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Title: Military culture and psychosocial factors associated with motivation for, and engagement in, rehabilitation after musculoskeletal injury : a feasibility study with male British military and civilian physiotherapy patients
Author: Paskell, Rachel Grace
ISNI:       0000 0004 5993 8079
Awarding Body: University of Bath
Current Institution: University of Bath
Date of Award: 2016
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Engagement in rehabilitation, such as physiotherapy, is critical to enhanced outcomes from musculoskeletal injuries (MIs) and has been found to be related to psychosocial factors, including increased personal control, higher levels of autonomous-motivation and more problem-focused type coping strategies in sports populations. However, this has not been empirically studied in British military groups, despite MIs being the most common reason for medical discharge from the British armed forces. Military personnel are thought to cope with injury within the context of a 'military culture' that is not found in civilians. This study tested a concept of military culture being related to greater adherence to masculine norms; higher levels of perceived personal control and autonomous motivation; lower levels of emotion-focused coping strategies; a greater use of problem-focused coping strategies and better engagement in rehabilitation. Data from self-report questionnaires and physiotherapist ratings of engagement in rehabilitation, provided by two groups, was compared. Group one consisted of 16 serving male military personnel and group two of 22 committed sports men; all had MIs sustained within the past 6 months, for which they were having physiotherapy. The sports group were found to show statistically significant greater adherence to masculine norms, and use of problem-focused and emotion-focused coping strategies. No significant differences were found between the groups on perceived personal control, autonomous motivation nor engagement in rehabilitation. A military culture defined by greater adherence to masculine norms; higher levels of perceived personal control and autonomous motivation and a greater use of problem-focused coping strategies has therefore not been supported by this study. However, only sufficient power was achieved for the analysis of emotional-focused coping strategies so caution must be taken when interpreting these results. Clinical and research implications are discussed with recommendations for further work with methodological lessons learnt.
Supervisor: Butler, Catherine ; Randle-Phillips, Catherine ; Gregory, James ; Salkovskis, Paul Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Pain ; military ; CBT ; Injury ; Psychology ; phantom limb ; Sport ; Intensive care ; Critical care ; Musculoskeletal