Analysis of Data (Final)

Introduction

The evaluative tools for my research were two questionnaires containing the same questions and delivered once before the physiotherapy sessions which formed the intervention portion of my project and once following the sessions. On completion of the ‘after’ questionnaire three questions were asked of the six participants in my study in an interview setting. The questions allowed participants to say as much or as little as they wanted in response.

 

Comparison of Questionnaires

Q1: On a scale of 0-10 with 10 being the most painful and 0 being no pain at all, how much pain are you currently in when exercising?

Before – There was a range from 3-9 of recorded pain before physiotherapy. 7 was the most common response with 33.33% of respondents citing it as the degree of pain they were in. The mean was 6.2.

After – The range after physiotherapy was between 2 and 6 with an even split of two respondents each on 2, two on 4 and two on 6. The pain mean had dropped to 4.

Q2: On a scale of 0-10 with 10 being the most painful and 0 no pain at all, how much pain are you currently in when sitting?

Before – This question had a pain response rate range from 0-7, the mode figure was 3 (33.33% of respondents) and the mean is also 3.

After –  The pain response rate range for this question was 0-4, the mean being 2.3.

Q3: My injury negatively affects my mood.

Before – Respondents were asked to rate this statement in accordance with their own experiences from a scale of strongly agree at one end, to strongly disagree at the other. The responses were split ranging from strongly agree to disagree but with nobody choosing strongly disagree perhaps suggesting that to some extent we are all negatively affected by injuries.

After – This time the results ranged from agree to disagree, no respondent choosing the two extreme ranges. The perhaps surprising result was that 50% of respondents said they agreed that the injury was still negatively affecting them – the same number as in the before survey.

Q4: My injury makes me frustrated.

Before – This was the strongest response so far with four respondents agreeing with this statement and two strongly agreeing.

After – Four respondents still agreed they were frustrated but the level of frustration overall decreased, nobody strongly disagreeing, one respondent with a neutral response and one disagreeing – they were effectively no longer as frustrated.

Q5: My injury negatively affects my self-esteem.

Before – This result was completely split down the middle with three respondents agreeing and three respondents disagreeing that their injury negatively affected self-esteem.

After – This was the most altered response so far with nobody now thinking their self-esteem was negatively affected. This seems to be the biggest influence the physiotherapy has had on the psychology of the injured dancers. 50% neither agreed nor disagreed, 33.33% disagreed and 16.67% strongly disagreed.

Q6: My injury motivates me positively.

Before – This statement generated a three way response: two respondents each for agree, neither agree nor disagree and strongly disagree.

After – One respondent now strongly agrees that their injury has motivated them positively, three neither agree nor disagree and two still disagree, although nobody now strongly disagrees so there does appear to have been a slight positive shift.

Q7: Do you believe physiotherapy will help the psychological aspects of your injury?

Before – 66.67% believed it would help, 33.33% that it wouldn’t.

After –  The question was slightly altered on the after questionnaire to “Did physiotherapy help with the psychological aspects of your injury?” but interestingly the response was unchanged from the before.

Q8: On a scale of 0-10 with 10 being the most and 0 the least, how much do you think the physiotherapy will help you with the psychological aspects of your injury?

Before – Responses ranged from 3-7 with a mean of 5.2% which is right in the middle of the scale.

After – This question was also slightly altered for the after questionnaire to “…how much do you think the physiotherapy did help you with the psychological aspects of your injury?” This time the results did change with the responses now ranging from 5-9 giving a mean of 7 which is quite high.

 

Interview Results

Q1: Explain the nature of your injury and how it has made you feel.

Several of the participants expressed feelings of distress as the injury affected not only their ability to dance but to prepare for forthcoming examinations and competitions as demonstrated in the following two quotes:

“I had an ankle injury and I did that due to dance and it made me feel quite upset because it was before my exam and I felt a bit stressed out because I couldn’t do everything I needed to in order to prepare.”

“Torn ligaments on my ankle. It just made me feel upset because I couldn’t dance.”

Feeling of frustration came out strongly in response to this question as well:

“At the time of the injury it was quite annoying because I wasn’t allowed to do any sports. I couldn’t really do a lot on my feet because if I did it would just get worse so I just had to rest it. I had torn ligaments in my ankle.”

“I had badly sprained my ankle and was having mobility issues which was really difficult because I am a highland dancer and it meant performing certain steps was really painful and I couldn’t perform to the best of my ability. It was frustrating I guess.”

“I had a sore knee that hurt when I danced or ran. It made me a bit frustrated because it stopped me from doing things.”

This quotation supports evidence found in the literature that one of the difficulties in treating dance injuries is a failure to report it in many instances, which then results in additional difficulties:

“So it was at dancing I pulled my hamstring away from the bone. At first I didn’t know if I should do anything about it so I was just like getting on with it. Obviously it was sore but I was just like going to dancing. It obviously annoyed me but I just thought that it was just a small injury like it happens to most people that play sports and stuff so you just get on with it and it gets better.”

Q2: What causes you to feel negatively about your injury, if anything?

Respondents could see that their injuries were making things much more difficult for them although couldn’t always pinpoint what the specific difficulties were:

“Because I can’t like do everything to the best of my ability because my injuries are like making things a lot harder because I’m in a lot of pain.”

“Because it stopped you from doing certain stuff because it was like too sore to do or like you were worried it would maybe make it worse.”

Some dancers, however, were able to give more specific negative side effects inclusing upset, boredom and once again, frustration:

“The fact that I can’t dance because I was out for weeks. It makes me feel upset.”

“It had quite a negative effect because I wasn’t allowed to do anything so I was just sitting about and just waiting for it to get better for about 6-8 weeks so it obviously led to me being bored and just feeling like there was nothing I could really do to help it.”

“Not being able to dance to the best of my ability makes me feel bad and I guess frustrated because I know I am better than my performances with the injury were showing. Does that make sense?”

“I felt negatively because I couldn’t do things. I had to stop doing a lot. It was frustrating.

Q3: Do you feel the physiotherapy has helped you cope psychologically with your injury? Explain.

Motivation and the confidence to get back to dancing were the two positive psychological effects highlighted by the responses to this question:

“Yes because after I got the physio it made me feel a lot more confident because I knew that it helped me so I was a lot more confident with my dancing.”

“Yes, because it made me more motivated to get back up and dance.”

“ I feel that physio definitely did help in a sense because if I didn’t have it it would probably have taken a bit longer for my ankle to get better but then again there was nothing really that I could do much about, even with physio I just had to wait for it to get better.”

“Yes because I could see and feel that I was making good progress and so I felt like I was on the right track and would eventually get better.”

“Yeah because you had someone there to help you and show you things. She gave you things that would help and told you like if you do this this might make you feel better. I suppose it did a wee bit.”

However, some respondents were once again unable to recognise what may have been an effect. As a researcher I have to consider whether this was something to do with the wording of the questions:

“Yeah, a bit. It just did, I don’t really know how.”

 

Thematic Analysis

Having compared the results from the two questionnaires and transcribed interview responses the following themes stood out: pain, frustration, sadness and motivation.

Pain – There was a range from 3-9 of recorded pain before physiotherapy with a mean of 6.2. After six physiotherapy sessions the range was 2-6 and the degree of pain mean had dropped to just 4. We know already that physiotherapy can have a positive impact on the pain presenting clients are in from scientific reports such as that from the Chartered Society of Physiotherapy (http://www.csp.org.uk/publications/physiotherapy-works-chronic-pain). It would therefore be appropriate to comment on the fact that there is a subsequent correlation between levels of pain and levels of psychological impact. Although none of my interview questions specifically asked about pain (this was mentioned in questions one and two of the questionnaires) a number of respondents mentioned it as they associated it with negative psychological feeling: “things (are) a lot harder because I’m in a lot of pain.” How much pain correlates to psychological impact would be an interesting potential research area for further development.

Frustration – During my initial research of associated literature frustration was a common theme which emerged which was the reason for individually categorising it in my questionnaire. 100% of respondents reported being frustrated to some degree in the before questionnaire but in the after questionnaire the level of frustration had decreased. A majority of participants physically mentioned frustration in their interview responses: “it was quite annoying”, “it was frustrating”, “a bit frustrated”, “frustrating”, “it obviously annoyed me.” The results show an agreement therefore with the literature (Hemmings and Povey, 2002) that frustration is a key psychological element when dealing with a dance injury and physiotherapy did, in this instance, have a positive effect on this negative emotion.

Upset –  As well as frustration I had also asked specifically about self-esteem. According to the quantitative data 50% felt their self-esteem was negatively affected by injury. After the series of physiotherapy sessions not one respondent reported a negative effect on self-esteem. This would appear to be a large positive effect, however, in the interview nobody commented on this. Instead a number of comments were based around feeling upset about the injury which was interesting. Did this feeling of sadness subsequently effect the self-esteem? “It made me feel quite upset”, “it just made me feel quite upset”, “Not being able to dance to the best of my ability makes me feel bad”.

Motivated – A lot of the data gathered focussed on the before effects, however, my initial intention was to see if there was any positive impact that physiotherapy could have on these negativities. According to my data the physiotherapy did help, 66.67% agreeing outright on that topic. In the interview responses motivation seemed to be the biggest specific effect, comments including: “after I got the physio it made me feel a lot more confident because I knew that it helped me so I was a lot more confident with my dancing”, “it made me more motivated to get back up and dance”, “I could see and feel that I was making good progress and so I felt like I was on the right track and would eventually get better.”

 

Discussion

The overarching aims of my research were to better understand the psychological impact of injury and to find out whether physiotherapy can alleviate any negative psychological impact. The results show that there are a number of potential negative effects associated with dance injury, most notably a feeling of frustration. The physiotherapy did go some way to alleviating this and in doing so motivated dancers positively to improve.  This supports my initial aims and expectations.

What was difficult, however, was to tell if this was associated with specific injuries and personalities as I chose to make my initial data anonymous. In hindsight I would have been more specific with respondent 1, respondent 2 and so on to see if there were any particular patterns. For example, did those who felt the most frustrated initially feel there had been more or less benefit to them?

I am pleased the results showed that physiotherapy can have a positive overall effect as it can now be recommended as a solid treatment option for students presenting with dance injuries to keep them on track and alleviate possible negative psychological effects which may arise from being unable to perform and compete in the short-term.

If I was to conduct this research again I would try to get more information from my interviews. This could involve more questions or rewording the questions so that they were easier for my participant to answer. In hindsight I should have conducted a pilot study of the questions. I also didn’t focus enough on the how the physiotherapy had helped which may inform future research.

 

 

Project Conclusions and Recommendations (Draft 1)

Research questions and professional goals

In completing this project, my overarching aims were to better understand the psychological impact of chronic and overuse injury in dancers and to explore whether or not intensive physiotherapy can alleviate not only the physical but also the psychological impact on the dancer and more specifically to answer the following:

  • What are the possible negative psychological impacts of injury on the dancer?

Following a thematic analysis it became clear that frustration and upset were the biggest psychological effects. Frustration in particular coming up many times throughout the questionnaire and interview responses.

  • Are there any positive psychological impacts of chronic and overuse injury on dancers?

Dancers reported feeling motivated by their injury following the physiotherapy but not necessarily when the injury first took place and before they undertook medical treatment.

  • How do these potential psychological impacts manifest in the dance studio environment?

All the injuries which my participants had prevented them from dancing so this question became null and void.

  • What can be done to limit any negative psychological impacts of injury on dancers?

Physiotherapy came out as a positive way to limit negative psychological impacts.

  • Does physiotherapy make a difference to how young people cope with the psychological impacts of injury?

In this study the overall results showed yes it did making students feel “a lot more confident because I knew that it helped me so I was a lot more confident with my dancing”, “it made me more motivated to get back up and dance”, “I feel that physio definitely did help in a sense because if I didn’t have it it would probably have taken a bit longer for my ankle to get better”, “I could see and feel that I was making good progress and so I felt like I was on the right track and would eventually get better” and “you had someone there to help you and show you things. She gave you things that would help and told you like if you do this this might make you feel better. I suppose it did (help).”

To return to my overarching aims,

  • To better understand the psychological impact of chronic and overuse injury in dancers
  • To explore whether or not intensive physiotherapy can alleviate not only the physical but also the psychological impact on the dancer

I feel that I understand more clearly the specific issues arising from dance injury and believe that yes, intensive physiotherapy can help to alleviate both physical and psychological effects on the dancer.

 

Designing and delivering meaningful learning experiences

Having the physiotherapy sessions was ultimately a valuable experience for the dancers as without the sessions they may have struggled for longer with their injuries, they may not have known or considered having physiotherapy to help them with their injuries and they may therefore have suffered for longer with both the physical and psychological difficulties which arose from their injuries. Students were therefore able to get back into the studio more quickly to prepare for competition and examinations.

The questionnaires and interview questions allowed an opportunity to use literacy skills of reading and talking and to develop a knowledge an understanding of more complex vocabulary. An interview scenario can build confidence and allowed students to be analytical in their responses, going beyond simple yes and no responses and instead having to analyse and evaluate why they believed things to be so.

This is all valuable education and experience for young people.

 

Supporting learners in their development

It is the duty of all teachers to support their learners and encourage and aid them in their development. In this instance support was made available from the outset and was made clear to participants in my oral explanation and written information sheet which made clear that participation was entirely on a voluntary basis and they had the right to withdraw their consent or discontinue participation at any time. They could leave any responses on the questionnaires blank and did not have to answer the interview questions.

I was in close contact with the physiotherapists throughout the process who provided their own clarification and support as per company policy.

During the interviews some students did not understand particular questions and I differentiated and reworded them as a form of support.

 

Assessing and providing feedback to learners

There was no formal assessment involved with my project. Feedback to learners will have come from the weekly sessions with the physiotherapist who will have reported on progress made week-by-week and work to be conducted at home to support what was happening in the clinc. This would have been a potential area for further study to see, for example, if there was a particular number of sessions where impact started to be seen, however, given the small-scale nature of the study I was not privy to any feedback given to the learners at this stage.

 

Engaging in a meaningful development of your knowledge and skills in research, effective pedagogy and evaluation of your professional practice

One of my personal aims in completing this project was highlighted in my project proposal and was to ‘Develop my own research and project management skills.’ From the beginning to the end of the project there have been opportunities to develop a piece of work which took account of our prior knowledge from the course but stretched us to provide a more thorough and complete project.

Before starting the research project I felt confident in some areas such as study of literature but some parts were completely new to me such as completing an ethics form and the relevant forms to go along with it, conducting small scale research and analysing results to the degree required. I have learnt much from the process and if asked to complete something similar again would have a timeline and structure to support this.

In terms of my own teaching practice, although I expected physiotherapy would alleviate some of the psychological difficulties related to dance injury, it was not something as a dance teacher I felt in a position to recommend. That was for medical professionals. Although to a degree this is true part of my prior research suggested that medical professionals and dance teachers need to work much more closely together and enhance their awareness of negative psychology in treatment to prevent or reduce injuries (Kerr et al, 1994). Dance teaching is still a relatively new practice in secondary schools and as such schools need to be open to the new practices which may come with this new subject area. In my outside school teaching experience I would never question whether I should or should not recommend a medical treatment such as physiotherapy but somehow because we are primarily secondary school teachers  we feel nervous about perhaps recommending something that could be seen as outside our knowledge set. As my knowledge set has now been improved and backed up my the evidence from this project, however, I think it is important to feel confident in outlining the potential positives physiotherapy could have.

I acted professionally throughout this project and will continue to do so in both a research and teaching context. Teachers have a requirement to be continuously learning and improving and conducting research such as this provides opportunities both to improve as learners and as teachers with potential for research work to aid dance teaching in schools which is still undergoing great change.

 

Recommendations

There are three groups of people who I feel would gain value from this project: dancers, dance teachers/schools and physiotherapists. I would therefore make the following recommendations to each group:

Dancers – Dancers need to understand that, like sport, injuries are part and parcel of their lives but can have a damaging effect on both their physical ability to perform and their psychological ability to get better. Dancers should see physiotherapy is a potential treatment option which if sought quickly could support recovery by easing frustrations and stress around the injury and support dancers with exercises they can do to improve themselves on a daily basis. Although physiotherapists do not offer psychological services it cannot be denied that the work they do can be both motivating and progressive in terms of getting dancers back on track.

Dance Teachers – Need to understand that given we look after the whole wellbeing of the child recommending medical practices such as physiotherapy can have a positive impact on all aspects of the dancer’s recovery.  It is startling how negative injuries can make people feel  supported by both my own study an renowned researchers Mainwaring, Krasnow and Kerr who say “dancers’ reactions to injury involve initial negative affects that may become more positive as the injury heals”, therefore teachers (and schools) should feel confident in recommending physiotherapy as a treatment option.

Physiotherapists – Should be aware of the psychological impact their treatment can have and work closely with dancers and dance teachers/schools to limit any negative impact injuries might be having. My research would not suggest their practice needs to change in anyway but it is an additional positive effect that physiotherapists should be aware of when advertising treatment options.

 

Evaluation of impact

My initial research title was to: Explore the Impact of Intensive Physiotherapy on the Psychology of the Injured Dancer.

Overall the impact of the physiotherapy was that dancers felt less frustrated and down about theor injuries and more confident that things would improve. This suggests that without physiotherapy dancers would potentially continue to feel negatively and therefore not recovers o quickly or certainly not feel they could recover, negative psychology can subsequently lead to more serious mental health problems and so it is vital that dancers seek treatment as quickly as possible to negate potential negative side-effects.

It is important to note, however, that my study was completed with a small number of students over a relatively short period of time and further research would be necessary to clarify whether specific injuries were improved more or less, did the length or amount of physiotherapy sessions make a difference and to investigate the difference by perhaps using two groups – one getting physiotherapy treatment and one not.

However, this is an area which is gaining gravitas in the world of dance, a couple of recent reports highlighting the need for dance companies to be more in touch with potential difficulties arising from injuries and the importance of physiotherapists in countering problems. Entitled simply ‘Dancers Need More Physio Support’, author Helen Laws estimates that about 100 physiotherapists around the UK are now working with professional dancers but disappointingly only a handful of the larger companies have so far established adequate services and facilities for their dancers.

Recommendations arising from Laws report were:

  • more emphasis on assessing and improving dancers’ aerobic fitness levels, and providing advice on physiological and psychological issues
  • bringing in physiotherapists and counsellors to do more prevention and treatment work with dance groups and companies
  • providing direct access to treatment facilities and better access to gym equipment

Therefore my work, although small, could support this study still further to perhaps educate dance schools and companies on the importance of physiotherapy.

 

Analysis of Data (Draft 1)

Introduction

The evaluative tools for my research were two questionnaires containing the same questions and delivered once before the physiotherapy sessions which formed the intervention portion of my project and once following the sessions. On completion of the ‘after’ questionnaire three questions were asked of the six participants in my study in an interview setting. The questions allowed participants to say as much or as little as they wanted in response.

 

Comparison of Questionnaires

Q1: On a scale of 0-10 with 10 being the most painful and 0 being no pain at all, how much pain are you currently in when exercising?

Before – There was a range from 3-9 of recorded pain before physiotherapy. 7 was the most common response with 33.33% of respondents citing it as the degree of pain they were in. The average was 6.2.

After – The range after physiotherapy was between 2 and 6 with an even split of two respondents each on 2, two on 4 and two on 6. The pain average had dropped to 4.

Q2: On a scale of 0-10 with 10 being the most painful and 0 no pain at all, how much pain are you currently in when sitting?

Before – This question had a pain response rate from 0-7, the most common was 3 (33.33% of respondents) and the average is also 3.

After –  The pain response rate for this question was 0-4, the average being 2.3.

Q3: My injury negatively affects my mood.

Before – Respondents were asked to rate this statement in accordance with their own experiences from a scale of strongly agree at one end, to strongly disagree at the other. The responses were split ranging from strongly agree to disagree but with nobody choosing strongly disagree perhaps suggesting that to some degree we are all negatively affected by injuries.

After – This time the results ranged from agree to disagree, no respondent choosing the two extreme ranges. The perhaps surprising result was that 50% of respondents said they agreed that the injury was still negatively affecting them – the same number as in the before survey.

Q4: My injury makes me frustrated.

Before – This was the strongest response so far with four respondents agreeing with this statement and two strongly agreeing.

After – Four respondents still agreed they were frustrated but the level of frustration overall decreased, nobody strongly disagreeing, one respondent with a neutral response and one disagreeing – they were effectively no longer frustrated.

Q5: My injury negatively affects my self-esteem.

Before – This result was completely split down the middle with three respondents agreeing and three respondents disagreeing that their injury negatively affected self-esteem.

After – This was the most altered response so far with nobody now thinking their self-esteem was negatively affected. This seems to be the biggest influence the physiotherapy has had on the psychology of the injured dancers. 50% neither agreed nor disagreed, 33.33% disagreed and 16.67% strongly disagreed.

Q6: My injury motivates me positively.

Before – This statement generated a three way response: two respondents each for agree, neither agree nor disagree and strongly disagree.

After – One respondent now strongly agrees that their injury has motivated them positively, three neither agree nor disagree and two still disagree, although nobody now strongly disagrees so their does appear to have been a slight positive shift.

Q7: Do you believe Physiotherapy will help the psychological aspects of your injury?

Before – 66.67% believed it would help, 33.33% that it wouldn’t.

After –  The question was slightly altered on the after questionnaire to “Did physiotherapy help with the psychological aspects of your injury?” but interestingly the response was unchanged from the before.

Q8: On a scale of 0-10 with 10 being the most and 0 the least, how much do you think the physiotherapy will help you with the psychological aspects of your injury?

Before – Responses ranged from 3-7 with an average of 5.2% which is right in the middle of the scale.

After – This question was also slightly altered for the after questionnaire to “…how much do you think the physiotherapy did help you with the psychological aspects of your injury?” This time the results did change with the responses now ranging from 5-9 giving an average of 7 which is quite high.

 

Transcription of Interviews

Q1: Explain the nature of your injury and how it has made you feel.

“I had an ankle injury and I did that due to dance and it made me feel quite upset because it was before my exam and I felt a bit stressed out because I couldn’t do everything I needed to in order to prepare.”

“Torn ligaments on my ankle. It just made me feel upset because I couldn’t dance.”

“At the time of the injury it was quite annoying because I wasn’t allowed to do any sports. I couldn’t really do a lot on my feet because if I did it would just get worse so I just had to rest it. I had torn ligaments in my ankle.”

“I had badly sprained my ankle and was having mobility issues which was really difficult because I am a highland dancer and it meant performing certain steps was really painful and I couldn’t perform to the best of my ability. It was frustrating I guess.”

“I had a sore knee that hurt when I danced or ran. It made me a bit frustrated because it stopped me from doing things.”

“So it was at dancing I pulled my hamstring away from the bone. At first I didn’t know if I should do anything about it so I was just like getting on with it. Obviously it was sore but I was just like going to dancing. It obviously annoyed me but I just thought that it was just a small injury like it happens to most people that play sports and stuff so you just get on with it and it gets better.”

Q2: What causes you to feel negatively about your injury, if anything?

“Because I can’t like do everything to the best of my ability because my injuries are like making things a lot harder because I’m in a lot of pain.”

“The fact that I can’t dance because I was out for weeks. It makes me feel upset.”

“It had quite a negative effect because I wasn’t allowed to do anything so I was just sitting about and just waiting for it to get better for about 6-8 weeks so it obviously led to me being bored and just feeling like there was nothing I could really do to help it.”

“Not being able to dance to the best of my ability makes me feel bad and I guess frustrated because I know I am better than my performances with the injury were showing. Does that make sense?”

“I felt negatively because I couldn’t do things. I had to stop doing a lot. It was frustrating.

“Because it stopped you from doing certain stuff because it was like too sore to do or like you were worried it would maybe make it worse.”

Q3: Do you feel the physiotherapy has helped you cope psychologically with your injury? Explain.

“Yes because after I got the physio it made me feel a lot more confident because I knew that it helped me so I was a lot more confident with my dancing.”

“Yes, because it made me more motivated to get back up and dance.”

“ I feel that physio definitely did help in a sense because if I didn’t have it it would probably have taken a bit longer for my ankle to get better but then again there was nothing really that I could do much about, even with physio I just had to wait for it to get better.”

“Yes because I could see and feel that I was making good progress and so I felt like I was on the right track and would eventually get better.”

“Yeah, a bit. It just did, I don’t really know how.”

“Yeah because you had someone there to help you and show you things. She gave you things that would help and told you like if you do this this might make you feel better. I suppose it did a wee bit.”

 

Thematic Analysis

Having compared my two questionnaires and transcribed interview responses the following themes stood out: pain, frustration, sadness and motivation. I will analyse each of these in turn.

Pain – There was a range from 3-9 of recorded pain before physiotherapy with an average of 6.2. After six physiotherapy sessions the range was 2-6 and the pain average had dropped to just 4. We know already that physiotherapy can have a positive impact on the pain presenting clients are in, it would therefore be appropriate to comment on the fact that there is a subsequent correlation between levels of pain and levels of psychological impact. Although none of my interview questions specifically asked about pain a number of respondents mentioned it as they associated it with negative psychological feeling: “things (are) a lot harder because I’m in a lot of pain.” This is an interesting theme to come out of my research although not necessarily the intention as it is not directly related to the psychological. How much pain correlates to psychological impact would be an interesting potential research area for further development.

Frustration – During my initial research of associated literature frustration was a common theme which came up which was the reason for individually categorising it in my questionnaire. 100% of respondents reported being frustrated to some degree in the before questionnaire and in the after questionnaire the level of frustration had decreased. A majority of participants physically mentioned frustration in their interview responses: “it was quite annoying”, “it was frustrating”, “a bit frustrated”, “frustrating”, “it obviously annoyed me.” The results show an agreement therefore with the literature that frustration is a key psychological element when dealing with a dance injury and physiotherapy did, in this instance, have a positive effect on this negative emotion.

Upset –  As well as frustration I had also asked specifically about self-esteem. According to the quantitative data 50% felt their self-esteem was negatively affected by injury. After the series of physiotherapy sessions not one respondent reported an effect on self-esteem. This would appear to be a large positive effect, however, in the interview nobody commented on this. Instead a number of comments were based around feeling upset about the injury which was interesting. Did this feeling of sadness subsequently effect the self-esteem? “It made me feel quite upset”, “it just made me feel quite upset”, “Not being able to dance to the best of my ability makes me feel bad”.

Motivated – A lot of the data gathered focussed on the before effects, however, my initial intention was to see if there was any positive impact that physiotherapy could have on these negativities. According to my data the physiotherapy did help, 66.67% agreeing outright. In the interview responses motivation seemed to be the biggest specific effect, comments including: “after I got the physio it made me feel a lot more confident because I knew that it helped me so I was a lot more confident with my dancing”, “it made me more motivated to get back up and dance”, “I could see and feel that I was making good progress and so I felt like I was on the right track and would eventually get better.”

 

Discussion

The overarching aims of my research were to better understand the psychological impact of injury and to find out whether can alleviate any negative psychological impact. The results show that there are a number of potential negative effects associated with dance injury, most notably a feeling of frustration. The physiotherapy did go some way to alleviating this and in doing so motivated dancers positively to improve.

What was difficult, however, was to tell if this was associated with specific injuries and personalities as I chose to make my initial data anonymous. In hindsight I would have been more specific with respondent 1, respondent 2 and so on to see if there were any particular patterns. For example, did those who felt the most frustrated initially feel there had been more or less benefit to them?

I am pleased the results showed that physiotherapy can have a positive overall effect as it can now be recommended as a solid treatment option for students presenting with dance injuries to keep them on track and alleviate possible negative psychological effects which may arise from being unable to perform and compete in the short-term.

If I was to conduct this research again I would try to get more information from my interviews. This could involve more questions or rewording the questions so that they were easier for my participant to answer. I also didn’t focus enough on the how the physiotherapy had helped which may inform future research.

Evaluative Tools – Final

My evaluative tools are two questionnaires and an interview. The questionnaires were designed using Survey Monkey as it was advised at a previous tutorial given that it is free, easy-to-use and gives some data analysis. I also found it useful as I could send links to pupils for them to complete at their own convenience. This was important as I didn’t want any input or potential bias at this stage and it also made it less invasive for the participants.

The questionnaires contained eight questions to be completed both before and after the physiotherapy sessions which formed the basis of the intervention for my project. The questions were the same on both questionnaires in order to compare results and required participants to click just once per question on a Likert scale format. My initial research on data gathering showed that Likert scales are an increasingly popular way to get mass opinions quickly.

My questionnaire reads as follows:

  1. On a scale of 0-10 with 10 being the most painful and 0 being no pain at all, how much pain are you currently in when exercising?
  2. On a scale of 0-10 with 10 being the most painful and 0 no pain at all, how much pain are you currently in when sitting?

The opening two questions were used to gauge whether or not the physical implications of the injury were a) improved by the physiotherapy and b) had an impact on the psychological effects. For example, did those respondents who were in the most pain gain more or less psychological benefit from the physiotherapy?

  1. My injury negatively affects my mood.

My assumption, based on both my reading on the subject and my personal experience would be that injury would negatively affect mood, however, I have learnt over the course of my investigation and study that a researcher can never assume results and needs to be open to different types of responses. Those who are negatively affected will presumably show a greater deal of improvement and thus more interesting results for my study.

  1. My injury makes me frustrated.

Frustration is something which comes out regularly in the literature surrounding sporting injuries and so I felt it was an important topic to investigate. Like the previous question those who are negatively affected by thus particular feeling/mood will presumably show a greater deal of improvement and thus more interesting results for my study.

  1. My injury negatively affects my self-esteem.

Self-esteem is something which I have previously explored during this course and seems to be particularly prevalent amongst dancers. I am therefore interested to find out what the potential impact  of injury is on this important area.

  1. My injury motivates me positively.

As stated previously, although it may be a natural assumption that injury is negative not all respondents may feel like this and so I felt it was important to bench my own potential bias and allow people to think about the potential positive effects of injury.

  1. Do you believe Physiotherapy will help the psychological aspects of your injury?

Does the belief you step into the physiotherapy room with aid the psychological recovery? It will be interesting to see if those who believe it will have more positive results than those who are perhaps sceptical and see physiotherapy as of purely physical benefit. After physiotherapy the question will obviously be ‘Did physiotherapy help with the psychological aspects of your injury?’ This question will require a simple yes or no response.

  1. On a scale of 0-10 with 10 being the most and 0 the least, how much do you think (did) the physiotherapy will help you with the psychological aspects of your injury?

Returning to a numerical response allows participants to give varied responses and will be an interesting comparison in how much improvement there has been.

 

The interview questions conducted after the second questionnaire allowed participants to expand on their thoughts and feelings. Interview questions are useful to obtain more detailed information about personal feelings, perceptions and opinions. Responses will be used alongside the questionnaires to inform the research:

1 Explain the nature of your injury and how it has made you feel.

Do different injuries attract different feelings? Does it depend on the severity of the injury? I also hoped that a simple question would allow participants to feel more relaxed about the more difficult second and third questions.
2 What causes you to feel negatively about your injury, if anything?

This is perhaps the most interesting question as it allows participants to be specific about what it is that makes them feel negatively. Do they feel angry or frustrated? Do they in fact not feel negatively at all?
3 Do you feel the physiotherapy has helped you cope psychologically with your injury? Explain.

This is the crux of my research project and although I will analyse the results of all the questions asked in both questionnaire and interview the answers to this question alone may give me an overall conclusion to my research.

In order to analyse the results of my interview questions I have chosen to use thematic analysis focussing on specific relevant points and/or interesting or unusual responses in order to find gaps in the research or something new which could benefit dance teachers, practitioners and physiotherapists in the future. Thematic analysis is a rarely acknowledged method of analysis but is a widely-used qualitative analytic method within psychology (University of Bristol), the key area of my research. It is an accessible and flexible approach to analysing data. This type of analysis allows the researcher to pinpoint between three and six themes which is a good number for a project on this scale and yet enough to fulfil the demands of research when looking for something new and relevant to report on. The importance of transcription in this type of work is paramount as transcribing closely ensures you pick out key points and the researcher can easily see features of the data that are considered pertinent to the research question. The researcher can look for repeated patterns before refining themes. My research of this particular type of analysis highlighted that each theme then needs to be clearly defined in itself and accompanied by detailed analysis. These will be recorded in my data analysis under sub-headings.

 

 

7 weeks later…

Just posted this status on my instagram. I am absolutely delighted with my progress and looking forward to dancing again soon!

Evaluative Tools Redraft

Introduction

My evaluative tools are two questionnaires and an interview. The questionnaires were designed using Survey Monkey as it was advised at a previous tutorial given that it is free, easy-to-use and gives some data analysis. I also found it useful as I could send links to pupils for them to complete at their own convenience. This was important as I didn’t want any input or potential bias at this stage and it also made it less invasive for the participants.

The questionnaires contained eight questions to be completed both before and after the physiotherapy sessions which formed the basis of the intervention for my project. The questions were the same on both questionnaires in order to compare results and require participants to click just once per question on a Likert scale format. My initial research on data gathering showed that Likert scales are an increasingly popular way to get mass opinions quickly.

The interview questions conducted after the second questionnaire allowed participants to expand on their thoughts and feelings and responses will be used alongside the questionnaires to inform the research. I have then chosen to use thematic analysis focussing on specific relevant points and/or interesting or unusual responses. The reason for my choice is because although thematic analysis is a rarely-acknowledged method of analysis it is a widely-used qualitative analytic method within psychology (Univeristy of Bristol), the key area of my research. It is an accessible and flexible approach to analysing data.

 

Comparison of Questionnaires

Q1: On a scale of 0-10 with 10 being the most painful and 0 being no pain at all, how much pain are you currently in when exercising?

Before – There was a range from 3-9 of recorded pain before physiotherapy. 7 was the most common response with 33.33% of respondents citing it as the degree of pain they were in. The average was 6.2.

After – The range after physiotherapy was between 2 and 6 with an even split of two respondents each on 2, two on 4 and two on 6. The pain average had dropped to 4.

Q2: On a scale of 0-10 with 10 being the most painful and 0 no pain at all, how much pain are you currently in when sitting?

Before – This question had a pain response rate from 0-7, the most common was 3 (33.33% of respondents) and the average is also 3.

After –  The pain response rate for this question was 0-4, the average being 2.3.

Q3: My injury negatively affects my mood.

Before – Respondents were asked to rate this statement in accordance with their own experiences from a scale of strongly agree at one end, to strongly disagree at the other. The responses were split ranging from strongly agree to disagree but with nobody choosing strongly disagree perhaps suggesting that to some degree we are all negatively affected by injuries.

After – This time the results ranged from agree to disagree, no respondent choosing the two extreme ranges. The perhaps surprising result was that 50% of respondents said they agreed that the injury was still negatively affecting them – the same number as in the before survey.

Q4: My injury makes me frustrated.

Before – This was the strongest response so far with four respondents agreeing with this statement and two strongly agreeing.

After – Four respondents still agreed they were frustrated but the level of frustration overall decreased, nobody strongly disagreeing, one respondent with a neutral response and one disagreeing – they were effectively no longer frustrated.

Q5: My injury negatively affects my self-esteem.

Before – This result was completely split down the middle with three respondents agreeing and three respondents disagreeing that their injury negatively affected self-esteem.

After – This was the most altered response so far with nobody now thinking their self-esteem was negatively affected. This seems to be the biggest influence the physiotherapy has had on the psychology of the injured dancers. 50% neither agreed nor disagreed, 33.33% disagreed and 16.67% strongly disagreed.

Q6: My injury motivates me positively.

Before – This statement generated a three way response: two respondents each for agree, neither agree nor disagree and strongly disagree.

After – One respondent now strongly agrees that their injury has motivated them positively, three neither agree nor disagree and two still disagree, although nobody now strongly disagrees so their does appear to have been a slight positive shift.

 

Transcription of Interview Questions

Q1: Explain the nature of your injury and how it has made you feel.

“I had an ankle injury and I did that due to dance and it made me feel quite upset because it was before my exam and I felt a bit stressed out because I couldn’t do everything I needed to in order to prepare.”

“Torn ligaments on my ankle. It just made me feel upset because I couldn’t dance.”

“At the time of the injury it was quite annoying because I wasn’t allowed to do any sports. I couldn’t really do a lot on my feet because if I did it would just get worse so I just had to rest it. I had torn ligaments in my ankle.”

“I had badly sprained my ankle and was having mobility issues which was really difficult because I am a highland dancer and it meant performing certain steps was really painful and I couldn’t perform to the best of my ability. It was frustrating I guess.”

“I had a sore knee that hurt when I danced or ran. It made me a bit frustrated because it stopped me from doing things.”

“So it was at dancing I pulled my hamstring away from the bone. At first I didn’t know if I should do anything about it so I was just like getting on with it. Obviously it was sore but I was just like going to dancing. It obviously annoyed me but I just thought that it was just a small injury like it happens to most people that play sports and stuff so you just get on with it and it gets better.”

Q2: What causes you to feel negatively about your injury, if anything?

“Because I can’t like do everything to the best of my ability because my injuries are like making things a lot harder because I’m in a lot of pain.”

“The fact that I can’t dance because I was out for weeks. It makes me feel upset.”

“It had quite a negative effect because I wasn’t allowed to do anything so I was just sitting about and just waiting for it to get better for about 6-8 weeks so it obviously led to me being bored and just feeling like there was nothing I could really do to help it.”

“Not being able to dance to the best of my ability makes me feel bad and I guess frustrated because I know I am better than my performances with the injury were showing. Does that make sense?”

“I felt negatively because I couldn’t do things. I had to stop doing a lot. It was frustrating.

“Because it stopped you from doing certain stuff because it was like too sore to do or like you were worried it would maybe make it worse.”

Q3: Do you feel the physiotherapy has helped you cope psychologically with your injury? Explain.

“Yes because after I got the physio it made me feel a lot more confident because I knew that it helped me so I was a lot more confident with my dancing.”

“Yes, because it made me more motivated to get back up and dance.”

“ I feel that physio definitely did help in a sense because if I didn’t have it it would probably have taken a bit longer for my ankle to get better but then again there was nothing really that I could do much about, even with physio I just had to wait for it to get better.”

“Yes because I could see and feel that I was making good progress and so I felt like I was on the right track and would eventually get better.”

“Yeah, a bit. It just did, I don’t really know how.”

“Yeah because you had someone there to help you and show you things. She gave you things that would help and told you like if you do this this might make you feel better. I suppose it did a wee bit.”

 

 

I now have all the material I need in order to conduct a thorough thematic analysis and critically reflect on the findings.

Thematic Analysis

Made a start on my ‘Analysis of Data’ today and now at the stage of looking more closely at the main themes. To help me along with this I found the following useful thematic analysis study (unrelated to my research but the layout and key points are still helpful):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166520/

The main points I have taken from the analysis are:

  • The study had picked just 4 themes (between 3-6 my recommendation).
  • Transcribe closely and over and over to ensure you pick out key points.
  • “…during the (transcription) process the initial thoughts and ideas were noted down.”
  • “…features of the data that the researcher considered pertinent to the research question” were noted at this stage.
  • Look for repeated patterns
  • Then refine themes
  • Each theme needs to be clearly defined in itself and accompanied by detailed analysis
  • Report each theme under a sub-heading