Thoughts about encounters between nondisabled and disabled peers: Situational constraints,states-of-mind,valenced thought categories

This study explores three issues: thoughts and feelings of individuals with and without physical disabilities concerning encounters in different situations, ways of grouping self-statements into valenced categories, and use of states-of-mind (SOM) ratios as an alternative to positive and negative thought frequencies. Data from 127 able-bodied and 46 physically disabled college students indicate that, in everyday social encounters, nondisabled individuals' thoughts and feelings were more negative, while those of disabled individuals were more negative when helping was involved and when encounters centered on the impairment. Thus, problematic encounters between people with and without disabilities may be due to the reactions of individuals with disabilities in situations which involve help, and to reactions of able-bodied persons in everyday contexts. The data also confirm the utility of SOM ratios as an alternative to valenced frequencies in cognitive assessment: SOM scores discriminated groups when situational demands were manipulated and scores were linearly related to criterion measures. However, SOM ratios differed dramatically, depending on the attentional focus of thoughts. The findings illustrate types of thoughts which occur during interaction between people with and without disabilities, demonstrate a simple technique for grouping thoughts into valenced categories on an empirical basis, and highlight the relative contribution of cognitive and affective elements to overall valenced scores. Implications for research on assessment of self-statements are discussed and recommendations are made concerning programming to facilitate the social integration of people with disabilities.This research was supported by grants to the first author from the Social Sciences and Humanities Research Council of Canada and from Fonds F.C.A.R. pour l'aide et le soutien à la recherche. Thanks are due to Meribah Aikens, Maria Barile, Leo Bissonette, Bosco Daude, Jim Dubois, Lillian Fox, Evelyn Gold, Naomi Goodz, Darlene Judd, André Leblanc, John Martos, Sue McKenzie, Irwin Slopak, and Joan Wolforth for their assistance with various stages of this investigation.     

Self,other, and situation-referent automatic thoughts: Interaction between people who have a physical disability and those who do not

The nature of facilitatory and inhibitory automatic thoughts concerning interaction between able-bodied college students and students who do and who do not have a physical disability was investigated. Both the valence (positive or negative) and the focus of attention of automatic thoughts (on oneself, on the other person, or on the situation) were studied. Thought listings of 115 able-bodied college students concerning interaction with able-bodied students and with those who have a physical disability were coded as positive or negative and as self-, other, or situation-referent. Comfort interacting and self-efficacy beliefs were also assessed. Results indicate that valence and focus of attention are discrete elements that have differential impact on comfort interacting and self-efficacy beliefs. The situational demands of interaction with able-bodied people and with individuals with a physical disability were shown to have a marked impact not only on comfort but also on the patterning of thoughts generated. The findings illustrate the importance of assessing the effects of differing situational demands on automatic thoughts and highlight the need for both a more sophisticated typology for the coding of cognitions as well as for an empirical approach to classifying thoughts as positive or negative. The implications of the findings for the design of cognitive interventions inteneded to make individuals more comfortable interacting with people who have a physical disability are discussed.This study was funded by a grant from Fonds FCAR pour la formation de chercheurs et l'aide à la recherche. Portions of this paper were presented at the 1984 annual convention of the Association for Advancement of Behavior Therapy. Thanks are due to Claudia V. Bourdon, John G. Martos, and Rhonda Amsel for their assistance with various stages of this study.     

Content analysis of verbal communication between spinal cord injured and nondisabled male college students.

Does the interaction between a disabled person and a nondisabled person differ in content and climate from the interaction between two nondisabled persons? The purpose of this study was to compare dyadic interaction behavior of traumatically disabled and nondisabled men paired in homogeneous or mixed dyads. Forty-five disabled and 45 nondisabled men, assigned to dyads consisting either of two disabled students, two nondisabled students, or one disabled and one nondisabled student, discussed a low, medium and high intimacy topic. A group of trials analysis of variance was used to assess the effects of dyad composition and topic intimacy on self-disclosure. Dyads consisting of two nondisabled partners exhibited the least self-disclosure at all levels of topic intimacy. Dyads in which both partners were disabled exhibited the most self-disclosure on low and medium intimacy topics and had the greatest frequency of disability related responses. The mixed dyads exhibited the most self-disclosure on the high intimacy topic. Disabled subjects in homogeneous dyads exhibited greater depth of self-disclosure than nondisabled subjects in homogeneous dyads. The implications of the results are discussed in terms of facilitating the acquisition of interaction skills for traumatically disabled persons, evaluating patient-staff communication and the role of peer counseling in rehabilitation settings.     

The measurement of the Hong Kong-based 'Baseline Survey of Students' Attitudes toward People with a Disability': cross-cultural validation in Lebanon

The negative attitudes of nondisabled persons are among the most serious invisible barriers to the full participation and integration of disabled citizens into society. A big question is, 'what is the current level of acceptance and recognition of disabled persons in a given society, and what kind of public awareness interventions shall be devised to promote positive changes?'. The purpose of this pilot study was to assess the level of the existing attitudinal barriers in a war-torn, middle-income Arab country, Lebanon. The study attempted to determine the present level of prejudice against people with a disability in Lebanon, and to examine the relationship between the participants' attitudes, and their previous exposure to and personal experience with disability. An instrument, the 'Baseline Survey of Students' Attitudes toward People with a Disability', developed by the Equal Opportunity Commission of Hong Kong, was selected as the instrument. A total of 94 valid questionnaires were collected from three universities in Beirut, Lebanon. This instrument was able to differentiate the participating students' attitudes toward people with different types of disabilities. The scale and its subscales showed that students generally had less favorable attitudes toward people with intellectual impairment and mental illness (including the ex-mentally ill). The participating Lebanese university students (an older age group than the Hong Kong students) are more differentiating in their attitudes toward people with the two most-discriminated categories of disabled people (the intellectually disabled and those with mental illness history). The cross-cultural validity and reliability of this instrument has been confirmed, and the major findings of this study could inform future policy directions, public awareness-raising strategies and social interaction variables to foster positive public attitudes in Lebanon.     

The attentional mechanisms model of interaction strain

Integration of people with physical and sensory disabilities requires effective interactions in occupational and recreational contexts. Major impediments are nondisabled individuals' discomfort, negative thoughts, and stereotyped characterizations. This article describes the Attentional Mechanisms Model of Interaction Strain (AMMIS), which integrates known findings about these cognitive and affective factors and generates hypotheses both about causes of interaction difficulties and about remedies. Ways to evaluate the model are proposed through: examination of attentional processes, exploration of attentional focus effects on affect, cognitions, and attitudes, and preparation and evaluation of intervention strategies based on the model. Implications of using the model are discussed.     

A comparison of the attitudes of students and non-students toward the disabled in Ghana

A comparison of attitudes toward the disabled in Ghana was made between 146 college students (majoring in general education, special education administration and medicine) and 128 non-students. The study focuses on an analysis of responses to a select number of attitude statements which revealed the following: Students responded more favorably than non-students to statements emphasizing the value of educating the disabled. Students were less likely to blame the disabled or his/her family for the presence of a disability. On the other hand, both students and non-students were least favorable to social interaction with the disabled. A major finding of the study was that all scores fell within or above the moderately positive range. However, analysis of data revealed an inconsistency between the cognitive and affective attitude components. These findings suggest the influence of traditional beliefs on attitudes toward the disabled.     

Attitudes towards people with physical or intellectual disabilities: nursing students and non‐nursing peers

Title. Attitudes towards people with physical or intellectual disabilities: nursing students and non‐nursing peers. Aim. This paper is a report of a study of the attitudes of Dutch nursing students towards people with physical or intellectual disabilities. Background. Attitudes of healthcare professionals are a major factor in the rehabilitation and self‐acceptance of persons with disabilities. Consequently, it is important that nurses develop or maintain positive attitudes towards people with disabilities during their education. However, more knowledge is needed about current attitudes of nursing students and factors influencing these attitudes. Methods. A sample of Dutch nursing students (n = 81) and an age‐matched group of non‐nursing peers (n = 48) completed standardized scales measuring attitudes about physically or intellectually disabled people. Data were collected in 2006. Findings. Nursing students were more positive towards physically disabled people than their peers, and more strongly endorsed empowerment and similarity of intellectually disabled people. These attitudinal differences generally remained statistically significant after multivariate adjustment for demographic variables and experience and contact with individuals with disabilities. An important independent determinant of a positive attitude towards physically disabled people in the total sample was having a relative or friend with a physical disability. This association, however, was not apparent in attitudes towards intellectually disabled persons. Conclusion. Educational interventions aimed at improving attitudes towards people with disabilities should include focus on forms of contact beyond the context of formal care relationships.     

An Educational Program's Effects on Students' Attitudes Toward People with Disabilities: A 1-Year Follow-Up

The purpose of the study described here was to examine the attitudes of nursing students toward people with disabilities 1 year after the students had participated in an educational program on caring for such people. The program provided (a) information about this care, (b) simulated experiences related to different aspects of care, and (c) contact with disabled people as well as with rehabilitation health professionals. The study also examined how students' attitudes were influenced by the students' age, the number of years they had spent in the nursing program, their degree of experience in caring for people with disabilities, and their amount of personal interaction with disabled people. The Attitudes Towards Disabled Persons (ATDP) scale was administered to 67 nursing students before they completed the workshop. The participants were tested again 1 year later, thereby providing a matched group for examining attitude changes over time. The participants' attitudes were significantly more positive at the follow-up. At the 1-year follow-up, the ATDP scores of the intervention group were also compared with those of a second group of nursing students (n = 170) who had not participated in the educational program. The findings suggested that completion of the educational program was an important influence on students' development of positive attitudes toward people with disabilities.     

Medical students' and allied health care professionals' perceptions toward the mentally retarded population

The purpose of this study was to determine if differences in expectations toward individuals with varying levels of mental retardation exist between medical students themselves and between health care professionals involved with these individuals. There were 136 medical students (52%) and 119 health care professionals (89%) who completed the modified Prognostic Beliefs Scale survey. Medical students demonstrated lower expectations compared to health care professionals. No relationship was found among medical student expectations and selected background variables including a family member with a disability and working with disabled individuals. A curriculum was developed focusing on informing and sensitizing medical students toward the needs of developmentally disabled persons. The response of the students to the program has been outstanding, with a positive change in attitudes and perceptions.     

The Effects of Integration on the Attitudes of Non-disabled Pupils to their Disabled Peers

Positive attitudes towards children with disabilities are vital for success in integration (Gilfoyle and Gliner, 1985). In this study, the attitudes of pupils at an integrated and non-integrated school were investigated using the Chedoke-McMaster Attitudes Towards Children with Handicaps scale (Rosebaum et al, 1986). This questionnaire is based on a three-dimensional model of attitudes and contains affective, behavioural intent and cognitive components. The relationship between gender and attitude was also investigated.

Results showed that pupils at the integrated school had significantly more positive attitudes to their disabled peers than those at the non-integrated school. At the non-integrated school, those pupils with a disabled relative or friend outside school were found to have more positive attitudes than those without. Gender was not found to be a significant determinant of attitude. Factor analysis revealed that children's attitudes to their disabled peers are influenced mainly by the affective and behavioural dimensions of attitude.     

Enabling or disabling? Students' attitudes toward persons with disabilities.

Persons with disabilities are devalued by society. Occupational therapists may be contributing to this devaluation through their attitudes. This study focused on the attitudes of undergraduate students. From a sample of 223 occupational therapy students and 326 business students at an Australian university, it was found, with the use of the Attitudes Toward Disabled Persons Scale-Form A (Yuker, Block, & Young, 1966), that the attitudes of freshman occupational therapy students did not differ significantly from those of their business-major peers. Furthermore, the occupational therapy students' attitudes did not vary with the years of undergraduate education completed. However, those students who had had contact with persons with disabilities beyond the context of a caregiver-care receiver relationship (i.e., those students who had assumed roles that emphasized valued attributes of the person with a disability) had significantly more positive attitudes than did those students without such contact. Educational curricula must address the issue of students' attitudes and, in particular, the facilitation of valued social role contact with persons with disabilities.     

Attitudes of college students toward sexual behavior of disabled persons.

Empirical data on attitudes toward sexual behavior of disabled persons were gathered from a written, sentence-completion task in which 110 college students engaged. The task consisted of 36 sentence stubs, 18 of which probed attitudes toward sex. To facilitate expression of attitudes rather than values, respondents were instructed to respond rapidly with the first thoughts that came to mind. Responses were scored as positive or negative. Negative responders took significantly less time to complete the sentences than did positive responders. The X2 comparisons of negative responses to 5 pairs of parallel sentence stubs concerned with aspects of sex in general and the same aspects of sex in disabled women yielded statistically significant differences. Four of those differences showed more disapproval of sex for the disabled than for the able-bodied. The 5th difference indicated greater tolerance of homosexual play among disabled girls. On 9 of the 13 sentence stubs concerned with sex and disability, at least 43% of all participants gave negative responses. Similarly, order analysis disclosed that 9 of 10 aspects of sex viewed most negatively were related to sexual behavior by the disabled. It was concluded that attitudes in the sexual revolution have not as yet embraced the disabled even among college students.     

Attitudes of nurse professionals and nursing students towards children with disabilities. Do nurses really overcome children's physical and mental handicaps?

Background:  Many health professionals and nurses, who are involved in the care of disabled children, do not exhibit the essential sensitivity and appropriate attitudes towards them, resulting in a poor quality of nursing care.
Aim:  The objective of this study was to investigate the attitudes of nurse professionals (paediatric nurses) and nursing students towards disabled children.
Patients and methods:  The present study is a comparative study. The sample consisted of 228 first-year nursing students, 90 post-diploma nurses attending MSc degree course and 123 nurse professionals who are employed in paediatric hospitals. After obtaining permission from the hospitals and the educational settings and informing about the subjects of the study, data were collected using the paediatric Attitude Towards Disabled Person Scale (ATDP).
Results:  Overall nurses' attitudes appeared to be poor (mean ATDP score 61.7 ± 14.2). However, the post-diploma nurses had significantly higher ATDP scores than first-year students and paediatric nurses ( P  < 0.001). In addition, first-year students had significantly higher scores than paediatric nurses ( P  = 0.047). Across the sample, females hold significantly more positive attitudes than males ( F  = 9.5, P  = 0.002), while age did not have any significant effect.
Conclusions:  Carefully designed curricula can influence the attitudes of nursing students towards children with disabilities. Special courses for treating disabled children should be integrated to the basic nursing studies. Moreover, continuing hospital education can change paediatric nurses' attitudes towards children with disabilities.     

The impact of humorous media on attitudes toward persons with disabilities

Purpose: To examine the relationship between disability-related humor and attitudes toward persons with disabilities in business students (i.e. “future employers”). Method: Students watched one of two films designed to reduce negative attitudes toward persons with disabilities (one humorous in tone and the other serious in tone) or no film at all, and completed a measure of attitudes toward persons with disabilities. Results: Results indicated that, after controlling for previous contact with persons with disabilities, age, and gender, students who watched the humorous film reported significantly more positive attitudes toward persons with disabilities. Conclusions: Disability humor may be an effective means of positively influencing attitudes toward persons with disabilities in future employers.

Implications for Rehabilitation

• The acceptance and integration of persons with disabilities into society continues to be limited by negative attitudes.

• Previous research has shown that employers with positive attitudes toward persons with disabilities may be more likely to hire a person with a disability than employers with negative attitudes.

• In this study, students who watched a humorous film reported significantly more positive attitudes toward persons with disabilities than students who watched a serious film or no film at all.

• Consequently, it may be beneficial to embed disability humor into job-placement strategies in order to improve attitudes and positively influence hiring decisions.

     

Sex counseling: comparison of attitudes of disabled and nondisabled subjects

The present study compared the views on sex counseling of a group of 103 orthopedically disabled persons and a group of 124 nondisabled persons. Subjects responded to a specially constructed questionnaire covering several issues related to sex counseling. Disabled persons preferred that the counseling be by a physician, rather than by a psychologist or social worker and that the counseling begin as late as ages 16-18, and they were less interested than nondisabled persons in counseling on sexual functioning and establishing a family. The responses of disabled persons were interpreted as indicating their greater anxiety toward the sensitive issue of sex. It was concluded that training programs for professionals--particularly physicians--who deal in sex counseling should include instruction about disabled persons and about the influence of cultural background on clients' attitudes towards sex counseling.     

Attitudes toward people with disabilities caused by illness or injury: beyond physical impairment

This study examined differences in attitudes toward and reactions to individuals with comparable disabilities caused by injury or illness. Participants were students and healthcare professionals randomly assigned to read one of eight vignettes constructed in a between-subjects, full-factorial design: 2 (illness/injury)× 2 (male/female)× 2 (visible/not visible). Participants completed questionnaires measuring reactions to the target person and attitudes toward people with disabilities. We found that both students and healthcare professionals expressed more positive attitudes toward persons with injury-related compared with illness-related disabilities, but that these differences were typically not expressed in reported social encounters with individual disabled persons. The effects of the illness-injury distinction were moderated by sex only among students, with the highest distancing reported from a female with an illness-related disability. Visibility of the disability triggered more social distancing among students, regardless of the injury-illness distinction. We concluded that the illness-injury distinction is a socially and psychologically significant factor.     

The Effect of Video-Based Peer Education on the Social Acceptability of Adults With Tourette's Syndrome

Research has consistently shown that persons with Tourette's Syndrome (TS) are perceived as less socially acceptable by peers than persons who do not exhibit tics. Despite the calls for peer education about the syndrome, little research has actually been conducted to evaluate the effectiveness of peer education in altering the negative social impact. In this study, 112 college students were randomly assigned to 1 of 4 groups. Two groups viewed an educational video about TS and the remaining groups received no education about the syndrome. Next, both groups viewed a video of an actor or actress portraying a person with TS. Subjects were then asked to rate their attitudes toward the actor or actress. Finally, a social proximity measure was taken to assess the actual behavioral impact of the educational video. Results showed that persons who viewed the educational video about TS had more positive attitudes toward persons with TS and chose to sit closer to that person than individuals who did not view the educational video. Implications and suggestions for future research are discussed.     

Validity of self-efficacy as a predictor of writing performance

This exploratory field study examined Bandura's (1977) self-efficacy model to determine how well efficacy expectations predicted writing performance, and whether cognitive (deep processing) and affective (anxiety) variables were related to efficacy expectations. Other variables assessed with respect to efficacy and writing performance were race, sex, an English entrance exam (ACT) score, and locus of control. Subjects were college freshmen enrolled in introductory writing courses. The major findings were that (a) efficacy expectations predicted writing on phase 1 (beginning of writing course) data, but not phase 2 (end of course); (b) depth of processing, locus of control, and anxiety were related in varying degrees to amount of efficacy and to the accuracy of efficacy predictions of writing; (c) subjects significantly overestimated their writing performance, the discrepancy being even larger at phase 2. These results provide partial support for the construct validity of self-efficacy and suggest that cognitive and affective variables influence efficacy.     

Preference Assessment in Toddlers with Mild Developmental and Physical Disabilities: A Comparative Study

In this study, a preference assessment involving presentation of pairs of toys was conducted with 10 toddlers with mild developmental and physical disabilities and a matched control group of 10 nondisabled toddlers. An exploration phase preceded the preference assessment. Our main findings were that (a) the pair-wise presentation method yielded a significant rank ordering of preferences in developmentally disabled toddlers, but not in the nondisabled toddlers; (b) dynamic toys were more preferred than nondynamic toys in disabled toddlers; but not in the nondisabled toddlers; and (c) for both nondisabled and disabled toddlers, the rank order of preferences established by the pair-wise presentation method did not significantly correlate with the rank order of preferences reported by the toddlers' parents and teachers.     

Treatment disparities for disabled medicare beneficiaries with stage I non-small cell lung cancer

Iezzoni LI, Ngo LH, Li D, Roetzheim RG, Drews RE, McCarthy EP. Treatment disparities for disabled Medicare beneficiaries with stage I non-small cell lung cancer.

Objective

To compare initial treatment and survival of nonelderly adults with and without disabilities newly diagnosed with non-small cell lung cancer.

Design

Retrospective analyses; population-based cohorts.

Setting

Eleven Surveillance, Epidemiology, and End Results cancer registries.

Participants

Persons with disability Medicare entitlement (n=1016) and nondisabled persons (n=8425) ages 21 to 64 years when diagnosed with stage I, pathologically confirmed, first primary non-small cell lung cancer between January 1, 1988, and December 31, 1999.

Interventions

Not applicable.

Main Outcome Measures

Initial cancer treatments (surgery, radiotherapy), survival (through December 31, 2001). Multivariable logistic regression and Cox proportional hazards regression estimated adjusted associations of disability status with treatments and survival.

Results

Persons with disabilities were much more likely to be male, non-Hispanic black, and not currently married. Although 82.2% of nondisabled persons had surgery, 68.5% of disabled persons received operations. Adjusted relative risks (RRs) of receiving surgery were especially low for persons with respiratory disabilities (adjusted RR=.76; 95% confidence interval [CI], .67-.85), nervous system conditions (adjusted RR=.86; 95% CI, .76-.98), and mental health and/or mental retardation disorders (adjusted RR=.92; 95% CI, .86-.99). Persons with disabilities had significantly higher cancer-specific mortality rates (hazard ratio [HR]=1.37; 95% CI, 1.24-1.51) than persons without disabilities. Observed differences in cancer mortality persisted after adjusting for demographic and tumor characteristics (adjusted relative HR=1.23; 95% CI, 1.10-1.39). Further adjustment for surgery use eliminated statistically significant differences in cancer mortality between persons with and without disabilities across disabling conditions.

Conclusions

Persons with disabilities were much less likely than nondisabled Medicare beneficiaries to receive surgery; statistically significant cancer-specific mortality differences disappeared after accounting for these treatment differences. Future research must explore reasons for these findings and whether survival of disabled Medicare beneficiaries with early-stage, non-small cell lung cancer could improve if surgical treatment disparities were eliminated.