ATTITUDE OF STUDENTS TOWARDS PEOPLE WITH DISABILITIES

Objective. To determine the attitude of students of PIPOS (Pakistan Institute of Prosthetic and Orthotics Sciences) towards people with disabilities. Methods. Cross-sectional study. Pakistan Institute of Prosthetic and Orthotic Sciences Peshawar. Duration of the study was from September 2021 to November 2021. Research strategy for this study was a cross-sectional survey in which census sampling was used and data was collected by using standard questionnaire. Data was collected in PIPOS Peshawar and calculated sample size was 68 students studying in all semesters of PIPOS Peshawar. Out of 68 students 14 students were female and 54 students were male. Results . In this research total 68 students participated in which population of the students 60(80%) had positive attitude while rest of them 8(11%) had negative attitude towards people with disabilities. Mostly all the senior students show positive attitude i.e. semester 4 th shows most positive attitude 89%, semester 8 th shows second most positive response 88%, semester 6 th shows positive response 86% and then semester 2 nd shows positive response 80%. Overall attitude of the students was positive towards people with disabilities. Conclusion. The conclusion of our study is that mostly student’s shows positive attitude 80% towards people with disabilities while 11% of students shows a little negative attitude because they don't have much interaction with patients.


Introduction
The prevalence of disability is considerably higher in low income countries in contrast to higher income countries. According to a world report, about 80% of the disabled people live in low income countries. (Rozali N, Abdullah S, Ishak SID, Azmii AA, 2017). Data about the census and the diseases of disability are scarce but some of the studies identified the common forms of disability which includes physical disability, blindness, mental retardation and deafness. Persons with disability are facing various physical, social, political and economic issues, due to which they are not able to move freely in the society and to make a contribution in its development (Stachura & Garven, 2003). Unfortunately, now even in the twentieth century such type of people exists who do not favor in providing medical treatment to the new-born with certain disability. (Rozali N, Abdullah S, Ishak SID, Azmii AA, 2017). Attitude is a complex combination of the values, thinking, feelings and the beliefs. According to a study conducted in Turkey, it was concluded that 62.6% of the students had the opinion that disabled people are facing the issue of denial and prejudice. (Rathore & Mansoor, 2016).
As people with disability are very much devalued in the society. Since full acceptance of persons with disability by persons without disabilities will not occur, unless barriers such as negative attitude of health care providers, teachers, co-worker, friends and students is eliminated. Negative attitudes towards persons with disabilities generate real hurdles to the fulfilment of their roles and the accomplishment of their life goals. (Anwer & Awan, 2003). Furthermore, understanding the primary dimensions of negative attitudes can put forward different change procedures and can endorse appropriate assessment of the effects of these interventions. Therefore, this study will determine the attitude of the students of PIPOS Peshawar towards the disabled persons along with it the necessary steps for improving awareness in the society regarding the rights of person with disability.
Disability is a condition which is considered to be impaired as compared to the normal individuals. Disability is used to refer physical, sensory, cognitive, intellectual and mental impairment. This condition is a multidimensional experience for the person with disability. Not only the body parts of the person with disability are affected but also his role in social and economic perspective of life. There are three dimensions of disability which are recognized in ICF.
1. Structure and function of body (and the impairment) 2. Activity (its restrictions) then 3. Participation (its restriction) this classification also considered the importance of physical, social and environmental factors which ultimately affects the outcome of disability. (Paris, 1993) The development of modern society is impossible without respect for rights and freedoms of all of its members as well as without their active involvement in various activities and allowing all citizens an access to quality education for further self-realization in professional work (Zheng et al., 2016). The most necessary is to increase the individuals' educational level with disabilities in order to include them actively into work and increase their role in the market. At the same time one of the most powerful means of adaptation is the process of sharing studying in higher educational institutions with healthy peers because in addition to acquisition of the specialty, the student with problems in intellectual or physical development is able to communicate with peers. (Brillhart et al., 1990) In the course of this communication, students with disabilities enrich their social, communicative experience, which promotes active inclusion of this category into the system of social relations. The present study is design (Girli et al., 2016). Thus, this study aims to enrich the existing attitude literature with detailed qualitative information on the coping process of students, their ups and downs, and their overall experience with the disability through the application of the turning points analysis. Exploring the closeness of these relationships also has further interdisciplinary (Ali Khan & Shah Khan, 2017) People with disabilities have been always eliminated from the mainstream society. Students plays a major role in improving, strengthening and establishing the educated society so it is important to know how the current society students think about the disable people and understanding both positive and negative attitudes towards the disability. Thus, the purpose of this study is to know about the Attitude of the students towards people with disabilities in PIPOS Peshawar.

STUDY DESIGN
The research strategy for this study was cross sectional survey. This study was conducted in a renowned institute of Peshawar, Pakistan Institute of Prosthetic and Orthotic Sciences.

STUDY SETTINGS
This study was conducted in all semesters of PIPOS.

STUDY POPULATION
The study population was all the students of PIPOS.

STUDY DURATION
The study was carried out and finished in approximately 3 months starting from September 2021 to November 2021. During the said period all the steps of research thesis was completed i.e. Data collection, Analysis, result and providing recommendations based on study findings.

SAMPLE SIZE
All the students of PIPOS i.e. 68 students.

SAMPLING TECHNIQUE:
Census method was used to collect the data from the required sample size which was 68. 7. SAMPLE SELECTION Inclusion Criteria:  Both male and female students.  The respondents who are in the category of age above 18 to 25 years.  All semester students Exclusion Criteria:  Those students who are not interested in this regard, or they don't want to participate in this survey.

DATA COLLECTION TOOL
Data was collected by using standard questionnaire.

DATA COLLECTION PROCEDURE
All the willing students were briefed about the purpose and procedure of the study. The agreed students were screened through inclusion and exclusion criteria. Data was collected by using standard questionnaire. Every student was free to ask any kind of help while filling the questionnaire.

DATA ANALYSIS PROCEDURE
The data was analyzed by using SPSS (Statistical Package for Social Sciences version 21).
11. ETHICAL CONSIDERATION  Permission was taken from each student before filling the questionnaire.  Confidentiality was maintained.

Results
SPSS statistic data editor was used for data analysis. Descriptive analysis was applied to find the frequencies and percentage.

Semester#2:
Semester  I try to act normally and to ignore the disability Table 3a.11 shows that 11.8% students agreed a little, 17.6% agree somehow, 35.3% agreed very much, 17.6% disagree a little, 11.8% disagree somehow and 5.9% disagree very much.  Table 3a.14 shows that 11.8% students agreed a little, 11.8% agree somehow, 35.3% agreed very much, 17.6% disagree a little, 11.8% disagree somehow and 11.8% disagree very much.

I feel unsecure because I don't know how to behave
Frequency Percent I agree a little 3 17.6 I agree somehow 2 11.8 I agree very much 7 41.2 I disagree a little 2 11.8 I disagree somehow 1 5.9 I disagree very much 2 11.8 Total 17 100.0 Table 3a.15 shows that 17.6% students agreed a little, 11.8% agree somehow, 41.2% agreed very much, 11.8% disagree a little, 5.9% disagree somehow and 11.8% disagree very much.

It irritates me when patient gives me wrong history
Frequency Percent I agree a little 3 17.6 I agree somehow 4 23.5 I agree very much 1 5.9 I disagree a little 2 11.8 I disagree somehow 1 5.9 I disagree very much 6 35.3 Total 17 100.0 Table 3c.18 shows that 17.6% students agreed a little, 23.5% agree somehow, 5.9% agreed very much, 11.8% disagree a little, 5.9% disagree somehow and 35.3% disagree very much. Table 3c.19 shows that 17.6% students agreed a little, 11.8% agree somehow, 17.6% agreed very much, 23.5% disagree a little and 29.4% disagree somehow.

I tend to make contacts only brief and finish them as quickly as possible
Frequency Percent I agree a little 2 11.8 I agree somehow 2 11.8 I agree very much 3 17.6 I disagree a little 2 11.8 I disagree somehow 3 17.6 I disagree very much 5 29.4 Total 17 100.0 Table 3c.20 shows that 11.8% students agreed a little, 11.8% agree somehow, 17.6% agreed very much, 11.8% disagree a little, 17.6% disagree somehow and 29.4% disagree very much.  Table 3d.5 shows that 17.6% students agreed a little, 23.5% agree somehow, 41.2% agreed very much, 5.9% disagree a little, 5.9% disagree somehow and 5.9% disagree very much.  Table 3d.20 shows that 11.8% students agreed a little, 11.8% agree somehow, 23.5% agreed very much, 5.9% disagree a little, 17.6% disagree somehow and 29.4% disagree very much.

Discussion
This study assesses the attitude towards people with disability at undergraduate health sciences students at PIPOS Peshawar. In this research total 68 students participated in which population of the students 60(80%) had positive attitude while rest of them 8(11%) had negative attitude towards people with disabilities.
Overall attitude towards the disability was positive whereas the most positive attitude was shown by senior students. Some juniors' students' shows a little negative attitude because they don't have much interaction with patients.
A study revealed that the nursing students detained unsatisfactory attitudes concerning medical students' physical disability. (Andringa et al., 2013;Satchidanand et al., 2012) and besides they are more negative in attitude unlike the other health care students. (Verbrugge & Jette, 1994) however nursing students from China were described in context of having more positive attitude compared to health care and social work students (Tervo & Palmer, 2004). Interaction with these people with disabilities either during clinical experiences or employment, in family or socially, contacting and closeness of contact with them is vital for making a responsiveness of the problems that PWDs are likely to experience. Understanding of interaction encourages satisfactory behavior towards PWDs. Similar conclusions were found in study reporting that students who had known someone with disability had higher averages than who did not (Tervo & Palmer, 2004).
Interaction with PWDs was a noteworthy factor in the attitudes assumed by the students. Those previously cherish PWDs in social life and does not approach them with a rejection and pity. Concerning a PWDs as a respected individual in public without sympathies for him is a sign of a positive attitude. Positive influence on attitude is proportional to prior knowledge of disability (Chang et al., 2011). A study revealed background in disability effects attitudes with person with disability. Undergraduates and graduates' health sciences students (nursing, medical, physical and occupational therapy, audiology and communication disorder, psychology) remained likely to have more optimistic and positive views on the IDP (Tervo & Palmer, 2004). Likewise, in the current study, prior familiarity on the matter of disability had also a fruitful and positive impact on attitude scores. Formerly having knowledge has a rich and positive effect on creating alertness and make people aware, as well as developing attitudes. Conversely, the results cannot be generalized healthcare students and especially in context to the difference that were obtained from one of the study almost had the sample of 80% female participants (Tervo & Palmer, 2004). An additional matter that rose through the effort for the departmental comparisons was that here are no recognized specific cut-off scores and normative values to let more effective and direct understanding of the results. Therefore, forthcoming researches should try to subside this limitation (Matziou et al., 2009). And in the end, this study was of cross-sectional design and did not allow portrayal of any conclusions on cause concerning the association between knowledge, attitude and cause.

Conclusion and Recommendation
The conclusion of our study is that mostly students' shows positive attitude towards people with disabilities i.e. 89% of students shows positive attitude and the rest of 11% students show a little negative attitude towards PWDs because they don't have much interaction with patients.
People with disabilities have been always eliminated from the mainstream society. Students plays a major role in improving, strengthening and establishing the educated society so it is important to know how the current society students think about the disable people and understanding both positive and negative attitudes towards the disability.
The majority students show positive attitude towards people with disabilities while a few newly admitted students shows some negative attitude because they don't have much understanding and interaction with PWDs the competent authorities should plan and implement certain strategies to cope with negative attitude of the students towards disabled people.