Work-Family Guilt: The Perspective of Secondary School Athletic Trainers With Children

Abstract

Context

The literature in athletic training has consistently demonstrated evidence of work-family-life conflict and the potential consequences of that conflict among athletic trainers (ATs) employed in the clinical setting. Parental responsibilities have been suggested to increase the conflict among work, family, and life. The emotions that occur because of this conflict have received little attention and warrant further study.

Objective

To investigate perceptions and antecedents of work-family guilt (WFG) among secondary school ATs with children.

Design

Phenomenological qualitative study.

Setting

Secondary schools.

Patients or Other Participants

Twenty (13 women, 7 men) ATs with children (range = 1–3) employed in the secondary school setting. All but 3 were married (n = 17) at the time of the study. Their average age was 37 ± 11 years, and they were certified as ATs for 14 ± 11 years.

Data Collection and Analysis

Participants completed one-on-one semistructured phone interviews. Multiple-analyst triangulation and peer review were used to establish data credibility.

Results

General inductive analysis revealed that men and women participants experienced feelings of WFG despite having supportive work environments. The guilt for both sexes stemmed from work interfering with family and an altruistic mindset. Women indicated they felt pressure from their husbands that contributed to feelings of guilt.

Conclusions

Secondary school ATs experienced WFG. Trying to balance parental and athletic training duties can cause an emotional response, and ATs' giving and caring nature may be a precursor to guilt.

Key Points

• Regardless of sex, athletic trainers who identified as parents and were employed in the secondary school setting described feelings of guilt linked to work's interference with family.

• Perceptions of guilt were expressed despite athletic trainers' descriptions of supportive work environments.

• The altruistic mindset and giving nature of athletic trainers in this sample, who prioritized the needs of patients, appeared to lead to feelings of guilt when they were not able to balance them with the needs of their families.

The growing interest in the work-life interface within the sports culture has stemmed from descriptions of stressful work environments. Great demands are often placed on individuals, which limit their time and energy to be engaged in other roles.^1–3 Athletic trainers (ATs) who are employed in clinical settings such as colleges and secondary schools must work long hours in addition to being engaged in emotionally draining activities such as patient care and interpersonal communication with coaches, patients, and others in the sports community.¹ Evidence^2–4 suggested that work-family-life conflict was present among ATs employed in these settings, with many factors contributing to the conflict.

Sex, age, or marital status often does not drive the experiences of conflict, as men and women as well as single and married individuals will at some point have conflict between their personal or home life and their professional responsibilities.^2–4 The work-family-life paradigm is multifactorial, often characterized by organizational, individual, and sociocultural factors.^5–7 The long work weeks, which include weekend and nighttime coverage by the AT, are well known to result in limited time for household and parental responsibilities and personal hobbies.¹ Often, ATs employed in more traditional sport settings experience work-family-life conflict,^1–8 as the organizational demands placed on them create an inherent strain on their time, energy, and resources.^2–8 We have a strong understanding of the organizational aspects that lead to conflict, but authors are starting to explore the more individual and personal factors that stimulate conflict.

Coping behaviors, particularly as they relate to mindset and stress management (ie, resiliency, hardiness, and affect), can positively influence an AT's ability to balance his or her personal, domestic, and professional obligations.⁸ In addition to an individual's outlook on stress and coping abilities, one's ideologies regarding time spent at work and other activities (ie, personal hobbies, parenting) can positively or negatively mediate the work-family-life relationship.^6,7,9 Although the literature on work-family-life conflict is abundant, limited attention has been given to the emotions that arise from the conflict. One ideology that has begun to receive attention is the concept of guilt and the internal struggle that can occur from attempting to balance work, family, and life. Guilt is the result of behavior or past actions that are incongruous with individually held moral standards,¹⁰ and the guilt that is associated with the work-life interface comes from the need to make a choice between work and family.¹¹ This construct is important to understand as work-family guilt (WFG) results in a variety of negative consequences, including psychological distress, turnover intentions, and less family and life satisfaction.^12,13 Psychometrically validated measures of WFG have highlighted the bidirectional nature of this construct.^14,15 Essentially, guilt can manifest when work interferes with family (WIFG) or when family interferes with work (FIWG). Some researchers^9,14 have speculated that women specifically struggle with guilt; however, recent investigators¹⁶ have shown no sex differences in WFG among ATs employed in the collegiate setting. In the same study, ATs with children displayed higher WFG scores than those who did not have children and linked experiences of WFG to work-family conflict (WFC).¹⁶

Employment of ATs in the secondary school setting is growing rapidly, and this was the setting with the second highest percentage of ATs (18% of all membership in 2020).¹⁷ The workload of the AT in this setting can be demanding, as he or she is often the sole AT providing medical services to more than 350 student-athletes¹⁸; this is a precursor to conflict, role overload, and burnout.^3,19 Thus, the purpose of our study was to explore the WFC and WFG perceptions of ATs who were parents and to gather descriptive information on the experiences of secondary school ATs who were parents and how they currently managed both roles. Our research was guided by the following questions: (1) Do secondary school ATs with children express any feelings of WFG as they balance these roles? (2) If feelings of guilt are described by the AT, what is precipitating these feelings of WFG?

METHODS

Research Design

We determined that a phenomenologic approach was the best design for our study, in which we sought to understand experiences of guilt, particularly WFG, among ATs in secondary schools who were balancing full-time roles as parents. The phenomenologic framework is rooted in understanding a “phenomenon” inductively among those individuals who are living and experiencing it at the time of study.²⁰ The inductive process allows results to emerge from the data and was most appropriate, given our purpose. Phenomenologists believe that the researcher inherently brings his or her own presuppositions and experiences and that this cannot be denied but should rather be embraced.^21,22 The research team comprised 3 members who represented different types of relationships and family status (ie, single, married, and married with children). At the outset of study development, each discussed her personal experiences with work-life balance to demonstrate reflexivity.^20,23

Participants

Using a purposive sampling procedure, we recruited 20 ATs (13 women, 7 men) who were employed in the secondary school setting and for whom at least 50% of job responsibilities involved clinical work as an AT at a secondary school. However, participants were not asked if they were employed directly by the school or contracted to their schools by a hospital system or clinic. All recruits had children (range = 1–3), and all but 3 were married (n = 17) at the time of the study. Their average age was 37 ± 11 years, and they had been certified as ATs for 14 ± 11 years. Our participants reported working an average of 42 ± 17 hours per week and engaged in household duties or chores 13 ± 11 hours per week. Individual data for each person are provided in Table 1. Data saturation was achieved with our sample of 20 participants.

Table 1.

Participants' Characteristics

Pseudonym	Sex	Age, y	Experience as Athletic Trainer, y	Average Time Worked, h/wk	Average Time Spent on Household Duties, h/wk	Married?	Years Married	Spouse Employed Full Time?	Children, No.	Age(s) of Child(ren)
Aly	Female	35	13	45.0	22.5	Yes	4.5	Yes	2	3 y and 1 mo
Brittany	Female	32	10	35.0	12.5	Yes	5.5	Yes	2	21 mo and pregnant
Casey	Female	50	26	25.0	20.0	Yes	22.0	Yes	2	19 and 16 y
Derek	Male	31	7	11.0	3.5	Yes	4.0	Yes	2	2 and 3 y
Evan	Male	35	10	47.5	17.5	Yes	10.0	Yes	2	7 and 3 y
Fran	Female	31	8	40.0	14.0	Yes	8.0	Yes	2	5 and 3 y
Gabby	Female	25	2	30.0	5.0	No	NA	NA	1	2 y
Henry	Male	33	9	40.0	40.0	Yes	10.0	No	3	6, 5, and 2 y
Ian	Male	48	22	36.0	17.5	Yes	15.0	Yes	2	12 and 8 y
Jen	Female	33	9	60.0	1.5	Yes	3.0	Yes	1	1 y
Kayla	Female	31	10	45.0	NA	Yes	8.0	Yes	1	13 mo
Luke	Male	72	52	11.0	6.5	Yes	49.0	No	2	36 and 34 y
Megan	Female	NA	20	60.0	15.0	Yes	19.0	Yes	3	14, 11, and 8 y
Natalie	Female	31	10	45.0	5.0	Yes	3.0	Yes	1	8 mo
Olivia	Female	30	8	40.0	22.5	Yes	5.0	Yes	1	2 y
Pat	Male	38	15	57.5	12.5	Yes	12.0	Yes	2	14 and 11 y
Rachel	Female	33	11	60.0	10.0	Yes	1.0	Yes	3	11 y, 8 y, and pregnant
Sarah	Female	36	13	45.0	5.0	Yes	9.0	Yes	1	4 y
Tara	Female	30	7	33.0	12.5	No	NA	NA	1	4 y
Walter	Male	51	26	80.0	6.0	No	NA	NA	2	24 and 21 y

Abbreviation: NA, not audible.

Data-Collection Procedures

Recruitment

A cross-sectional survey was distributed to ATs who worked in the collegiate and secondary school settings and were parents. The survey examined participants' experiences with WFC and social support. At the end of the survey, interested individuals were asked to provide their name and contact information if they wished to be involved in a follow-up interview related to their experiences as an AT and parent in the secondary school setting. Emails were then sent directly to them to schedule one-on-one interviews.

Instrumentation

A semistructured interview guide was developed using the current literature on WFC and parental guilt^2–9 and the study's objectives. The final interview protocol is shown in Table 2. A semistructured format is commonly used in phenomenologic research.²³ The advantage of this format is the natural dialogue that can come about from the open, 2-way communication, which can offer more in-depth information from the participant. If the participant organically brought up feelings of guilt, we asked specific questions about this topic. The interview guide was initially developed by 2 members of the research team. It was then peer reviewed by the third member of the team. The peer reviewer assessed the questions for content, clarity, and flow. Changes were made based on the reviewer's feedback and included minor revisions to ensure that the questions were not leading. Items that did not meet the purpose or research items of the study were removed. The order of some questions was also modified to increase flow from one topic to the next and to allow for a more natural and conversational dialogue.

Table 2.

Interview Protocol^a

Can you talk to me about being a parent and AT?

How do you view and feel about your role as a parent?

What expectations do you have for yourself as a mother or father?

How do you view and feel about your role as an AT?

What expectations do you have for yourself as an AT?

Do you find anything particularly difficult or challenging about being a parent?

Do you find anything particularly difficult or challenging about being an AT?

Is there anything that is difficult or challenging about balancing parenthood with full-time employment as an AT?

What were your career goals when you first started in the athletic training field?

What are your career goals now?

What influence has being a parent and an AT had on your career plans or response to my question?

Do you plan to continue working as an AT throughout the duration of your career?

Why or why not?

Have you considered seeking employment in a different setting or different profession after having children?

Why or why not?

What other settings or professions have you considered?

Is there anything that would make you consider switching careers?

In your experiences, do you believe your employer understands your role as a mother or father?

Can you provide specific examples of why you feel they do or do not?

Can you describe your experience in your ability to take time off for personal or family-related events?

Do you ever feel you need to choose between conflicting work or family events?

Do you feel pressured to be at one event over another (ie, work over family or vice versa)?

From where or whom do you feel pressure?

How often do you feel stressed or overwhelmed because of the number of hours you need to dedicate to work and household chores or duties?

Can you describe any instances in which you felt some form of guilt due to your commitments or responsibilities?

What would you say is the main reason you experience feelings of guilt?

Who is your biggest source of support in helping to balance your work and family responsibilities?

Is this or are these individual(s) supportive of your career?

What do they do that is the most helpful to you?

Do you have friends and family members who are also moms or dads?

Are they in the athletic training field?

Can you describe your relationship with these individuals?

Is there anything your family or friends could do to help you adequately perform all of your duties as an AT and mother or father?

Do you have colleagues or coworkers who work clinically in the athletic training field and are also moms or dads?

Can you describe your relationship with these individuals?

Do they work at your place of employment?

Is there anything your coworkers or colleagues could do to help you adequately perform all your duties as an AT and mother or father?

Is there anything your employer could do to help you adequately perform all your duties as an AT and mother or father?

Do you have any additional comments you would like to add that may not have been addressed by these specific questions?

Abbreviation: AT, athletic trainer.

^aItems are presented in their original format.

Procedures

Before recruitment, we secured institutional review board approval. All participants then completed the semistructured interview protocol with the second author (K.M.R.) during a phone interview. One author conducted all interviews to promote structure, as the semistructured nature allowed for more of a natural dialogue. Interviews began with an oral consent process and provision of demographic information, followed by the open-ended questions. Interview sessions lasted approximately 30 minutes and were audio recorded on a tablet computer. A member of the research team used the audio recordings to transcribe all interview sessions verbatim.

Data Analysis and Credibility Strategies

Following the stepwise process of a phenomenologic approach outlined by Creswell,²³ the first 2 authors (C.M.E., K.M.R.) coded the data. The coding began with an open read of the individual transcripts to more holistically understand the perceptions of our participants on parenthood and working full time as an AT in the secondary school setting. Subsequent reads focused on isolating the significant statements that reflected the study's purpose in order to better understand the participants' experiences related to WFG as ATs. Data were highlighted and annotated using notes in the margins of the transcripts. Data from each transcript were also summarized to reflect the dominant and most interesting information expressed by the participant. Significant statements with similar meanings were grouped and then labeled to reflect the overall meaning. The labels represented an overarching theme that emerged from the collective data of all interview transcripts.

We selected several tactics to ensure credibility and trustworthiness of the findings, including multiple-analyst triangulation, peer review, and bracketing. As part of multiple-analyst triangulation, the first 2 authors (C.M.E., K.M.R.) independently coded the transcripts following the stepwise process described earlier. Before the process began, they discussed the steps to be used. After completing the coding process individually, the authors compared their coded transcripts and emergent themes. The discussions during the exchange focused on operationally defining the notable themes with the supporting data identified to categorize the theme. The 2 authors agreed on the themes, and the findings we present reflect their agreement. The third author (S.M.S.) was provided with the interview guide, uncoded transcripts for each participant interview, and 2 coded transcripts for each interview (1 from each of the first 2 authors) to conduct a peer review. The peer was also supplied with the data that were selected for the corresponding themes by the first 2 authors and corroborated the analyses. As mentioned earlier, each researcher had discussed her experiences with work-life balance before data collection. Using bracketing,²³ we identified any preconceptions that could influence or bring biases to the research process. Given our various life (ie, single, married, and married with children) and work experiences, each of us experienced her own challenges as part of the work-life interface throughout her career, including instances of WFC and WFG. Similarly, we each had our own solutions for achieving work-life balance and mitigating negative outcomes.

RESULTS

From our qualitative general inductive data analysis, 4 themes and 1 subtheme emerged that allowed us to better understand the perceptions of secondary school ATs with children regarding perceptions of guilt and the potential sources of that guilt. The 4 themes were (1) WIFG, (2) supportive work environments, (3) an altruistic mindset, and (4) pressure from husband. All themes are presented with supporting quotes.

Work Interferes With Family

Although most participants commented that they currently worked in supportive environments, all expressed or described some feelings of guilt. They were making the choice to devote a great deal of time and energy to their work, which created feelings of guilt because they did not have more time to be home with their families, specifically their children.

As previously discussed, WFG is bidirectional in nature. Our participants clearly indicated that they experienced feelings of guilt and that their guilt stemmed from work interference with family, or WIFG. According to the WFG scale,¹⁴ WIFG involves individuals feeling guilty because they are not able to care for their children as well as they would like or frequently must take time away from their family to deal with work concerns. When asked if he experienced guilt, Walter stated, “More towards my family than work. . . I know there's 2 or 3 birthdays. . . that I couldn't make.” When asked if she had ever felt some form of guilt, Aly responded,

I mean, it's hard not to. It's hard to look at your husband who's stressed with a crazy toddler running around and jumping on him and say, “Bye. I can't. I'm leaving to go back to work.” So it's hard not to [feel guilty]. . . a little bit.

These feelings were present in both males and females. Derek stated,

I would say my view as a dad is that it's limited. I don't get to put in the 100% that I would really, truly want to because [of] my rigor and my job and all that different stuff. I mean, of course, I wake up, maybe have 1 hour with the kids while I'm trying to get ready for work and then get home and maybe have 2 to 3 hours tops with the kids and leave; maybe the weekends aren't there. So it's limited, definitely not 100% what I want to do.

As Pat said, “If I'm on the sidelines at a game, I can't really be helping my older son with his geography homework, so it's challenging just trying to be at both places at the same time.” Fran expressed similar feelings:

So probably the biggest struggle is just the guilt associated with telling your kids, “I'm not going to be home tonight.” You know, and they're like freaking out because maybe, you know, maybe you're their favorite putting them to bed right now and, you know, [they ask], “Can I come to the football game with you?” and you know, [I'm] struggling because I don't really try to take my kids to work, especially [during] the spring events that I'm working, just in case something were to happen. They come to some practices with me, but they don't really come see me at work or see me doing work things, and so they have a pretty negative perspective on that because working sporting events means that I'm going to be gone, and I probably won't be home until after they fall asleep, which is occasionally life altering for them.

Evan described the challenges of working as a secondary school AT: “I mean, when you're having to miss time at home,²⁴ have to miss a ball game or miss something like that because scheduling conflicts, yeah, it's a struggle.” Gabby echoed this: “I would say that I don't get to see my daughter as often as I would like. I mean, it's only because of the high school. . .” Our participants also discussed how missing events due to work and their children's response caused them to feel guilt. When asked if he has experienced guilt, Henry remarked, “. . . there was a significant event. . . I just wasn't going to be at. My child asked me, ‘Why?' or they say, ‘Well, dad's got to work.'” Tara noted that she feels a “daily guilt” and explained, “I'm at work instead of being with my kid. . . but when your son says, ‘No, mommy, don't go to work. Play with me,' it's a daily. . . working mom guilt.” Our participants also discussed the guilt they felt in being at work sporting events instead of supporting their own children. Megan addressed the way in which work interfered with her family time:

It's always hard to do a lot of things exceptionally. I think sometimes you sacrifice in areas of that quality time that you get to spend, whether it be quality time with my husband or quality time with my kids. I miss out on several of their athletic competitions, if you will. My boys are very active, so there are several times where I am sitting and watching one of my high school kids' games instead of my own kids. That's probably the hardest part. I think my boys understand that. It's also. . . I think that's where the guilt comes in.

Our participants consistently offered examples of how their work interfered with family but did not provide examples of how their family interfered with work.

Supportive Work Environments

Most participants indicated that they were currently working in a supportive work environment or in an environment in which their coworkers and supervisors understood their role as a parent. When asked if her employer understood her role as a parent, Olivia simply responded, “Yeah.” Then she went on:

. . . my immediate supervisor has 3 kids. They [my kids] get sick, and sometimes you're going to have to leave, so just communicate that. I can pretty much like tell them that he's sick. . . and just let them know what's going on.

Natalie, whose athletic director (AD) and coworker also had children, stated,

. . . my AD and also my assistant both have young children, so we're all very, very understanding. So if my daughter is sick or my coworker's daughter is sick, she, my coworker, sometimes brings her daughter, not that I bring mine because she's still an infant, but they're very understanding. So I think it helps when you're around people who are in the same situation as you. I mean, that's one of the main reasons why I left my college position. My head [AT], even though he was a father, there was very, I want to say. . . strict, was very much like. . . “This is a career, not a job. This comes first” [mentality].

Megan had a similar response: “My AD has 2 kids. . . so my employer gets it.” When asked if her employer understood her role as a parent, Jen remarked,

Absolutely. Yeah, 100%. There's a ton of other faculty kids on campus, so everyone has either been there or is there, so we all get it. There's definitely mutual respect with it. . . It's been pretty easy. Myself and another [AT] and then our [AD], who's also an [AT], and one of our biology teachers is an [AT]. So we kind of have like 2 per diem [ATs] as we need them. So because we have a full-time job, for example, and when I went on maternity leave, they were really supportive of hiring someone else and not calling them in unnecessarily.

Ian explained how his current employer was different than previous employers:

And he's [my current employer], you know, he's a father of 5, has a daughter in athletics and stuff like that. So when I have, you know, time requests, other stuff like that, I'm able to actually get some [time off], whereas other employers I was with, it was like, “Well, you can't go anywhere,” because, you know, they didn't hire any people. They had no backup. So if you left, it was, “Yeah, well, you can't leave. You need to be in the school.” Well, I need to do this. “Mm-hmm, well, that's too bad.”

A few participants considered their current environment more supportive than previous positions. When asked if his employer understood his role as a parent, Henry said simply, “Yes, currently.” Of note, many individuals told us their current jobs were not necessarily in line with the professional goals they had set for themselves earlier in their careers. Aly observed, “When I first started, I really wanted to stay in college. . . but I never saw my family. . . and so that's when I chose to work in secondary settings.” Aly portrayed her current job as “very family supportive, and that's part of the reason I took the job.” Kayla mentioned:

I worked at a private [Division I] school for undergrad, so I saw from my experience there that wasn't where I wanted to spend my time because of the conflict with work and family life. The secondary setting is where you can have, in my opinion, the best of both with a lot less travel.

Altruistic Mindset

As indicated previously, our participants appeared to experience guilt stemming from work interfering with family. One reason for this may be the altruistic mindset of our participants that made them feel that their patients were their main priority. When describing her role as an AT, Brittany commented:

As an [AT], my priority is always my athletes, and I feel like I am doing that to the best of my ability like I take care of my kids. When I'm here, they [student-athletes] are my priority above all else.

Ian echoed this: “There's something built into an [AT] that [makes you] feel responsible for your athletes as well as your family.” Evan also commented on treating his athletes like family: “As an [AT], I treat these kids the same way I treat my own. . . I have the same expectations for them as I do for my kids.” Casey noted, “It's [being an AT] been a part of who I am for so long. I can't separate. . . I've been an [AT] longer than I've been a parent.” When describing her role as an AT, Sarah acknowledged,

I have very high expectations. I'm kind of an overachiever. I want to make sure that I'm doing the best for me and my students and my parents and my admin[istration] and take care of my kids and working with all of my coaches, but not only in my role at my job. I'm also active in the [National Athletic Trainers' Association] and on the district level. I'm active on the state board, so it's important for me to do work with my job and outside my job.

When asked to define his role as an AT, Derek said:

My feeling of my role as an [AT] is to be a service to our athletes that I do work for and make sure I am there and actually help them out and their needs. Even if it means answering phone calls at home, even though they had access to me all day, I mean, I still am available and open to them calling me at 8:00, 9:00 at night, too.

Luke conveyed the challenges of being both a parent and an AT:

. . . I'll be honest with you. I don't think I did as good a job as I could've from the standpoint is that I put so much effort and passion into my job that that took me away from things [that were] happening at home.

It was not surprising that participants in our sample displayed an altruistic mindset or a selfless concern for the wellbeing of others. However, this behavior appeared to create a sense of imbalance and led to feelings of guilt.

Pressure From Husband

Many of the women in our sample discussed that some of their feelings of guilt stemmed from stress and pressure from their husbands. When asked the source of the pressure she felt, Aly responded, “It probably comes from my husband. . . they're not really pressuring me to go to work at work.” Gabby attributed much of the pressure she felt to “my daughter's father.” She went on to say, “I feel like he kind of guilt trips me into not working on the weekend.” Kayla remarked, “I think some of it [the pressure I feel] comes from myself and then some of it comes from my spouse.” Fran cited similar sentiments when asked why she felt pressure: “My husband. Yeah, I think I get a good dose of the guilt trip from him about choosing work stuff over family stuff.”

Some of the pressure seemed to come from expectations husbands had for their wives regarding a caretaking role. Fran remarked, “That's not necessarily the role [my husband wants me to play], you know, like he's the man, and he wants to be the breadwinner.” When asked if she ever felt the need to choose between family and work, Brittany agreed:

I do. I grew up in a family where work was important, like work and school were important, and my husband didn't grow up with stuff like that. We have conflict where I'm like, “Well, I have [to] work. I can't be here,” or my son had to leave daycare sick, and I had to go to Atlanta for a playoff football tournament. It's like, “Well, you need to leave work because I'm driving to Atlanta. I'm not leaving. I have a football game. They don't have any of their stuff with them. I'm not leaving that on the other [AT], like you better figure it out.”

In some instances, their husbands prompted participants to think about the time they were spending away from their families. For example, Natalie expressed, “My current husband. . . opened my eyes to, ‘Do you see how much you're working? Do you see how much you're missing?'” When she was at work, Olivia's husband sent her pictures: “I was gone the whole weekend, and he [son] was just at home and just miserable, and my husband would send me pictures, and he just did not look good.” The actions of their husbands, although perhaps unintentional, added to the feelings of guilt experienced by many of our participants.

It is important to note that, in many instances, participants identified their biggest source of support as their husbands. This held true even if they believed their husbands were a source of pressure. Aly answered, “My husband, definitely,” when asked who her biggest source of support was. Fran responded:

. . . truly my husband. I mean, he's been in the trenches with me doing this for the last almost 9 years now, and I understand where he's coming from, where he is kind of tired of the nights and weekends, and I know that I say he guilts me. You know, I used that before. He truly is supportive, too. . . I couldn't do this without him, and he knows that, and we just want to, I guess, you know, as our kids get older. . . be able to do the stuff that we want to do together as a family and not go totally crazy over working so much.

The men in our sample only described their wives as sources of support and did not indicate feeling pressure from them.

DISCUSSION

Regardless of sex, ATs working in the secondary school setting who had children appeared to experience feelings of guilt. This guilt seemed to stem from work interfering with family despite our participants indicating they viewed their work environments as supportive, which suggests they may have been experiencing WFG. Additionally, our results imply that some of these feelings of guilt stemmed from intrinsic sources. Both men and women expressed feelings of guilt stemming from work interfering with family and their own desires to best serve their patients, but women's feelings of guilt originated from their husbands' pressure. Furthermore, although most participants clearly believed they were currently employed in a family-friendly and supportive work environment, they still had experiences of guilt. To our knowledge, we are the first to qualitatively examine the concept of guilt and, more specifically, WFG among an AT population employed in the secondary school setting.

Work-family scholars^14,15 have described the construct of guilt as bidirectional and proposed a differentiation in the direction of guilt. Guilt may manifest when work interferes with family or when family interferes with work, suggesting that WFG is a potential result of interrole conflict. Interrole conflict occurs when a person has membership in 2 groups and the roles and responsibilities of 1 role conflict with the demands of the other.²⁵ Our participants consistently gave examples of work interfering with their family roles. A small positive correlation of WIFG with psychological distress has been shown, whereas FIWG was not significantly related to psychological distress.¹⁴ Also, when work interferes with family, the resulting effect is typically on family satisfaction.²⁶ The fact that participants provided more examples of WIFG than FIWG is not surprising, given that a previous investigator¹⁴ found that both men and women reported higher levels of WIFG than FIWG. These data are important because WIFG has been correlated with turnover intentions and psychological distress, whereas FIWG has not.¹⁴ An altruistic mindset could be precipitating the feelings of guilt for our participants and leading to the perceived work interference with family. Although an altruistic mindset may be beneficial for the patient and can create a feeling of needing to put patients first, this mindset may prevent ATs from spending time with their families.

Our results indicated that both men and women experienced some level of WFG. This is consistent with the finding of previous authors,¹⁶ who demonstrated that ATs with children experienced higher WFG, WIFG, and FIWG scores than did ATs without children. Anecdotal reports suggested that women may experience more guilt than men (“mom guilt”), yet our participants of both sexes described feelings of guilt. These outcomes are consistent with those of a recent quantitative investigation¹⁶ of WFG among a collegiate AT population in which no sex differences were observed. However, we did not quantify WFG within our sample and cannot say if women had higher levels of guilt than men.

Participants in our sample overwhelmingly described their workplaces as supportive. They highlighted the importance of having supervisors with children, who they felt were more accommodating or receptive to parental responsibilities. Perceptions of organizational and supervisor support of family are known to affect the job satisfaction and career intentions of ATs.²⁷ Still, despite reporting a supportive work environment, our participants continued to experience WFG. This may reflect guilt as an individual construct, stemming from an intrinsic sense of duty and self-defined role as a parent, and that organizational factors, such as supportive work environments, may not provide a buffer against WFG.

Our participants' demonstrations of an altruistic mindset were not surprising, given that researchers²⁸ identified health care professionals as being generally motivated by intrinsic factors, including altruism, to pursue their careers. Altruism is the belief in or practice of selfless concern for the wellbeing of others.²⁹ In our sample, this notion of wanting to be present for the benefit of their patients created feelings of guilt because it meant time away from their families. Role theory predicts that the multiple roles an individual fills can be in conflict due to the limited time and resources available to spend in each role.³⁰ Role theory is often used to explain WFC, and it has been hypothesized to lead to feelings of guilt.³¹ Altruistic ideals and the qualities of empathy decreased as individuals faced increasingly heavy workloads and dealt with strenuous demands.³² These circumstances resulted in emotional suppression, burnout, and detachment from patients.³²

It was apparent from the women in our sample that their husbands were a source of stress. Whether or not the stress was intentional, women felt pressure from their husbands to fulfill their traditional gender role as caretaker. This finding is an example of a sociocultural-level factor that can influence the work-life interface. Athletic training does not exist in a vacuum but rather in a larger social system in which societal meanings, norms, and values can affect manifestations of guilt. Conventional gender ideologies present specific barriers for women and perpetuate societal norms that women have more responsibilities in family life.³³ Gender ideologies matter because, if work behavior conflicts with attitudes about gender, the consequences may include reductions in wellbeing and feelings of goodness and competence.²⁴ This perception of stress from their husbands may be intrinsically motivated because the women in our sample experienced self-imposed guilt by not meeting their own expectations of motherhood. This concept should be further explored so that we can better understand where the feelings of guilt originate.

LIMITATIONS AND FUTURE DIRECTIONS

Our study was not without limitations. Because we gained perspectives from ATs employed in the secondary school setting, it is important to recognize that the factors that may precipitate feelings of guilt in this population may not hold true for all AT populations. It would be beneficial for future authors to address this concept among other AT populations. We acknowledge our assumption that at least some of our participants would express feelings of guilt and the likelihood that some of those would be WFG. This influenced why we asked participants to describe experiences with guilt as part of the interview. However, including this question was purposeful, as we sought to understand participants' experiences and the context surrounding instances of guilt rather than a simple yes or no answer, and the question was asked if the participant organically described feelings of guilt. Additionally, the data we collected were from 1 timepoint and therefore can only represent the perceptions of the participants when the interview was conducted. Future researchers should consider examining the concept of WFG in a longitudinal study. We did not assess the construct of guilt quantitatively; this construct could be examined using previously validated instruments to further characterize the concept of work interfering with family. Given our findings, it would be prudent to further assess the role of a supportive work environment in mitigating feelings of WFG and evaluate gender differences in relation to sources of stress that may lead to feelings of guilt.

CONCLUSIONS AND IMPLICATIONS

Regardless of sex and support within the work environment, our ATs in the secondary school setting experienced guilt that appeared to stem from work interfering with family. Their responsibilities at work often conflicted with their roles at home, limiting their ability to fully engage in family life. Overall, our participants considered their work environments supportive, especially when their colleagues and supervisors were also parents and understood the responsibilities and necessary tasks related to this role. Participants expressed strong desires to perform optimally both at work and at home. These ATs expressed a strong altruistic mindset in wanting to devote time to their work and make their patients a priority. Women in our sample indicated pressure and expectations from their husbands as explanations for their feelings of guilt.

Despite support, ATs still experienced feelings of guilt, though men and women may have experienced guilt in different ways and from different sources. Therefore, it is important to recognize that this emotional response can affect an AT's performance both at home and in the workplace. If ATs are experiencing guilt, patient care and family role performance may suffer because of role overload. Athletic trainers must have some flexibility in the workplace to help alleviate feelings of guilt and increase job satisfaction. It is also critical for employers to recognize that the giving nature and altruistic mindset of ATs as health care providers may lead to feelings of guilt. Employers can encourage time away so that the AT can better balance his or her own resources rather than simply being praised for good work.