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074 Promotion of para athlete well-being in South Africa (the PROPEL studies), part III: factors associated with mental health
  1. Marelise Badenhorst1,2,
  2. Phoebe Runciman1,2,3,
  3. James Craig Brown1,2,
  4. Wayne Derman1,2
  1. 1Institute of Sport and Exercise Medicine (ISEM), Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
  2. 2International Olympic Committee (IOC) Research Centre, Cape Town, South Africa
  3. 3Department of Sport Science, Faculty of Education, Stellenbosch University, Cape Town, South Africa


Background Para athletes may have specific mental health challenges that, together with the demands of high-level sports performance, could put them at risk for mental health disorders.

However, research in this population is limited.

Objective To investigate factors associated with mental health in South African para athletes.

Design Descriptive, cross-sectional survey.

Setting National to international level athletes competing in the 2019 National Championships.

Patients (or Participants) A total of 124 athletes (93 males; 31 females) with a mean age 26.7 (±9.2) were included in the study.

Interventions (or Assessment of Risk Factors) Demographic, medical history and sleep-related variables were included in bivariate analyses to assess their association with mental health. Between-group differences were analysed using the Mann-Whitney U or T-tests. Variables significantly associated in the bivariate analyses were included in multiple regression analyses for mental health.

Main Outcome Measurements Mental health was measured with the State/Trait Anxiety Inventory (STAI) and the Kessler Psychological Distress Scale (K-10 Questionnaire). Sleep quality, sleepiness and chronotype were measured with the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness scale and Morningness-Eveningness Questionnaire (MEQ-SA).

Results The model explained 40% of the variance in mental health (F=12.04, p<0.001) in these athletes. Compared to athletes with ‘good’ sleep quality, K-10 and STAI scores were significantly higher (indicating poorer mental health) in athletes with ‘poor’ sleep quality (U =2.6, p<0.001; t(116.8)=-4.30, p<0.001). ‘Poor’ sleep quality (B:0.8; 95% CI 0.4 to 1.3), moderate to severe daytime sleepiness (B:4.2; 95% CI 1.1 to 7.3) intermediate (B:3.5 95% CI 0.4 to 6.6) and evening chronotypes (B:12.0 95% CI 5.0 to 19.1), the presence of allergies (B:3.9 95% CI 0.1 to 7.6) and male gender (B:3.3 95% CI 0.1 to 6.5) were most strongly associated with high STAI scores.

Conclusions This study has identified novel factors associated with poor mental health in elite para athletes. As some of these factors are modifiable, further research towards prevention strategies is warranted.

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