Evaluation of nursing and medical students' attitudes towards people with disabilities

Voices unheard, insights into the lives of people with disabilities: A needs assessment study

BACKGROUND

The phenomenon of disability in society is as ancient as human history itself. Approximately one billion people worldwide experience some form of disability, with a fifth of these individuals facing significant disabilities. Disability affects various life dimensions, including access to health services. This study aimed to identify the needs and challenges encountered by people with disabilities and to propose solutions for these issues.

MATERIALS AND METHODS

This qualitative content analysis research was conducted at Isfahan University of Medical Sciences in 2019. Participants included faculty members from the rehabilitation school, senior students, therapists, disabled individuals, and their families (23 interviews in total). These participants were chosen for their extensive knowledge of the challenges faced by people with disabilities. Semi-structured interviews were conducted, with informed consent obtained before each interview. The interviews were analyzed using the Graneheim and Lundman content analysis method and MAXQDA software. To ensure data accuracy, the criteria of conformability, credibility, dependability, and transferability were applied.

RESULTS

The analysis of the interviews yielded two main categories and 10 subcategories. In the category of disability-related problems, family problems, therapeutic problems, psychological problems, academic problems, and social problems were identified as the most significant. As for solutions, educational solutions, therapeutic solutions, social solutions, research solutions, and solutions for reintegrating patients into normal life were proposed to address the problems faced by disabled individuals.

CONCLUSION

People with disabilities are an integral part of any country's society. To adequately address their therapeutic needs, it is essential to equip our health workers with the knowledge and skills tailored to the specific needs and challenges of disabled individuals.

Problematic Internet use and attitudes towards persons with disabilities - cross-sectional research among Polish students

BACKGROUND

Problematic Internet use (PIU) can have detrimental effects on physical, emotional, psychological, and social functioning. Besides well-described PIU correlations in psychological domains such as personality traits, or life satisfaction, and self-assessment, the social aspect of PIU risk also appeared to be important. This study aimed to investigate the association between PIU and attitudes towards persons with disabilities.

METHODS

A total of 595 Polish students aged 18-29 participated in this research by completing the Internet Addiction Test, Multidimensional Attitudes Scale Towards Persons With Disabilities, and personal information form.

RESULTS

The findings revealed that 30.6% of the respondents were at high risk for PIU. Moreover, heightened levels of PIU were more prevalent among male participants and students in technical fields of study than in those in medical and social fields of study. Increased PIU was also associated with more negative attitudes towards persons with disabilities in general and in the domains of emotions and behaviours. Additionally, prior personal contact with individuals with disabilities was related to both PIU rates and attitudes towards persons with disabilities in the domain of emotions and beliefs.

CONCLUSIONS

This study highlights the prevalence of PIU among Polish students and emphasizes the need for preventive measures, particularly targeting male students and those in technical fields of study. The results indicate a relationship between PIU and attitudes towards individuals with disabilities. Further research is required to determine the direction of the relationship. It is recommended that educational programs provide opportunities for interaction with individuals with disabilities to promote understanding and acceptance.

Do we react differently toward bionic devices vs. cochlear implants and wheelchairs? Possible links with personality traits

The present study explored the attitudes toward individuals with bionic eyes and limbs, cochlear implants, and people with disabilities that imply using a wheelchair. Our sample consisted of 474 Romanian adults aged 18-61 (M = 27.56, SD = 11.80). Participants were randomly divided into five groups. They all filled scales related to personality characteristics, i.e., agreeableness, neuroticism, openness to experience, comprehension/intellectual efficiency, and previous contact with disability. Then, each group was presented with a vignette describing a character (wheelchair/bionic eye/bionic leg/cochlear implant/control group). Finally, they answered questions about their emotions, cognitions, and behaviors related to that context. Overall, our results suggested that higher agreeability, extraversion, openness to experience, intellectual complexity, and lower neuroticism were generally associated with more positive attitudes toward disability. When examining the differences in participants' emotions, cognitions, and behaviors depending on the target's characteristics, our results generally suggested that the most negative reactions were toward the character with a bionic eye. We discuss these findings considering their importance for shaping positive attitudes related to disability, especially related to the future technological advances in bionic devices.

The effect of advocacy education of nursing students on attitudes towards disability: a quasi-experimental study

Objectives

To determine the effect of advocacy education on the attitude of nursing students towards persons with disabilities.

Methods

This study is a one-group pretest-posttest design: a quasi-experimental study. The study population consisted of 38 students who were enrolled in the advocacy course in the final year of nursing school in a public university. A ten-week Disability Advocacy Education Program was implemented. Data was collected using the Data Sheet and Multidimensional Attitudes Scale Toward Persons with Disabilities.

Results

Male students were found to have higher mean scores after the education; there was no statistically significant difference for other variables such as family structure, place of residence, and whether they have received education on disabilities.

Conclusions

Nursing students have a positive attitude towards people with disabilities, and that male students’ attitudes improved after education.

Implications for International Audience

Advocacy education provided to students help them develop a positive attitude towards people with disabilities.

Attitudes of Students of Social Sciences and Humanities towards People with Physical Disabilities (MAS-PL)

Negative social attitudes towards people with disabilities are a serious barrier to their social, professional, and cultural functioning. Due to negative perception, disabled individuals are often homebound. The present study was an attempt to compare declared attitudes with the results of other studies using the Polish version of an international assessment tool. The aim was to verify the MAS-PL tool and to analyse the attitudes of students of social sciences and humanities towards people with physical disabilities. An additional aim was to compare declared attitudes with the results of other studies using the Polish version of an international assessment tool for students of medicine and health sciences. In total, 540 students were surveyed using the Polish adaptation of the Multidimensional Attitudes Scale towards Persons with Disabilities (MAS-PL). The study confirmed the high reliability of the MAS-PL Scale. The mean global score of the scale was 82.79. There were no significant differences in the global MAS-PL score depending on respondents’ sex; however, an effect of this variable on the subscales was found. The surveyed females exhibited more positive attitudes in terms of the cognitive and behavioural components, whereas the males showed more positive attitudes in the affective subscale. There was no significant impact of the place of residence, age, and majors. Along with the year of studies, the intensity of the global and affective scale slightly increased. The surveyed students of social sciences and humanities exhibited similar attitudes towards people with physical disabilities to those declared by Polish students of medical and health sciences surveyed by Radlińska et al. The authors recommend implementation of didactic classes, projects, and activities at the stage of planning and creation of student education programs to promote tolerance towards disabled people.

Cocurricular Clinical Opportunity: Addressing Student Attitudes, Knowledge, and Skills With Disability Education

BACKGROUND

Multiple organizations have urged inclusion of disability content in health care professional's education and training. Few nursing schools in the United States have adopted dedicated disability curricula nor studied its impact on attitudes, knowledge, and skills of disability education. Evidence suggests that inadequate education contributes to health care disparities and unmet needs of people with disabilities.

METHOD

A 2-hour cocurricular clinical experience was developed, using established competencies, and offered to senior nursing students. Students participated in multimodal experiences, with an emphasis on clinical exposure in various facilities serving children and adults with disabilities.

RESULTS

Five cohorts of students (N = 34) participated in the fellowship. Data illustrate the strong need to continue and require the curricula.

CONCLUSION

Faculty should develop disability education secondary to population prevalence and in accordance with the American Association of Colleges of Nursing's essential competencies. [J Nurs Educ. 2021;60(11):637-641.].

The Attitudes of Nurses in the Hospital toward Vulnerable People

Background: Vulnerable people are at higher risk for ill health and often experience discrimination in health services. Persons with disabilities, People with Dementia (PWD), and People with HIV/AIDS (PLWHA) are some groups of people with vulnerabilities who often need hospital care. Nurses are the largest group of health personnel and frequently meet with these patients so that the attitude of nurses can have a consequence on the quality of health care. Research Objectives: To identify nurses' attitudes towards vulnerable people and factors related to their attitudes. Methods: This quantitative research used a cross-sectional design. The research subjects were 386 nurses in the main public Dr. Sardjito hospital selected using a convenience sampling technique. Data were collected in January-February 2021 with a Google Form. Researchers used a demographic data questionnaire, an attitude questionnaire (Attitude Toward Disabled Person Scale Form O, Dementia Attitude Scale, and AIDS Attitude Scale), and a knowledge questionnaire (Self-Administered Questionnaire about Knowledge), Dementia Knowledge Assessment Scale, and HIV-Knowledge Questionnaire-18). Data were analyzed using non-parametric statistical tests, specifically the Spearman rank, Mann-Whitney, and Kruskal-Wallis tests. Results: The score of nurses' attitudes towards persons with disabilities was 54.00 out of 120; the score of nurses' attitudes to PWD was 102.00 out of 140; and the score of nurses' attitudes toward PLWHA was -0.65 out of +5. Knowledge, history of interaction, and experience in caring have a significant effect on nurses' attitudes towards vulnerable people (p value <0.05). The education level only affects the attitudes of nurses towards persons with disabilities (p value = 0.042). Family history only affects nurses' attitudes to PWD (p value = 0.013). Age and special education/training only affect the attitudes of nurses on PWD and PLWHA (p value <0.05). Conclusion: Nurses tend to present positive attitudes toward PWD, but nurses are inclined to show negative attitudes against people with disabilities and PLWHA. Knowledge, caring experience, and interaction are confirmed to have an effect on nurses' attitudes with the result that programs to increase knowledge and experience of nurses towards vulnerable groups are recommended for this group. Keywords: Attitude, Dementia, Disability, HIV/AIDS, Knowledge, Nurse.

Attitudes of Polish Medical and Health Sciences Students towards Persons with Physical Disabilities Using the MAS-PL Scale

Discovering the role of negative attitudes in the social functioning of people with disabilities, tools were developed to measure these attitudes, of which the Multidimensional Attitude Scale of People with Disabilities (MAS) is a good one. It is particularly important to study the attitudes of people who are professionally involved in meeting the needs of people with disabilities. The aim of this study was to determine the attitudes towards people with physical disabilities among medical and health sciences students regarding gender, year of study, field of study, and place of residence. The study was conducted among 625 students in Poland with the use of the MAS-PL scale. The results obtained indicate that women display more positive attitudes towards people with disabilities than men in the cognition and behavioural domains. In the emotional domain, these attitudes were more negative than in the other domains and almost identical for both genders. The year of study, field of study, and place of residence did not differentiate students in terms of their MAS score. Since the sociodemographic variables studied do not determine a positive attitude, educational interventions to increase contact with people with disabilities should be undertaken in future research, and this factor should be investigated as an element of attitude modulation.

Appraisal of disability attitudes and curriculum of nursing students: a literature review

Worldwide, more than one billion people live with a disability (World Health Organization. (2011). World report on disability. Retrieved from https://www.who.int/disabilities/world_report/2011/report/en/). People with a disability (PWD) have unmet needs with the delivery of health care, secondary to nursing student's negative attitudes, knowledge, and skill deficits. This integrative literature review evaluated nursing student's education and attitudes towards PWD. Deficient education, attitudes, knowledge, and skills are addressed. Combined search terms utilized included: healthcare students; healthcare education; nursing students; clinical experience; clinical rotation; attitude of health care students; and exposure to PWD. Thirty articles were analyzed with common themes identified. Educational methods that produced improved attitudes, knowledge and skills included standardized patients with disabilities; phenomenological approaches; curriculum enhancement; empathy exercises and clinical experiences (Anderson, E. S., Ford, J., & Thorpe, L. (2011). Learning to listen: Improving students' communication with disabled people. Medical Teacher, 33(1), 44-52. doi: 10.3109/0142159X.2010.498491; Castro, S. S., Rowe, M., Andrade, L. F., & Cyrino, E. G. (2018). Developing competencies among health professions students related to the care of people with disabilities: A pilot study. Interface: Comunicacao, Saude, Educacao, 22(65), 551-563. doi: 10.1590/1807-57622016.0684; Hensel, D., Malinowski, C., & Watts, P. A. (2015). Implementing a pediatric camp clinical for pre-licensure education. Nursing Education Perspectives, 36(1), 60-61. doi: 10.5480/12-871.1; Levett-Jones, T., Lapkin, S., Govind, N., Pich, J., Hoffman, K., Jeong, S. Y., . . . Everson, N. (2017). Measuring the impact of a 'point of view' disability simulation on nursing students' empathy using the comprehensive state empathy scale. Nurse Education Today, 59, 75-81. doi: 10.1016/j.nedt.2017.09.007; Smith, P., Ooms, A., & Marks-Maran, D. (2016). Active involvement of learning disabilities service users in the development and delivery of a teaching session to pre-registration nurses: Students' perspectives. Nurse Education in Practice, 16(1), 111-118. doi: 10.1016/j.nepr.2015.09.010). Nursing schools must incorporate disability education to fully realize its impact and eliminate barriers to transform care.

Factors associated with public attitudes towards persons with disabilities: a systematic review

OBJECTIVE

The aim of this review is to identify and summarize factors that are associated with public attitudes towards people with various disabilities systematically.

METHODS

An electronic search of three databases was performed (Medline, EMBASE and Cochrane) covering the period from 1950 to present. A comprehensive search strategy was developed and the lists of citations were screened for potential eligible studies. Only quantitative studies using valid measurements were included, and the methodological quality of included studies was appraised based on three criteria (sample, measurement, analysis) by two independent reviewers.

RESULTS

The initial electronic search yielded 995 articles after duplicates removed, and 27 studies met the eligibility criteria were included in the study. Three categories of the factors were found to be associated with the public attitudes, which are related to the attitude provider, disabled people, and society respectively. Specifically, the more people know about disabilities, the more likely they were to have positive attitude; and the frequency and quality of the contact with the disabled are also proved to be influential to the attitudes. Meanwhile, the type of disability is also closely correlated to the public's attitude towards the disabilities.

CONCLUSION

People's knowledge of the disability and their contact with individuals with disabilities are the main influential factors in public attitudes towards persons with disabilities.

Attitude towards People with Disability of Nursing and Physiotherapy Students

BACKGROUND

Attitudes are a component of our behaviour. Health professionals should have a global perspective of disability. They must provide treatment to people with disability and care for them, but they also should accept them with no judgements or discrimination. The general objective of this study was to know the attitude towards people with disability of nursing and physiotherapy students at the University of Cadiz.

METHODS

This was a descriptive, correlational, transversal and synchronous study. A total of 200 students participated in the study (91 from the bachelor's degree in nursing and 109 from the bachelor's degree in physiotherapy). The 'Attitudes towards people with disability scale' was used.

RESULTS

The mean score for both groups of students was 157.05 (SD = 14.14).

CONCLUSIONS

Attitudes towards disability of nursing and physiotherapy students at the University of Cadiz tend to be positive. However, this was considered not sufficient since they will be health professionals in the future.

Self-other overlap: A unique predictor of willingness to work with people with disability as part of one's career

BACKGROUND

People with disability (PWD) often rely on others, both for direct support and for the creation of enabling environments to meet their needs. This need makes it crucial for professionals to be willing to work with PWD, and for people to pursue careers that focus on supporting PWD.

OBJECTIVES

To explore self-other overlap as a unique predictor of willingness to work with PWD as part of one's career, using three studies.

METHODS

Studies 1 and 2 used cross-sectional surveys of college undergraduates to explore: 1. whether an association between self-other overlap and willingness to work with PWD exists, and 2. whether self-other overlap is a unique predictor, controlling for attitudes and empathy. Study 3 investigated whether self-other overlap is associated with the groups with whom the students indicated they want (and do not want) to work as part of their career.

RESULTS

Across the three studies, self-other overlap was uniquely associated with students' willingness to work with PWD as part of one's profession, even when controlling for attitudes and empathy.

CONCLUSIONS

Self-other overlap may be an important additional factor to take into consideration when developing interventions targeted toward promoting working with PWD.

Intellectual disability health content within medical curriculum: an audit of what our future doctors are taught

BACKGROUND

There is a high burden of unmet health needs for people with intellectual disability. Despite experiencing significantly higher rates of morbidity and mortality compared with the general population, this group faces greater barriers to accessing healthcare. While increasing workplace capacity is one way to reduce this inequitable access, previous research indicates a scarcity of undergraduate teaching in intellectual disability. The aim of the study was to determine the extent and nature of intellectual disability content currently offered within medical degree curricula.

METHODS

All Australian universities (n = 20) providing accredited medical training were invited to participate in a two-phase audit via an email invitation to the Dean of each medical school. The Dean's delegate from 14 medical schools completed Phase 1, which involved a questionnaire or telephone interview about the overall medical course structure. Unit coordinators and/or teaching staff from 12 medical schools completed Phase 2, which involved an online survey about intellectual disability content within the curriculum.

RESULTS

In Australia, medical school curricula contain a median of 2.55 h of compulsory intellectual disability content. The majority of universities only offer a small amount of compulsory content. Of compulsory units, intellectual disability teaching is minimal in sexual health and emergency medicine (only one unit offered in one school for each). Topics of key relevance in intellectual disability health such as human rights issues, interdisciplinary team work and preventative health are poorly represented in intellectual disability teaching. Elective content varies markedly across universities (1 to 122 h), but emergency medicine, women's health, men's health and many other specialist medicine areas are not represented. Inclusive practice is inconsistent in degree and nature, but a majority of universities (nine) involve people with intellectual disability in the development or delivery of content.

CONCLUSIONS

There is a mismatch between the considerable unmet health needs of people with intellectual disability and the inconsistent teaching within medical schools. Future doctors will be better equipped to support the health and wellbeing of people with intellectual disability if curricula are enhanced in this area.

Development and validation of the self-acceptance scale for persons with early blindness: the SAS-EB

Investigations of self-acceptance are critical to understanding the development and maintenance of psychological health. However, valid and reliable instruments for measuring self-acceptance in persons with early blindness have yet to be developed. The current research describes three studies designed to develop and validate the Self-acceptance Scale for Persons with Early Blindness (SAS-EB). In Study 1, we developed the initial item pool. Thirty-three items were generated, based on data from specialized literature and from 2 focus groups. Items were organized in a three-factor structure, theoretically predicted for SAS-EB - (1) body acceptance, (2) self-protection from social stigmas, and (3) feeling and believing in one's capacities. In Study 2, information obtained from a panel of 9 experts and 22 persons with early blindness representing the target population was used to refine the initial item pool, generating a new pool of 27 items. In Study 3, 318 persons with early blindness (141 women and 177 men), between 18 and 60 years of age (M = 37.74 years, SD = 12.37) answered the new pool of 27 items. After the elimination of 9 items using confirmatory factor analysis, we confirmed the theoretical three-factor structure of the SAS-EB. Study 3 also provided support for the scale's internal consistency and construct validity. Finally, the psychometric properties of the SAS-EB, its utility, and its limitations are discussed along with considerations for future research.

Model of Intellectual Disability and the Relationship of Attitudes Towards the Sexuality of Persons with an Intellectual Disability

The following article discusses the relationship between the model of intellectual disability and the attitudes towards sexuality of people with disabilities. This correlation has been verified during the author’s own research conducted on students of several medical faculties such as nursing, public health, emergency medical services and physiotherapy. Tools of the author’s design have been used in the research. Likert-type scale “Perspective of intellectual disability” has been used to determine the model of disability seen from the medical (individual) or social perspective. To examine the attitudes towards sexuality two tools of the author’s own design have been used: a Likert-type scale “The essence of sexuality in persons with an intellectual disability” which has been used to analyze the cognitive aspect of the attitudes, and a semantic differential with notions concerning physical and psychosocial aspects of sexuality including the affective-evaluative aspect. As expected, significant correlations have been found between the model and the attitudes both in the cognitive and the affective-evaluative aspect. Higher scores for the individual model correlated with: (a) lover scores for most aspects of sexuality of people with intellectual disability, (b) perceiving them as asexual, (c) biological determinism in the sexual sphere. The social model concurred with positive values given to sexuality of people with intellectual disability and its normalization in the sphere of its determinants and symptoms.

Genetic counseling for prenatal testing: where is the discussion about disability?

There are little data revealing how genetic counselors talk about disability in the prenatal setting. We performed a qualitative analysis of 93 existing transcripts from simulated patient (SP) genetic counseling sessions conducted in 2003–4 through the Genetic Counseling Video Project. We found that most genetic counselors (95%) focused on the physical aspects of disability while fewer (27%) discussed the social aspects. In addition, few genetic counselors (38%) asked patients about personal experiences with disability. When discussing options available if a pregnancy were diagnosed with a disability, most genetic counselors mentioned termination (86%) while fewer mentioned the continuation of the pregnancy (37%) or adoption (13%). Only half of the genetic counselors asked the SP if she had thought about how she might use the results of prenatal screening. To better facilitate informed decision-making that is consistent with patient values, we recommend genetic counselors engage prenatal patients in a deeper discussion about their ability and willingness to parent a child with a disability.

Genetic counseling for prenatal testing: where is the discussion about disability?

There are little data revealing how genetic counselors talk about disability in the prenatal setting. We performed a qualitative analysis of 93 existing transcripts from simulated patient (SP) genetic counseling sessions conducted in 2003–4 through the Genetic Counseling Video Project. We found that most genetic counselors (95%) focused on the physical aspects of disability while fewer (27%) discussed the social aspects. In addition, few genetic counselors (38%) asked patients about personal experiences with disability. When discussing options available if a pregnancy were diagnosed with a disability, most genetic counselors mentioned termination (86%) while fewer mentioned the continuation of the pregnancy (37%) or adoption (13%). Only half of the genetic counselors asked the SP if she had thought about how she might use the results of prenatal screening. To better facilitate informed decision-making that is consistent with patient values, we recommend genetic counselors engage prenatal patients in a deeper discussion about their ability and willingness to parent a child with a disability.

Dentistry for Mexicans with special needs: a commentary

There are more than 2 million residents with disabilities in Mexico. Despite national legislation to assure individuals with disabilities needed services, including education and employment, social inclusion of these individuals is difficult since societal views exclude them from functioning as members of a community. While there are no national studies of the dental needs of individuals with disabilities in Mexico, reports of the general population indicate limited use of dental services and the need for increased restorative services. Examples of dental education accreditation standards in other countries are used as models for the improvement in the preparation of dental students to provide services for individual with special needs.