J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 11, Number 11, November 2019, pages 729-739

Mental Health Status and Related Factors Among Visually Impaired Athletes

**Table 1.** Participants’ Attributes, Condition of Visual Impairment and Competition Activities (n = 81)
	Mean ± SD or n (%)
SD: standard deviation. ^aB1: blind; B2: severe low vision; B3: low vision.
Attributes
Age (years)	32.8 ± 12.0
Gender
Male	59 (72.8%)
Female	22 (27.2%)
Residential style
Living with family	44 (54.3%)
Living alone or without family	37 (45.7%)
Condition of visual impairment
Athletic classification^a
B1	31 (38.3%)
B2	25 (30.9%)
B3	25 (30.9%)
Causing time of disability
Congenital	48 (59.3%)
Acquired	33 (40.7%)
Competition activities
Sports events
Track and field (marathon)	18 (22.2%)
Goalball	11 (13.6%)
Swimming	23 (28.4%)
Blind soccer	14 (17.3%)
Judo	15 (18.5%)
Athletic career (years)	11.5 ± 9.0
Performance level
International medalist	26 (32.1%)
International	16 (19.8%)
Prizes at national competitions	23 (28.4%)
Others	16 (19.8%)
Athletic level
Japanese delegate	47 (58.0%)
Others	34 (42.0%)
Training day per week (times)	5.3 ± 1.8
Total training time per week (minutes)	778.3 ± 429.9

Table 1. Participants’ Attributes, Condition of Visual Impairment and Competition Activities (n = 81)

Mean ± SD or n (%)

SD: standard deviation. ^aB1: blind; B2: severe low vision; B3: low vision.

Attributes

Age (years)

32.8 ± 12.0

Gender

Male

59 (72.8%)

Female

22 (27.2%)

Residential style

Living with family

44 (54.3%)

Living alone or without family

37 (45.7%)

Condition of visual impairment

Athletic classification^a

31 (38.3%)

25 (30.9%)

Causing time of disability

Congenital

48 (59.3%)

Acquired

33 (40.7%)

Competition activities

Sports events

Track and field (marathon)

18 (22.2%)

Goalball

11 (13.6%)

Swimming

23 (28.4%)

Blind soccer

14 (17.3%)

Judo

15 (18.5%)

Athletic career (years)

11.5 ± 9.0

Performance level

International medalist

26 (32.1%)

International

16 (19.8%)

Prizes at national competitions

23 (28.4%)

Others

16 (19.8%)

Athletic level

Japanese delegate

47 (58.0%)

Others

34 (42.0%)

Training day per week (times)

5.3 ± 1.8

Total training time per week (minutes)

778.3 ± 429.9

**Table 2.** Participants’ Status of Mental Health, Social Support, and Competition Stressors (n = 81)
	Median (interquartile range)	n (%)	Mean ± SD
SD: standard deviation.
Mental health	2.0 (0.0 - 4.0)
Good (K6 score less than or equal to 4)		64 (79.0%)
Bad (K6 score more than or equal to 5)		17 (21.0%)
Competition stressors
Interpersonal relationships			4.9 ± 3.8
Competition results			4.7 ± 2.7
Evaluations from one’s surroundings			2.7 ± 2.8
Expectations and pressure from others			5.2 ± 3.7
Motivation loss			3.9 ± 3.3
Social support
Family members			14.9 ± 3.8
Friends of athletic peers			15.4 ± 2.7
Friends of non-athletic peers			15.5 ± 2.7
Coaches			15.3 ± 3.0

Table 2. Participants’ Status of Mental Health, Social Support, and Competition Stressors (n = 81)

Median (interquartile range)

n (%)

Mean ± SD

SD: standard deviation.

Mental health

2.0 (0.0 - 4.0)

Good (K6 score less than or equal to 4)

64 (79.0%)

Bad (K6 score more than or equal to 5)

17 (21.0%)

Competition stressors

Interpersonal relationships

4.9 ± 3.8

Competition results

4.7 ± 2.7

Evaluations from one’s surroundings

2.7 ± 2.8

Expectations and pressure from others

5.2 ± 3.7

Motivation loss

3.9 ± 3.3

Social support

Family members

14.9 ± 3.8

Friends of athletic peers

15.4 ± 2.7

Friends of non-athletic peers

15.5 ± 2.7

Coaches

15.3 ± 3.0

**Table 3.** Comparison of Characteristics Between Participants With Good and Bad Mental Health
	Mental health	P value
SD: standard deviation. Statistical methodologies are as follows: ^aMann-Whitney U-test, ^bFisher’s exact test, and ^cunpaired t-test.
Attributes
Age	34.2 ± 12.2	27.6 ± 9.6	0.061^a
Gender
Male	52 (88.1%)	7 (11.9%)	0.002^b
Female	12 (54.5%)	10 (45.5%)
Residential style
Living with family	37 (84.1%)	7 (15.9%)	0.278^b
Living alone or without family	27 (73.0%)	10 (27.0%)
Condition of visual impairment
Athletic classification
B1	27 (87.1%)	4 (12.9%)	0.101^b
B2	21 (84.0%)	4 (16.0%)
B3	16 (64.0%)	9 (36.0%)
Causing time of disability
Congenital	35 (72.9%)	13 (27.1%)	0.164^b
Acquired	29 (87.9%)	4 (12.1%)
Competition activities
Sport events
Track and field (marathon)	16 (88.9%)	2 (11.1%)	0.803^b
Goalball	9 (81.8%)	2 (18.2%)
Swimming	17 (73.9%)	6 (26.1%)
Blind soccer	11 (78.6%)	3 (21.4%)
Judo	11 (73.3%)	4 (26.7%)
Atheletic career (years)	12.3 ± 9.6	8.7 ± 5.7	0.227^a
Performance level
International medalist	22 (84.6%)	4 (15.4%)	0.506^b
International	14 (87.5%)	2 (12.5%)
Prizes at national competition	16 (72.7%)	6 (27.3%)
Others	12 (70.6%)	5 (29.4%)
Athletic level
Japanese delegate	38 (80.9%)	9 (19.1%)	0.783^b
Others	26 (76.5%)	8 (23.5%)
Training day per week (times)	5.2 ± 1.9	5.4 ± 1.5	0.976^a
Total training time per week (min)	786.4 ± 429.3	742.1 ± 451.0	0.709^c
Competition stressors
Interpersonal relationships	4.8 ± 3.7	5.7 ± 4.2	0.466^a
Competition results	4.5 ± 2.6	5.5 ± 2.9	0.057^a
Evaluations from one’s surroundings	2.3 ± 2.5	4.4 ± 3.3	0.014^a
Expectations and pressure from others	4.8 ± 3.5	6.5 ± 3.9	0.081^a
Motivation loss	3.4 ± 3.0	5.7 ± 3.6	0.010^a
Social support
Family members	15.5 ± 3.4	12.8 ± 4.6	0.028^a
Friends of athletic peers	15.2 ± 2.6	15.9 ± 2.8	0.298^a
Friends of non-athletic peers	15.3 ± 2.4	16.1 ± 3.8	0.116^a
Coaches	15.2 ± 3.2	15.7± 2.1	0.556^a

Table 3. Comparison of Characteristics Between Participants With Good and Bad Mental Health

Mental health

P value

Good (K6 ≤ 4, n = 64), n (%) or mean ± SD

Bad (K6 ≥ 5, n =17), n (%) or mean ± SD

SD: standard deviation. Statistical methodologies are as follows: ^aMann-Whitney U-test, ^bFisher’s exact test, and ^cunpaired t-test.

Attributes

Age

34.2 ± 12.2

27.6 ± 9.6

0.061^a

Gender

Male

52 (88.1%)

7 (11.9%)

0.002^b

Female

12 (54.5%)

10 (45.5%)

Residential style

Living with family

37 (84.1%)

7 (15.9%)

0.278^b

Living alone or without family

27 (73.0%)

10 (27.0%)

Condition of visual impairment

Athletic classification

27 (87.1%)

4 (12.9%)

0.101^b

21 (84.0%)

4 (16.0%)

16 (64.0%)

9 (36.0%)

Causing time of disability

Congenital

35 (72.9%)

13 (27.1%)

0.164^b

Acquired

29 (87.9%)

4 (12.1%)

Competition activities

Sport events

Track and field (marathon)

16 (88.9%)

2 (11.1%)

0.803^b

Goalball

9 (81.8%)

2 (18.2%)

Swimming

17 (73.9%)

6 (26.1%)

Blind soccer

11 (78.6%)

3 (21.4%)

Judo

11 (73.3%)

4 (26.7%)

Atheletic career (years)

12.3 ± 9.6

8.7 ± 5.7

0.227^a

Performance level

International medalist

22 (84.6%)

4 (15.4%)

0.506^b

International

14 (87.5%)

2 (12.5%)

Prizes at national competition

16 (72.7%)

6 (27.3%)

Others

12 (70.6%)

5 (29.4%)

Athletic level

Japanese delegate

38 (80.9%)

9 (19.1%)

0.783^b

Others

26 (76.5%)

8 (23.5%)

Training day per week (times)

5.2 ± 1.9

5.4 ± 1.5

0.976^a

Total training time per week (min)

786.4 ± 429.3

742.1 ± 451.0

0.709^c

Competition stressors

Interpersonal relationships

4.8 ± 3.7

5.7 ± 4.2

0.466^a

Competition results

4.5 ± 2.6

5.5 ± 2.9

0.057^a

Evaluations from one’s surroundings

2.3 ± 2.5

4.4 ± 3.3

0.014^a

Expectations and pressure from others

4.8 ± 3.5

6.5 ± 3.9

0.081^a

Motivation loss

3.4 ± 3.0

5.7 ± 3.6

0.010^a

Social support

Family members

15.5 ± 3.4

12.8 ± 4.6

0.028^a

Friends of athletic peers

15.2 ± 2.6

15.9 ± 2.8

0.298^a

Friends of non-athletic peers

15.3 ± 2.4

16.1 ± 3.8

0.116^a

Coaches

15.2 ± 3.2

15.7± 2.1

0.556^a

**Table 4.** Logistic Regression Analyses Investigating the Relationships Between Attributes, Condition of Visual Impairment, Competition Activities, Competition Stressors, Social Support and Mental Health
	Univariate analysis	Multivariate analysis^a
OR: odds ratio; CI: confidence interval. ^aFor multivariate analysis, we used the stepwise forward method (likelihood ratio); the factors which had a significant relation with mental health in univariate analysis were only used as independent variables in multivariate analysis.
Attributes
Age
Thirty years or more	1.00
Less than 29 years	2.90	0.91 - 9.18	0.071
Gender
Male	1.00			1.00
Female	6.19	1.96 - 19.99	0.002	11.94	2.60 - 54.76	0.001
Residential style
With family	1.00
Without family	1.96	0.66 - 5.80	0.225
Condition of visual impairment
Athletic classification
B1	1.00
B2	1.29	0.29 - 5.75	0.742
B3	3.80	1.00 - 14.36	0.049
Causing time of disability
Congenital	1.00
Acquired	2.69	0.79 - 9.16	0.113
Competition activities
Sport events
Track and field (marathon)	1.00
Goalball	1.78	0.21 - 14.86	0.595
Swimming	2.82	0.50 - 16.08	0.242
Blind soccer	2.18	0.31 - 15.29	0.432
Judo	2.91	0.45 - 18.74	0.261
Athletic career
Less than 10 years	1.00
Ten or more years	1.06	0.36 - 3.09	0.250
Performance level
International medalist	1.00
International	0.79	0.13 - 4.87	0.796
Prizes at national games	2.06	0.50 - 8.53	0.318
Others	2.29	0.52 - 10.18	0.276
Athletic level
Japanese delegate	1.00
Others	1.30	0.44 - 3.81	0.633
Training day per week
6 - 7 days	1.00
1 - 5 days	1.09	0.37 - 3.24	0.874
Total training time per week
Less than 700 min	1.00
700 or more min	2.56	0.81 - 8.09	0.111
Competition stressors
Interpersonal relationships
0 - 4 points	1.00
Five or more points	1.72	0.58 - 5.10	0.325
Competition results
0 - 5 points	1.00
Six or more points	4.28	1.34 - 13.67	0.014
Evaluation from one’s surroundings
0 - 2 points	1.00			1.00
Three or more points	3.50	1.14 - 10.73	0.028	5.74	1.34 - 24.60	0.019
Expectation and pressure from others
0 - 5 points	1.00
Six or more points	1.54	0.53 - 4.51	0.429
Motivation loss
0 - 4 points	1.00
Five or more points	3.75	1.22 - 11.54	0.021
Social support
Family members
Fifteen or more points	1.00			1.00
0 - 14 points	3.65	1.20 - 11.07	0.022	3.97	1.03 - 15.25	0.045
Friends of athletic peers
0 - 14 points	1.00
Fifteen or more points	2.12	0.55 - 8.22	0.276
Friends of non-athletic peers
0 - 14 points	1.00
Fifteen or more points	1.59	0.46 - 5.46	0.464
Coaches
0 - 14 points	1.00
Fifteen or more points	1.48	0.43 - 5.10	0.537

Table 4. Logistic Regression Analyses Investigating the Relationships Between Attributes, Condition of Visual Impairment, Competition Activities, Competition Stressors, Social Support and Mental Health

Univariate analysis

Multivariate analysis^a

95% CI

P value

95% CI

P value

OR: odds ratio; CI: confidence interval. ^aFor multivariate analysis, we used the stepwise forward method (likelihood ratio); the factors which had a significant relation with mental health in univariate analysis were only used as independent variables in multivariate analysis.

Attributes

Age

Thirty years or more

1.00

Less than 29 years

2.90

0.91 - 9.18

0.071

Gender

Male

1.00

Female

6.19

1.96 - 19.99

0.002

11.94

2.60 - 54.76

0.001

Residential style

With family

1.00

Without family

1.96

0.66 - 5.80

0.225

Condition of visual impairment

Athletic classification

1.00

1.29

0.29 - 5.75

0.742

3.80

1.00 - 14.36

0.049

Causing time of disability

Congenital

1.00

Acquired

2.69

0.79 - 9.16

0.113

Competition activities

Sport events

Track and field (marathon)

1.00

Goalball

1.78

0.21 - 14.86

0.595

Swimming

2.82

0.50 - 16.08

0.242

Blind soccer

2.18

0.31 - 15.29

0.432

Judo

2.91

0.45 - 18.74

0.261

Athletic career

Less than 10 years

1.00

Ten or more years

1.06

0.36 - 3.09

0.250

Performance level

International medalist

1.00

International

0.79

0.13 - 4.87

0.796

Prizes at national games

2.06

0.50 - 8.53

0.318

Others

2.29

0.52 - 10.18

0.276

Athletic level

Japanese delegate

1.00

Others

1.30

0.44 - 3.81

0.633

Training day per week

6 - 7 days

1.00

1 - 5 days

1.09

0.37 - 3.24

0.874

Total training time per week

Less than 700 min

1.00

700 or more min

2.56

0.81 - 8.09

0.111

Competition stressors

Interpersonal relationships

0 - 4 points

1.00

Five or more points

1.72

0.58 - 5.10

0.325

Competition results

0 - 5 points

1.00

Six or more points

4.28

1.34 - 13.67

0.014

Evaluation from one’s surroundings

0 - 2 points

1.00

Three or more points

3.50

1.14 - 10.73

0.028

5.74

1.34 - 24.60

0.019

Expectation and pressure from others

0 - 5 points

1.00

Six or more points

1.54

0.53 - 4.51

0.429

Motivation loss

0 - 4 points

1.00

Five or more points

3.75

1.22 - 11.54

0.021

Social support

Family members

Fifteen or more points

1.00

0 - 14 points

3.65

1.20 - 11.07

0.022

3.97

1.03 - 15.25

0.045

Friends of athletic peers

0 - 14 points

1.00

Fifteen or more points

2.12

0.55 - 8.22

0.276

Friends of non-athletic peers

0 - 14 points

1.00

Fifteen or more points

1.59

0.46 - 5.46

0.464

Coaches

0 - 14 points

1.00

Fifteen or more points

1.48

0.43 - 5.10

0.537