Questionnaire

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PARTICIPANT CONSENT

TITLE OF RESEARCH STUDY:

An investigation into the perception of rugby coaches on concussion in the Surrey county

Researcher's Name: Harrison James Kiy
Researchers Contact Details: 11 Colver Road
Sheffield
S2 7UP
Tel: 07710 792326
Email: harrison@hkiy.co.uk

I have read the Information Sheet for this study and have had details of the study explained to me.(*)

Yes
No Invalid Input

The Information Sheet can be read here on the home page www.hkiy.co.uk

My questions about the study have been answered to my satisfaction and I understand that I may ask further questions at any point.(*)

Yes
No Invalid Input

I understand that I am free to withdraw from the study within the time limits outlined in the Information Sheet, without giving a reason for my withdrawal or to decline to answer any particular questions in the study without any consequences to my future treatment by the researcher. (*)

Yes
No Invalid Input

I agree to provide information to the researchers under the conditions of confidentiality set out in the Information Sheet.(*)

Yes
No Invalid Input

I wish to participate in the study under the conditions set out in the Information Sheet.(*)

Yes
No Invalid Input

I consent to the information collected for the purposes of this research study, once anonymised (so that I cannot be identified), to be used for any other research purposes.(*)

Yes
No Invalid Input

First Name(*)

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Last Name(*)

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Contact Number(*)

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Email Address(*)

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I am willing to expand on my views in a telephone / Zoom interveiw

Yes
No Invalid Input

Research Questionnaire

Your Personal Profile

1 How many years have you worked as a Rugby Union coach?

Less than 5
5-10 years

10-15 years
More than 15 years

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2. What is the highest level of Rugby Union you have coached in the last 12 months?

Adult Professional
International Age Grade
Adult Club

Youth Club
Other

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2a. Tell us your other coaching level

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3. What is your coaching role?

Head Coach
Assistant Coach
Forwards Coach

Backs Coach
Kicking Coach
Other

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3a. Tell us your other coaching role

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Personal Experience

4. Have you ever played Rugby Union?

Yes
No Invalid Input

5. For how many years have you played?

Less than 5
5-10 years
10-15 years
More than 15 years Invalid Input

6. What is the highest level of Rugby Union that you have played?

International
Adult Professional
International Age Grade

Adult Club
Youth Club

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7. What is/was your main Rugby Union playing position?

Forward
Back Invalid Input

Concussions Experience

8. Have you heard of the term concussion?

Yes
No Invalid Input

9. Have you ever been knocked out?

Yes
No Invalid Input

10. Have you ever been concussed?

Yes
No Invalid Input

11. How many times?

1-2
3-5

6-10
10+

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12. Did you seek medical attention after being concussed?

Yes
No Invalid Input

13. After how many of these concussions?

All
1-2
3-5

6-10
10+

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14. How many times have you seen a player of your team concussed?

0-10
11-20

21-40
41+

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Concussion Knowledge

15. Select all immediate symptoms of a concussion

Convulsions or seizures
One pupil larger than the other
Drowsiness or inability to awaken
Loss of consciousness

Lost sense of taste
Inability to recognize certain people or places
Persistent confusion or agitation
Tightness in chest/ trouble breathing

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16. What would you do if you thought one of your players was concussed?

Remove from the game immediately
Look again in 5 minutes to see if they have run it off
Give them a headguard

Nothing, it’s the player’s responsibility to tell me
Rely on the medical team to make the right decision

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17. What would you do if a player was showing signs of concussion but insisted, they were fine to play on?

Allow them to play on, it’s the player’s decision
Try to persuade them to come off but if they refuse allow them to continue
Allow them to play for another 5 minutes to see if they run it off

Consult the referee
Insist they leave the pitch
If present, rely on the match medical team to make the right decision

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Concussion Experience and Witness

18. Have you ever allowed a player to continue that you thought was concussed?

Yes
No
Prefer not to say Invalid Input

19. Have you ever seen other coaching staff allowing a player to continue that you thought was concussed?

Yes
No
Prefer not to say Invalid Input

21. Have you ever had any education regarding concussion?

Yes
No Invalid Input

From which of the below? (Please answer yes to all the relevant answers and state the source if known)

21A Online Training

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21B Group Training

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21C Team Medic/Physiotherapist

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21D First Aid Course

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21E Other

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22. Which of the following currently provides you information about recognising and managing concussion?

Online search
RFU Website
Rugby Magazine
Team Medic / Physiotherapist
Coach

Training Course
Hard copy educational handouts
Free Smartphone App (please specify)
Other (please specify)

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22A Please tell us which App you use

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22B Please tell us which other source you use

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23. In the future which of these would be your preferred source/s of information about recognising and managing concussion?

Online search
RFU Website
Rugby Magazine
Team Medic / Physiotherapist
Coach

Training Course
Hard copy educational handouts
Free Smartphone App (please specify)
Other (please specify)

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23A Please tell us which App you use

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23B Please tell us which other source you use

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