Knowledge, Perception And Attitude Of Adults Towards People With Disabilities
Knowledge, Perception And Attitude Of Adults Towards People With Disabilities
Abstract
The literature on people with disability demonstrates poor knowledge of people with disability among the general population and also indicates that people often have stigmatizing attitudes towards people with disability.
A descriptive cross-sectional study and quantitative approaches were employed in data collection and 67 respondents were involved both males and females who were selected using simple random sampling method.
The results indicated that generally knowledge on people with disability was poor although majority of the respondents (67%) knew the meaning of people with disability. Attitudes towards people with disability were very poor as 55.2% agreed that they cannot associate with people with disability and 49.2% expressed fear for people with disability. Results about the care for people with disability indicated that 54% cannot take people with disability to hospital but 48.4% of these would instead take people with disability to a traditional healer.
The recommendation is that basic Physical Disability awareness programs should be implemented for general public especially newly school going children and youth to improve the knowledge and understanding and attitudes to reduce fear and negative perceptions and attitudes in order to enhance positive patient experiences and improve the care for people with disability.
Chapter One
Introduction
1.1 Background of the Study
Whether inception of disability occurs gradually or sudden, may it be congenital or acquired, temporary or permanent, disability alters the biological, psychological, social, and spiritual health of individuals (Falvo, 2014; Nosek, 2012; World Health Organization (WHO), 1980; World Health Organization (WHO), 2001). Disability related terms are often used incorrectly and interchangeably. Vash and Crewe (2004) use The World Health Organization’s International Code of Impairment, Disease, and Handicap’s (1980) recommendation to help clarify acceptable language use for referring to disability; impairment refers to “conditions or diseases of the body or its organs”, disability refers to “any functional limitation or restrictions in the ability to carry our activity resulting from an illness, injury, or birth defect”, and handicap “refers to the interference experienced by a person with a disability in a restrictive environment”. The experience of disability impacts a large majority of the population to varying degrees, either directly or indirectly. Falvo (2014) explains that, “the term experience implies that not all individuals–even those with the same medication condition—are affected by disability in the same way” (p. 2). This statement gives perspective into the myriad of complexities involving disability and its multidimensionality. Personal factors, social environments, physical environments and developmental factors, all impact individuals lived experiences with disability (Falvo, 2014).
A considerable amount of the information available to persons with disabilities and their families, is rooted in historic traditions that represent the presence of disability as burdensome and negative (Falvo, 2014; Meyers, Jenkins-Lindburg, Nied, 2013; Nosek, 2012). This predisposes persons affected by disability to feelings of blame and isolation in an unjust society as ours (Griffin & McClintock, 1997; Haegele& Hodge, 2016). Medical discoveries and technological advancements make treatment options available for many who wish to decrease the effects of disabling conditions. Regrettably, societal oppression of persons with disabilities is propagated by the notion that impairments, which lead to disability due to attitudinal and environmental factors, should be cured. In Sub Saharan African (SSA) countries few studies have been conducted in recent years on knowledge, attitudes and beliefs of community members and healthcare workers towards people with disability (Chikaodiri, 2009). The aforementioned studies indicated that people with higher education tend to have more knowledge and positive attitudes towards people with disability (Ndetei, et al, 2011). Some studies conducted also expose the various myths and misconceptions about people with disability were the participants in the study often expressed fear and attitudes towards people with people with disability and often viewed the people with disability as dirty, worthless, and dangerous. Sometimes people also associate people with people with disability with witchcraft and works of evil machines (Ewhoudjakpor, 2009). In Nigeria, poverty, war, famine displacement and homelessness are common, Physical Disability is also becoming a major public health problem. However, little is known about perception of the public regarding people with disability (Tibebe & Tesfay., 2015).
1.2. Problem Statement
People with disability are estimated to constitute about 14% of the global burden of disease, with approximately 80% of people with people with disability living in low- and middle-income countries (LMIC) such as Nigeria. Majority of these cases are handled by non-medical experts where majority of them go unrecognized leading financial loss. Misconceptions about physical disability patients being under the control of evil spirits and therefore being dangerous (Kigozi, et al, 2015).
Cultural beliefs have a great impact on Physical Disability care, treatment and people with disability. Globally, more than 70% of people with people with disability receive no treatment from health care staff. This phenomenon is more prominent in African communities especially in Sub Saharan Africa (Manda, et al, 2017).
Despite the increased burden of physical disability, still there is information gap showing the knowledge and attitude of residents towards people with disability. Therefore, the results of this study will be used as base line data for planning to improve the knowledge and attitude of residents and for further studies on the subject area.
1.3 Purpose of the Study
The purpose of the study is to assess the knowledge, perception and attitude of adults towards people with disabilities
1.4 Objectives of the Study
- To assess the knowledge and perception towards people with disability among residents of Orlu Local government Imo State.
- To explore the attitudes towards people with disability among residents of Orlu Local government Imo State.
- To assess the care towards people with disability among residents of Orlu Local government Imo State.
1.5 Research Questions
The research questions are:
- What is the knowledge and perception of the residents of Orlu Local government Imo State towards people with disability?
- What are the attitudes of the residents of Orlu Local government Imo State towards people with disability?
- What is the care towards people with disability among residents of Orlu Local government Imo State?
1.6 Justification of the Study
Various studies have indicated that negative attitudes, prejudice and discrimination towards persons with disability occur globally (Barke, et al, 2011). Studies have also shown that lack of knowledge regarding the manifestation of people with disability has a role to play in handling these patients. This indicates the need for the public regarding Physical Disability literacy (Kutcher, et al, 2016). Therefore, the study findings will be beneficial to;
Ministry of Health
It might enable policy makers to formulate training guidelines for community sensitization on management of people with disability and how they can be changed.
Nursing practice
The results of the study could contribute to a body of knowledge on the public’s attitudes towards people with disability which may contribute to the implementation and initiation of relevant study programs.
1.7 Organization of The Study
This study is organized into five chapters. Chapter one included the background of the study, research problem, research objectives and questions as well as limitation of the study. Chapter two contains the literature review. Chapter three includes the methodology and study area. Chapter Four contains the results and discussion of key findings of the study. Chapter Five finally looks at the summary, conclusions, and recommendations based on the findings.
1.8 Limitations of the study
Rainy weather: The rains would interfere with the scheduled dates and time of interaction with the respondents. This was over came by use of an umbrella, rain coat and gumboots. The researcher sought assistance from the parent, and friends to provide him with money for research.
Chapter Five
Discussion, Conclusion and Recommendation
5.0 Introduction
This chapter deals with interpretation and discussion of findings objectively in relation to the study background, problem statement and literature review to answer research questions, conclude and make recommendations about knowledge, perception and attitudes of residents of Orlu Local government towards people with disability and the care. Out of the 67 participants recruited in the study, 67 questionnaires were returned completely filled thus a response rate of 100%.
5.1 Discussion of Study Findings.
5.1.1 Demographic Characteristics
Most of the respondents (47.8%) were of the age range 29-39 years while only 7.4% were 51 and above years. Although this study did not correlate between age and care for people with disability, it is important to note that knowledge of Physical Disability improves with time basing on the previous experience. Therefore, as one grows he/she acquires knowledge on the different aspects of people with disability. A mixed method study conducted by Quinn et al, (2009) in the United Kingdom suggests that older people have a more positive perspective towards people with disability. Majority of the respondents (62.7%) were females while only 37.3% were males. This could probably have been because most females were married and would remain home to do house work.
A big percentage of the respondents (52.2%) were married 43.3% were single and only 4.5% had separated. Although this study did not correlate between marital status and people with disability, it is worth noting that married couples always share the responsibility of passing cultural issues to their offspring which in turn determines their attitudes and how they treat people with disability.
Most of the respondents (40.3%) attained primary level of education while only 7.5% attained tertiary level. Majority attained primary level education probably due to government influence of Universal Primary Education (UPE).The aforementioned studies indicated that people with higher education tend to have more knowledge and positive attitudes towards people with disability (Ndetei, et al, 2011).
Most of the respondents (55.2%) were Christians, 28.4% were Muslims and 16.4% belonged to other beliefs. This probably implies that most people are exposed to religious teachings which discourage traditional practices related to people with disability. Respondents who receive the information from religious places receive more sympathetic preaching about people with people with disability and thus adopt good attitudes towards people with disability.
Most of the respondents (55.2%) were unemployed, 29.9% were employed and only 14.9% were self-employed. Socio-economic status of the individual can probably affect him/her psychologically and hence may resort to substance abuse to relieve stress.
5.1.2 Knowledge Towards People with Disability
Majority of the respondents (67%) knew the meaning of people with disability and only 12% didn’t know the meaning of people with disability. This could have been because they might have had someone in their family or community who is people with disability. This assumption is based on the findings of the CDC, (2011) that suggest that familiarity with people with disability and Physical Disability services as well as exposure to people with disability increases the knowledge pertaining to people with disability. For those who didn’t know what the term means (12%), it could have been due to the focus on people with disability as a general term other than on specific physical disabilities which might have created a bias to respondents in individual studies.
More than half of the respondents (58.2%) didn’t mention any physical disabilities while only 14.9% were able to mention at least five physical disabilities. The results are in line with the report by Ganesh, (2011) which suggested that the knowledge on people with disability amongst the general public in South India was poor. Some of the participants in the study conducted by Ganesh could mention a few people with disability disorders.
However, Van der Ham, et al, (2011), in an explorative study conducted in Vietnam, found that the participants in the study were unable to identify and name the different people with disability. This is because knowledge can be influenced by factors such as ethnicity, religion, age, gender, working experience and culture (Chaudhury & Minas,
2011).
Most respondents (38.8%) attributed people with disability to witchcraft, 26.9% attributed it to substance abuse, 22.4% attribute it to stress and only 11.9% mentioned punishment from God. The findings in the aforementioned studies indicate that the knowledge of the public regarding the etiology of people with disability is poor Bener & Ghuloum, (2011). A study which involved African American woman postulates that the participants attribute the causes of people with disability to stress, family and work related matters (Ward & Heidrich, 2009). However, the results of the study are in line with the research by Crabb, et al, (2012) which revealed that most people in Sub-Saharan Africa associate people with disabilities to cultural beliefs. Sometimes people with people with disability are associated with witchcraft and works of evil machines Culturally, Nigerians regardless of education seem to adhere in varying degrees to a belief in supernatural causation for any illness or outcome (Ewhoudjakpor, 2009).However, the results might be due to the fact that the majority of the sample was deeply rooted in cultural/ethnic beliefs as found amongst Africans.
5.1.3 Attitudes Towards People with Disability.
Studies investigating and exploring the attitudes of the general public globally revealed that the attitudes towards people with disability are mostly negative (Des Courtiset al, 2008). Studies indicate that large populations have negative attitudes and beliefs towards people with disability, usually stemming from the fact that lay people, generally have poor knowledge regarding people with disability (Sadik, et al, 2010). Despite the fact that people with disability and Physical Disability care awareness programs being extended extensively over the past few decades, mentally challenged patients are still being mocked, ostracized, labeled, ill-treated and misunderstood by the greater community, family and sometimes health care personnel (Ukpong&Abasiugbong, 2010).
Most of the respondents (51%) disagreed with the statement that people with disability can still have a job and work normally while 20% agreed with the statement. Henderson et al, (2013) contradict with the study findings in a study conducted in England on Physical Disability problems in the workplace suggested that depending on a person’s diagnosis, people with disability can have work and still function optimally. However, the study findings are in line with Sorsdahl, Stein & Myers, (2012) who suggested that a person who has recovered from a people with disability will not be able to return to work.
More than half of the respondents (55.2%) disagreed with whether people with disability should be associated with while 13.4% agreed with the statement. 16.4% strongly disagreed with it. This could have been because they regard people with disability as dangerous and unpredictable. The findings are in line with the study on attitude towards people with disability among Nigerians which indicated that the most prevalent attitude expressed was social distance and avoidance expressed in 52% (13/25) of the participants (Chikaodiri, 2009). A study conducted in Switzerland participants reflected and displayed more negative attitudes, stigmatization and social distance towards people with disability (Des Courtis, et al, 2008).
5.1.4 Care for the People with Disability
All these objectionable views and beliefs on causes of people with disability further complicate the preference for type of care.
More than half of the respondents (54%) stated they would not take people with disability to hospital while 46% of the respondents were positive about the statement. Nearly half of the respondents (48.4%) mentioned that they would take people with disability to a traditional healer instead of hospital while only 9.7% mentioned church/mosque. Although results from our scoping review showed that a few studies reported preference for a combination of both treatment options, it is likely that the element of cultural misconception, which has been shown in the Nigerian society to affect their health seeking behavior, may still make them choose the traditional means of treatment over the western approach. The issue is that a lot of Nigerians, who have lost hope in the health-care system, will resort to spiritual answers by going to prayer houses, traditional healers and spiritualists (Chikaodiri, 2009).
Most of the respondents (65%) have never looked after people with disability while only 35% have ever. This may be explained by a comparative study between Physical Disability and non-Physical Disability personnel conducted in Lincolnshire- UK by Gateshillet al (2011) who reported that non Physical Disability care workers regard people with disability as being dangerous and unpredictable.
Half of the respondents (50%) would occupy the patients mind with different activities while only 18.2% would help people with disability to bathe and wash their clothes while 31.8% would give them food. In Nigeria, it is evident that non-Physical Disability care workers fear Physical Disability users. This fear has caused unwillingness among them to treat people with disability in a general teaching hospital (Chikaodiri, 2009).
5.2 Conclusion
According to the researcher, this study revealed that the residents in Orlu Local government still have poor knowledge on people with disabilities based on the fact that most of them still attribute people with disability to supernatural causes. This reveals choice for traditional means of treatment to western medicine which delays referral to hospitals for proper management by a physician hence worsening the patient’s condition. A higher education level was associated with fewer stigmatizing attitudes against people with people with disability.
Interventions for fighting stigma against people with people with disability should be targeted more on rural communities. Exposure to people with disability information and a higher education level led to a greater reduction in poor attitudes and improved knowledge on people with disability. Any form of explanation for the cause of people with disability, whether supernatural or psychosocial and biological, reduces poor attitudes and improves care towards people with people with disability. Interventions also should target people with higher income but a lower level of education. Community Physical Disability information, education, and communication interventions generally are helpful to improve knowledge and care towards people with people with disability.
5.3 Recommendations
There is an urgent necessity, to improve the health care system by developing strategies that would improve Physical Disability literacy, and change stigmatizing attitude at both institutional and community levels. This will in the long run improve the quality of the societal attitude towards people with disability and the socio-economy of the people with disability. One practical yet feasible way to improve literacy in Physical Disability is by instituting age appropriate school-based educational programs.
The researcher also recommends that guidelines with basic information on people with disability should be established and distributed to general public to inform and educate them regarding basic Physical Disability literacy. This will possibly enhance Physical Disability literacy and to possibly reduce negative perceptions and attitudes towards people with disability.
In addition, it is necessary to encourage health workers (nurses, psychologists, physicians and other health care professionals) to show positive attitude towards people with disability persons as this play an important role in influencing their response to treatment.
In order to determine whether all people share the same views, the researcher recommends that a study should be conducted in both rural and urban areas to investigate the general public’s knowledge about basic people with disability.
Future research should, among other areas, include evaluation of the implementation of the entire Physical Disability care plan, including the benefits of integrated service delivery to provide evidence, particularly for policy makers, to enable them to make informed decisions on resource allocation.
5.4 Implications for Nursing Practice
Morbidity due to people with disability is on increase in among people both in young and old people due to poor knowledge and attitudes about people with disability which in the end affects the care. Therefore, as members of the nursing fraternity, it is our responsibility to diligently carry out sensitization tailored to improve knowledge and care of people with disability in communities while executing our duties.
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