaches of learning. Findings suggest how continued integration between experiential and empirical knowledge of practitioners may increase the acceptance of contemporary pedagogical approaches, facilitating acceptance of new approaches to learning.

Contemporary practices of high-performance swimming coaches on pacing skill development and competition preparation

Pacing is arguably more crucial for optimal performance in swimming than in land-based sports, however little is known about the process of developing pacing skills in swimmers. The aim of this study was to examine the current practices of high-performance swimming coaches in relation to pacing entrainment and competition preparation. Twenty-one swimming coaches who were currently coaching or had coached swimmers at national open, international age or international open level, participated in a semi-structured interview. Interview transcripts were examined using hierarchical content (qualitative) analysis to identify general dimensions, higher-order themes and sub-themes. Data were categorised into two main areas: training and competition. The general dimensions of monitoring, pacing aids, periodisation and training for multiple events emerged within training; whereas optimal strategy, racing, warm up swims and multiple main events emerged within competition. Coaches identified the importance of a highly individualised approach based on swimmer needs and characteristics. However, the difficulty in achieving this goal when working with large groups of swimmers was identified as a challenge. Although swimming is a time-based sport, efficient technique and pacing were considered vital to success. Despite this, it appears that key variables including stroke rate, stroke count, split times and rating of perceived exertion were not monitored by a number of coaches. These parameters are likely important tools to maximise pacing skill development, especially in young swimmers. However, given the current lack of information on how athletes learn and develop pacing skills, coaches would benefit from evidence-based guidelines in this area.

Racing to a staffing solution: an investigation into the current staffing crisis within the UK horseracing industry

The British Horseracing Industry has been experiencing a labour shortage since the 1970’s and despite recent improvements reported in staff retainment, the industry still reports high staff turnover. We investigated staffing challenges experienced by UK horseracing employers and employees, to formulate strategic targets to address any issues identified. Thirty UK trainers and staff (12 staff, 9 senior staff, 9 trainers) participated in semi-structured inductive focus groups lasting on average 39±9 min. Questions explored staff background in racing, perceptions of the current staff challenges, retention and recommendations for improvement. Thematic analysis revealed four higher order themes; (1) lack of skills, (2) differences in perceived work ethic, (3) job conditions, and (4) media portrayal. This study concluded that there are dedicated staff working in the industry, but significant skills gaps, high workloads, poor work-life balance and a lack of training and career progression negatively influence retention in the horseracing industry.

Training Load Monitoring in Amateur Rugby Union: A Survey of Current Practices.

Griffin, A, Kenny, IC, Comyns, TM, and Lyons, M. Training load monitoring in amateur Rugby Union: A survey of current practices. J Strength Cond Res 35(6): 1568-1575, 2021-Amateur Rugby Union has an inherent risk of injury that is associated with detrimental effects on player welfare and team performance. Training load (TL) is a modifiable risk factor that, when monitored, may provide strength and conditioning (S&C) coaches with opportunities to reduce the risk of injury. The purpose of this study was to explore TL monitoring practices used by S&C coaches working with male and female amateur adult Rugby Union teams and their rationale for using such. Thirty-three (n = 31 male and n = 2 female) S&C coaches representing 62% of the total number of male clubs and 71% of female clubs, playing at the highest national amateur level, participated in the study by completing an online survey. Seventy-three percent of respondents stated that they monitor TL. The most common method of recording TL was the session rating of perceived exertion (sRPE), used in 83% of monitoring systems. Thirty-three percent of the S&C coaches surveyed use the sRPE data to calculate the acute:chronic workload ratio (ACWR) for highlighting when players are at risk of injury. This study is the first of its kind to exclusively examine the TL monitoring practices of S&C coaches working with amateur adult Rugby Union teams. Thirteen S&C coaches responded to the open-ended question and 3 higher order themes were highlighted: (a) communication with players (b) support from other staff and (c) limiting factors.

(Dis)Joining Fitness Gyms Membership: Sustained Participation and Deterred Mindset amongst Female Teachers in Singapore

OBJECTIVES The purpose of this study was to examine the key decision making elements of why female teachers join and disjoin a fitness gym membership.METHODS The participants of the study comprised of ten healthy female teachers, aging from 34 to 45. Out of the ten participants, five of them were members of fitness gyms while five of them were non-members of fitness gyms. A semi-structured interview was conducted with each participant. Each interview was audiorecorded, before being transcribed verbatim. A thematic analysis approach was used for data analysis and higher-order themes were identified for each group of participants.RESULTS The key elements to sign up for a gym membership included keeping body and mental health, group synergy and peer influence, instructors’ guidance and convenience of gym facilities. The key elements for deterrence included the high cost of membership, lack of time, dislike for long term commitment and inconvenience of schedule.CONCLUSIONS The study discusses the controllable and uncontrollable factors associated with signing up for a gym membership including, the cost of membership and the occupations of teachers such as working hours and teachers’ circumstances. The results of this study enable gym operators to better understand how to cater and engage a specific target audience.

Adapted emotion skills training group for young people with anorexia nervosa : Amixed-methods evaluation.

Brief interventions focused on emotion processing are needed to support young people (YP) in inpatient treatment programmes to manage emotions. Cognitive Remediation and Emotion Skills Training (CREST) has been found beneficial in adult anorexia nervosa (AN) groups. An initial case series found that CREST is afeasible intervention for YP with AN. Further age-appropriate adaptations were needed to improve YP's engagement. Following qualitative feedback on the original CREST manual, asecond case series was conducted in an inpatient unit with age-appropriate adaptations to evaluate its feasibility in aYP inpatient setting. Amixed-methods methodology was used to evaluate the intervention. A total of 30YP were asked to write afeedback letter about their experience of the group and to complete the Emotion Skills Scale (ESS), an ad hoc 12-item self-report Likert scale assessing emotional functioning. The ESS was also completed by amember of the multidisciplinary team for an external assessment. Quantitative results showed no statistically significant changes in YP's emotional functioning, while qualitative results showed that YP found it helpful to learn about emotion processes, acknowledging their need to be supported to express them and understand the link with AN symptoms. Four high-order themes were identified: Helpfulness of CREST Group for Young People (CREST-GYP), Perception of contents, Challenges of group therapy, Suggestions for improvement. Pilot findings suggest that CREST-GYP is an acceptable intervention for YP with AN. Clinical and research studies are needed to clarify whether CREST-GYP can produce more beneficial treatment results than treatment as usual.

Testing and verification of neural-network-based safety-critical control software: A systematic literature review

Context: Neural Network (NN) algorithms have been successfully adopted in a number of Safety-Critical Cyber-Physical Systems (SCCPSs). Testing and Verification (T&V) of NN-based control software in safety-critical domains are gaining interest and attention from both software engineering and safety engineering researchers and practitioners. Objective: With the increase in studies on the T&V of NN-based control software in safety-critical domains, it is important to systematically review the state-of-the-art T&V methodologies, to classify approaches and tools that are invented, and to identify challenges and gaps for future studies. Method: We retrieved 950 papers on the T&V of NN-based Safety-Critical Control Software (SCCS). To reach our result, we filtered 83 primary papers published between 2001 and 2018, applied the thematic analysis approach for analyzing the data extracted from the selected papers, presented the classification of approaches, and identified challenges. Conclusion: The approaches were categorized into five high-order themes: assuring robustness of NNs, assuring safety properties of NN-based control software, improving the failure resilience of NNs, measuring and ensuring test completeness, and improving the interpretability of NNs. From the industry perspective, improving the interpretability of NNs is a crucial need in safety-critical applications. We also investigated nine safety integrity properties within four major safety lifecycle phases to investigate the achievement level of T&V goals in IEC 61508-3. Results show that correctness, completeness, freedom from intrinsic faults, and fault tolerance have drawn most attention from the research community. However, little effort has been invested in achieving repeatability; no reviewed study focused on precisely defined testing configuration or on defense against common cause failure.

Experiences of Peak Performance in Elite American Football

Elite athletes strive for a superior state of psychological functioning to achieve peak performance, and peak performance is the central construct of this study. Peak performance as a phenomenon is a state of superior functioning allowing athletes to perform at their highest levels, attaining outstanding results. The purpose of this study was to understand the phenomenon of peak performance through semistructured interviews with 16 elite-level American football players. Four higher-order themes divided into mental, physical, emotional, and sensory elements. Those themes are supported by 18 lower-level categories. Findings were largely consistent with previous research despite this being the first study to include American football players. A specific noteworthy conclusion is the connection between mental and physical components that provides ample opportunities for both researchers and applied practitioners. In addition, the participant quotes prompted a return to the discussion of the connection between individual zones of optimal functioning, peak performance, and flow states.

Good practice delivery in sport science and medicine support: perceptions of experienced sport leaders and practitioners

ABSTRACT Purpose/Rationale: Sport Science and Medicine practitioner delivery is clearly of interest, with numerous anecdotal insights to good practice and research focussing on the evaluation of competence in delivery. However, little research has explicitly examined perceptions of the skills sets, process and mechanisms that lead to good practice. Accordingly, our aim was to develop a deeper understanding of the mechanisms of Sport Science and Medicine delivery, examining perceptions in high-performance environments and whether constructs apparent in other performance domains could be relevant in the Sport Science and Medicine delivery context. Design/Methodology/Approach: Semi-structured interviews were undertaken with six experienced Sport Science and Medicine practitioners and six primary employers of the support itself, namely performance directors. Data were transcribed and analysed to generate higher-order themes. Findings: There were four emergent themes of environmental appreciation, role appreciation, understanding people and the importance of team for good practice delivery. Moreover, there were sources of knowledge apparent from other performance domains that offer constructs or concepts with implications for good practice in Sport Science and Medicine. Practical Implications: Findings promote a greater focus on non-technical skills, selection of appropriate delivery models, and an increased emphasis on evidence-based practice. Building from the results, we make some recommendations to support both the practitioner in striving for impactful delivery and those who lead and manage their delivery and development in the roles. Research Contribution: This academic evidence-based offering supports and extends current anecdotal insights on offer in his important function.

Practitioner perceptions regarding the practices of soccer substitutes.

Despite empirical observations suggesting that practitioners value the use of substitutions during soccer match-play, limited research has sought to substantiate such claims. This study used online surveys to assess the perceptions of practitioners within professional soccer about the use and practices of substitutes. Thirty-three practitioners completed one of two surveys (each requiring both open and closed questions to be answered), depending upon whether their primary role related mostly to tactical (‘tactical practitioners’; n = 7) or physical (‘physical practitioners’; n = 26) aspects of player/team management. Thematic content analysis of responses identified four higher-order themes: ‘impact of substitutions’, ‘planning and communication’, ‘player preparation and recovery’ and ‘regulations’. Eighty-five percent of practitioners believed that substitutes are important in determining success during soccer match-play, with the primary justification being the perceived ability of such players to provide a physical and/or tactical impact. However, contextual factors such as the match situation, timing of introduction, and players undergoing adequate pre-pitch-entry preparation, may be important for realising such aims. Although many practitioners believed that there was a need for substitutes to engage in bespoke non-match-day preparations and recovery strategies that differ from starting players, logistical considerations, such as scarcity of resources, often limit their scope. Notwithstanding, 96% of respondents indicated that substitutes frequently perform extra conditioning sessions to account for deficits in high-speed running loads compared with players exposed to a longer period of match-play. Substitutes’ pre-match warm-ups are typically led by team staff, however practitioners reported providing varying levels of input with regards to the practices adopted between kick-off and pitch-entry. Uncertainty exists as to the efficacy of current pre-pitch-entry practices, and 100% of practitioners highlighted ‘preparatory strategies’ as at least a ‘moderately important’ direction for future research. This study presents novel insights and highlights areas that are considered future research priorities amongst those working in the field.

Surrogate Measures to Assess Mobility of People as a Resilience Indicator in Disaster Management: An Exploratory Study in Southeastern Sri Lanka

Understanding social resilience can assist in the formulation of disaster management policies to help communities better prepare for, respond to, and recover from disasters. However, direct social resilience measurement methods such as household surveys are not always a practical option as they are a time- and resource-exhaustive process. Existing measures mainly utilize publicly available census data, which often provide a poor and outdated assessment of current social resilience status. Another limitation includes a failure to capture multiple facets of indicators that are process-oriented and dynamic in nature such as mobility of people. These challenges can be addressed by employing a surrogate approach. Surrogates are alternative measures to depict the target indicator. The surrogate approach can capture key facets of a target indicator, which can be used as potential measures for the target indicator. A framework to conceptualize the surrogate approach is presented, and operationalized using a case study approach on the southeastern coast of Sri Lanka to identify surrogates to measure mobility of people as a resilience indicator. Six higher-order themes were identified as potential surrogates to measure mobility of people in a disaster context. The approach proposed to methodically identify potential surrogates and their measurement protocols can help to improve the current knowledge base and understanding of complex interrelationships of social resilience.

Gifted but equal? Parents’ perspectives on sibling relationships in families with gifted and non-gifted children

ABSTRACT Childhood sibling relationships shape an individual’s interactions throughout life. To date, there have been only a few studies on sibling relationships in families with gifted and non-gifted children, and these have yielded mixed results. Based on the Family Systems Theory (FST) as a conceptual framework, specifically the homeostasis principle, the current study explores how parents in families with gifted and non-gifted children affect sibling relationships. Interviews with 40 parents of gifted children in Israel revealed three higher-order themes: differential equity, artificial equity, and situational equity. From an FST perspective, results suggest a preliminary typology that describes the parental contribution toward rebalanced sibling relationships. Despite good intentions, using artificial and situational strategies could provide unfavorable results for the gifted and the non-gifted children. The proposed typology may contribute toward developing a systemic theory of sibling relationships.