Health professionals, disability, and assisted suicide: An examination of relevant empirical evidence and reply to Batavia (2000).

Prominent disability rights groups have adopted positions opposing the legalization of assisted suicide. That physicians and other health professionals would assist in suicides of persons with incurable conditions while offering suicide prevention to "healthy" individuals is, they maintain, evidence of social discrimination and an unwarranted devaluation of the quality of life of people with disabilities. This article examined empirical literature relevant to the question: Is there evidence that disability affects life in a manner that justifies an exception to the general practice of preventing rather than endorsing suicide? Research findings are discussed in terms of their bearing on the disability rights opposition to physician-assisted suicide and the need for research addressing the dynamics of death requests of persons with disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors That Prevent Equitable Access to Rehabilitation for Aboriginal Australians With Disabilities: The Need for Culturally Safe Rehabilitation.

Objective: To investigate the barriers that prevent Aboriginal people with disabilities from accessing rehabilitation services. Study Design: Qualitative study with assistance from a local community research partner. Setting: A predominately Aboriginal town in Australia. Participants: Sixteen service providers from the local town, 8 from the nearest regional town, and 4 local people with disabilities. Main Outcome Measures: Data were categorized into themes that represented barriers to appropriate rehabilitation. Results: Six major themes were identified, including aspects of Aboriginal culture that influenced the ability of Aboriginal people with disabilities to access services and cultural stereotypes on the part of non-Aboriginal service providers. Conclusions: Significant obstacles to appropriate service provision exist in Australia. Models of culturally safe rehabilitation must be embraced. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perspectives on ethical practice with people who have disabilities.

An estimated 49.7 million people in the United States live with one or more disabilities, representing nearly 20% of the 257.2 million individuals ages 5 and older in the civilian population (U.S. Census Bureau, 2003). Most psychologists are likely to have the opportunity to work with clients who have disabilities (R. Olkin, 2002) and need the competencies to provide ethical services to this growing proportion of the population. What constitutes ethical practice with people with disabilities? First, the ethical issues involved in providing services for people with disabilities are outlined, and 2 vignettes and a number of questions for practitioners and educators are presented. Then, 3 invited experts provide commentaries that address these issues, raise additional questions, and provide important resources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes of management undergraduates toward persons with disabilities: A need for change.

Objective: To examine attitudes toward persons with disabilities of management undergraduates who will be the next generation of professionals and managers hiring and working with employees or clients with disabilities. Participants: A convenience sample of 231 volunteer management undergraduates (129 men and 102 women) ranging in age from 19 to 51 years (M?=?22.89, SD?=?4.43) from 7 human resource management and organizational behavior management classes in a small western Canadian university. Main Outcome Measures: L. Gething's (1991) Interaction With Disabled Persons Scale (IDP) along with openended questions and the Marlowe-Crowne Social Desirability Scale (D. P. Crowne & D. Marlowe, 1960). Results: This Canadian sample expressed a complex set of positive and negative attitudes toward persons with disabilities. Conclusions: There is a need to sensitize management undergraduates to issues regarding employment of people with disabilities. Recommendations are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial maturity in the transition to adulthood for people with and without motor disabilities.

Objective: To identify individual, family, and community variables that contribute to psychosocial maturity in the transition to adulthood for people with and without motor disabilities (mean age = 25 years, range = 20 to 30). Participants/Design: Seventy-four people (34 men, 40 women) with developmental motor disabilities (cerebral palsy or spina bifida) and 72 people (31 men, 41 women) without motor disabilities from a Canadian province completed questionnaires and participated in a semi-structured interview. Results: In a heirarchical regression analysis, individual and family variables explained variance in psychosocial maturity for the total sample. More use of task-focused coping, lower levels of depression, and perceptions of fathers as autonomy fostering were associated with increased psychosocial maturity. These variables were also significant in a similar analysis for the group with motor disabilities with 1 addition; older age also was related to higher psychosocial maturity. Community variables did not explain variation in psychosocial maturity in either analysis. Conclusion: Knowledge about barriers to and facilitators of a successful transition to adulthood can be used to design services to maximize opportunities for young people with disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology in the Public Forum: Perspectives on Persons with Disabilities.

Jackman (1983) states that the predominant perspective in America on persons with disabilities is to view them as flawed individuals who need to be rehabilitated in order to be made as normal as possible. Because people with disabilities cannot do some of those things done by people without disabilities, they are seen as incompetent, helpless, unproductive, and dependent on others for care. If individuals with disabilities are to improve their status, it is necessary for them to rely on those who can help them accommodate to their disabilities. An alternative conception is to view individuals with disabilities as members of a minority group who lack power and are denied their civil rights. From this perspective, persons with disabilities face problems stemming from a society that stigmatizes and devalues those who are different. Many psychologists could be contributing to knowledge on and service to people with handicaps from both perspectives, but most view such activities as a narrow area of specialization outside the mainstream. The articles in this forum discuss the relationship among psychological knowledge, issues relating to those with disabilities, and public policy primarily from the civil rights perspective. It is hoped that the civil rights perspective can be added to the dominant rehabilitation viewpoint within psychology, attract a greater following within psychology, and produce a psychology of disability that can speak more forcefully to issues of disability and public policy. The six articles in this forum suggest that issues of disability need not remain narrowly segmented within psychology and nearly invisible to most of the discipline. Through greater attention by a broader segment of psychology and attention to the civil rights as well as the rehabilitation perspective, more enlightened public policies on issues of disability can emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of a Computer-Assisted, 2-D Virtual Reality System for Training People With Intellectual Disabilities on How to Shop.

Objective: To evaluate the effectiveness of a 2-D virtual reality (VR) program for training people with intellectual disabilities to shop. Study Design: Pretest and posttest quasi-experimental design. Participants: Sixteen persons with intellectual disabilities (age 17-23 years; IQ = 40-54). Intervention: A VR program or a conventional program training them in supermarket-shopping skills. Main Outcome Measure: Checklist for supermarket-shopping skills. Results: Participants in both training groups showed significant improvement. There was no significant difference in effectiveness between the two methods. Conclusions: The VR program appears effective in training people with intellectual disabilities in an important community living skill. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mortality among people with mental retardation living in the United States: research review and policy application

A literature review was conducted to examine mortality among people with mental retardation and related developmental disabilities living in the United States and determine how research findings relate to or assist in policy development. Two questions were considered: What do the differences between earlier and more recent research mean to policy development? What does the research literature indicate about other aspects of mortality that relate to policy development? Five major limitations of mortality research as a useful tool to policy development were discussed. Recommendations were made to identify what policymakers need to do to develop an oversight mechanism and type of research needed to assist policymakers in providing appropriate services and supports to this population.     

The psychosocial impact of Hurricane Katrina on persons with disabilities and independent living center staff living on the American Gulf Coast.

Objectives: To determine the impact of Hurricane Katrina on the psychosocial health of people with disabilities and on the ability of people with disabilities in the affected area to live independently. Participants: Transcribed conversations were analyzed for 56 survivors of Hurricane Katrina on the American Gulf Coast, all of whom were persons with disabilities or persons working with them. Method: Semi-structured interviews were conducted either individually or in focus groups with participants. Qualitative analysis was undertaken using hermeneutic techniques. Results: Six major themes emerged: faith, incredulousness, blaming others or oneself, family adaptation and resiliency, and work and professional responsibility. Conclusions: The resiliency of persons with disabilities to adapt to disasters can be better understood through factors such as these, providing an effective barometer of social capital that can help societies prepare for future disasters among those most vulnerable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How Changes in Population Demographics Will Impact Health Psychology: Incorporating a Broader Notion of Cultural Competence Into the Field.

U.S. population demographics are undergoing striking changes that will impact health care and the research and practice of health psychology. An increase in the number of people who are older; belong to an ethnic minority group; have disabilities; identify as lesbian, gay, bisexual, or transgendered; or live in poverty will influence definitions of aging, health, and illness, and will challenge current psychological and medical treatment models. The authors argue that health psychologists need to become context competent for the field to be relevant and viable over the course of this new century. Health psychologists need to become aware of the multiple, overlapping contexts in which people live and apply this knowledge on a regular basis to research, practice, education and training, and policy in health psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes toward people with disabilities: The perspective of attachment theory.

Objective: Attachment theory was employed as the theoretical framework for the purpose of examining attitudes toward people with disabilities. Method: A total of 404 Jewish Israeli students without disabilities completed the Multidimensional Attitudes Scale Toward Persons With Disabilities (MAS) and the Experiences in Close Relationships Scale (ECR). Results: Reading a scenario about an encounter with a person with a disability gave rise to more negative emotions than reading a similar scenario about an encounter with a person without a disability, regardless of participants' attachment orientations. However, attachment orientations moderated participants' positive cognitions and distancing behaviors. Conclusions: Findings suggest a dynamic process of self-regulation when reacting to a written scenario about people with disabilities. This process consists of an initial spontaneous negative emotional response accompanied by compensatory positive cognitions and behavioral tendencies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hospital to community: Changes in practice and outcomes.

This article describes the need for psychologists working with persons with disabilities to establish validity procedures within research findings and clinical practices. It highlights the importance of providing a contextual framework for behavior by adopting a socioecological paradigm of disability. Theoretical, research, and clinical practice implications are discussed, such as the evolution of paradigms guiding rehabilitation, the need to move research out of the laboratories and into the field, and the importance of focusing on the broader socioenvironmental needs of persons with disabilities. The author also offers specific recommendations for psychologists engaged in activities across education, research, and clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of technology by people with physical disabilities in Australia

PURPOSE: This study aimed to quantify the extent to which computers and assistive devices were being used by people with physical disabilities and the levels of computer training being undertaken by this group. METHOD: With the help of Queensland disability associations a written survey was distributed to people over 15 years in age with physical disabilities living in the greater Brisbane metropolitan area. Responses were received from 82 people (comprising spinal cord injuries (n = 71), cerebral palsy (n = 8), muscular dystrophy (n = 3)). RESULTS: Indicate that 60% of respondents were computer users, while only 15 respondents used assistive devices. Computer ability was correlated to age and time of disability onset. Respondents with quadriplegia had higher levels of computer ability than those with paraplegia. The study indicates that while many people with disabilities have used computers and assistive devices, many have not. CONCLUSIONS: The low rate of assistive device use by people with high-level quadriplegia is of concern. This study suggests that increased levels of training in the use of computers and assistive devices needs to be provided to people with physical disabilities.     

A review of research on physical exercise with people with severe and profound developmental disabilities

During the last two decades, a significant amount of research has examined physical exercise with people with severe and profound developmental disabilities. The research has followed three main objectives: 1) finding strategies for allowing the people to engage in physical exercise fairly independent; 2) improving the people's physical fitness; and 3) reducing the people's deviant behavior. This paper reviews the studies related to the aforementioned objectives and comments on the main findings and on the practicality and acceptability of physical exercise.     

Does Volunteering With Children Affect Attitudes Toward Adults With Disabilities? A Prospective Study of Unequal Contact.

Objectives: Determine effects of volunteering with children with disabilities on attitudes toward adults with disabilities; examine predictors of social distance. Setting: Pediatric educational-rehabilitation center. Method: Seventy-one adult volunteers completed measures before and after volunteering for 4 to 10 months with children with physical or hearing impairments. Main outcome variables: Questionnaire measures of social distance, self- and other-focused attitudes, thoughts, and affect toward adults with disabilities. Results: Volunteering decreased social distance and had the greatest impact on comfort and ease, regardless of the group with which participants volunteered. There was little change in thoughts and beliefs about people with disabilities. Social distance was best predicted by an other-focused variable: thoughts about the person with a disability. Conclusions: Working with children with disabilities diminished social distance and improved self-focused aspects of attitudes, thoughts, and feelings. This experience generally did not affect other-focused views, which are important for interaction with peers with disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression self-management program for rural women with physical disabilities.

Objective: To examine the efficacy of a depression self-management intervention for rural women with physical disabilities. Participants and Design: A sample of 96 rural women with disabilities experiencing depression, who were recruited through centers for independent living (CILs), were randomly assigned to either a depression self-management intervention or a control group, and completed pre-, post-, and 3-month follow-up questionnaires. Intervention: An 8-week depression self-management program led by CIL staff members who received preintervention training and ongoing clinical supervision. Measures: Primary outcomes were the Beck Depression Inventory II (BDI-II) and the 10-item Center for Epidemiologic Studies-Depression scale (CESD-10). Results: Relative to the control group, women in the intervention group demonstrated a greater reduction in BDI-II scores at posttest and follow-up. Significant differential improvement was not observed on the CESD-10 or on the following hypothesized mediators: self-efficacy, depression self-management skills, social support, and connectedness. Conclusion: A brief, peer-led, depression self-management program resulted in a reduction of depressive symptomatology on 1 of the 2 measures of depression. This study serves as 1 model for delivering depression treatment to a rural population with significant needs yet extremely limited access to mental health services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strained interaction: Evidence that interpersonal contact moderates the death?disability rejection link.

Objective: Our objective was to examine whether brief yet significant contact between a confederate seated in a wheelchair and a nondisabled participant may attenuate the relationship between death reminders and disability rejection found in previous research. Method: One hundred two participants were randomly assigned to a mortality salience or control condition and were then seated in a room with a confederate. In half the cases, the confederate sat in a wheelchair, and in the other half in a regular chair. Furthermore, half the participants were assigned to either a collaborative task with the confederate, or to an individual task condition. At the end of the session, participants were asked to evaluate the confederate. Results: Death primes led to a more negative evaluation of the confederate in a wheelchair in the individual task condition. However, this effect was attenuated in the collaborative task condition. Conclusions: The death-disability rejection link is not deterministic and may be attenuated through meaningful contact between people without disabilities and people with physical disabilities (PWD). The findings suggest that terror management theory is a particularly useful framework for understanding and intervening in the strained interaction between PWD and nondisabled individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rapid detection and counting of viable bacteria in vegetables and environmental water using a photon-counting TV camera

A physical, cognitive, or mental disability presents significant challenges to an individual in gaining access to a coordinated program of preventive, primary, and secondary health care services. This article describes the health care needs of people with disabilities and discusses how the financial incentives in managed care may threaten access to the health care services they need to maintain their health and functional independence. We argue that despite the shortcomings of present models, managed care has the potential to improve the health care of people with disabilities. Moreover, as health plans become increasingly accountable to consumers (and begin to compete on the basis of quality), they will not be able to ignore the distinct health care needs of people with disabilities.