1. Background
According to the definition of the World Health Organization (WHO) about aging and the disabled elderly, and the necessity to change the attitude of communities toward this important social and economic matter, the proper care of different key groups of the community may result in meeting the needs of the elderly in future. The importance of this matter is under the shadow of available data. The studies show that the motor and sensory disorders are the main problems of the elderly. According to the results of the current study motor and sensory disorders, such as visual impairments of the elderly are 57.7%-79.2% and 60.8%-62.3%, respectively (1). Training and improving the knowledge of health workers cause correcting misconceptions or wrong attitudes toward the health care (2). Since the students of medical sciences are responsible for the future health of the country, their knowledge in different fields, such as the elderly needs, is one of the necessities to manage health care issues, because change in their knowledge and attitude can change the knowledge and attitude of other social classes (3). Besides, the conducted studies show that the model designed to modify the attitude of the community toward culture and lifestyle play an important role in improving the life of the disabled people (4). Results of a study performed on the knowledge of 320 health workers regarding the healthy lifestyle during the old age in Shiraz, Iran, reported that some particular groups of the society have to be trained in this regard (5).
Different mental and physical disorders hurt people during the old age, but the most important point is although the elderly have different needs, their health should not and cannot be separated from the health policies of other community groups and should be considered as a part of national health policies (6). Therefore, the elderly people may face disabilities and become dependent on the others in their private affairs under some circumstances. Disabled elderly refers to people who have problems in handling their private daily affairs (the core ADLs: bathing, changing clothes, using the toilet, transferring from bed to chair, and feeding oneself) and are dependent on the others (7).
According to the community based rehabilitation strategy, using local contributions and human resources, and also correcting community attitudes toward decreasing the problems of disabled elderly have been emphasized to the evaluate the attitude of different groups of community such as key managers (8). There is a small disagreement between community members, but this small disagreement causes significant differences in the society. One of these differences is the attitude of people, but the main difference is whether it is positive or negative (9). Previous studies have reported that negative attitudes of people cause different problems such as despair and disappointment of the disabled people and prevent their further developments; for example, in some regions of the world people believe that disability is a tragedy and death is better for the disabled people (10). It has been also recommended that understanding the attitudes of community toward the disabled people results in further successful programing. According to a study, when people recognize the disabled people, half of them try to treat them like healthy people (11). Therefore, according to the mentioned issues and based on the fact that before any planning, it is necessary to understand the attitude of people toward disability.
3. Patients and Methods
In the current study, 90 students (60 females and 30 males) of paramedics (except for rehabilitation, since they have direct contact with the matter of disability) from Semnan University of Medical Sciences participated. To evaluate the attitude of community members toward disability, the Scale of Attitudes toward Disabled People (SADP) questionnaire was employed. This 24-item questionnaire with the approved reliability has been used in different countries such as Jordan (12). In the current study, the students’ comments on different matters such as discomfort, sensibility or tenderness, knowledge of causes, knowledge of capacity, and rights were evaluated (13).
4. Results
Results of the current study showed that 13.5% of the population was unaware or had misconceptions about social problems of the elderly; and 30.5% of the population was unaware or had misconceptions about family problems of the elderly. Also, 43.78% of the population was unaware or had misconceptions about disability. Results of the current study (comments of 90 students in different courses regarding their attitude toward the disabled elderly) are shown in Tables 1 and 2.
Table 1. Knowledge and Attitude of Students Toward Social Problems of the Disabled Elderly a
| Index | Agree | Disagree | Unaware |
|---|---|---|---|
| Suitable design of the buildings for the disabled elderly | 8 (8.8) | 72 (80) | 10 (11.11) |
| Feel pity toward the disabled elderly | 47 (52.22) | 39 (43.33) | 4 (4.44) |
| It is better for the disabled elderly not to go to streets due to traffic problems | 8 (8.8) | 77 (85) | 5 (5.5) |
| The disabled elderly faced serious discrimination in the community | 73 (81.1) | 4 (4.4) | 13 (14) |
| The government should not spend heavily for the part of community who do not have enough efficiency | 18 (20) | 66 (72.2) | 6 (6.6) |
| The percent of the people who refer to the governmental offices (elderly or disabled) | 30 (33.3) | 30 (33.3) | 30 (33.3) |
| Elderly people who are capable of being expert | 67 (74.4) | 12 (13.3) | 11 (12.22) |
| The disabled elderly are less successful in their works | 13 (14.4) | 69 (76.6) | 8 (8.8) |
aData are presented as No. (%).
Table 2. Knowledge and Attitude of Students Toward Family Problems of the Disabled Elderly a
| Index | Agree | Disagree | Unaware |
|---|---|---|---|
| The elderly who use canes are disabled | 23 (25.5) | 54 (60) | 13 (14.4) |
| The elderly who use hearing aids are disabled | 36 (40) | 43 (47.7) | 11 (12.2) |
| The elderly who have amnesia are disabled | 24 (26) | 53 (58.8) | 13 (14.4) |
| The elderly who sometimes use wheelchairs are disabled | 22 (24.4) | 58 (64.4) | 10 (11.1) |
| The utility of community based on rehabilitation for the disabled elderly | 60 (70) | 5 (5.5) | 22 (24.4) |
a Data are presented as No. (%).
5. Discussion
WHO emphasizes on life quality of the disabled elderly to evaluate the level of their success.
Different studies have been conducted in different countries; for example, Mustapha has emphasized on the role of environment and awareness of the community about the problems of the disabled people in “the fourth conference of rehabilitation and disability in Islam world” (14). Harder and Scottl reported that human beings do not live isolated, but they are in contact with a wide range of humans and other creatures. Hence, the role of each person in the community is influenced by the role of others. They also added that disability management needs to identify services, functions, and the relationship between the community members (4). Results of the current study showed that the level of knowledge about the needs and factors affecting community involvement of the elderly varies among the students. Also, it was showed that almost half of the participants had incorrect attitudes, or were unaware of the elderly problems. The results of the current study were compatible with those of the previous studies. Saffari and Moradi evaluated the level of knowledge regarding the old age among health workers and reported that their knowledge was insufficient, and community involvement and training is necessary for the healthy and active elderly (5). Ebadiazar et al. evaluated the level of knowledge and attitude of the health care managers toward the management of health system. Their results showed that to improve the level of health in the community managers should be trained and this training have to be performed based on the needs (3). Finkenflugel et al. evaluated the attitude of different community groups toward the success of Community Based Rehabilitation Programs (CBR) and reported that the knowledge of people affects their attitude (15).
Harder and Scott suggested a disability management model with three basic concepts as follows: beliefs and values; goals of practice (what we want to do); knowledge and skills (required knowledge and skills to achieve the goals). They also emphasized on the effect of knowledge regarding the achievement of the mentioned goals (4). Employing different training methods and learning the required knowledge may modify and change wrong attitudes toward health care issues (2). Results of the current study showed that the level of knowledge regarding the needs and effective factors in the community involvement of the elderly varies among the students.
The results of the current study showed that only 50% of the participants had a proper attitude toward the problems of the elderly in different fields. Since the students are future managers of the country and can play an important role in relative policymaking, it is necessary to make them aware of the needs of the elderly.
