Author(s): CHUNG, P., Institution: NATIONAL TAIWAN SPORT UNIVERSITY, Country: TAIWAN, Abstract-ID: 173

Introduction
Following sport injury, rehabilitation is not only a process of physical recovery but also a dynamic period of psychological adaptation and behavioral change. Rehabilitation adherence refers to athletes' timely, complete, and active engagement in prescribed rehabilitation programs and plays a critical role in physical recovery and return-to-sport readiness. However, existing research has largely relied on quantitative approaches, providing limited insight into how injured athletes interpret injury experiences and social contexts across rehabilitation stages.
Methods
Guided by the integrated model of psychological response to sport injury, this study adopted a qualitative research approach using grounded theory methodology to explore how competitive athletes make sense of post-injury experiences and develop rehabilitation adherence behaviors. Semi-structured interviews were conducted with six injured athletes, four coaches, and four athletic trainers. Field observations and researcher reflexive notes were incorporated to enrich data interpretation.
Results
Data analysis identified three interrelated core themes. First, initial cognitive appraisal and perceived resource loss reflected athletes' early interpretations of injury as a threat to physical ability, athletic identity, and future development, often accompanied by anxiety and uncertainty. At this stage, rehabilitation behaviors were primarily driven by external demands rather than internal motivation. Second, internal transformation and cognitive reconstruction described how athletes gradually reinterpreted rehabilitation as meaningful as progress became visible. Through increased awareness of bodily changes, internalization of rehabilitation-related knowledge, and re-evaluation of athletic goals, athletes shifted from passive compliance to active engagement, enhancing adherence. Third, interpersonal interactions and social expectations highlighted the bidirectional influence of coaches, teammates, family members, and athletic trainers. Supportive communication and appropriate expectations facilitated motivation, whereas excessive pressure and ambiguous role expectations undermined adherence behaviors.
Conclusion
Based on these findings, a process-oriented psychological model of rehabilitation adherence was developed to illustrate how cognitive appraisal, motivational transformation, and social interactions shape adherence behaviors across rehabilitation stages. This model extends previous variable-centered research by emphasizing the dynamic psychological and social processes underlying rehabilitation adherence and provides practical implications for early identification of adherence risks and stage-sensitive psychological support during rehabilitation.
Reference
Wiese-Bjornstal, D. M., Smith, A. M., Shaffer, S. M., & Morrey, M. A. (1998). An integrated model of response to sport injury: Psychological and sociological dynamics. Journal of Applied Sport Psychology, 10(1), 46-69