Examining Attitudes Toward Aging and Disability Among Occupational

Therapy TraineesArielle SilvermanJennifer Pitonyak

Ivan MoltonOctober 18, 2015

Guiding Questions

• What beliefs do incoming OT trainees have about aging and disability?

• How does prior contact affect these beliefs?

• How do these beliefs change during the first year of training?

OT curriculum: Disability theory & culture

• Disability theory and culture are important components of OT curriculum (AOTA, 2009; Baum et al., 2010).

• We need to understand the attitudes incoming students have and how specific learning activities affect them.

Ambivalent Attitudes and Mixed Stereotypes

Group Positive Negative

PWD Innocent, heroic, inspiring, warm

Helpless, childlike, dependent, depressed

Older adults Wise, friendly Dependent, rigid, forgetful

Fiske et al. 2002

Study Participants

• Twelve incoming OT students (11 women; mean age = 25).

• All had some contact with PWD and older adults.

• Seven had relatives with disabilities.

• Five had taken disability studies courses.

• Most had unequal-status contact (e.g., working with children or in assisted-living center).

Procedures

• Students completed a survey online within a month of enrolling at UW.

• Completed the same survey six months later, near end of their first year.

• Procedures were approved by the Institutional Review Board.

Attitude Measures

Scale Subscale Sample Item Source

IDP Discomfort with PWD

I feel uncomfortable and find it hard to relax.

Gething & Wheeler 1992

IDP Paternalistic sympathy

It hurts me when they try to do something and can’t.

Gething & Wheeler 1992

IDP Vulnerability to disability

I am grateful that I don’t have such a burden.

Gething & Wheeler 1992

Quality of life with spinal cord injury

Single Item What percentage of people with SCI are clinically depressed?

Developed in-house

Facts on Aging Quiz Single scale Personality changes with age. [false]

Palmore, 1977

Q1. Attitudes and Beliefs at Enrollment

• Ambivalence: compared to scale midpoint, low discomfort (t = -7.11), high paternalistic sympathy (t = 18.91), and moderate vulnerability toward disability (t = 3.04).

• Rate of depression with SCI was estimated at 30% (significantly higher than actual rates 17-22%).

• Aging knowledge was moderately high (77% correct answers), but some misconceptions (belief that older adults are depressed, have trouble moving to new environments, have trouble learning).

Q2. Associations between contact and beliefs

• Students with disability studies background felt less vulnerable (p = .10).

• Working with children with disabilities was associated with more paternalistic sympathy (p = .01). Students with disability in their families over-estimated depression in SCI (37%), but students without disability in their families did not (21%).

Curricular experiences related to attitudes & beliefs about health

• First year, fall quarter– Foundations of OT

• Health-related beliefs assignment

– OT Practice Skills• Experience of person with SCI (guest session)

• First year, winter quarter– Occupational Performance Across the Lifespan

• Life history interview & occupational profile of older adult– Use of Occupational Performance History Interview (OPHI)

Q3. Attitude Changes at Follow-Up

• Students’ aging knowledge scores improved by 5% (p=.06).

• Students reported less paternalistic sympathy (p=.1) and vulnerability (p=.07).

• Predicted depression rates in SCI decreased from 32% to 26% (p=.06).

Next Steps

• What instructional methods and pedagogical approaches (e.g., problem-based learning, simulation, service learning, video cases, discussion, and so on) are most suited to developing positive student attitudes and values for working with individuals with disability?

• Simulations are popular and attractive, but if not done carefully, can increase paternalism (Silverman, Gwinn, & Van Boven, 2015).

Next Steps

• Designed a simulation to teach OT students how to use basic assistive devices.

• Students will learn to transfer to a wheelchair and to make a sandwich using adapted kitchen utensils.

• Hoped to promote identification with and empowerment of PWD.

Conclusions

• Incoming OT students hold ambivalent attitudes toward PWD and older adults, consistent with the general population.

• Disability theory and culture coursework at the undergraduate level can reduce misconceptions about PWD.

• Structured contact with PWD and older adults as part of the first-year OT curriculum can improve knowledge and attitudes.

Acknowledgments

• I would like to thank the faculty and students of the occupational therapy program at UW for their support of this research, as well as research staff Amanda Smith, Aimee Verrall, and Ian Nelson.

• This research was supported by a grant from the Department of Education, NIDRR under grant no. H133B080024.

References1. AOTA. (2009). Occupational Therapy Model Curriculum. Retrieved from:

http://www.aota.org/-/media/Corporate/Files/EducationCareers/Educators/FINAL%20Copy%20Edit%20OT%20Model%20Curriculum%20Guide%2012-08.pdf

2. Baum et al. (2010). Blueprint for Entry-Level Education. American Journal of Occupational Therapy, 64(1), 186-203.

3. Fiske, S. T., Cuddy, A. J. C., Glick, P., and Xu, J. (2002). A model of (often mixed) stereotype content: Competence and warmth respectively follow from perceived status and competition. Journal of Personality and Social Psychology, 82, 878-902.

4. Gething, L. & Wheeler, B. (1992). The interaction with disabled persons scale: A new Australian instrument to measure attitudes toward people with disabilities. Australian Journal of Psychology, 44, 75-82.

5. Palmore, E. (1977). Facts on aging: A short quiz. Gerontologist, 17, 315-320.

6. Silverman, A. M., Gwinn, J. D. & Van Boven, L. (2015). Stumbling in their shoes: Disability simulations reduce judged capabilities of disabled people. Social Psychological and Personality Science, 6, 464-471.