Enhancing rehabilitation adherence in ethiopian footballers A contextual analysis of psychological and socio-economic factors
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Background: Physical injury rehabilitation in football is strongly influenced by psychological factors. In Ethiopia, a lack of culturally tailored psychosocial strategies may hinder rehabilitation adherence. Objective: This study investigated psychological factors associated with injury recovery among professional and semi-professional Ethiopian footballers to establish an exploratory, hypothesis-generating framework for under-resourced athletic contexts. Method: A convergent parallel mixed-methods design included quantitative data from an exploratory sample of N = 50 players who sustained an injury requiring at least 4 weeks of rehabilitation during the 2024–2025 competitive seasons and qualitative interviews with a purposive subsample (n = 10). Given the observational cross-sectional design, purposive recruitment, small sample size, self-report measures, and limited qualitative component, findings do not support causal conclusions or broad generalization. Results: Adherence was positively correlated with motivation (r = .42, p < .01) and self-confidence (r = .38, p < .05), and negatively correlated with fear of reinjury (r = −.50, p < .01). The regression model was significant, F(4, 45) = 8.83, p < .001, R² = .44, adjusted R² = .39. Fear of reinjury showed the strongest negative association with adherence (β = −.40, p = .001), whereas motivation (β = .35, p = .006), self-confidence (β = .28, p = .025), and psychological support (β = .22, p = .028) were positively associated. Three qualitative themes emerged: (a) spiritual resilience versus initial fatalism, (b) informal collectivist community support mitigating perceived institutional isolation, and (c) economic anxieties underpinning kinesiophobia. Conclusion: Psychological factors were associated with rehabilitation adherence and were embedded in local socioeconomic and cultural contexts. The study proposes the preliminary concept of socioeconomic kinesiophobia, which requires independent validation. Recommendations: Sports organizations could explore low-cost, culturally grounded interventions. Their feasibility, acceptability, safety, and effectiveness should be evaluated in co-designed, adequately powered studies.
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