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.     

Attitudes towards disability in an undergraduate nursing curriculum: the effects of a curriculum change

Through improved technology and treatment and ongoing de-institutionalisation, nurses will encounter growing numbers of people with disabilities in the New Zealand community and hospitals. Quality of nursing care is influenced by attitude and this study was to evaluate the effect of a curriculum change on the attitudes of two different streams of student nurses towards people with disabilities. During the year 2002 a focused disability unit was introduced to the revised undergraduate nursing curriculum of a major educational institution in New Zealand. The opportunity arose to consider student nurses' attitudes toward disabled people, comparing two streams of students undertaking two different curricula. A convenience sample of students completed the attitudes toward disabled persons questionnaire form B (Yuker, H.E., Block, J.R., Younng, J.H., 1970. The Measurement of Attitudes Toward Disabled Persons. INA Mend Institute, New York), prior to and on completion of their relevant disability unit. No statistically significant difference in scores was demonstrated. A number of possible reasons for this are suggested.     

A systematic review of disability awareness interventions for children and youth

Purpose: Children’s lack of knowledge about disability can adversely impact their attitudes toward people with disabilities. The purpose of this study is to review the common elements of effective disability awareness interventions. Methods: A systematic review of disability awareness interventions for children and youth was conducted to assess the effective components of these interventions. Electronic searches were conducted using OVID, CENTRAL, PsychInfo, ERIC, Social Science Citation Index, GreyNET Scopus and Google Scholar. The inclusion criteria included (i) an intervention raising awareness about disability, (ii) school-age children with the average age between 5–19 years old, (iii) at least one measurable outcome focusing on knowledge about disability or attitudes towards and/or acceptance of people with a disability and (iv) published article or grey literature. Results: Of the 1031 articles that were identified in the search, 42 met the criteria to be included in the review. We classified the disability awareness interventions into 5 broad types including (i) social contact, (ii) simulation, (iii) curriculum, (iv) multi-media curriculum and (v) multiple components. Thirty-four studies showed an improvement in attitudes towards and/or acceptance of peers with disabilities. Eight of these studies also demonstrated an improvement in knowledge of people with disabilities. Five of the interventions found no support for improving knowledge about, or acceptance of people with disabilities. Conclusion: Disability awareness interventions can successfully improve children’s knowledge about and attitudes towards peers with a disability; they should include several different components over multiple sessions. Relevance: These findings are being used to further develop disability awareness interventions to help improve the social inclusion and participation of children with disabilities within mainstream classrooms.

Implications for Rehabilitation

• Well-designed disability awareness interventions for children and youth can help improve knowledge about disability, attitudes towards people with a disability and acceptance of peers with a disability.

• Rehabilitation health care providers and educators should be trained to recognize when children with disabilities are being socially excluded and be prepared to provide or recommend appropriate resources and interventions on how to address this issue.

• Clinicians, educators and children with disabilities should all be involved in the development of disability awareness programs.

• Educators should carefully choose an appropriate intervention to meet the needs of the children in their class while considering age appropriateness and diversity of the students. It is also important for educators to be cognizant of the broader societal influences that impact attitudes towards disability.

     

DO OUTPATIENT PHYSIOTHERAPISTS IN WALES HAVE ADEQUATE KNOWLEDGE AND EXPERIENCE OF INTELLECTUAL DISABILITY

As people with an intellectual disability are resettled from institutions, the likelihood increases that physiotherapists working in outpatient departments will have patients who have an intellectual disability. This study, therefore, sought to establish from a sample of 88 outpatient physiotherapists the degree of their knowledge of the All Wales Strategy for the Development of Services for the Mentally Handicapped, die adequacy of their experience and knowledge to treat this particular client group effectively and their attitudes towards people with intellectual disabilities. Although physiotherapists were generally aware of the principles of the AWS, 88% did not know its specific objectives. They had very little experience and knowledge of intellectual disability, 77% believing themselves inexperienced. Nevertheless, a large majority held positive attitudes towards this client group and agreed in principle with integration into the community. Training with respect to people who exhibit challenging behaviour was identified as necessary.     

Attitudes towards disability in an undergraduate nursing curriculum: a literature review

In the process of introducing a new disability unit into an undergraduate nursing curriculum in a New Zealand educational setting, the opportunity arose to conduct a small study comparing the attitudes of student nurses towards people with disabilities. This paper discusses the literature reviewed, which formed the basis for the study. A range of perspectives and research was identified that explored societal and nurses' attitudes, disability studies in undergraduate nursing curricula, the impact of nurses' attitudes on patient care, and interventions for changing those attitudes. Effective nursing care can be severely compromised through negative attitudes, and concerns are expressed at the lack of attention given to this issue in nursing curricula generally. The literature showed that combining educational approaches with opportunities for student nurses to interact with disabled people provides the most effective means for student nurses to develop positive attitudes towards disabled people. The goal for nurse educators is to ensure the inclusion of disability studies as a core component in undergraduate nursing education.     

Public Attitudes towards People with Intellectual Disabilities: A Qualitative Comparison of White British & South Asian People

Background National and international polices promote the acceptance, integration and inclusion of people with intellectual disabilities into mainstream society. However, there is little systematic research into general population attitudes towards people with intellectual disabilities, and even less research, which considers the impact of culture on attitudes. The aim of this study was to explore how young people from White British and South Asian backgrounds differ in their attitudes towards people with intellectual disabilities and above all, how they arrive at their beliefs. Materials and Method A qualitative design utilizing focus groups and individual interviews with White British and South Asian adolescents aged 16–19 years (N = 61) was employed. Questionnaire data were collected to compare this sample to findings from a larger study run concurrently (Attitudes to people with intellectual disabilities: a cross cultural study. Thesis, University College London). Interview and focus group data were analysed using thematic analysis. Results Thematic analysis yielded five themes and pointed to widespread confusion about the concept of ‘intellectual disability’, not helped by the continuing invisibility of people with intellectual disabilities in the media. Participants expressed many positive beliefs, yet closer analysis revealed that underlying these may be more ambivalent or even hostile attitudes. Key differences between the two cultural groups are discussed. Conclusions The findings highlight the need for raising public awareness and the importance of culturally sensitive support.     

Children’s contact with people with disabilities and their attitudes towards disability: a cross-sectional study

Purpose: To explore the association between children’s self-reported contact with people with disabilities and attitudes towards them, as well the potential mediating influence of anxiety about interacting with people with disabilities and empathy for them. Method: 1881 children, aged 7–16 years, from 20 schools in South West England completed a survey assessing their contact with people with disabilities and their attitudes towards them. Anxiety about interacting with people with disabilities and empathy towards them were examined as potential mediators. Gender, school year, perceived similarity between people with and without disabilities, proportion of children with additional needs at the school and socioeconomic status (SES) were assessed as moderators. A random effects (“multilevel”) regression model was used to test the contact–attitude association and moderation, and path analysis was used to test for mediation. Results: Participants with more self-reported contact reported more positive attitudes towards disability (p?Conclusions: Self-reported contact was observed to be associated with more positive attitudes towards disability, which was partially mediated by empathy and anxiety. Providing opportunities for contact with people with disabilities that reduces anxiety and increases empathy may improve attitudes to disability and merits evaluation in interventions.

• Implications for Rehabilitation

• Children who reported greater levels of contact with people with disabilities had more positive attitudes towards disability.

• Anxiety about interacting with people with disabilities and empathy towards them partially mediated the contact–attitude associations.

• Providing opportunities for contact with people with disabilities, reducing anxiety and increasing empathy may improve children’s attitudes to disability.

     

Attitudes of High School Students toward their Classmates with Severe Disabilities: a Pilot Study

Calls to expand inclusive education for students with severe disabilities are pervasive throughout recent policy and research initiatives. The perspectives of peers without disabilities on such inclusion are an important vantage point to understand, particularly at the high school level. In this pilot study, we examined the attitudes of 44 high school peers who were enrolled in general education classes with students with severe disabilities. Overall, these peers reported fairly high levels of exposure and contact with students with severe disabilities. Moreover, they largely endorsed positive attitudes towards adolescents with severe disabilities and inclusion. However, significant gender differences were found, with females demonstrating more positive attitudes than males. We discuss implications for research and practice focused on enhancing positive attitudes toward and relationships among students with and without severe disabilities at the high school level.     

Attitudes towards people with disabilities across different healthcare undergraduate students: A cluster analysis approach

Background and Purpose

Negative attitudes towards disability amongst healthcare professionals endanger social inclusion of people with disabilities (PwD). This study aimed to investigate the attitude of undergraduate healthcare students of various disciplines towards PwD, including specific aspects of their attitude.

Methods

We assessed the attitudes of university students, including physiotherapy, speech therapy, nursing, social work and medical students, through the Greek Interaction with Disabled Person Scale (IDPS) in a survey. Data were analysed using a two-step clustering technique.

Results

Four hundred-eighty undergraduate healthcare students (21.4 ± 5.3 years-old; 135 males, 345 females) were recruited. Two-step cluster analysis identified three homogenous subgroups labelled Least positive attitude (42.3%), Moderately positive attitude (26.9%), and Most positive attitude (30.8%) groups. Τhe main differences in healthcare students' attitudes between the three distinct groups appeared to be in feelings of sympathy, fear and susceptibility towards disability, suggesting that these aspects of attitude needed to be primarily addressed. Results also revealed that females, being in higher semester/year of studies, having completed a clinical module with PwD and having frequent contact with PwD were related to more positive attitudes.

Conclusion

Taking into account that the majority of the healthcare students' sample yielded least and moderately positive attitudes, towards PwD, further actions should be taken for promoting more positive attitudes towards disability. A social model in teaching to increase student's awareness of PwD and skills to work with these people, having PwD themselves teaching such modules, focussing on positive experiences and reminding the students of the benefits of having positive attitudes towards PwD, as well as promoting ways to increase the contact of healthcare students with PwD (such as teaching in co-operation with organisations of PwD or finding alternative clinical placements with PwD), can be beneficial in promoting more positive attitudes towards disability.     

Attitudes Toward Disability

The work of health rofessionals is directly influenced by somatopsychological attitudes. Expectations from the disabled person, from health professionals, and from society play an important part in adjustment to disability. Role theory has helped us look at the "sick role" versus the disabled role and we now realize that role confusion often interferes with the adjustment process. It is important that students be made aware of these different theories to help them get in touch with their own feelings about disability and develop an understanding of attitudes which will facilitate the adjustment process. An instrument measuring attitudes toward the disabled was administered to two successive junior occupational therapy classes, at the beginning and the end of the school year. Change in attitudes was analyzed and positive significant results were discussed in relation to implications for education and practice.     

Knowledge of and attitudes towards resuscitation in New Zealand high-school students

Background

Introducing cardiopulmonary resuscitation (CPR) training in the high‐school curriculum has been widely recommended as a long‐term strategy to educate the wider community. Although CPR has been included in the New Zealand school curriculum, it is listed as an optional subject only.

Aim

To assess the attitude towards and knowledge of CPR in 16–17‐year‐old high‐school students in New Zealand.

Methods

Questionnaires were administered to 494 students aged 16–17 years across six high schools in Wellington, New Zealand. Both knowledge and attitude were evaluated in the questionnaire.

Results

Students showed poor theoretical knowledge, with a mean (SD) score of 5.61 (2.61) out of a maximum score of 18. Although there was no difference between male and female students, those who had received previous first‐aid training (70%) showed greater knowledge (6.04 (2.56)) than their untrained counterparts (4.91 (2.24); p = 0.001). Those students with a positive attitude towards CPR and first‐aid training (63%) acquired a higher knowledge score (6.12 (2.4)) than those with a negative attitude (17%; 4.65 (2.5); p = 0.001). Students with negative associations were also less likely to want to learn more about CPR and first aid (11%) when compared with those with positive associations (92%), and indicated less willingness to perform CPR on a stranger (negative v positive, 47% v 70%).

Conclusions

These findings suggest that although most high‐school students are willing and motivated to learn CPR, a smaller percentage of students had a negative attitude towards CPR that would act as a barrier to future learning or performance of resuscitation. Introducing CPR training to high schools is still recommended; however, this study shows the need to associate this training with positive references in an attempt to assist those for whom negative attitude may present as a barrier to learning and retaining CPR knowledge.Survival from out‐of‐hospital cardiac arrest is dependent on the rapid institution of bystander cardiopulmonary resuscitation (CPR), and the early arrival of advanced rescuers and equipment. Bystander CPR, combined with rapid activation of emergency medical services, increases survival rates from sudden cardiac arrest 2–3‐fold.¹The importance of CPR and basic emergency care is recognised in New Zealand by the inclusion of these subjects in the school curriculum, albeit as an optional subject,² and by the Department of Occupational Health and Safety in the aspect of workplace first‐aid training. In a previous study of an adult population in Wellington, New Zealand, we found that 74% of the general population had received CPR training, although for most this was more than 5 years previously, and the level of knowledge retained on how to perform CPR was extremely low. Despite low levels of knowledge, we found that most subjects had an extremely positive attitude regarding the importance of CPR.³Previous international studies have shown that children of school age are more likely to accept CPR training than older citizens,⁴ are motivated to learn, and do so quickly and easily.^5,6 The importance of first‐aid education in the school context has often been emphasised, both as a means of educating a wide cross section of society,⁷ and as a way of imparting a positive attitude towards CPR that may lead to an increased value of CPR as a skill later in life.Given the potential importance of training high‐school students, we conducted this study to investigate the level of knowledge of CPR in 16–17‐year‐old school students, and to examine their attitudes towards CPR.     

Medical students' attitudes about complementary and alternative medicine

OBJECTIVE: To compare the attitudes about complementary and alternative medicine (CAM) of medical students from two different medical schools and at different stages of their medical training (first and third years). DESIGN: Four-group, cross-sectional, self-administered survey study. SETTINGS AND SUBJECTS: Three hundred and eleven (311) students from two British medical schools (Newcastle and London). OUTCOME MEASURES: Self-reported knowledge of, attitudes about, and beliefs about CAM. RESULTS: Third-year students thought CAM overall was less effective than first-year students and also were significantly less interested in training in CAM techniques. The 43 attitude statements factored into six interpretable factors. A medical school x year ANOVA on the factor scores showed many results consistent with the first part of the study. First-year students seemed more eager to be taught CAM than third-year students, and students at Newcastle were more positive about CAM than those at University College London. CONCLUSIONS: Education at medical school does influence attitudes to CAM. As their orthodox medical training proceeds, medical students seem to increase their skepticism about CAM.     

Taiwanese adolescents' gender differences in knowledge and attitudes towards menstruation

The purpose of the study was to explore gender differences in knowledge and attitudes towards menstruation among Taiwanese adolescents. This study was a secondary data analysis of a cross-sectional comparison study conducted in Taiwan. A total of 287 female and 269 male students at a junior high school participated in the study. The results showed that almost all the students had heard about menstruation and most of them had received menstrual information at school. However, their knowledge about menstruation was not accurate. Moreover, the male students expressed more negative attitudes towards menstruation than the female students. Taboos were heard by most students and, although many female students doubted the reality of the taboos they had heard, they observed them anyway. The study calls for an evaluation of sex education and suggests more open discussions about menstruation among young people in those education sessions. In addition, school nurses and obstetrical/gynecological nurses should be involved more in adolescents' sexual education.     

Photographs of the ageing body in a nursing journal: a profession’s response

In New Zealand in 2006, a professional photographer undertook a photo essay of residents and staff in an aged care residential setting. The photographer captured the ‘lifeworld’ of the institution through photographing the images of daily life. The resulting photo essay, which included some photographs of older people naked and in semi‐dress, was published in New Zealand’s principal nursing journal in May 2006. There ensued an unprecedented reaction that divided New Zealand’s nursing world. In this paper, I explore possible meanings of the ‘photo furore’, through discourse analysis of the numerous letters to the nursing journal editors. These letters reveal reactions and opinions from both ‘sides’– rejection and disapproval, acceptance and approval – as the situation developed into dichotomy. In this paper, the further aim is to address the issue of attitudes and reactions of the exposed ageing body from theoretical perspectives. Results reveal conflicting discourses and attitudes within nursing towards photographs of the ageing body and underlying this, how nurses believe older people should be thought about and cared for. These attitudes are wide‐ranging and, on the one hand, include ageism and a desire to protect and supervise older people versus a greater tolerance and acceptance of older people as competent, autonomous beings.     

Measuring perceptions of the clinical career pathway in a New Zealand hospital

Clinical Career Pathways (CCPs) for nurses were introduced in the 1970s and they were first established in New Zealand during the late 1980s. The implementation of CCP programmes has met with mixed response; many nurses view it negatively as an extra and unnecessary demand from their employers while others perceive it to be a valuable form of professional development. This paper introduces a new instrument, the Clinical Career Pathway Evaluation Tool (CCPET) designed to assess nurses' and midwives' knowledge of and attitudes towards their Clinical Career Pathway. The 51 item instrument takes the form of a self-report questionnaire in two sections. The first tests knowledge of the CCP, as implemented at the study hospital, the second measures attitudes towards CCP and professional development. In this paper we describe the development of the CCPET and present some of the results from an initial application of the instrument with 239 nurses and midwives in a New Zealand hospital. Results indicate that knowledge levels were moderate in this sample and were correlated with both positive and negative attitudes. Results of t-test comparisons indicated that, on average, the group who had already completed a CCP portfolio had greater knowledge and more positive attitudes than the group who had not. The authors suggest firstly that the CCPET is useful for measuring CCP knowledge and attitudes in a constantly restructuring nursing environment, and secondly that the instrument can be easily adapted for use in other hospitals and organisations.     

Curricula oriented inclusion of children and adolescents with haemophilia in school sports - A new approach within the project "fit for life"

Inclusive paedagogic thinking and acting is a modern and increasingly important topic in school sports. It will affect teachers as well as parents and students. The new international guidelines and national curricula enable new ways of inclusion especially for students with chronic illnesses like haemophilia. Special help from the sport teachers is of vital importance. In our project "fit for life" where we advice children and young adults with haemophilia to find their appropriate sport, we developed a new approach for an optimised inclusion of children with haemophilia into sport lessons. The whole project is running in corporation with the German Sport Teachers Association/Hessen. We analysed and rated the actual curricula of the different school years and looked at the specific needs, risks and necessary abilities for persons with haemophilia. By this means we gathered about 600 typical movements and/or exercises for school sports and developed individual advice and adapted exercise solutions for sport lessons.     

‘If We are Going to Include Them We have to do it Before We Die’: Norwegian Seniors’ Views of Including Seniors with Intellectual Disability in Senior Centres

Background Concepts of inclusion and participation are at the core of both international and Norwegian policy for people with intellectual disability. The aim of this study was to identify senior centre users’ views of the barriers and solutions to the inclusion of seniors with intellectual disability in community senior centres. Method Thirty seniors without intellectual disability participated in one of four focus groups. The groups were recorded and transcribed verbatim. Data were analysed for themes using the constant comparative method of qualitative analysis. Results Major themes included benefits, perceptions of people with intellectual disability, barriers and solutions to inclusion, need for support and need for information. Conclusions The findings suggest that participants agreed that seniors with intellectual disability could benefit from being a senior centre user. Consideration must be given to this group’s need for assistance, staff education, economic resources and ways to overcome negative community attitudes towards people with intellectual disability.     

Cognitive dissonance and undergraduate nursing students' knowledge of, and attitudes about, smoking

BACKGROUND: Smoking is a major cause of morbidity and mortality. Although nurses have an important role in health promotion, and are well placed to see the harmful effects of tobacco smoking, studies suggest that they smoke at much the same rate as the general population. AIM: The aim of this paper is to report a study examining undergraduate nursing students' knowledge about the impact of smoking on health, and their attitudes towards smokers and smoking. METHODS: The study took place in 2001, using a non-probability sample of 366 undergraduate nursing students from an Australian university. Participants completed the Smoking and Health Promotion instrument. Festinger's theory of cognitive dissonance provided an explanatory framework for the findings. RESULTS: Most respondents who were still smoking began the habit while in high school. Students had greater generic than specialized knowledge about the effects of smoking on health, and there was no significant difference between second and third year students' knowledge. Those who still smoked had less favourable attitudes towards smoking-related health promotion than those who had never smoked or stopped smoking. Non-smokers were more supportive of non-smokers' rights than those who continued to smoke, while those who had stopped smoking were undecided. There was minimal association between levels of knowledge and attitudes about being sensitive to smoking-related health risks. CONCLUSION: The findings have implications for both high school education and undergraduate nursing education, and for the recruitment of students to undergraduate nursing programmes. More attention needs to be given in undergraduate nursing programmes to smoking and smoking-related illnesses, and to nurses' role in smoking health promotion.     

An evaluation of the effectiveness of an educational and experiential intervention on nursing students' attitudes towards older people

Objectives.  This paper reports the results of a study that aimed to evaluate the effectiveness of an educational and experiential intervention on nursing students' attitudes towards older people.
Background.  With repeated exposure to very sick older people in hospitals or nursing homes, nursing students are at risk of adopting stereotypical views about this section of the population as frail and dependent.
Design.  A pre- and post-test design was used to conduct the study.
Methods.  Using Kogan's Attitudes Towards Old People Scale, the attitudes of nursing students were tested at the beginning of a degree programme in Adult Nursing ( n  = 130) and one year later ( n  = 94) following a series of visits to a well-older person in the community.
Results.  Nursing students reported positive attitudes towards older people and these were retained throughout the first year of their nurse training. No statistically significant differences were found associated with any of the five independent variables in either pre- or postintervention students.
Conclusions.  The attitudes of nursing students towards older people remained positive. While it is possible that the experiential and educational interventions utilized in this study may have contributed to the retention of positive attitudes, further research is required to test this hypothesis.
Relevance to clinical practice.  Nurses have a major role to play in responding to the health and social care needs of older people and their families. The cultivation of positive attitudes is a key factor in enabling practising nurses to respond to this challenge.     

Knowledge of,attitudes towards,and willingness to care for sex workers: Differences between general and mental health nursing students

BackgroundIt is not common in most nursing education programmes to teach students how to care for sex workers. Little is known about whether nursing students are prepared to care for sex workers upon graduation.ObjectivesThis study aims to explore and compare students in the general and mental health nursing programmes in Hong Kong in terms of their knowledge of, support for the human rights of sex workers; attitudes towards, and willingness to care for sex workers. This study also aims to explore the factors associated with attitudes towards and willingness to care for sex workers among all nursing students, general nursing students, and mental health nursing students.MethodsA cross-sectional study. Undergraduate nursing students were invited to participate in an online survey in 2019.ResultsA total of 317 students completed the questionnaire. The students had little knowledge of sex workers, and their attitudes were polarized. Their attitudes towards sex workers and their support for the human rights of sex workers were significantly associated with their willingness to care for sex workers. A perceived need for education relating to caring for sex workers was positively associated with attitudes towards sex workers and a willingness to care for them. Final year students had a more positive attitude towards sex workers than first-year students.ConclusionThe study may contribute to the development of a nursing curriculum for the promotion of non-judgmental care for sex workers or disadvantaged client groups.