Disability Attitudes Research Articles

‘George’s Gymnastics Program’, a Community Gymnastic Program for Children with a Disability: Perceptions of Participant Stakeholders

Background: The aim of this study is to understand what children with a disability like and dislike about participating in a gymnastics program, and to understand the views of the adults supporting the program. Methods: Children with a mild intellectual disability (aged 5–12) from a primary school providing special education participated in one of four gymnastics programs (1 h/week for 5 weeks) at a gymnastics centre. The program included ~25–50 children per group, with ~20 adults providing support, including gymnastics coaches, teachers, and adult students on placement. To evaluate the program, children (11–12-year-olds; n = 51) were invited to complete a written two-page reflection, and the adults were invited to participate in one of three focus groups. Results: 150 children attended one of four programs. Twenty-six 11–12-year-olds participated in the evaluation (n = 26/51, 51%), and, from the written responses, the themes of ‘individual preference’ and ‘resilience’ emerged. It was found that 96% (n = 25/26) reported they would like to do more gymnastics, 88% (n = 23/26) reported positive feelings during gymnastics, and 65% (n = 17/26) expressed concerns such as feeling tired or hot. Twenty-three adults participated in a focus group. Key themes included the positive impact the program delivery had on the children’s participation; and the positive impact on coaches, students, and teacher’s disability attitudes and knowledge. Conclusions: This gymnastics program was well-liked by children with a disability. To optimise participation, promoting individual choice and control may be of benefit.

Disability attitudes in healthcare scale: translation and cross-cultural validation into Arabic using various medical samples

Purpose Cross-cultural adaptation of the Disability Attitudes in Health Care Scale (DAHCS) into Arabic to assess the attitude toward people with disabilities. The objective of this study was to: firstly, translate and cross-culturally adapt the DAHCS into Arabic and secondly, assess its psychometric properties. Further, the goal was to investigate bachelor medical students’ and doctors’ attitude toward people with disabilities and highlight the need to establish the scale’s reliability and validity by employing various samples. Methods A convenience sample of 201 medical students and 105 doctors was used. Arabic DAHCS factors were extracted and confirmed by Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA). Results The findings revealed that medical professionals and students hold a positive attitude toward people with disabilities. The Mann-Whitney U and Kruskal-Wallis tests revealed no significant differences in the study’s variables. EFA identified four factors. CFA showed a good fit to the model. Also, convergent and discriminant validity were achieved. Cronbach’s Alpha and McDonald’s Omega values for all factors were satisfactory. However, the study found a low value of Cronbach’s Alpha and Omega for the fourth factor. Conclusions The DAHCS was cross-culturally adapted into the Arabic language and its validity and reliability were achieved.

Developing Disability Advocates Through Deliberate Interprofessional Conversations Regarding Quality of Life After Stroke

ObjectiveStroke can result in significant mental and physical impairment. Training health care professionals on effective strategies for mitigating stroke-related quality-of-life issues is crucial in facilitating comprehensive stroke management. This study aimed to evaluate the impact of an interprofessional education (IPE) experience on students’ attitudes regarding poststroke disability. MethodsIn this pre-post interventional study, pharmacy and medical students received an electronic patient chart and a store-and-forward video depicting physical and cognitive impairment in a patient with stroke. Students were instructed to discuss the acute management and postdischarge needs of the patient from an advocacy perspective. After the IPE experience, students completed the Student Perceptions of Interprofessional Clinical Education-Revised, version 2 and an unvalidated disability attitudes survey. The surveys were analyzed using a paired t test. In addition, students reflected on the prompt, “What are some things you had NOT considered prior to this IPE?” ResultsA total of 708 students completed the surveys. After IPE, there was a significant improvement in all domains of the Student Perceptions of Interprofessional Clinical Education-Revised, version 2. On the disability survey, there was significant improvement on all statements, including “rate your comfort with…”: “discussing the expected disabilities associated with new-onset stroke” and “discussing strategies for improving the quality of life of a patient who has long-term disabilities.” On the self-reflections, 31.7% (n = 211) had not considered the need for poststroke care services before this IPE. ConclusionThis IPE experience was instrumental in improving student perspectives regarding poststroke disability.

Adolescents' implicit and explicit attitudes toward their peers with genetic conditions.

Previous research has demonstrated that children lacking knowledge about genetic disorders may have harmful attitudes toward people with disabilities, but disability awareness can successfully modify these attitudes. We explored adolescents' implicit and explicit attitudes towardpeers with genetic conditions to determine whether improved genetics/genomics literacy can mitigate the impact of ableism in this population. English-speaking adolescents (10-18 years) from British Columbia were invited to complete a Disability Attitudes Implicit Association Test (DA-IAT) and participate in a semi-structured focus group centering on a fictionalized vignette about an adolescent with Down syndrome. We used pragmatism as an analytical paradigm. Descriptive and inferential statistics were used to analyze DA-IAT and sociodemographic data; phronetic iterative analysis with constant comparison as a coding strategy for transcripts; and interpretive description to develop a conceptual model. Twenty-two adolescents completed the DA-IAT and participated in one of four focus groups. Participants had a statistically significant implicit preference for non-disabled people (D-score = 0.72, SD = 0.44; t = 7.18, p < .00001). They demonstrated greater diversity in their explicit attitudes during the focus groups. Although participants articulated a positive attitude towardimproved genetics education, results demonstrate their belief that social and personal interactions with disabled peers would be essential to address negative perceptions. This study lays important groundwork to understand, explain, and influence the negative attitudes of adolescents towardindividuals with disabilities. Findings will be used to inform the design of interventions that address biased perceptions of people with genetic disorders, with the goal of reducing prejudices and improving social interactions.

The Relationship Between Rehabilitation Therapists’ Attitudes Towards Individuals With Disabilities and Job Burnout: An Empirical Investigation

Background and Objectives: This research aims to explore the interplay between rehabilitation therapists’ attitudes toward people with disabilities and their job burnout. Methods: The study population included all rehabilitation therapists in Tehran Province, Iran, in 2022, working in both public and private sectors. A sample of 261 therapists was selected using a quota sampling technique. The disability attitude questionnaire was employed to gauge attitudes towards individuals with disabilities, while therapists’ job burnout was evaluated using the Maslach burnout inventory. The therapists were approached through both in-person and online visits. Hypotheses were tested using correlation coefficients, linear regression, and analysis of variance (ANOVA), and data were analyzed using SPSS software, version 26. Results: The results revealed a significant negative relationship between job burnout and its dimensions (emotional exhaustion, depersonalization, and reduced personal accomplishment) with attitudes towards individuals with disabilities. Additionally, a negative and significant relationship was observed between job burnout and the variables of age, and work experience, while a positive and significant relationship was found with the variable of weekly working hours. Furthermore, a positive and significant relationship was observed between attitudes and the variables of age and work experience, while a negative and significant association was detected with weekly working hours. Occupational therapists exhibited more favorable attitudes compared to other rehabilitation groups. Physiotherapists displayed the highest burnout levels among the various rehabilitation disciplines. Conclusion: The study underscores the importance of integrating strategies to enhance rehabilitation therapists’ attitudes and alleviate burnout into the strategic planning initiatives of the Ministry of Health. Furthermore, efforts to reduce the work hours of rehabilitation therapists should be prioritized.

Explicit and implicit attitudes of occupational therapy workshops' staff towards people with intellectual disabilities.

The aim of this article is to present explicit and implicit attitudes of occupational therapy (OT) staff towards people with intellectual disabilities. The study was conducted on a group of 77 OT employees. To explore the explicit attitude, the Conditional Respect for Persons with Disabilities Questionnaire (Kurtek, Roczniki Psychologiczne, 2018, 4, 327-344) was used, while to estimate the implicit attitude, the Intellectual Disability Attitudes Implicit Association Test was applied (Kurtek, Roczniki Psychologiczne, 2021, 1, 43-64). At the explicit level, OT staff tended to tolerate negative and overrate positive behaviours of people with intellectual disabilities, which indicates a tendency to favour the individuals. However, the opposite devalorizing tendency was observed at the implicit dimension, which indicates aversive ableism. Although the study confirmed the independence of the two dimensions of the personnel's attitude, relationships were observed between the disclosure of negativity towards antagonistic behaviours of the people with intellectual disabilities and a decrease in the level of their implicit devaluation.

Explicit and implicit: Ableism of disability professionals

BackgroundPeople who work with disabled people or whose work is about disability – disability professionals – often have direct power over disabled people and can impact their lives immensely; they also have a role in creating and institutionalizing knowledge about disability. ObjectiveThe aim of this study was to examine the explicit (conscious) and implicit (unconscious) disability attitudes of disability professionals. MethodsBetween October 2021 and February 2023, disability professionals (n = 417) completed the Symbolic Ableism Scale (SAS) and the Disability Attitudes Implicit Association Test (DA-IAT). We had the following research questions: (1.) What are disability professionals' explicit attitudes towards disability? (2.) What are disability professionals' implicit attitudes towards disability? (3.) What is the relationship between disability professionals' explicit and implicit disability attitudes? and (4.) What sociodemographic factors correlate with disability professionals’ explicit and implicit disability attitudes? We examined these questions using descriptive statistics, t-tests, a two-dimensional model of prejudice, and linear regression models. ResultsIn our sample, 77.24% of disability professionals preferred nondisabled people explicitly and 82.03% implicitly. Most commonly, disability professionals were symbolic ableists (37.8%). Race, political orientation, and job type correlated with disability professionals’ explicit attitudes, while disability, gender, and job type correlated with their implicit attitudes. ConclusionsAbleism cannot be eradicated until disability professionals look inward and rid themselves of negative attitudes; until that occurs, disability professionals will continue to do a disservice to the very people they have dedicated their careers to – disabled people.

Development and Pilot Testing of the Disability Awareness Training and Education Program Among Community-Based Group Fitness Instructors.

Lack of disability awareness of fitness professionals is a well-established barrier to exercise participation among people with disabilities that is likely related to the lack of disability awareness training for group fitness instructors. The purposes of this study were to develop, implement, and evaluate a disability awareness training for group fitness instructors. A 90-min video training and resource manual were developed. We recruited 10 group fitness instructors from one recreation center to participate. Participants completed baseline, posttraining, and 2-month follow-up testing on survey-based outcomes including disability attitudes, confidence in exercise adaptations, and training satisfaction. Participants' confidence to adapt fitness classes was significantly improved; however, disability attitudes were high in the pretest and not significantly different posttraining. Semistructured interviews were conducted posttraining and revealed three themes: Formal disability training is needed, Managing inclusive class dynamics, and Training suggestions and satisfaction. This training demonstrated a feasible intervention for increasing disability awareness among community-based group fitness instructors.

Intolerance of uncertainty and attitudes towards persons living with disabilities in medical students: Is there a correlation?

Patients living with a disability experience an illness trajectory that may be uncertain. While navigating clinical uncertainty has been well-researched, health professionals' intolerance of uncertainty for patients living with disabilities has yet to be explored. We examined the relationship between medical students' intolerance of uncertainty with their attitudes towards people living with disabilities to better inform curricular efforts. We employed a survey-based design consisting of the Intolerance of Uncertainty Scale (IUS) and Disability Attitudes in Healthcare (DAHC) Scale to medical students upon completion of core clerkships (end of third-year of training). Data were de-identified. Mean DAHC and IUS scores were compared with published values via t-test. Linear regression was used to examine IUS/DAHC scores for anonymized students. Pearson correlation coefficient was calculated to assess correlation between IUS and DAHC scores. Response rate was 97% (268/275 students). Mean IUS score did not differ from previously cited medical student scores, but mean DAHC score was significantly higher than previously cited scores. We observed a statistically-significant relationship between IUS and DAHC scores. Students with greater intolerance of uncertainty had lower scores for disability attitudes [F(1,243) = 8.05, value of p < 0.01], with an R 2-value of 0.032, suggesting that 3% of DAHC score variance can be explained by IUS score changes. We identified a weak negative correlation between IUS and DAHC scores in medical students. Further research is needed to clarify findings and identify best practices that equip trainees with skills to care for patients with uncertain illness trajectories and patients living with disabilities.

Violent Discipline in North Kivu, Democratic Republic of Congo: The Role of Child Gender and Disability Status in Cross-sectional Analysis

IntroductionViolence is used to punish or educate children across the world, with detrimental effects on their physical, emotional, and social health that persist into their adulthood. This study aimed to understand the use of violent discipline by caregivers in conflict-affected communities and how it varied by the child’s gender and disability level.MethodsUsing cross-sectional data collected from 394 respondents (196 men and 198 women) in North Kivu, Democratic Republic of Congo, logistic generalized estimating equations stratified by gender assessed the association between past-three-month perpetration of violent discipline, caregiver demographics, conflict experiences, and disability attitudes, as well as child demographics of age, gender, disability level, and the interaction of gender and disability.ResultsCompared to women with boy children with no disability, odds of perpetration of violent discipline were higher among those with girl children with no disability (aOR: 2.24; 95%CI: 1.11–4.51) and boy children with moderate or severe disability (aOR: 2.91; 95%CI: 1.14–7.33), and the interaction of girl children with a moderate or severe disability showed a 7.80 increase in odds of perpetration; however, association with women’s discriminatory disability attitudes was not significant. In contrast, the interaction of child gender and disability level were not significantly associated with perpetration of violent discipline for men, but disability attitudes were significantly associated (aOR: 1.07; 95%CI: 1.00-1.15).DiscussionResults suggest that levels of violence in conflict-affected households in North Kivu, DRC are high, with women reporting higher levels of violent discipline overall, and amplified use of violence against girl children with disabilities. More research and programs with an intersectional lens are needed in conflict settings to better understand and address the use of violent discipline and underlying discriminatory norms around gender and disability.

CULTURAL INTELLIGENCE AS A FACTOR SHAPING ATTITUDES TOWARDS DISABILITY IN THE WORKPLACE

The issues of disability inclusion represent a challenge to managers and experts. Attitudes towards disa-bility influence the effectiveness of disability inclusion. In Russia, even though a social model of disabil-ity has been promoted and people are willing to assist persons with disabilities, attitudes towards such employees tend to be ambiguous. These attitudes are highly associated with the perception of the disabled as incapable of work, with the feeling of charity and also distrust. It appears necessary to ease negative at-titudes, especiallyin the workplaces. This paper considers individual cultural intelligence as a factor in-fluencing attitudes towards disability. 122 employees from Russian organizations participated in a survey and filled in the standard Cultural Intelligence Scale, the Disability Attitude Implicit Association Test, and the Attitudes to Physical Disability Scale. The study confirmed that cultural intelligence significantly affects attitudes towards employees with disabilities. Individuals with higher cultural intelligence show more positive attitudes towards the disabled. On the one hand, this suggests that cultural intelligence can be used as a new tool to regulate attitudes towards people with disabilities and ensure effective coopera-tion between disabled and non-disabled employees. On the other hand, this also inspires a wide range of possible applications of cultural intelligence.

ADAPTATION AND TESTING OF THE DEVELOPMENTAL DISABILITY ATTITUDES IN NURSING CARE INSTRUMENT.

Background and Purpose: Individuals with developmental disability (DD) often experience poor health outcomes, potentiated by healthcare inequities. Nurses have the potential to reduce these inequities through the quality of care provided. The quality of care provided by nursing students, the future generation of nurses, is affected by the attitudes of their clinical nursing faculty. The purpose of this study was to adapt and test an instrument to specifically measure the attitudes of clinical nursing faculty toward providing care to people with DD. Methods: The Disability Attitudes in Health Care (DAHC) instrument was adapted to create the new Developmental Disability Attitudes in Nursing Care (DDANC) instrument. Results: Content experts reviewed the DDANC for content validity (CVI = 0.88), followed by testing for internal consistency reliability (Cronbach's alpha = 0.7). The study respondents had overall positive attitudes toward the care of people with DD. Conclusions: The DDANC is an acceptably valid and reliable instrument to assess attitudes of clinical nursing faculty toward providing care to people with DD.

Intervening on disability attitudes through disability models and contact in psychology education.

Intervening on disability attitudes through disability models and contact in psychology education.

Explicit and implicit disability attitudes of occupational and physical therapy assistants.

Reduction of explicit and implicit bias in healthcare providers is a critical issue faced by our society in moving toward more equitable and culturally appropriate health and rehabilitation care. Because resources for OT and PT services are limited and shortages in these professions exist, direct care provision by occupational and physical therapist assistants (OTA/PTA) is on the rise and valued in comprehensive rehabilitation practice. It is important to consider attitudes and biases of OTA/PTA, as they are directly involved in provision of rehabilitation services for people with disabilities. This study examined the explicit and implicit disability attitudes of a large cross-section of OTA/PTA. Secondary data analysis was completed using data from 6113 OTA/PTA from the Project Implicit Disability Attitudes Implicit Association Test. Implicit attitudes were calculated and OTA/PTA explicit and implicit disability attitudes were compared. Results were further categorized using an adapted version of Son Hing etal.'s two-dimensional model of prejudice. Findings revealed the majority of OTA/PTA reported having no explicit preference for people with disabilities or nondisabled people. However, the majority of OTA/PTA were aversive ableists, indicating low explicit and high implicit bias. Though explicit bias is lower in OTA/PTA, implicit bias is strong, indicating that people with disabilities face bias that may influence clinical interactions, and may be reproduced in professional education, practice, and policy. Concrete action must be taken to recognize and address disability bias to reduce health disparities in people with disabilities.

Disability Attitudes of Nursing Students: A Curriculum Intervention.

People with disabilities (PWD) have reported that health care workers' negative attitudes are among the most significant barriers to accessing health care services. PWD constitute one quarter of the population, yet the curriculum for PWD is inconsistent. This study describes a curriculum intervention allowing student interaction with a panel of PWD to change nursing student attitudes. Surveys were administered before and after the intervention. Our pilot study did not reveal a significant change in attitudes, which suggests that more exposure to PWD and education may be needed.

Implicit associations related to physical disability among nursing students

BackgroundNegative beliefs about disability are associated with poorer outcomes for individuals with disabilities; understanding disability-related attitudes is critical for clinical care. Recently, interest in attitudes toward people with disabilities has increased; however, most studies focus on explicit attitudes. In contrast, the Disability Attitude Implicit Association Test (DA-IAT) is designed to evaluate respondents’ underlying automatic preferences regarding physical ability. ObjectiveThe aim of this pilot study was to expand the literature on health professionals’ implicit disability attitudes by analyzing the DA-IAT in a sample of nursing students. MethodsA cross-sectional design was utilized with a sample of nursing students (n = 95; 88.7% female). Respondents completed the DA-IAT online before responding to some basic demographic questions. ResultsParticipants associated able-bodied status with positive descriptors more quickly than disability related stimuli. ConclusionsMost participants in this sample of nursing students (87%) mentally associated able-bodiedness with desirable traits in a more efficient manner than disability. Future research should focus on developing models to better understand the relationship between automatic processing, disability-related attitudes, and how this relationship informs clinician behavior.

Impact of Occupational Therapy Education on Students' Disability Attitudes: A Longitudinal Study.

Discrimination based on disability-ableism-is pervasive and affects the opportunities of people with disabilities to fully engage in society. The aim of this study was to explore the impact of occupational therapy graduate education on students' explicit and implicit disability attitudes throughout their graduate education. Longitudinal observational study, measuring occupational therapy students' attitudes on an annual basis. Three Midwestern graduate occupational therapy programs. Occupational therapy students (N = 67). Outcomes and Measures: Participants completed the Symbolic Ableism Scale (to measure their explicit disability attitudes) and the Disability Attitude Implicit Association Test (to measure their implicit disability attitudes) on an annual basis, from when they entered their occupational therapy program to when they graduated. The students' explicit attitudes decreased (i.e., became more favorable) throughout their education; however, their implicit attitudes did not change. In fact, most students (68%) were implicitly ableist at graduation. Occupational therapy education programs have an important role to play in terms of intervening with students' beliefs and preconceived assumptions about disability. Our finding suggests that occupational therapy programs may fail to intervene with students' ableist attitudes. What This Article Adds: Little longitudinal research has examined how students' implicit disability bias may be affected by their academic experience. Our findings about ableism among occupational therapy students should open the door for further dialogue on the existence of ableism in program content, its potential impact on future client interactions, and the development of approaches to address it.

Filipino Attitudes to Disability Scale (Fil-ADS(D)): Factor Structure Validation and an Assessment of Filipino Attitudes

Purpose: This study aimed to evaluate the cross-cultural validity of the Filipino version of the Attitude to Disability Scale Physical Disability (Fil-ADS(D)) forms and to describe Filipinos’ disability attitudes and its correlations with sociodemographic factors. Methods: Personal and general Fil-ADS(D) forms were distributed to Filipino persons with disability and general adult population, respectively, for self-administration. Confirmatory factor analysis was used to assess cross-cultural validity of Fil-ADS(D). Fil-ADS(D) score correlations with age, education, and financial situation were explored through Spearman rank correlation analysis; correlations with sex, employment, and health and disability status were explored through point-biserial correlation analysis. Results: Factor structure of the original ADS was retained in the Fil-ADS(D) forms making it cross-culturally valid. The forms are valuable for generating information for improving attitudinal barriers and for cross-cultural comparisons. Positive attitudes among respondents and significant yet weak correlation with age and occupation were found.

Ageism and Ableism: Unrecognized Biases in Occupational Therapy Students

Aims This study explored occupational therapy students’ implicit (unconscious) ageism. Because of the relationship between impairment and dependence, and ageism and ableism, we also explored if there was a relationship between occupational therapy students’ implicit ageism and their implicit ableism. Methods We conducted and analyzed implicit age and disability attitude data (i.e., Age Implicit Association Test; Disability Attitude Implicit Association Test) from 54 occupational therapy students. Results Most occupational therapy students in our study (70%) were ageist, with the majority strongly or moderately preferring younger adults over older adults. Our findings also suggest ableism plays a role in ageism – ableism accounted for almost 30% of variance in occupational therapy students’ ageism in our study. Conclusions Through attending to functional interdependence and home modifications occupational therapists can support older adults in the natural processes of aging, instead of reinforcing ageism and its influences on intervention and plan of care development.

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.