Players’ Experiences of Barriers and Facilitators of the Immediate Management of Rugby-Related Acute Spinal Cord Injury

Another one of our qualitative studies just got published. It is good to see that the value and importance of this important methodology is gaining attention. In this study Marelise Badenhorst applied a qualitative approach to describe rugby players’ perceptions of the immediate management of rugby-related acute spinal cord injuries (ASCIs). These findings are relevant for all rugby stakeholders and may help shape education, awareness, and future policy around the immediate management of ASCIs.

Most contact sports, including rugby union, carry a risk of injury. Although acute spinal cord injuries (ASCIs) in rugby are rare, the consequences of such injuries are far-reaching. Optimal management of these injuries is challenging, and a detailed understanding of the different barriers and facilitators to optimal care is needed. In this study, we aimed to describe the perception of players, regarding factors related to the optimal immediate management of a catastrophic injury in a developing country with socioeconomic and health care inequities.

Barriers and facilitators to optimal immediate management of rugby-related ASCIs. Note.  ASCI = acute spinal cord injuries; SES = socioeconomic status.

Barriers and facilitators to optimal immediate management of rugby-related ASCIs.Note. ASCI = acute spinal cord injuries; SES = socioeconomic status.

The most frequently reported barriers were transportation delays after injury and admission to appropriate medical facilities. Other barriers included inadequate equipment, the quality of first aid care, and barriers within the acute hospital setting. Barriers were more prevalent in rural and lower socioeconomic areas. The initial management of ASCIs requires swift and experienced medical treatment, both of which were recognized by participants in this study. Specifically, transportation delays and admission to appropriate medical facilities were the most frequently reported barriers. These barriers, as well as inadequate equipment and quality of first aid care, can all be improved by ensuring that medical personnel are adequately trained and available, applying an appropriate action plan, acquiring correct equipment, and determining the correct lines of communication to emergency medical services. These processes are in place in coaches’ continued education, but it appears that this knowledge may not be reaching all the end users on the field.

The current findings could assist rugby associations to focus their resources on strategies that ensure the dissemination and the translation of knowledge into practices on field. Finally, some of the challenges identified in this study, such as those of the health care system, are beyond the control of sporting agencies. Nonetheless, these findings may be useful for all relevant stakeholders to understand the experiences and needs of seriously injured players and to aid in the design of future interventions.

Badenhorst M, Verhagen E, Lambert M, van Mechelen W, Brown JC. When This Happens, You Want the Best Care: Players’ Experiences of Barriers and Facilitators of the Immediate Management of Rugby-Related Acute Spinal Cord Injury. Qual Health Res. 2019 Mar 13;100:104973231983493–15. 

The full manuscript can be accessed here (paid access)