Athletic Trainers' Influence on National Collegiate Athletic Association Division I Athletes' Basic Psychological Needs During Sport Injury Rehabilitation

Context: Athletic trainers (ATs) have indicated a desire to better understand the motivations of athletes during rehabilitation. Self-determination theory offers an ideal lens for conceptualizing the antecedents, mediators, and consequences of motivated behavior. Objective: To explore athletes' perceptions of ATs' influence on their basic psychological needs as well as their motivation during sport injury rehabilitation. Design: Qualitative study. Setting: National Collegiate Athletic Association Division I universities in the northwestern and southeastern United States. Patients or Other Participants: A total of 10 injured and previously injured athletes (7 women, 3 men; mean age = 20.9 +/- 2.0 years) active in a variety of sports. Data Collection and Analysis: Participants completed semistructured interviews, which were transcribed verbatim. The data were analyzed using consensual qualitative research methods. Trustworthiness techniques (eg, bracketing interview, discussion of biases, member checking, external auditor) were used throughout the process. Results: Four domains were constructed: (a) athletes' concerns about injury and rehabilitation, (b) ATs' feedback and athletes' perceptions of competence, (c) a person-centered approach from ATs and athletes' perceptions of autonomy, and (d) a connection between ATs' and athletes' perceptions of relatedness. Athletes' experiences were largely influenced by the degree to which they perceived that ATs satisfied their 3 basic psychological needs, which, in turn, was determined by the presence or absence of particular AT behaviors, such as providing encouragement (competence), soliciting input (autonomy), and building rapport (relatedness). Furthermore, the degree to which they perceived these basic psychological needs were fulfilled (or thwarted) affected their overall motivation during sport injury rehabilitation. Conclusions: Self-determination theory is a promising framework for ATs to consider when addressing motivational challenges among injured athletes.