Attitudes towards people with disability among nursing students of Birgunj

 

Richa Singh1, Aastha Ghimire2, Asmita Chaudhary3, Rinku Yadav4, Keshav Bhandari5

1Nursing Lecturer, Community Health Nursing, National Medical College, Nursing Campus, Birgunj.

2Staff Nurse, Neuro Department, Nobel Medical College and Teaching Hospital, Biratnagar.

3Nursing Lecturer, Obstetrics and Gynaecology Nursing, National Medical College, Nursing Campus, Birgunj.

4Nursing Lecturer, Medical and Surgical Nursing, National Medical College, Nursing Campus, Birgunj.

5Nursing Lecturer, Medical and Surgical Nursing, National Medical College, Nursing Campus, Birgunj.

*Corresponding Author E-mail: richasinghnmc@gmail.com

 

ABSTRACT:

According to Nepal's official census data (2011), the disability rate is 1.94% of total population. Individuals with disabilities continue to be one of the most socially excluded groups in society, continually pushing for equal rights and social inclusion. There is absence of any published research about nursing students' attitudes toward disabled people. The objective of the study is to find out the attitudes towards disabled person among nursing students of selected private colleges of Birgunj. A descriptive cross-sectional study design was adopted to conduct study among 149 nursing students and the study sample was selected by using Proportionate stratified random sampling technique. Data was collected by using self-administered standardized Attitude Towards Disabled Person (ATDP) Scale. The obtained data was entered in Software Package for Social Science (SPSS) version 26 and analyzed by using descriptive and inferential statistics. The study findings depicted that 55.7% of the respondents were between the age group of 19-22 years old with mean age 19.147 and SD±1.69. Based on religion, 82.6% of respondents belongs to Hindu religion. The highest proportion (33.6%) of respondents were from the 1st and 3rd years.  The majority (65.8%) of respondents had been in contact with a disabled person. Among those, 37.6% have been in contact with disable person as their patients. The mean and standard deviation of attitudes towards people with disabilities among nursing students were 56.01 and 14.076, respectively. The majority of the nursing students, 61.1% had a negative attitude towards disabled people, and 38.9% nursing students had a positive attitude towards disabled person. According to the findings, more than half of the students had negative attitude towards disabled person. The findings may be valuable to the responsible authority in incorporating disability-related content into the curriculum.

 

KEYWORDS: Attitude, Disability, Nursing Students.

 

 


 

INTRODUCTION:

(Centers for Disease Control and Prevention, 2020) Disability includes impairments associated with vision, movement, thinking, remembering, learning, communicating, hearing, mental health, and social relationships.

 

(Thapaliya, 2016) The constitution of Nepal defines a disabled person as one who is mentally or physically unable to lead a normal life. Similarly, the World Health Organization’s (WHO) definition of disability denotes impairments, activity limitations and participation restrictions. The term includes persons whose mobility is limited and those with hearing and visual impairments.

 

(World Health Organization [WHO], 2020) The world's largest groups of minorities are persons living with disabilities. This community estimates over a billion population that corresponds to be around 15 percent of the entire global accommodate. Relatively, persons with disabilities (PWDs) are sought to seek more health care services than anyone. Undermining their expectation, most of the time their greater needs are unmet. Besides, the PWDs are multiple times liable to report being dealt badly and almost multiple times bound to report being denied health services. For example, an overview of people with genuine mental issues stressed that somewhere in the range of 76 and 85 percent of people living in developing countries have not received any treatment in the year before the study (Sofi and Cherian, 2014) A person’s life is a product and part of the larger social structure and the persons with disabilities are no longer different. Their relationship, disposition, and personal conduct standards are imperatively influenced by the content and degree of the harmony with the family persons, companions, relatives, work environment partners, and so on. Certainly, the disabled persons face serious problems in the societal attitude and approach than in their disability.

 

(Noe, 2002) “Attitudes are a combination of beliefs and feelings that predispose a person to behave a certain way”

 

(Mishra, 2006) elaborated the attitude of non-disabled treating the disabled as different. Mishra reported that they were not included in the competitive cliques that form among active adolescents. They are treated as an outcast whom people may like but exclude from their inner circle for sports and leisure activities. They live with their disabilities in the community but they never fully accepted by the teen age peers.

 

(Kritsotakis et al., 2017) Research confirms that when students are exposed to Patients with Disabilities and offered the opportunity to learn about disabilities, their perceptions and attitudes change

 

(Thompson et al., 2003) Research studies in nursing and other healthcare professions suggest that students’ attitudes towards disabled persons may be improved by various educational programmes, such as direct contact and working with disabled people, experiential learning camps, simulation exercises or by combinations of strategies.

 

NEED OF THE STUDY:

(World Health Organization [WHO], 2011) Disability is a common health issue in both developed and developing countries. Recent estimates have shown that more than 1 billion individuals are living with some form of disability worldwide, of whom nearly 93 million are children. Global prevalence of disability is expected to be increased in the following decades mainly due to the growing ageing population the increased risk of disability in elderly people and the global rise in chronic diseases.

 

(Islam et al., 2016) Inspite of considerable recent advances in minimizing misperception of different types of disability, persons still experience various challenges such as inequalities in life opportunities, limited access to education or to health care and generally poor accommodation of their needs. Positive societal attitudes may eliminate all obstacles and facilitate acceptance of disability

 

(Hilalulla et al., 2021) Perspectives toward disabilities reflect convictions about PWDs and as such guide towards the same to control and overcome the situation, more knowledge is needed on the present status of the interactions and attitudes of future health care professionals towards PWDs.

 

(Polikandriot et al., 2019) Health professionals have the potential to stimulate and guide future efforts. Therefore, it is important to evaluate their attitudes towards persons with disabilities and build an education that may modify the already established wrong behaviors thus facilitating provision of high-quality care.

 

(Shrestha et al., 2021) A descriptive cross-sectional study showed that there is prevalence of negative attitude towards people with disability.

 

(Hilalulla et al., 2021) A descriptive study was conducted among nursing students which reveals that more than half of the respondents have a negative attitude with PWDs.

 

(Khan et al., 2016) The cross-sectional study showed that respondents had a more negative attitude towards people with disabilities. All the participants had a mean personal score of 76.74 and standard deviation of 12.02 (n=230) which showed that respondents had a more negative attitude towards people with disabilities. 

 

In Nepal context, this area is reported to be less likely studied and this research study addresses the gap. So, the researcher is interested to conduct research in this topic.

 

OBJECTIVES OF THE STUDY:

General Objective:

The general objective of the study is to find out the attitude towards disabled person among nursing students of Birgunj

Specific Objectives:

The specific objectives of the study were

To assess the attitude towards disabled person among nursing students.

 

To determine the association between attitude of nursing students and socio demographic information.

 

RESEARCH VARIABLES:

Dependent Variable:

Attitude towards disabled person among nursing students.

 

Independent Variables:

Age, Religion, Year of Study, Exposure with disabled person.

 

OPERATIONAL DEFINITIONS:

Attitude:

In this study, attitude means evaluations that people hold regarding a person with disability. It is categorized as: Positive and Negative attitude.

 

Negative attitude: 0 – 60

Positive attitude: 61 – 120

 

The total scores ranged from 0, indicative of a very negative attitude, to 120, indicative of a very positive attitude (Ogiwara, 2001)

 

Nursing Students:

In this study nursing student is an individual who is enrolled in 1st year, 2nd Year and 3rd Year of PCL Nursing program among selected private nursing colleges of Birgunj.

 

Disability:

In this study, disability means physical or mental impairment that substantially limits one or more major life activities of an individual.

 

METHODOLOGY:

Research Design:

A descriptive cross-sectional study design was selected for the study.

 

Setting:

This study was conducted at the two private nursing campuses of Birgunj namely National Medical College Nursing Campus, The Himal Institute of Health and Technical Science, Birgunj, Parsa.

 

Population:

The study population were all the PCL nursing students from 1st year, 2nd year and 3rd year who are currently enrolled and studying at 2 selected private nursing campuses of Birgunj.

SAMPLING PROCEDURE:

Sample Size: 149

The sample size of the study was calculated by using Slovin’s formula.

 

Criteria for Selection of Sample:

Inclusion Criteria:

PCL nursing students of 2 selected private nursing campuses of Birgunj

Those who were willing to participate in the study.

Those who were present at the time of data collection.

 

Sampling Technique:

Proportionate stratified random sampling technique was adopted to select the nursing students from 2 selected private nursing campuses of Birgunj for the study. The total number of students meeting the criteria were 238, 118 were from one selected colloge and 120 from another selected college. Considering nursing campuses as strata, 74 sample   and 75 sample was taken from respectively campuses by using random sampling technique (lottery method).

 

Research Instrumentation:

The Attitude Toward Disabled Persons Scale (ATDP) was used after the review of related literatures, consultation with research advisor to collect the data. The ATDP scale; was designed as a measure of attitudes towards individuals with disabilities (Yuker, Block, and Campbell, 1960). Three versions of the ATDP (form O, form A, and form B) have been developed Form O is the original form and contains 20 items (Yuker and Block, 1986). The ATDP-O was used in this study A research tool consisted of two Sections.

 

SECTION A:

Section A of the questionnaire consisted of the Socio-demographic variables which include: age, gender, year of study, Exposure with person with disability.

 

SECTION B:

Section B consists of The Attitude Towards Disabled Persons scale which was developed to measure attitudes held by both disabled and able-bodied persons (Yuker and Block, 1986), furthermore the scale was designed to measure the attitudes of able-bodied people towards disabled people and the attitudes of disabled people towards other disabled people, or themselves.

 

Research participants responded to test items by indicating their agreement or disagreement with statements on the instrument according to the six item Likert scale that ranges from -3 ‘I Disagree Very Much” to +3 “I Agree Very Much”. The ATDP-O was used in this study. The ATDP-O has been widely used to measure attitudes among students.

 

Direction of Scoring:

The scale is scored in the following manner (Haba and Ogiwara, 2001):  the signs of items 2, 5, 6, 11 and 12 was changed. The sum of the items for the individual participants was determined. Following this, the sign of the sum was reversed with total scores which ranges from –60 to +60. To get rid of the negative values, a constant of 60 was added to all the scores. The total scores ranged from 0, indicative of a very negative attitude, to 120, indicative of a very favorable attitude.

 

Pretesting of the instrument:

The instrument was pretested in 10% sample size (i.e., 15) nursing student of Evergreen Technical Institute of Health Science Parsa, Birgunj, to check its clarity, sequence and feasibility with the purpose to increase the reliability of the instrument. The reliability of ATDP-O was calculated by using Cronbach Alpha and it was found to be 0.82. Hence, the tool was found to be reliable for conducting the study.

 

RESULTS:

Table 1 represents the socio-demographic characteristics of the respondents where 55.7% respondents were between the age group of 19-22 years old with mean age 19.147 and SD±1.69. Majority (82.6%) of respondents belongs to Hindu religion. Highest proportion (33.6%) of respondents were from 1st Year and 3rd Year. Majority (65.8%) respondent had been in exposed with disabled person. Among those 37.6% has met disabled person as their patients.

 

Table 2 represents that most of the nursing students 65 (43.6 %) chose ‘I Disagree Very Much’ with the statement that physically disabled person is just as intelligent as non-disabled person. Only 26 (17.4) respondents Agreed Vey Much to the statement that disabled people are the same ass anyone else.

 

Table 1 Socio-Demographic Characteristics of Respondents n= 149

Variables

Frequency (n)

Percentage (%)

Age (in years)

 

 

15-18

60

40.3

19-22

83                                             

55.7

23-26                                                                            

6

4

Mean age± S.D. = 19.147 ± 1.69

Religion

 

 

Hindu

123

82.6

Muslim

2

1.3

Buddhist

21

14.1

Christian

3

2

Year of Study

 

 

1st Year

50

33.6

2nd Year

49

32.9

3rd Year

50

33.6

Exposure with disabled person

 

 

Yes

98

65.8

No

51

34.2

If yes, what is your relation with them

 

 

Family

15

10.1

Friends

18

12.1

Patients

56

37.6

Others

9

6

 

Table 3 shows that majority of respondent 81 (54.5%) Agreed Very Much to the statement that there should not be special schools for disabled children. A Little less than half of the respondents 44.3% disagreed a little to the statement that disabled people should not be expected to meet the same standards as non-disabled person.


 

 

Table 2 Respondent Attitude Towards Disabled Person in Attitude Statement  n= 149

Statements

Disagree Very Much

Disagree Pretty Much

Disagree a Little

Agree a Little

Agree Pretty Much

Agree Very Much

Frequency (%)

Frequency (%)

Frequency (%)

Frequency (%)

Frequency (%)

Frequency (%)

Parents of disabled children should be less strict than other parents.

13 (8.7)

9 (6)

11 (7.4)

20 (13.4)

  34 (22.8)

62 (41.6)

Physically disabled persons are just as intelligent as nondisabled ones.

65 (43.6)

25 (16.8)

23 (15.4)

20 (13.4)

3 (2)

13 (8.7)

Disabled people are usually easier to get along with than other people.

18 (12.1)

19 (12.8)

21 (14.1)

36 (24.2)

26 (17.4)

29 (19.5)

Most disabled people feel sorry for themselves.

22 (14.8)

16 (10.7)

11 (7.4)

37 (24.8)

20 (13.4)

43 (28.9)

Disabled people are the same as anyone else.

71 (47.7)

16 (10.7)

10 (6.7)

17 (11.4)

9 (6)

26 (17.4)

 

Table 3 Respondent Attitude Towards Disabled Person in Attitude Statement n= 149

Statements

Disagree Very Much

Disagree Pretty Much

Disagree a Little

Agree a Little

Agree Pretty Much

Agree Very Much

Frequency (%)

Frequency (%)

Frequency (%)

Frequency (%)

Frequency (%)

Frequency (%)

There should not be special schools for disabled children.

25 (16.8)

3 (2)

9 (6)

21 (14.1)

10 (6.7)

81 (54.4)

It would be best for disabled persons to live and work in special communities.

16 (10.7)

8 (5.4)

6(4)

13 (8.7)

31 (20.8)

75 (50.3)

It is up to the government to take care of disabled persons.

25 (16.8)

9 (6)

13 98.7)

16 (10.7)

30 (20.1)

56 (37.6)

Most disabled people worry a great deal.

11 (7.4)

13 (8.7)

13 (8.7)

51 (34.2)

35 925.3)

26 (17.4)

Disabled people should not be expected to meet the same standards as nondisabled people.

66 (44.3)

25 (16.8)

18 (12.1)

11 (7.4)

13 (8.7)

16 (10.7)

 

Table 4 Respondent Attitude Towards Disabled Person in Attitude Statement  n= 149

Statements

Disagree Very Much

Disagree Pretty Much

Disagree a Little

Agree a Little

Agree Pretty Much

Agree Very Much

Frequency(%)

Frequency(%)

Frequency (%)

Frequency(%)

Frequency (%)

Frequency(%)

Disabled people are as happy as nondisabled people.

36 (24.2)

25 (16.8)

33 (22.1)

20 (13.4)

15 (10.1)

20 (13.4)

Severely disabled people are not harder to get along with than those with minor disabilities.

23 (15.4)

25 (16.8)

31 (20.8)

41 (27.5)

13 (8.7)

16 (10.7)

It is almost impossible for a disabled person to lead a normal life.

40 (26.8)

14 (9.4)

15 (10.1)

23 (15.4)

26 (17.4)

31 (20.8)

You should not expect too much from disabled people.

44 (29.5)

24 (16.1)

26 (17.4)

25 (16.8)

12 (8.1)

18 (12.1)

Disabled people tend to keep to themselves much of the time.

13 (8.7)

18 (12.1)

26 (17.4)

43 (28.9)

20 (13.4)

29 (19.5)

 

Table 5 Respondent Attitude Towards Disabled Person in Attitude Statement    n= 149

Statements

Disagree Very Much

Disagree Pretty Much

Disagree a Little

Agree a Little

Agree Pretty Much

Agree Very Much

Frequency(%)

Frequency(%)

Frequency (%)

Frequency(%)

Frequency (%)

Frequency(%)

Disabled people are more easily upset than nondisabled people.

21 (14.1)

25 (16.8)

16 (10.7)

30 (20.1)

23 (15.4)

34 (22.8)

Disabled persons cannot have a normal social life

69 (46.3)

23 (15.4)

12 (8.1)

16 (10.7)

10 (6.7)

19 (12.8)

Most disabled people feel that they are not as good as other people.

14 (9.8)

10 (6.7)

16 (10.7)

33 (22.1)

41 (27.5)

35 (23.5)

You have to be careful what you say when you are with disabled people.

14 (9.8)

8 (5.4)

8 (5.4)

19 (12.8)

18 (12.1)

82 (55)

Disabled people are often grouchy.

34 (22.8)

16 (10.7)

31 (20.8)

30 (20.1)

21 (14.1)

17 (11.4)

 


Table 4 represents that about 26.8% of the respondents agreed that it is almost impossible for a disabled person to lead a normal life. Nearly one fourth of the population agreed a little that disabled people are as happy as non-disabled people.

 

Table 5 shows that 30 (20.1%) respondents disagreed very much on the statement that disabled people are grouchy. A little more than half of the respondents 55% Agreed Very Much to the statement that you have to be careful what you say when you are with disabled people.

 

Table 6 shows that majority of nursing students 91 (61.1%) were having negative attitude and 58 (38.9%) of nursing students were having positive attitude towards people with disability.

 

Table 6 Level of Attitude Towards Disabled Person         n= 149

Attitude Level

Frequency

Percentage

Negative Attitude

91

61.1

Positive Attitude

58

38.9

 

TABLE 7 Mean and Standard Deviation of Attitude Towards Disabled Person                                   n= 149

Mean

Standard Deviation (SD)

Attitude Score

56.01

14.076

Table 7 shows the mean and standard deviation of attitude towards people with disability among nursing students were 56.01 and 14.076 respectively.


 

 

Table 8 Association Between Socio-Demographic Characters and Attitude Score of Age and Religion n= 149

Socio-demographic Characters

Level of Attitude

χ˛

df

P value

Significance

Positive attitude

Negative attitude

Frequency (%)

Frequency (%)

Age*

 

 

 

 

 

 

15-18

25(41.7)

35(58.3)

 

 

 

 

19-22

32(38.6)

51(61.4)

1.264

2

0.553

NS

23-26

1(16.7)

5(83.3)

 

 

 

 

Religion*

 

 

 

 

 

 

Hindu

49(39.8)

74(60.2)

 

 

 

 

Buddhist

6(28.6)

15(71.4)

3.759

3

0.276

NS

Muslim

2(100)

0

 

 

 

 

Christian

1(33.3)

2(66.7)

 

 

 

 

Year of Study

 

 

 

 

 

 

1st Year

22(44)

28(56)

 

 

 

 

2nd Year

21(42.9)

28(57.1)

2.536

2

0.301

NS

3rd Year

15(30)

35(70)

 

 

 

 

Exposure with disabled person

 

 

 

 

 

 

Yes

39 (39.8)

59(60.2)

0

1

0.436

NS

No

19 (37.3)

32(62.7)

 

 

 

 

If yes, what is your relation with them*

 

 

 

 

 

Family

7 (46.7)

8 (53.3)

 

 

 

 

Friends

9 (50)

9 (50)

1.823

4

0.32

NS

Patients

20 (35.7)

36 (64.3)

 

 

 

 

Others

3 (33.3)

6 (66.7)

 

 

 

 

* = Fisher’s Exact Test, NS= Not Significant, df= degree of Freedom, χ˛= Chi-square, Significant at p ≤ 0.05

 


Table 8 depicts the association between socio-demographic variables and attitude score which showed that there was no association of attitude with the age and religion of the respondents. Also, there was no association of attitude with the year of study and exposure with disabled person.

 

CONCLUSION:

On the basis of the study findings, it can be concluded that the nursing students studying in Birgunj were having negative attitude towards people with disability. The study also reveals that there is no association of attitude with age, religion, year of study and exposure with person with disability.

 

IMPLICATIONS:

This study may help and guide the future researchers to conduct the further research and explore ideas regarding disability. The result of the study also helps to identify the attitude of future health professionals which may facilitate or may hinder the integration and provision of services provided to the people with disability. The findings will also be useful for curriculum development committee to incorporate disability related contents in the curriculum.

 

LIMITATIONS:

Findings of this study should be interpreted based on these limitations. This study was carried out only in Province 2 among PCL Nursing Students, studying at private nursing campuses of Birgunj so the findings of the study is hard to generalize in all the other provinces of Nepal.

 

RECOMMENDATIONS:

On the basis of the study findings following recommendations can be made:

Similar study can be conducted in different settings in order to compare findings and make generalization in other settings.

Comparative studies can be conducted between different level of nursing students.

Disability related content can be added in the curriculum in broad aspect.

 

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Received on 12.12.2023         Modified on 16.01.2024

Accepted on 09.02.2024       ©A&V Publications All right reserved

A and V Pub J. of Nursing and Medical Res. 2024; 3(1):1-6.

DOI: 10.52711/jnmr.2024.01