Activity and participation of people with disabilities from the perspective of students of helping professions and the general population

Activity and participation of people with disabilities from the perspective of students of helping professions and the general population The perception of disability and attitudes toward people with disabilities influence the behavior of workers in helping professions toward a person with a disability. As pointed out by Al-Abdulwahab and Al-Gain (2003), professionals’ attitudes toward people with disabilities are shaped by cultural values, traditional opinion, educational conditions, beliefs, age, professional experience, and gender. Professionals’ attitudes can influence the self-image of people with disabilities. It can be assumed that the image of a person with disability held by professionals who come into contact with people with disabilities will be conditioned by knowledge and greater experience, and their attitudes may differ from those in the majority society. However, Roush (1986) states that healthcare professionals have attitudes toward people with disabilities similar to those of the majority society. These attitudes are often negative and represent barriers to the full realization of persons with disabilities.

In the formation of the image of people with disabilities, cultural stereotypes, prejudices, and misconceptions play a substantial role. Green et al. (2005) point to their negative psychosocial consequences in the lives of people with disabilities and their families. Studies dealing with cultural stereotypes about people with disabilities point to a generalized stereotype independent of the type of disability (Szobiová, 2012). As for models of disability, a strong influence is seen in the traditional linking of disability with deficit, disorder, and illness. The biomedical model describes disability in terms of pathology and defines disability normatively in relation to the general healthy population (Smart and Smart, 2012). The social model approaches disability as a product of society. The biopsychosocial model links the above models and emphasizes the integrative influence of biological, individual, and social determinants on health and a person’s functional ability. At the broader societal level, the biopsychosocial approach to disability is represented by the International Classification of Functioning, Disability and Health (WHO, 2001). It takes into account environmental factors and the context in which individuals live. Assessment of an individual’s health status also includes assessment of activity—performance and functional capacity—and participation—engagement in life situations—which represents the social aspect of functional capacity.

The goal of our research study was to determine how participation of people with disabilities is perceived by students of helping professions in comparison with the perception of people in the general population. We also focused on factors that could be related to the perception of participation of people with disabilities—age, self-rated health, and self-rated participation among students of helping professions and participants from the general population.

Participants

The research sample consisted of 176 respondents without disability. The first research sample consisted of 114 students of helping professions at the Faculty of Education, Comenius University in Bratislava, in the study programs special pedagogy (n=33), social work (n=30), and teaching psychology (n=51). The students’ age ranged from 18 to 41 years (M = 22.3 SD = 4.74), including 110 female students (96.5%) and 4 male students (3.5%). Most students were full-time students (81.6%). The second research sample consisted of 62 adult participants from the general population aged 25 to 69 years (M = 43.7 SD = 12.54), including 17 men (27.4%) and 45 women (72.6%).

Research methods

For assessing participation, we selected the Participation Scale (van Brakel et al., 2006), which is an 18-item tool focused on respondents’ subjective perception of problems in various life domains. It includes 8 of the 9 participation domains defined by the International Classification of Functioning, Disability and Health (WHO, 2001): Learning and applying knowledge, Communication, Mobility, Self-care, Domestic life, Interpersonal relationships, Major life areas, and Community, social and civic life (van Brakel et al., 2006; Schultz, 2008). The Participation Scale allows quantification of limitations in participation. Each item contains two questions. The first relates to a respondent’s participation in different areas of life, and the second expresses the degree to which it is a problem for the respondent to participate in the respective area of life. As an example, item no. 1 is: Do you have the same opportunities to get a job as other people? (response options: yes, sometimes, no, not applicable to me). The second part concerns the degree of the problem (no problem, small problem, moderate problem, severe problem). Based on the total score, it is possible to place a respondent into one of five categories: no limitations, mild limitations, moderate limitations, severe limitations, extreme limitations. The Participation Scale is intended primarily for people with disabilities and people with chronic illness.

In our study, we used the Participation Scale to assess participants’ own participation, and at the same time asked them to try to evaluate, in the Participation Scale, participation and the degree of participation problems in various life areas for people with disabilities. For the purpose of assessing others’ participation, we modified the scale items so that respondents expressed their own perceptions of people with disabilities’ participation instead of self-assessment. For example, item no. 1: Do they have the same opportunities to get a job as other people? How big a problem is this for them?

To assess respondents’ own health, we used a simple scale from 0 to 10, where they rated their own health over the past year. A value of 0 represented very poor health and 10 represented very good health.

Results

When assessing their own health on the My Health scale (0–10), students assigned an average value of 7.67 (SD = 1.90), and people from the general population an average value of 7.81 (SD = 1.47). The difference is not statistically significant. This indicates similar self-rated health among students and people from the general population despite a highly significant age difference between groups (t = 16.03; p<0,001).

In the Participation Scale, the degree of participation restriction in the student sample of helping professions was 14.54 (SD = 10.44), which corresponds to the category of mild participation limitations. Item analysis showed that students reported greater limitations in the areas: finding a job, working like other people, establishing long-term relationships, contributing financially to household finances, and visiting places outside the home. Conversely, they reported the lowest levels of participation restriction in the areas: learning new things, meeting new people, and having one’s own opinions respected within the family. Similarly, in the adult sample from the general population, the average value for participation restriction was 15.32 (SD = 10.97), corresponding to the category of mild limitations. Highest limitations were reported by respondents from the general population also in items related to work, visiting places outside the home, contributing financially to household finances, and participating in leisure activities. Items with the lowest degree of limitation were areas such as: respect for one’s own opinions within the family, learning new things, and meeting new people. Statistically significant differences between students and respondents from the general population in rating their own participation were found in items: financial contribution to the household (students report greater limitations: t = 4.72; p<0,01), having one’s own opinions respected within the family (students report greater limitations: t = 2.51; p<0,05), and participation in social events (respondents from the general population report greater limitations: t = 2,89; p<0,05), and participation in recreational and leisure activities (respondents from the general population report greater limitations: t = 3,85; p<0,01).

Perception of participation of people with disabilities by students of helping professions and the general population

Students of helping professions and respondents from the general population assessed the participation of people with disabilities similarly. The reported degree of limitation in participation corresponded to the category of severe limitations, almost bordering on the category of extreme limitations in participation (Table 1). There was no statistically significant difference in the assessment of participation of people with disabilities between students and people from the general population.

A comparison of participation assessments showed that students and respondents from the general population perceived their own participation and the participation of people with disabilities differently. The differences are statistically highly significant, in the student sample (p<0,001) as well as in the general population sample (p<0,001) (Table 1). Table 1. Differences in perceived participation

In the analysis of individual items of the Participation Scale from the perspective of students of helping professions and people from the general population, we found a statistically significant difference between these two samples only in the item related to willingness to learn new things. The general population attributes a higher degree of limitation to people with disabilities than students of helping professions do (t = 2,02; p<0,05).

Interrelationships between examined variables Table 2 Correlations between examined variables in students of helping professions

Table 3 Correlations between examined variables in people from the general population

The relationship between the degree of participation restriction and self-rated health was statistically significant in the sample of students of helping professions (p<0,01; Table 2) and in the sample of respondents from the general population (p<0,01) (Table 3). Worse self-rated health was associated with greater participation restriction. A statistically significant relationship between age and self-rated health was also found, but only in the sample of people from the general population (p<0,05). It was shown that age, self-rated health, and self-rated participation did not significantly correlate with perceived limitations in participation of people with disabilities.

Discussion and Conclusion

Assessment of one’s own participation by students, and by respondents from the general population, did not fall into the category of “no limitations.” On average, ratings in both groups were in the category of mild limitations in participation. It may be assumed that the expressed degree of participation limitations is determined by current life tasks and not always by sufficiently saturated needs, especially of younger people (relationships, etc.), but also reflects external societal factors that determine participation opportunities (e.g., in the area of work). At the same time, a relationship between self-rated health and the degree of restrictions in one’s own participation was shown.

The degree of participation restriction among students of helping professions and respondents from the general population corresponds to the category of mild limitation, whereas participation of people with disabilities is perceived as significantly limited, corresponding to the category of severe limitations up to the border of the extreme limitations category in participation.

A statistically significant difference in the perception of participation of people with disabilities from the perspective of students of helping professions and people from the general population was found only in the item representing learning new things. The general population attributes greater limitations to people with disabilities than students of helping professions do.

It was not shown that one’s own perceived participation or age influenced the assessment of participation of people with disabilities.

A significant relationship between assessment of one’s own participation and self-rated health was found among students of helping professions as well as among people from the general population. With more negative health ratings, the degree of participation restriction also increases. Health thus appears to be an important determinant of participation.

The views of students of helping professions and people from the general population about participation of people with disabilities correspond to a typological deficit-oriented image of a person with disability.

It can be concluded that the perception of participation of people with disabilities from the perspective of students of helping professions does not differ overall from that of the general population. This suggests that knowledge and understanding gained during studies in helping professions, which are not yet complemented and reinforced by sufficient work experience with people with disabilities, do not immediately and directly shape the image of a person with disability.

Authors: doc. PhDr. Marian Groma, PhD. Univerzita Komenského v Bratislave, Pedagogická fakulta, Katedra psychológie a patopsychológie PhDr. Katarína Jariabková, PhD. Ústav výskumu sociálnej komunikácie SAV Mgr. Zuzana Brunclíková, PhD. Univerzita Komenského v Bratislave, Pedagogická fakulta, Katedra psychológie a patopsychológie Mgr. Lucia Felcanová, PhD. Univerzita Komenského v Bratislave, Pedagogická fakulta, Katedra psychológie a patopsychológie Bibliographic references

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The research was supported by the VEGA grant 1/0829/13. The article was presented at the 10th national conference with international participation Health Psychology 2015, held on June 3, 2015 in Bratislava.