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Therapeutic Recreation Journal V ol. XlV, N o. 1 • pp. 1-16 • 2011 The authors: Yeshayahu Hutzler is affiliated with The Zinman College of Physical Education and Sport Sciences at the Wingate Institute, Netanya, Israel and The Israel Sport Center for the Disabled in Ramat Gan, Israel. Uri Bergman is affiliated with The Israel Sport Center for the Disabled in Ramat Gan, Israel and the College for Movement and Education, Seminar Hakibuzim, Tel Aviv, Israel. Correspondence regarding this article can be forwarded to the author at shayke@wincol.ac.il.
Research
Facilitators and Barriers to Participation
while Pursuing an Athletic Career
Retrospective Accounts of Swimmers with Disabilities
Yeshayahu Hutzler
Uri Bergman
Abstract
The purpose of this article was to explore mediating factors to pursuing a com- petitive swimming career as well as attributes of participation, retrospectively re- ported by nine retired competitive swimmers with a disability. A focus group discus- sion followed by a qualitative content analysis was performed. Categories of verbal comments were inductively analyzed by two trained social scientists. Trustworthi- ness was obtained through verbally and literally describing the proposed theme cat- egories to the focus group participants during a feedback session, who then filled in a questionnaire depicting their agreement or disagreement with the proposed themes. The main categories generated included (a) facilitators to participation, (b) barriers to participation, and (c) participation attributions. Strongest agreement of participants with facilitator sub categories regarded (a) feeling of being an elite group, and (b) joy and fun. Participants’ retrospective accounts reflected a need for reducing barriers and enhancing facilitators and empowerment in pursuing an ath- letic carrier.
Keywords: Barrier, career, facilitator, Paralympics, retirement, swimmers
2 Facilitators and Barriers of Competitive Swimmers Physical activity and sports have developed during the recent decade as a legitimate and appropriate social environment for persons with disabilities (DePauw & Gavron, 2005; Fey & Wolf, 2009). Article 30.5 of the U.N. Convention on the Rights for Persons with Disability (United Nations, 2006) is a landmark for acknowledging the commitment of society to establishing sports for persons with disability as a normative leisure activity. Successful athletes report psycho- social benefits of participation such as reduced depression, increased vigor, and enhanced mood (e.g., Morgan, 1985). Positive outcomes of sport participation have also been documented in athletes with disabilities (see review in Hutzler & Sherrill, 1999). Authors have compared psychological traits of athletes with disabilities to those of able-bodied athletes (e.g., Henschen, Horvat, & French, 1984; Horvat, French, & Henschen, 1986; Mastro & French, 1986), but have not specifically related them to their training and participation experiences. Several authors have specifically related the favorable psycho-social outcomes of athletes with disabilities to a sense of empowerment (Hutzler, 1990, 2003; Sørensen, 2003). Empowerment can be defined as “restoration to individuals of a sense of their own value and strength and their own capacity to handle life’s problems” (Bush & Folger, 1994, p. 2). Empowerment is strongly anchored in the development of physical activity practices in participants with disabilities. Following the preliminary linking of disability sport and psycho-social empowerment (Hutzler, 1990), the concept of empowerment was further promoted by Sherrill (1995) as the “social doctrine” of the adapted physical activity (APA) field of study and practice. Empowerment has also been acknowledged as one of the major criteria within the code of conduct for staff involved in organizing paralympic events (IPC-SSC, 1995), which states that “the involvement in sports should empower the athlete in his or her decision-making processes and his or her actions… the athletes should be empowered to make autonomous decisions and to further his or her development through the medium of sport” (p. 16). The empowerment role of sport organizations is to develop human resources through the athletic medium (Thomas & Ermler 1988; Wheeler, 2001). Empowering environments and atmospheres can be provided by sport organizations (Kidman & Davis, 2007); however, the most effectively means for achieving this goal is unclear. Pensgaard and Sørensen (2002) have proposed to study self-identity, goal orientation/motivational climate, and self-efficacy as mediating factors between the individuals with disabilities and empowerment in sports. The mediating effect of individual and environmental factors has also been articulated within the recently accepted International Classification of Function and Disability (ICF; WHO, 2001). In terms of the ICF, personal and environmental variables may either limit or facilitate activity and participation of individuals with disability in social life (see Sherrill, 2004; Ustún, 2003). In spite of the benefits attributed to physical activity of athletes with disabilities (see Hutzler & Sherrill, 1999), athletes with and without disabilities often report high levels of stress during participation in training and competition, which seem to result from a complex interplay between situational, cognitive, physiological, behavioral, personality and motivational factors, and affect the participant’s performance and psycho-social functioning (Coakley, 1992; Dale & Weinberg, 1990;
4 Facilitators and Barriers of Competitive Swimmers Table 1 Details of Participants’ Age, Disability, Family Status, and Swimming Career # Main Disability M/F Family Reason Activity Age Career Age Current Achievements status retired after ret. ret. years init- age iated 1 2 Paralympics Polio F M+4 De-selection Dancing 37 28 9 51 Gold; Bronze 2 2 Paralympics CP Di F S Classification No 26 19 7 37 Gold; Bronze 3 Paralympics Finals CP Tetra F S Did her best Swim 45 30 15 50 4 SM Games Gold SCI C6 F S Health No 38 13 25 48 5 Paralympics Bronze CP Di M M+2 Classification Swim 30 26 4 36 6 4 Paralympics Gold Polio M M+4 Professional Sailing 36 30 6 50 7 Paralympics AK F M+3 Conflicts with Swim 27 23 4 43 Gold coach and peers 8 4 Paralympics Polio M D+2 Did his best Swim 40 34 6 51 Gold 9 2 Youth games Gold CP tetra M S Did his best Cycling 19 16 3 27 Note: CP=cerebral palsy; Di=diplegia; Tetra=tetraplegia; AK=above knee amputation; SCI=Spinal cord injury; M=married; S=single; D=divorced; +Number= number of children; SM=Stoke Mandeville; ret. = retirement Procedure Participants attended one focus group discussion lasting three hours. Focus group discussions have been acknowledged as an important research tool in fields such as health education (Basch, 1987) and in marketing (Vaughn, Schumm, & Singaub, 1996). A focus group is described as “an informal discussion among selected individuals about specific topics relevant to the situation at hand (Beck, Trombetta, & Share, 1986). Focus groups usually adhere to several core elements: (a) The group is an informal assembly of target persons whose point of views are requested in order to address a selected topic; (b) the group is small, six to 12 members, and is relatively homogenous; (c) a trained moderator with a prepared layout of issues and questions sets the stage and induces participants’ responses; (d) the goal is to elicit the perceptions, feelings, attitudes, and ideas of participants concerning a selected topic; (e) focus groups do not generate quantitative information that can be projected to a larger population. (Vaughn et al., 1996, p. 5) The main focus in our study was broadly declared as participants’ perspectives on facilitators and barriers while pursuing their athletic career. Specific questions addressed during the group discussion related to examples of barriers
Hutzler and Bergman 5 and facilitators to pursuing their athletic career and the psycho-social consequences experienced. Both investigators addressed the topic to the group and co-moderated the session, but independently processed the data. Verbal contents of the meeting were transcribed and an inductive content analytical method (Mayring, 2000a, 2000b; Taylor & Bogdan, 1984) was used to formulate theme categories and sub- categories. Trustworthiness was checked across the process via bilateral agreement between category coders. In our study, the criteria for defining categories were (a) contextual factors facilitating or limiting participation, and (b) psycho- social outcomes of pursuing a competitive swimming career. Categories were parallel formulated step-by-step by the two investigators, and after about 50% of the material was read, agreement between the two investigators was reached. In order to further examine the trustworthiness of these categories, a meeting was held in which the process of analysis and the results were presented to the participants and they were then asked to provide oral feedback. During this meeting, participants were also requested to fill in a questionnaire describing the formulated categories with example citations. Participants expressed their degree of agreement with the categories on a 4-point bi-polar scale, ranging from very much agree (4) to very much disagree (1). In order to simplify the description of scale outcomes, responses were later dichotomized into agree vs. disagree labels. Frequencies of agreement vs. disagreement in each category are reported in Table 2. Table 2 Categories Induced through the Focus Group Inquiry and Participants’ Agreement Description Agree (%) Disagree (%) Facilitators 1 Peer swimmers 5 (56) 4 (44) 2 Feeling of being an elite group 8 (89) 1 (11) 3 Joy and fun 8 (89) 1 (11) Barriers 4 Classification 4 (44) 5 (56) 5 De-selection 6 (67) 3 (33) 6 Health disorders 2 (29) 5 (71) 7 Coach 4 (44) 5 (56) 8 Peer swimmers 5 (56) 4 (44) 9 Vocational and economical conflict with training 4 (44) 5 (56) Participation attributes 10 Empowerment 8 (89) 1 (11) 11 Abandonment 7 (78) 2 (22) Note: Bold marks above 75% agreement among respondents
Hutzler and Bergman 7 being excluded from the swimming team two weeks prior to their departure for the Paralympics, and considered this a traumatic event for her participation in swimming and in the club activities. While reflecting on the event, the athlete made her point that with respect to selection constraints, technical (e.g., not training with the rest of the team members, but rather with an opposing team) rather than professional (performance in swimming competitions) criteria were utilized by the club administration in their decision not to select her to the team. Since the selection criteria were not commonly known, this event was perceived by the swimmer as a trauma, evoking extremely high and prolonged stress, which, among other reasons, resulted in complete avoidance of any aquatic activity. “I was in a severe break down. I couldn’t look at the swimming pool. I am happy that I abandoned it…I want to cry…The blue water I had loved so much became a source of anger and betrayal.” Health disorders. Two participants, one with CP and one with SCI, reported that health problems were the direct reason for their retirement. Some of the disorders were non-disability-specific (“I retired because of my health condition. I had an operation”). It should be noted, however, that in the feedback questionnaire all other participants disagreed on this theme, demonstrating that this issue affected only a relative small part of our focus group. Coach’s low competence and ignorance. One participant reported loss of confidence in the coach soon after he had experienced a spasm during swimming and felt “I was about to drown, without the coach’s acknowledging this event.” The insecurity this swimmer felt during the event was recognized by him as the major reason for his retirement from competitive swimming. Another swimmer mentioned coach ignorance when he returned to swimming for recreation purposes after his retirement. He felt this coach was indifferent towards him as he came to swim only for health and weight control purposes. Another swimmer said she was disappointed that her coach did not “fight for her” and “did not even phone” when she was dismissed from the national team. Another female swimmer explicitly mentioned her coaches applied sanctions against her after she had retired from competitive swimming, thus limiting her motivation to continue participation for health and recreation purposes. Another swimmer referred to coach neglect after retirement, suggesting that the coach did not provide him with further supervision and he had to plan a gradual procedure of reducing the training load himself. During the feedback session, one participant said that the barrier to participation that he perceived during his career was due to his coach’s low professional efficacy. According to this swimmer, the training contents and methods used in their group by some of the coaches were outdated and were not at the level used in competitive swimming clubs incorporating able-bodied swimmers. Peer swimmers. Most swimmers with CP in our sample reported being partially rejected by some of their peer swimmers, and considered secondary to swimmers with amputation, polio or SCI. This ignorant behavior was experienced mostly within the national team and not the local club, and demonstrated by being told to swim in the outward lanes rather than in the central ones during training. They also did not receive some services, such as massage, that were given to their peer swimmers with other disability conditions. Vocational and economical conflict with training. Three participants explicitly mentioned conflicts between
8 Facilitators and Barriers of Competitive Swimmers their occupation and their training requirements—up to 10 training sessions per week during the competition season. One swimmer acknowledged the money he had to invest during the prolonged training hours for child care, for missing working days, for traveling, and so on. Another swimmer was a special education teacher and reported that her employer (the Ministry of Education) was unwilling to exempt her from her teaching obligations during competitions that were taking place at the beginning or end of the school year. Participation Attributes Empowerment. Four participants reported personal strength gained through the training in the aquatic environment. One of them said she felt able to walk independently in the water, which was impossible for her on land. She also depicted the process of personal growth: “We swam under difficult conditions and became strong … swimming gave us pride.” Another swimmer added, “The pool was a source of strength.” The swimmer with the most severe condition participating in the group described the impact of swimming on pride and self-esteem. “Due to the achievements in swimming, my family got to know who I am. It has helped my self-confidence a lot, even through difficult times.” She further mentioned the impact of participation in training on recovering from mourning her mother, who had died prior to her participation in the Paralympic games. All of the participants but one (89%) expressed agreement on this category. Abandonment. Several participants described a feeling of abandonment, particularly after retirement. A female swimmer who stopped training after being de-selected to the Paralympic team complained nobody phoned, nobody asked me whether I would like to swim a little bit…so I didn’t swim, maybe gained some weight… nobody fought for me, including coaches and friends. I felt so small…. Another swimmer felt he was left alone to cope with his retirement. “I decided I wanted to retire from big competitions and gradually reduced the load. It was my own decision, my own planning, nobody helped.” Seven out of nine (78%) participants agreed on this category. Discussion In the current study, a group representing most retired international competitive swimmers from a major sport club for athletes with a disability retrospectively reported their perspectives on facilitators and barriers to participation during and after their competitive career, and on emotional outcomes of this career. The average and range of participant ages at retirement in our focus group suggests that about two-thirds of the participants retired prematurely. Although the early 30s is not considered premature for competitive able-bodied swimmers, in disability sport participants often follow a competitive career until their late 40s. The participants clearly articulated barriers to pursuing their careers, as well as certain facilitators mediating toward adherence. These barriers and facilitators can be identified with the personal and environmental contextual factors pertaining to participation within the ICF framework (Figure 1). Table 1 demonstrates that most of our participants chose to continue participation, either in recreational swimming or alternative recreational activities including sailing, dancing and
10 Facilitators and Barriers of Competitive Swimmers election criteria, coach’s low competence, vocational and economical conflicts) appear to be environmental mediating factors. One factor—peer swimmers— was regarded as both a facilitator and a barrier, with five participants agreeing on each attribution (56%). It seems that the individual perception of this factor was highly contextual and should be carefully interpreted. Only one barrier generated could be described as an internal factor (health disorders). This factor was mentioned by two participants, one of them discontinued her physical activity after retirement. Furthermore, in order to facilitate participants’ adherence and empowerment, external factors are more easily accessed and influenced by organizational bodies. Therefore, we focus on external factors in the following section. Generally, it appears that the balance between facilitators and barriers contributed to adherence or, alternatively, burnout and retirement. This balance between barriers and facilitators was related to several potential conflict contexts: (a) coach–athlete conflict; (b) peer group– athlete conflict; (c) job–training conflict; (d) club selection process–athlete conflict. The concept of conflicts as barriers to pursuing an athletic career has been acknowledged in the sport literature, suggesting that the reason most often mentioned for dropout is the time problem, which occurs when trying to coordinate education, job and competitive sport (Gabler, 1981; Kroger, 1986; Sack, 1980; Singer 1992). In a study comprising 136 elite athletes, lack of time to be with significant others and role conflict were positively associated with burnout scores (Kjormo & Halvari, 2002). Further conflict areas addressed for swimmers, gymnasts, track and field athletes and ball game players appear within the athletic environment, including the coach, sport organization, and peers (Bussmann, 1999; Gabler, 1981; Kroger 1986; Singer 1992). The relationship of the swimmer with the coach is expected to be based on a very high level of confidence, commitment and security in his or her professional competence, thus revealing positive outcomes on motivation and performance (Amorose & Horn, 2000; Black & Weiss, 1992). Bussmann (1999) illustrated the contextual role of the coach in her conclusion that: Coaches play an extremely decisive role in the competitive development of their athlete, and their supporting or inhibiting influence cannot be estimated too highly. The coach is not only responsible for a successful career in competitive sport but he or she may also be responsible for the termination of a career. (p. 27) Similarly, the existence of conflicts with administrators and peers may play an important role in facilitating early burnout. In contrast, conflicts can also be an important trigger of an empowerment process (see Hutzler, 2003). However, in order to facilitate empowerment, some preliminary personal mediators such as self-identity as an athlete, self-efficacy, goal- orientation, and decisiveness are required. The development of an athletic and able- bodied social identity has been addressed among elite athletes with a disability (Wheeler et al., 1999) and particularly in swimmers with a disability (Martin, Adams- Mushett, & Smith, 1995). However, if these mediators are lacking, a vicious cycle of learned helplessness may occur (Seligman, 1992). Therefore, if conflicts are associated with alternative choices and independent decision making processes, then this context would typically result in reinforced mental power and durability, and may be
Hutzler and Bergman 11 considered as empowering. If, however, conflicts are associated with a forced and unexplained decision, the context may be considered disempowering and could create considerable stress and psychopathological symptoms to the individual (Campbell & Jones, 2002; Wheeler, 2001; Wheeler et al., 1999). The range from healthy to pathological reactions to stress is typically explained through the balance between the perceived facilitators and barriers as well as personal higher order executive systems appraising the threat (Antonovsky, 1987; Lazarus & Folkman, 1984). The categories we have identified as facilitators, including joy and fun during participation, the feeling of being an elite group, and the social support of the peer group, can be linked to group cohesion and unity that have been recommended in employee empowerment (Plunkett & Fournier,
- and appear to mediate psycho- social health and buffer stress reactions. In contrast, the environmental factors which we have identified as barriers, including uncertain criteria for selection, unaccepted classification systems, conflicts with the coach, with peers, and with the employer, as well as internal factors such as health disorders appear to threaten psycho- social health, thus promoting distress and premature retirement (burnout). All mediating factors appearing in our study with the exclusion of health disorders can be considered as organizational stressors, whose acknowledgment among 10 able-bodied athletes was more strongly represented than performance stressors (Hanton, Fletcher, & Coughlan, 2005). Limitations This study had several limitations, including the retrospective nature of the inquiry and the diversity of the sample in terms of age, gender, and type of disability. In addition, the participants in this study were a selected group of elite level swimmers and included a relatively small number of participants, representing a limited reference group. Finally, it should be acknowledged that our data is based on a focus group setting that may compromise the depth of information acquired. Recommendations Findings from this study indicate that social-environmental factors are crucial as facilitators to maintaining the careers of swimmers with disability; therefore, it is recommended that sport organizations consider implementing program and career developing procedures such as: (a) increasing their transparency of decision making, (b) incorporating athletes in the decision making process, (c) build on and augment the empowering, mediating function of the athletic social-identity, for example through modeling and peer tutoring programs (d) encouraging alternative tracks to competitive training when burnout is anticipated, (e) providing psycho-social consultation, that is intended to increase athletes’ coping strategies, both problem and emotion focused, and (f) emphasize the facilitators proposed by our participants, including joy and fun and being an elite group (table 2). The Long-Term Athlete Development (LTAD) model (Balyi, 2001) applied by the Canadian Sport Federations and implemented in organizations serving participants with a disability appears to be a promising example. The research establishing the validity and objectivity of the integrated swimming classification (Daly, Djobova, Malone, Vanlandewijck, & Steadward, 2003; Daly, Malone, Smith, Vanlandewijck, & Steadward, 2001; Wu & Williams, 1999) is another way to empower athletes, by decreasing the uncertainty
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