Assessment of Undergraduate Nursing Students' Perception towards Mentally Disabled Child

Objectives: The study aims to assess undergraduate nursing students' perception towards mentally disabled child and to find out the relationships between their perceptions with their socio-demographic characteristics.
Methodology: A descriptive analytical study was carried out from January 15, 2014 to July 15th, 2015 to students of Nursing College /University of Baghdad. An accidental random sample of (200) students was involved in the present study from the four academic year in College of Nursing/Baghdad. Self-administrative questionnaire was constructed by the investigator for the present study. The constructed questionnaire consisted of two parts: first one contained the socio-demographic characteristics such as gender, age, marital status, income, scholastic stage, having disabled child as family member and as friend; second one contained 19 items which measure perception of the students. Content validity for the instrument was determined through the use of panel experts and the reliability estimated through the internal consistency of the instrument by the computation of Alpha Correlation Data were collected through the use of the constructed questionnaire and the process of the self-administrative report as means for data collection. Data were analyzed through the application of descriptive and inferential statistical approaches by using Statistical Package for Social Science (SPSS) version 13.0.
Results: The result of study indicates that (56.5%) of students were females, (53%) of them between 21-23 years old, (81%) of them were single, (98%) do not have mentally disabled child in their family, (95%) of students have no mentally disabled child as friend, while (85%) of them having low experience with mentally disabled child. Students hold moderate perception towards mentally disabled child. And they have low experience to contact with mentally disabled child. Perception of students influenced by their age, marital status, and experience with mentally disabled child, and does not affected by gender and scholastic stage.
Conclusions: The study concluded that undergraduate nursing students hold moderate level of negative perception towards children with mental disability, students' age, marital status, and having disabled child as family member have significant relationship with the level of perception toward disabled child.
Recommendations: The study recommended of changing students' perception positively towards mentally disabled child by increasing their knowledge and giving opportunity to contact with that group of patients. Focus on the media and scientific symposia within the college and inclusion vocabulary within mental health nursing syllabus to raise the awareness of the students about the disabled child in all its types.


INTRODUCTION
In few last years, knowledge and perception and attitudes have been studied extensively.Specific studies have been conducted in the scope of perception and attitudes towards individuals with disabilities and some of them are particularly focused on attitudes towards people with intellectual disabilities (1) .
The percentage of children who were mildly disabled increased with the growth of towns, because of poor housing, lack of care before, during, and after birth, malnutrition, poverty, and poor working conditions for mothers.These causes remain, but, with the improvement of general standards of living and literacy, children handicapped in this way are now among the 'ablest' of the mentally handicapped (2) .
Recently there has been a drive towards educating people about psychiatric disorders and to improve the knowledge and perception of the mentally ill.Although, there is some improvement, people's perception of the mentally ill due to public education campaigns, a lot of work still needs to be done (3) .
In the Arab world, there has been limited research in the area of perception towards mentally disabled children (3) .

OBJECTIVES OF THE STUDY
The study aims to assess the perception of undergraduate nursing college students toward mentally disabled child; find out the relationship between students' perception towards mentally disabled child and socio-demographic characteristics such as: age, gender, marital status, scholastic stage, and experience with mentally disabled child.Status, scholastic stage, and experience with mentally disabled child.

METHODOLOGY:
A descriptive-analytic study was carried out, included (200) Undergraduate Nursing College students in order to assess their perception towards mentally disabled child and to find out the relationships between their perception with their socio-demographic characteristics, from period of January 15 th , 2014 to July 15 th 2015.The study was conducted for students of four scholastic stages in Nursing College / University of Baghdad.An accidental randomly sample of 200 students (males and females) were chosen.
Self administrative questionnaire was constructed by the investigator for the present study through: review of available literature and the related previous studies scale such as: Bi and Kitchen (4) (5) .
The constructed questionnaire consisted of two parts: The first one contained the socio-demographic characteristics; second one contained 19 items which measure the perception of the students.These items were rated on three level Likert scales; Agree, uncertain, and I Disagree, and scored as 3, 2 and 1, respectively.Relative sufficiency (RS) Less than (66.66) was considered low level of perception, (66.66-77.77)was considered moderate, while (77.78-100.0) was considered high level of perception.Self administrative questionnaire was distributed after being if he \she was willing to answer the questionnaire and participate in the study, and each one was given a time period between (15-20) minutes to answer the questions.
Content validity for the instrument was determined through the use of panel experts to investigate the clarity, relevancy, and adequacy of the questionnaire in order to achieve the present study's objectives.The expert were from college of nursing, two of them were from psychiatric mental health nursing department, one from pediatric nursing department and one from adult nursing department.
In addition to the experts' responses, their suggestions were taken into consideration.So far, modifications were employed and the final copy of the constructed instrument was completed to be an appropriate tool for conducting study.
The internal consistency of the instrument was determined through the computation of Alpha Correlation Coefficient (Cronbach's Alpha).The result of the reliability was (r = 0.70) and such an estimation was statistically adequate which means that the questionnaire had adequate level of internal consistency and equivalence measurability.
The data have been collected through the utilization of the self administrative questionnaire as a mean of data collection.
Statistical analyses were conducted by using statistical package for social science (SPSS) version 13.0.Data analysis was employed through the application of descriptive and inferential statistical approaches (6) .Table 1 indicates that the study included (200) students, (56.5%) of them were females, (53%) of them between 21-23 years old, (81%) of them were single, (27%) at the second scholastic stage, (98%) do not have mentally disabled child in their family, (95%) of students have no mentally disabled child as friend, while (85%) of them having low experience with mentally disabled child.Table 2 demonstrates the total mean of perception score and the total relative sufficiency for (19) items to assess undergraduate nursing student's perception towards mentally disabled child, which indicated that there is moderate level of perception for students concerning mentally disabled child, with respect to the total mean of scores which was (2.6), and to the relative sufficiency (RS) which was (68.7%).

Table (3): Relationship between Student's Perception and their Socio-demographic Characteristic
Students perception  3 shows that there is significant relationship between Student's Awareness their socio-demographic characteristic variables except gender and scholastic stage were not significant at P≤ 0.05.

DISCUSSION
The results of table (1) revealed that (56.5%) of students were females, (53%) of them between 21-23 years old, (81%) of them were single,(27%) at the second scholastic, and having low experience with mentally disabled child.This result was supported by Kitchen (5) who found that 71% of respondent were females and (47 %) were secondary major education.Most of the subjects were unmarried, which indicates that students were career oriented.These finding were in consistent with Mahto and others (6) who found that 84% from among males and 68% from among females were single.Concerning the increase proportion of females' students than males, this finding could be explained that females are more wishing to work in nursing than males.Most of them didn't meet or experienced with disabled child.
Table (2) shows the perception of students toward mentally disabled child which include (19) items to assess undergraduate nursing student's perception towards mentally disabled child, which indicated that there is moderate level of perception for students concerning mentally disabled child, with respect to the total mean of scores which was (2.6), and to the relative sufficiency (RS) which was (68.7%).These finding were consistent with Kitchen (5) who reported that there is high positive perception toward physical disabilities and high negative perception towards mental disability.And the findings were inconsistent with Bi (4) who was found a higher perception of students toward mentally disabled child.The interpretation of the above results is that nursing students hold negative view toward disabled child in which they are source of pity and shame in the community and also they form a source of burden for their families and significant others.
Analysis of the current study in the table (3) shows that there is significant relationship between perceptions of the students in regarding to their entire variable except gender and scholastic stage which were not significant.These results (gender and scholastic stage) were approved by several studies (7), ( 6), (8) who reported that there is no significant between gender and educational level regarding to mental disability.The results showed that there is significant relationship between students' perception and their age and marital status, these finding supported by Yuker & Block (7) who found a significant relationship; and disagreed with many studies (9),( 6), (8) who they reported that there is no significant relationship.The result indicates that there is significant relationship between perception of students and their experience, this finding was approved by Hamaideh& Mudallal (9) and Tervo (10) who reported that there is significance with students who have previous contact with mental patients and disabled persons.

CONCLUSION:
1. Undergraduate nursing students hold moderate level of perception towards children with mental disability.2. Nursing students' perception is influences by their gender, age, and marital status.3. Having mentally disabled child as family member and friend are significantly related with the students' perception due to direct contact with mentally disabled child.

RECOMMENDATIONS:
The present study recommended of the followings: 1. Changing students' perception positively towards mentally disabled child by increasing their knowledge and giving opportunity to contact with that group of patients.

2.
Focusing on the media and scientific symposia within the college and inclusion vocabulary within mental health nursing syllabus to raise the awareness of the students about the disabled child in all its types.