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.     

Effects of cognitive modeling,affect, and contact on attitudes,thoughts, and feelings toward college students with physical disabilities

One goal of the present study was to evaluate cognitive and affective factors which facilitate problem-free interaction between nondisabled and physically disabled college students by (1) exploring variables related to ease with people who have disabilities, and (2) evaluating the consequences of previous contact with disabled persons. A second goal was to explore the effects of four cognitive modeling interventions on thoughts, attitudes, affect, and self-efficacy expectations in relation to interaction with disabled peers. Results for 126 nondisabled college students indicate that lack of ease with persons who have disabilities is an important contributor to interaction difficulties; individuals who felt ill at ease with disabled college students (1) were more likely to anticipate being uncomfortable when interacting with a peer who has a disability, (2) had lower self-efficacy expectations about interacting in various social situations, (3) had more negative attitudes toward disabled persons, (4) expected to have more difficulty working with a disabled peer, and (5) had more negative thoughts about interacting with a disabled classmate. Previous contact with people who have disabilities was related to the frequency of positive thoughts about interaction but had minimal effects on attitudes or affect. Cognitive modeling was found to be ineffective in changing any aspect of these affective, attitudinal, and cognitive factors. The implications of the results for cognitive assessment and for resolving interaction problems between nondisabled and disabled individuals are discussed.

     

Locus of control in nondisabled versus congenitally physically disabled adolescents.

Locus of control in 13 nondisabled and 8 congenitally physically disabled adolescents was examined with the use of the Nowicki-Strickland Locus of Control Scale for Children (Nowicki & Strickland, 1973a). All subjects with disabilities had IQs within normal limits, used wheelchairs, and could communicate verbally. The two groups were matched in IQ, age, sex, race, and socioeconomic status. It was hypothesized that the locus of control scores for the disabled group would evidence significantly more externality than the scores for the nondisabled group. A Mann Whitney U test was done to analyze the data gathered, and the results were found to be statistically nonsignificant (U = 58.50, p = .635). Adjunct analyses were conducted to explore the percentage of internal and external answers between the two groups. Race was the only variable correlating significantly with locus of control scores (r = .54, p = .05). The study's results suggest that disability is not a significant predictor of externality in adolescents. Persons with an internal locus of control are more assertive and better able to cope with their environment; occupational therapists can offer many therapeutic strategies to persons with an external locus of control for improved function and quality of life.     

Concurrent and construct validity of the Pediatric Evaluation of Disability Inventory

The purpose of this study was to determine the validity of the Development Edition (pilot version) of the Pediatric Evaluation of Disability Inventory (PEDI) in groups of disabled and nondisabled children. The PEDI is a new functional assessment instrument for the evaluation of disabled children aged 6 months to 7 years. The PEDI has been developed to identify functional status and change along three dimensions: 1) functional skill level, 2) caregiver assistance, and 3) modifications or adaptive equipment used. The PEDIs were administered as a parental-report questionnaire, and the results were compared with data obtained by the Battelle Developmental Inventory Screening Test (BDIST). The BDIST is a standardized assessment with developmental and adaptive content. Subjects were 20 children between the ages of 2 and 8 years with arthritic conditions and spina bifida and 20 nondisabled children matched for age and sex. All subjects' scores on the BDIST cognitive domain were no greater than 1.50 standard deviations below the mean for their age group. Concurrent validity was supported by moderately high Pearson product-moment correlations between BDIST and PEDI summary scores (r = .70-.80). Construct validity was supported by significant differences between the disabled and nondisabled groups' PEDI scores and by discriminant analysis identifying the PEDI scores as better group discriminators than the BDIST scores. Results validate the Developmental Edition of the PEDI and support the further development and standardization of the final version. Use of the PEDI in clinical pediatric physical therapy practice is discussed.     

Changing approaches to methodology of research in special education

The author discusses the methodology applied in research in special education in Poland in the past and proposes new approaches in this respect. In the past the researchers concentrated rather on observation of disabled children with the same kind of disability; quantitative measurements were rarely applied. Objective data on personality traits and behaviour of disabled persons can be obtained by comparative studies of disabled with nondisabled people, using scientific methods. Such studies were conducted in 1976-1980 at Warsaw University, covering such problems like life goods, self evaluation, methods of teaching, outside-class activities, upbringing in disabled families, social activity and organization of special education. It appears from this approach that there are far more common than so called "specific" problems between the disabled and nondisabled. The identification of "common denominators" is the basis for decategorization of our perception of the disabled, for the development of adequate services for these people, and for their integration and normalization within society.     

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.     

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.     

Disability among schizophrenics in a rural community: services and social support.

Formerly hospitalized schizophrenics referred to a rural North Carolina Community Mental Health Center for aftercare were interviewed for evidence of disability in social functioning and for information on the extent and quality of their community ties. Of the 103 respondents, 25% were classified as severely disabled. Inadequate functioning was significantly (r < .001) associated with a low level of social support, whether this was measured by the amount of recent interaction with associates or by qualitative indices of respondents' beliefs about and attitudes toward intimates. Psychiatric treatment histories for these respondents were summarized from service records. There were no statistically significant differences between the disabled and nondisabled on the basis of duration or number of hospitalization experiences, amounts or categories of outpatient care, or intake of medication. The two groups were similar in terms of age, sex, and race.     

Environmental access to a rehabilitation center as a determinant of attitude to handicapped persons? A comparative empirical study of assumptions of the "contact hypothesis"]

A total of 263 respondents were interviewed relative to their attitudes towards disabled persons, using a standardized questionnaire. Of these 263 subjects, 144 lived in a community without any facility for disabled persons in the vicinity, 119 subjects lived close by a physically disabled persons centre. The "attitudinal climate" among all interviewees on the whole more on the positive side, it was found that those living in the vicinity of a physically disabled persons centre, though expressing less contact uneasiness when meeting physically handicapped children and young people, did however not give more positive--but neither more negative--opinions in other respects than those subjects not living near a facility for the disabled. The results obtained were further analyzed on the variables of age, sex, and closer contacts with disabled people among friends. It has, once again, been confirmed that attitudes toward disabled persons constitute a multidimensional construct that, to varying degrees, is influenced by a number of factors. Some consequences and considerations in terms of educational implementation possibilities of the findings are outlined in conclusion.     

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.     

Environmental barriers experienced by amputees: the Craig Hospital Inventory of Environmental Factors-Short Form

OBJECTIVES: To describe the prevalence of perceived environmental barriers in a population of amputees; to compare and contrast those barriers reported by amputees with reported barriers of a sample of disabled and nondisabled persons; and to identify the correlates of barriers among amputees. DESIGN: Cross-sectional survey. SETTING: A community sample who were interviewed by telephone. PARTICIPANTS: A stratified sample by etiology of 914 community-dwelling persons with limb loss. INTERVENTION: Telephone interview. MAIN OUTCOME MEASURES: Frequency (never, less than monthly, monthly, weekly, daily) and magnitude (little problem, big problem) of perceived environmental barriers in 5 domains as measured by the Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), characteristics of the amputation, prosthetic use, and sociodemographic characteristics of the amputee. RESULTS: The majority (87%) of persons surveyed reported barriers in 1 or more areas with 57% reporting barriers in 4 or more of the 5 domains (policies, physical/structural, work/school, attitudes/support, and services/assistance subscales). Mean frequency-magnitude scores were lower for amputees with cancer-related amputation across all subscales, while traumatic amputees reported the greatest perceived barriers, except in the area of services/assistance. Across all domains, poverty level and comorbidity were significant predictors of significant barriers (CHIEF-SF score >/=3; range, 0-8). When compared with a general population sample of disabled and nondisabled Americans, amputees were more likely to perceive barrier in all areas except work/school. CONCLUSIONS: Perceived environmental barriers among persons with limb loss are highly prevalent. Reduction of environmental barriers may lead to reduction of disability and improvement of overall quality of life for amputees.     

福利院残疾人生活自理能力行为训练效果观察

目的 :观察福利院残疾人实施生活自理能力行为训练的效果。方法 :按病种随机将 6 6例残疾人分为训练组 32例 ,对照组 34例 ,均为男性 ,训练组用行为纠正方法进行训练 ,内容包括 :基本生活自理能力 (如吃饭、二便、起居 )及社交能力 ,用日常生活能力量表评定疗效。对照组采用传统护理方法。结果 :训练 2个月后开始起效 ,到 6个月训练结束时效果最好 ,训练后 2组差异有高度显著性 (P <0 0 1)。结论 :用行为纠正方法训练福利院残疾患者效果良好 ,生活自理能力显著提高     

Disabled and nondisabled infants' interactions with their mothers

This study investigated social interactions between infants and mothers, comparing dyads with physically disabled infants and dyads with nondisabled infants. The groups were matched on mental and motor development, sex, socioeconomic status, birth order, and maternal education. Each infant-mother dyad was videotaped at home during a 10-minute period of free play, and blind observers subsequently transcribed infants' and mothers' behaviors. In general, the groups were remarkably similar in their interaction patterns. However, a few differences emerged: Mothers of infants with physical disabilities were significantly more commanding than were comparison mothers. Nondisabled infants tended to engage in more eye contact than did infants with physical disabilities. And whereas mothers of nondisabled infants responded to interactive play with interactive play, mothers of infants with physical handicaps tended to respond with commands and verbalizations. These results suggest reciprocal influences between infants and mothers in both groups and highlight emerging maternal behavior patterns that may interfere with the development of communication and independence in handicapped young children.     

Predicting outcome of group counseling with severely disabled patients

Client characteristics associated with outcome of group counseling were identified in a sample of physically disabled persons using standardized self report inventories. Thirty-eight subjects were tested before and after an 8 week treatment interval for signs of emotional disorder, inactivity, and social problems related to being severely disabled. Treatment consisted of group conference phone calls using self determined task assignments as a focus for discussion. Change in report of life satisfaction was predicted reliably from pretest data. Loneliness accounted for 73% of the variance in posttreatment life satisfaction scores. Other significant predictors included signs of depression, alcohol use, and constructs related to social support. Using regression analysis, persons with adjustment problems could be identified and prognosis for treatment predicted with acceptable reliability.     

Are prejudices against disabled persons determined by personality characteristics? Reviewing a theoretical approach on the basis of empirical research findings

Taking as point of departure the results obtained from research on prejudice, many authors believe that the quality of attitudes toward disabled persons is influenced by the personality structure of the nondisabled. In order to verify this assumption, a secondary analysis of 67 empirical studies was undertaken. These studies referred to different personality variables such as authoritarianism, ethnocentrism, dogmatism, rigidity, intolerance of ambiguity, cognitive simplicity, anxiety, ego-weakness, self-concept, body-concept, aggressiveness, empathy, intelligence, etc. The results can be summarized as follows: Statistical criteria show that single personality traits have relatively little influence on the attitudes towards disabled persons. An adequate evaluation of the research findings is complicated by, at times, considerable methodological problems which arise when applying the proper test instruments to non-clinical populations. Marked correlations are to be found in particular in the case of authoritarianism, ethnocentrism, intolerance of ambiguity, anxiety, and ego-weakness. The intercorrelations, however, between most of the personality variables are rather high, which by cumulation of "extreme" factors may, in fact, sometimes result in particularly unfavorable attitudes toward the disabled. Thus, personality-related research findings to provide certain valuable explanations. Special attention should be devoted to the multiple connections between personality structure and social structure.     

Patient characteristics and end-of-life health care utilization among Medicare beneficiaries in 1989 and 1999

OBJECTIVE: To evaluate the association of institutional residence and chronic disability with end-of-life Medicare utilization in 1989 and 1999. RESEARCH DESIGN: Retrospective study of nationally representative survey data linked to Medicare claims. SUBJECTS: Medicare beneficiaries who completed the National Long-Term Care Survey in 1989 or 1999 and died within 1 year. MEASURES: Medicare utilization [hospital, hospice, and skilled nursing facility (SNF)] in the last year of life and at death among the nondisabled, chronically disabled, and institutionalized. RESULTS: Medicare utilization over the last year of life was similar in 1989 and 1999 for the proportion hospitalized in all groups (eg, 76% vs. 73% among the nondisabled); there were significant increases in SNF use (eg, 9% vs. 20% among the nondisabled). Comparisons at the time of death were somewhat different, with significant increases in hospice use in all groups (eg, 4% vs. 22% in the nondisabled); there was a significant decrease in the proportion dying in the hospital only for the nondisabled group (53% vs. 40%). Utilization was similar for the nondisabled and chronically disabled, but was lower in the institutionalized (eg, proportion hospitalized in the last year of life was 51% in the institutionalized, 73% in the nondisabled, and 77% in the disabled group in 1999). CONCLUSIONS: Despite dramatic growth in hospice use, hospital and SNF utilization generally did not decline. Institutional residence, which is not usually included in analyses of Medicare claims, was strongly associated with utilization. This may affect the usefulness of claims-based efficiency indicators.     

Cognitive therapy to achieve personal goals: results of telephone group counseling with disabled adults

Physical disability alters a person's lifestyle and can be detrimental in its effects on mood and activity. We describe a counseling program for severely disabled persons who participated in cognitive therapy by telephone. Therapy involved solving problems related to personal dissatisfaction, loneliness, or depression. The treated group reported significantly less loneliness after treatment and were observed by their families to demonstrate more social role skills than the control group. High goal attainment reported by the treated groups was significantly correlated with decreased loneliness, positive changes in social role skills, and family expectations. Treating affective problems with scheduled telephone contact should be further evaluated because of the observed effectiveness and potential for reaching homebound clientele.     

Parents' perceptions, attitudes, and needs regarding sex education for the child with myelomeningocele.

Nurses working in a multidisciplinary outpatient clinic for children with myelomeningocele desired to learn more about parents' ideas and needs in the area of sex education. Private interviews were conducted with 52 parents, using a structured interview guide. Mothers were seen as the main sex educator for girls, whereas both parents were seen as sex educators for boys. Sixty percent of the parents believed that sex education should begin during the school-age years. Lack of adequate knowledge about their child's potential for sexual functioning was perceived by all parents. Parents' responses indicated a need for clinic staff to “open the door” to discussing sexuality and a need for realistic guidance about their child's sexual potential. Parents indicated that they saw the referral hospital as a more helpful resource than local resource persons, and selected means by which they and their children might learn more about sexuality from clinic staff. Based on information gathered in the study, clinic staff can plan a teaching and counseling program to help parents become more effective sex educators.     

Health-care utilization by disabled persons: A survey in rural Bangladesh

The purpose of the present study was to examine the utilization of health services by disabled persons in rural Bangladesh and to identify associated factors to inform the development of appropriate health services. Household surveys were conducted in two villages of Bangladesh by a trained primary-care specialist who lived in the study area for 4 months. About 81% of the sample had utilized some form of health care with more than half consulting unqualified practitioners of modern medicine. Disabled persons whose families perceived they were disabled were 14 times more likely than others to seek treatment. Being male and in the economically productive age group, having an acquired disability and having some form of belief about disability causation were associated with utilization. The conclusions of the study are that social and cultural barriers prevent certain groups, notably women and demographically dependent age groups, from accessing health care. Those who are economically beneficial to the family usually utilize health services. A combination of educational and economic initiatives such as a disability benefits allowance would strongly promote the health of disabled persons and create a general awareness of disability in Bangladesh. A long-term programme which includes disability training for health-care workers and use of financial institutions and existing local government infrastructure for intensive rehabilitation will improve quality of life for disabled persons and is proposed for urgent implementation.