case study of an individual with disability

Disability and Health Stories from People Living with a Disability

• Nickole's Story
• Jerry's Story
• Justin's Story
• Suhana's Story

Real Stories from People living with a Disability

Nickole cheron’s story.

In 2008, a rare winter storm buried Portland, Oregon under more than a foot of snow. The city was gridlocked. Nickole Cheron was stuck in her home for eight days. Many people would consider that an inconvenience. For Nickole, whose muscles are too weak to support her body, those eight days were potentially life-threatening.

Born with spinal muscular atrophy, a genetic disease that progressively weakens the body’s muscles, Nickole is fully reliant on a wheelchair and full-time caregivers for most routine tasks. Being alone for eight days was not an option. So Nickole signed up for “ Ready Now! pdf icon [PDF – 4.8MB] external icon ,” an emergency preparedness training program developed through the Oregon Office of Disability and Health external icon .

“The most important thing I learned from ‘Ready Now!’ was to have a back-up plan in case of an emergency situation ,” she said. “When I heard the snow storm was coming, I emailed all my caregivers to find out who lived close by and would be available. I made sure I had a generator, batteries for my wheelchair, and at least a week’s supply of food, water and prescription medication.”

Nickole said the training was empowering, and reinforced her ability to live independently with a disability. She felt better informed about the potential risks people with disabilities could encounter during a disaster. For example, clinics might close, streets and sidewalks might be impassable, or caregivers might be unable to travel.

Among the tips Nickole learned from Oregon’s “Ready Now!” training are:

• Develop a back-up plan. Inform caregivers, friends, family, neighbors or others who might be able to help during an emergency.
• Stock up on food, water, and any necessary prescription medications, medical supplies or equipment. Have enough to last at least a week.
• Make a list of emergency contact information and keep it handy.
• Keep a charged car battery at home. It can power electric wheelchairs and other motorized medical equipment if there is an electricity outage.
• Learn about alternate transportation and routes.
• Understand the responsibilities and limitations of a “first responder” (for example, members of your local fire department of law enforcement office) during a disaster.

“This training shows people with disabilities that they can do more to triage their situation in a crisis than anyone else can,” she said. “‘Ready Now!’ encourages people with disabilities to take ownership of their own care.”

CDC would like to thank Nikole and the Oregon Office of Disability and Health external icon for sharing this personal story.

Learn about emergency preparedness for people with disabilities »

Jerry’s Story

Jerry is a 53 year old father of four children. He’s independent, has a house, raised a family and his adult kids still look to him for support. Jerry recently retired as a computer programmer in 2009, and competes and coaches in several sports. This “healthy, everyday Joe, living a normal life” has even participated in the Boston Marathon. Jerry also has had a disability for over 35 y ears. In 1976 on December 3 (the same day that International Persons with Disabilities Day is recognized) Jerry was hit by a drunk driver. The accident left him as a partial paraplegic.

Jerry’s life is not defined by his disability. He lives life just like anyone else without a disability would live their life. “There’s lots I can do, and there are some things that I can’t do,” said Jerry. “I drive, I invest money. I’m not rich, but I’m not poor. I enjoy being healthy, and being independent.”

As a person with a disability, however, Jerry has experienced many barriers. Recovering from recent rotator cuff surgery, his rehabilitation specialists “couldn’t see past his disability”, administering tests and delivering additional rehabilitation visits that a person without a disability wouldn’t receive. He once was being prepared for surgery when a nurse proclaimed “he doesn’t need an epidural, he’s a paraplegic.” Jerry had to inform the nurse that he was only a partial paraplegic and that he would indeed need an epidural.

Jerry was in line at an Alabama court house to renew his parking permit and also renew his son’s registration. He watched a worker walk down the line and ask people “what do you need?” When she got to Jerry and saw his wheelchair, he was asked “who are you here with?” And Jerry finds it difficult to go to concerts and baseball games with a large family or friends gathering, because rarely are handicap-accessible tickets available for more than two people.

Jerry has seen a lot in over 35 years as someone living with a disability. He’s seen many of the barriers and attitudes towards people with disabilities persist. But he’s also seen many positive changes to get people with disabilities physically active through recreational opportunities such as golf, fishing and even snow-skiing. There are now organizations such as Lakeshore Foundation external icon – where Jerry works part-time coaching youth basketball and track – that provide recreational opportunities.

Jerry states: “I don’t expect the world to revolve around us. I will adapt – just make it so I can adapt.”

Justin’s Story

Justin was first diagnosed with a disability in the form of ADD (attention deficit disorder, now known as ADHD, or attention-deficit/hyperactivity disorder) at the age of 5 years. The diagnosis resulted in his removal from a regular classroom environment to special education courses. Justin’s parents were informed by Justin’s educators that he probably wouldn’t graduate high school, much less college.

Years later, as a young adult, Justin developed Meniere disease (an inner ear disorder), which affected his hearing and balance. The onset of the disorder left Justin with the scary reality that he could permanently lose his hearing at any time. Justin recalled a former supervisor taking advantage of this knowledge with an inappropriate prank: While speaking in a one-on-one meeting, the sound from the supervisor’s mouth abruptly halted, while his lips continued to move. Justin thought he had gone deaf – until the supervisor started laughing – which Justin could hear. Behaviors like the above took its toll on Justin’s confidence – yet, he knew he could contribute in society.

Spurred in part by adversity, Justin went back to school, earned a business degree, and shortly after, entered the commercial marketing industry. However, despite his education and experience, Justin was still regularly subject to the same stigma. Many of Justin’s work experiences over the course of his career left him feeling ashamed, guilty, offended, and sometimes, even intimidated. Rather than instilling confidence, it left him demoralized – simply because he was differently abled.

In July of 2013, everything changed for Justin. He joined the Centers for Disease Control and Prevention working as a contractor in the Division of Human Development and Disability at the National Center on Birth Defects and Developmental Disabilities. Justin’s colleagues put an emphasis on making him feel comfortable and respected as a member of a diverse and productive workforce. They welcomed Justin’s diversity, positively contributing to his overall health.

The mission of the Division of Human Development and Disability is to lead public health in preventing disease and promoting equity in health and development of children and adults with or at risk for disabilities. One in two adults with disabilities does not get enough aerobic physical activity 1 , and for Justin, regular physical activity is important to help him combat potentially lethal blood clots due to a genetic blood clotting disorder that he has. Every working hour, Justin walks for a few minutes, stretches, or uses his desk cycle. Justin also participates in walking meetings, which he believes leads to more creative and productive meetings.

Stories such as Justin’s are reminders that employment and health are connected. CDC is proud to support National Disability Employment Awareness Month every October. The awareness month aims to educate about disability employment issues and celebrate the many and varied contributions of America’s workers with disabilities.

Suhana’s Story

Suhana has a sister, Shahrine, who is older by 18 months. While Shahrine’s mother was pregnant with Suhana, their uncle came to town for a visit. During the visit, their uncle was quick to notice that Shahrine did not seem to be talking at an age appropriate level or respond when called upon. Shahrine would also turn up the volume on the television and radio when others could hear it without difficulty. Shahrine’s parents thought that her speech development and behavior were normal for a toddler, but thanks to the uncle expressing his concerns, the family soon took action. A hearing test found that Shahrine was hard of hearing.

Due to Shahrine’s diagnosis, Suhana received a hearing screening at birth and was found to be hard of hearing, as well. Had it not been for the concerns raised by the children’s uncle, not only would Shahrine’s hearing loss have possibly gone on longer without being detected, but Suhana would most likely not have had a hearing screening at birth.

As a result of their early diagnoses, Suhana and Shahrine’s parents were able to gain the knowledge they needed to make sure both of their children could reach their full potential in life. They had access to early services from a team of physicians, speech therapists, counselors, and teachers.

Suhana credits her parents for her own successes, saying that she couldn’t have made it as far as she has without their support and patience. Today, Suhana is employed at the Centers for Disease Control and Prevention (CDC) as an epidemiologist with the agency’s Early Hearing Detection and Intervention (EHDI) program. All children who are deaf or hard of hearing receive critical services they need as a result of the EHDI program, which funds the development of data systems and provides technical assistance to help improve screening, diagnosis and early intervention for these infants. When children who are deaf or hard of hearing receive services early, they are more likely to reach their full potential and live a healthy, productive adult life.

CDC is proud to support National Disability Employment Awareness Month every October. The goals of the awareness month are to educate the public about disability employment issues and celebrate the many and varied contributions of America’s workers with disabilities.

• Centers for Disease Control and Prevention. Vital Signs. [updated 2014 May 6; cited 2014 October 10] Available from: https://www.cdc.gov/vitalsigns/disabilities/

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Ten Incredible Stories of People Who Overcame their Disabilities to Achieve Greatness

There are dozens of incredible sagas of people overcoming disabilities to achieve great things. Here are just a few top-picks we think will leave anyone who reads them inspired.

Table of Contents

Nick vujicic, andrea bocelli, kyle maynard, bethany hamilton, mallory weggemann, muniba mazari, stephen hawking, stevie wonder.

• Michael J Fox

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Disabilities present challenges to millions of people around the world.

While some disabilities are harder to overcome than others, there are some pretty remarkable stories out there of people who didn’t let their disabilities keep them from achieving. 

Hearing about incredible achievements in the face of obstacles is inspiring no matter the circumstance. When these accomplishments are credited to people with disabilities it can be even more mesmerizing because the majority of people can’t even relate to the starting point, let alone the end result. Here are just a few of these incredible people with jaw-dropping determination.

It doesn’t get more inspiring than Nick Vujicic. Vujicic was born in 1982 with no limbs. He often recalls that as a child he suffered ridicule and discrimination. Things got so bad for Nick that at one point he even attempted to commit suicide. With time, however, he learned to see his potential.

Nick taught himself to improvise to accomplish several skills, including playing musical instruments and using a computer. 

In 2005, Nick founded Life Without Limbs in order to spread hope and inspiration around the world. He currently gives motivational talks around the world, has written several books and is a regular on talk shows and TV programs. 

Nick’s fame spiked after starring in the touching short film The Butterfly Circus back in 2009.

Tenor, musician, writer, and musical producer of Italian origin, Andrea Boccelli has had an exceptional music career and has sold more than 75 million records.

Boccelli was born with congenital glaucoma that made him partially blind from the beginning of his life. 

Identifying his musical talent, Boccelli’s parents arranged for him to take music lessons from a young age. He studied the piano until the age of six despite his visual difficulties.

At age 12, the young Andrea suffered a serious injury during a football game. The effects of the blow on top of his congenital vision impairment left him completely blind . Endowed with a special spirit, he decided to focus entirely on music, specifically on singing. Boccelli became an internationally acclaimed vocalist. He is one of the few artists ever that brought classical music to the top of international pop charts.

Boccelli has received numerous international awards and even has a beach named after him on the Adriatic coast.

Despite being born with a rare condition known as congenital amputation that left him with arms that end at the elbows and legs that end near his knees, Kyle learned early on to live life independently. 

Kyle’s feats are simply remarkable. In 2012, Kyle became the first quadruple amputee to climb the 19,340 feet to the top of Mount Kilimanjaro without the aid of prosthetics. Four years later in 2016, he reached the summit of Argentina’s Mount Aconcagua. Standing at 22,838 feet, Aconcagua is the highest peak in both the Western and Southern Hemispheres. Many of Kyle’s accomplishments are done to raise awareness for special causes such as injured veterans and children in need.  

Today, Kyle is a motivational speaker, author, entrepreneur, and ESPY award-winning mixed martial artist.

In 2003, Bethany survived a shark attack in which she lost her arm. 

Bethany didn’t let her injury keep her down. Already an avid surfer, Bethany was back in the water within three to four weeks of the attack. She turned pro and has competed internationally ever since, scoring six first-place trophies and several other prestigious sports awards over the past fifteen years. 

In addition to competing, Bethany runs courses on motivation and life transformation-based and powered on her own experiences and inspirational story.

In 2008, Mallory Weggeman went to the hospital to receive her third and final epidural injection that she was receiving to help treat back pain caused by postherpetic neuralgia. 

Tragically, the operation went wrong. The treatment that was supposed to ease her debilitating pain instead left Mallory a paraplegic with complete loss of movement from her abdomen down. She was 18 years old. 

Mallory had been an avid swimmer from her youth. She made the decision to not let her disability take her away from what she loved. Less than a year and a half after returning to the pool, Mallory broke her first set of world records at the 2009 Can-Am Speedo Para Swim Meet. Over the next four years, she broke thirty-four American Records and fifteen World Records. 

Mallory is a twelve-time World Champion and a two Paralympic Medalist from the London 2012 Games. She continues to travel the world competing in swim competitions and inspiring audiences in speaking appearances across the globe.

Muniba became confined to a wheelchair after a serious car accident in her native Pakistan that severely damaged her spinal cord. 

During her many months of rehabilitation, Muniba began discovering her artistic talent. She painted self-expressive portraits as an outlet for her personal sorrow. Muniba’s unique and vibrant style almost immediately attracted attention. She became a highly sought-after artist, working on private contracts on a variety of projects in Pakistan and abroad.  

As her fame grew due to her exceptional art and unique story, Muniba began to take up motivational speaking and humanitarian activism. She has received numerous international awards for her work over the years and is the first Goodwill Ambassador to UN Women from her home nation of Pakistan.

Hawkings was diagnosed with ALS (Lou Gehrig’s Disease) when he was 21 years old while still a student at Cambridge. His doctors initially told him he had two years to live. He ended up living with the disease for more than five decades. 

One of the most well-known physicists in the world, Stephen Hawking had prestigious careers as a theoretical physicist, cosmologist, author, and Director of Research at the Centre for Theoretical Cosmology at the University of Cambridge.

One of his most famous books was A Brief History of Time and he is one of the few contemporary physicists and researchers to transcend the world of scientists to become a household name around the world.

Dr. Hawkings spent years paralyzed from head to toe. He communicated through a voice synthesizer, which he operated with the use of a single cheek muscle. Hawking was able to continue with his scientific research, publication, and lecturing. His contributions to his field are numerous and include revolutionary new theories in physical cosmology. He was the recipient of no fewer than fifteen major awards, nearly all of which earned long after his body had become incapacitated by his ALS. 

Hawking passed away in 2018 at the age of seventy-six.

Stevie Wonder was born 6 weeks prematurely and the blood vessels in his eyes had not yet developed. The oxygen-rich atmosphere in the hospital incubator resulted in retinopathy of prematurity, a condition in which the growth of the eyes is aborted and causes the retinas to detach causing blindness. 

Despite being blind from birth, Stevie excelled at music from a young age. Stevie was identified as a child prodigy and signed his first record label at age eleven. He has recorded more than 30 U.S. top ten hits including famous tracks like “Signed, Sealed, Delivered I’m Yours,” “Superstition,” “You Are the Sunshine of My Life,” and “I Just Called to Say I Love You.” He has over 25 Grammy Awards to his name. 

Wonder has also spent years in political activism. He was one of the key campaigners to make Martin Luther King Jr.’s birthday a national holiday in the U.S. In 1985, he was honored by the United Nations for his stance against racism in South Africa. In 2009, he was named a United Nations Messenger of Peace for his years of efforts in peaceful political causes.

Michael J. Fox

Michael J. Fox was diagnosed with Parkinson’s Disease when he was 29 years old, after already achieving worldwide fame for his roles in the Back to the Future movies and the television show Family Ties.

Despite being told he should retire, Fox continued with his acting career and went on to produce several well-received productions over the next ten years including the wildly popular sitcom, Spin City. Fox retired from full-time acting in 2000. 

Since retirement, Fox has thrown most of his energy into advocacy for those living with Parkinson’s disease. His foundation has raised over $230 million for Parkinson’s research.

A Little Inspiration Goes a Long Way

If there’s one thing these and similar stories show, it’s the amazing potential of all people, regardless of their physical abilities--or lack thereof. It’s people like these, and millions more, that inspire us at accessiBe to do what we do. We believe in the importance of giving all individuals access to the information technologies that define our age and won’t let anything stand in our way, either.

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Case studies on disability and inclusion.

To document UNICEF’s work on disability and inclusion in Europe and Central Asia region, UNICEF Regional Office for Europe and Central Asia has developed a set of five case studies.

UNICEF takes a comprehensive approach to inclusion, working to ensure that all children have access to vital services and opportunities. When UNICEF speaks about “inclusion” this encompasses children with and without disabilities, marginalized and vulnerable children, and children from minority and hard-to-reach groups.

The case studies have a specific focus on children with disabilities and their families. However, many of the highlighted initiatives are designed for broad inclusion and benefit all children. In particular, this case study, covers such topics as: Inclusive Preschool, Assistive Technologies (AT), Early Childhood intervention (ECI), Deinstitutionalisation (DI).

Case studies

Case study 1: “Open source AAC in the ECA Region”

Files available for download (1).

Case study 2: “Inclusive Preschool in Bulgaria”

Case study 3: “Assistive technology in Armenia"

Case study 4: “Early childhood intervention in the ECA region”

Case study 5: “Deinstitutionalization in the ECA region”

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Case studies collection 2019. inclusion of persons with disabilities in humanitarian action.

 - December 3, 2019

Marking the International Day of Persons with Disabilities, the  international Disability alliance is pleased to share with you the  report “Case studies collection 2019. Inclusion of persons with  disabilities in humanitarian action”.

Jointly developed by the International Disability Alliance, CBM and  Humanity and Inclusion, the report collects 39 examples of field  practices inclusive of persons with disabilities in humanitarian  context and disaster risk reduction (DRR), from 20 countries of  intervention. The report is published as a support to the uptake of  the IASC Guidelines on Inclusion of Persons with Disabilities in  Humanitarian Action and it aims to promote learning by example.

The case studies included in the report focus on:

• Inclusive disaster risk reduction and preparedness, showing how DRR  and preparedness benefit by ensuring access and participation to  persons with disabilities and organizations of persons with  disabilities (OPDs).
• Collecting and using disability disaggregated data for assessments  and programming, such as through participatory research and rapid  assessment studies on the situation of persons with disabilities  during and after disasters.
• Participation of persons with disabilities and their representative  organizations in humanitarian response and recovery, including  projects led by OPDs, or done in collaboration between NGOs and OPDs.
• Removing barriers to access humanitarian assistance and protection  though projects in which persons with disabilities and OPDs are at the  center of assessing and addressing those barriers, and examples of  humanitarian actors seeking external technical support.
• Influencing coordination mechanisms and resource mobilization, such  as through disability-focused coordination mechanisms, as well as by  influencing national Humanitarian Response Plans and pooled funding.

The publication has been supported by the Australian Government and  the European Union Humanitarian Aid. Download the publication here.

In other news

Remembering sir robert george martin.

It is with profound sadness and a heavy heart that the International Disability Alliance mourns the loss of Sir Robert George Martin, member of the United Nations Committee on the...

• Read more about Remembering Sir Robert George Martin

• Research article
• Open access
• Published: 29 September 2016

Comparison of attitudes toward disability and people with disability among caregivers, the public, and people with disability: findings from a cross-sectional survey

• Qiaolan Zheng 1 ,
• Qi Tian 1 ,
• Chun Hao 1 ,
• Jing Gu 1 ,
• Jianting Tao 2 ,
• Zuoyi Liang 3 ,
• Xinlin Chen 4 ,
• Jiqian Fang 1 ,
• Jianhua Ruan 2 ,
• Qiuxiang Ai 2 &
• Yuantao Hao 1  

BMC Public Health volume  16 , Article number:  1024 ( 2016 ) Cite this article

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A negative attitude toward disability is one of the potential barriers for people with disability (PWD) to achieve social equality. Although numerous studies have investigated attitudes toward disability, few have evaluated personal attitudes toward disability among PWD, and made comparisons with attitudes of healthy respondents. This study was to investigate and compare the attitudes of PWD, caregivers, and the public toward disability and PWD in China, to identify discrepancies in attitude among the three groupsand to examine potential influencing factors of attitude within each group.

A cross-sectional study was conducted among 2912 PWD, 507 caregivers, and 354 members of the public in Guangzhou, China. Data were collected on participants’ socio-demographic information and personal attitudes toward disability using the Attitude to Disability Scale (ADS). ANOVA and ANCOVA were applied to compare the level of attitude among the three groups. Simple and multiple linear regression analyses were used to investigate the relationship between each background factor and attitude within each group.

Over 90 % of caregivers were PWD’s family members. After controlling the socio-demographic characteristics, caregivers had the lowest total scores of ADS (caregivers: 47.7; PWD: 52.3; the public: 50.5). Caregivers who had taken care of PWD for longer durations of time had a more negative attitude toward disability. In contrast, PWD who had been disabled for longer times had a more positive attitude toward disability.

Conclusions

The current national social security system of China does not adequately support PWD’s family-member caregivers who may need assistance coping with their life with PWDs. More research is needed, and the development of a new health-care model for PWD is warranted.

Peer Review reports

Disability has become a natural part of the human condition due to population ageing, the increase of chronic diseases, and medical advances that preserve and prolong life. Globally, adding life to years has become as important as adding years to life and is now on the agenda of the United Nations’ Millennium Development Goals (MDG) [ 1 ]. According to the report from the World Health Organization (WHO), there are over one billion people estimated to be living with disability in the world [ 2 ]. Social inclusion and community participation of people with a disability (PWD) are a central concept guiding current policies for disabled persons around the world [ 2 ]. As nations are realizing, negative attitudes toward disability affect the integration of disabled persons into the community [ 3 , 4 ], and thus may incur the loss of a potential resource. Negative perceptions can lead to lack of opportunities and work, low self-esteem, and isolation, and consequently to stigmatization, marginalization, and recurring negative health outcomes that prolong the discomfort of PWDs and also create a substantial social burden [ 5 – 7 ]. Identifying and understanding negative attitudes toward disability can helpfurther define the factors that hinder or foster PWD’s health and social integration, as well as the development and effectiveness of necessary corollary services. While much research on attitudes toward disability has been conducted in developed countries [ 8 ], scant research has been undertaken in developing countries. By the end of 2010, the number of PWD in China amounted to more than 85 million [ 9 ], yet little is known about attitudes toward disability even though a substantial national burden of disability exists.

In health and medicine, attitudes toward disability are defined as the cognitive and behavioral processes that involve judgment and favorable/unfavorable reactions to aspects of disability [ 10 ]. One recurrent focus of research on attitudes toward disability has been the attitude of the general public [ 11 , 12 ], and as a result it is well documented that negative public attitudes foster low expectations, discriminatory behaviors, and marginalization of PWD, whereas positive attitudes lead to acceptance of PWD and promote integration into society [ 2 , 13 ]. In traditional Chinese culture “disability is viewed as a punishment for the disabled person’s sins in a past life or the sins of the person’s parents” [ 14 , 15 ]. With more urban and younger populations, attitudes may be changing but because reliable data are unavailable, the extent and influence of this perception is not well established. Thus, this study investigated public attitude to detect and measure perceptions and influences extant in the general population that are hindering and fostering PWD’s health and social integration in the country.

Caregivers are a second focus of most research on attitudes to disability. Due to China’s collectivist culture, family members play a significant role in providing care and support for PWD at the family level [ 14 ]. In prevailing national conditions with a substantial lack of support in the community, PWDs have an increased dependence on their caregivers. Although caregivers do not experience disability themselves, they have to cope with multiple and conflicting related responsibilities: with the disability-related physical and emotional problems and practical medical care of PWD, with their own individual problems, and with family roles and relations. With a dual role as caregiver and close associate/relative to a person with a disability and his/her family, the attitude of caregivers to disability is influenced by the disability as well. A number of studies have reported the courtesy stigma exhibited by caregivers of PWD [ 16 – 18 ]; however, because this stigma is only one component of a complex of attitudes, few studies reported PWD family-member caregivers’ attitudes in Chinese society. Generally, a negative attitude can undermine the quality of assistance and support, thus decreasing PWD’s quality of life [ 19 ] and inhibiting PWD integration into the community. Lower prospects for the disabled may lead to maladaptive coping and inconsistent rehabilitation or treatment [ 20 ] and greater strain on both PWD and caregivers. Disability-related stigma or discrimination may interfere with a caregiver’s seeking help [ 17 , 18 , 21 ] to cope with increasing stress. But little has been established about whether or how a courtesy stigma may be bearing influence upon this group, and reliable data on caregiver attitudes toward disability and PWD in China were not available.

Consequently, the gap in research devoted to understanding the attitude to disability and PWD particularly among family-member caregivers in China helped initiate this investigation.

A third group focus consists of people with disabilities themselves. PWD’s attitude toward their own disability is significantly shaped by the experience of social interaction [ 22 ]. According to our previous study [ 19 ], PWD’s positive attitudes toward disability were highly associated with improved quality of life. Understanding PWD’s attitude toward their disability is a first step in the development of effective behavioral intervention as positive attitudes may result in corresponding positive behaviors [ 23 ]. Therefore, knowledge about PWD’s attitude could help improve relevant health services and facilitate PWD’s self-acceptance, fostering integration into society [ 13 ]. Most existing research assessing attitudes toward disability has targeted the public, caregivers, or health professionals separately [ 8 ], and consequently this lack of data on PWD’s attitude toward their disability also helped initiate this study.

As stated, a purpose of this investigation was to identify any existing discrepancies in attitudes toward disability among the public, PWD, and caregivers. It is well known that attitudes can be formed from a person’s past and present experiences [ 24 ]. The general public’s experiences related to disability may result from television, social media, or temporary contact with PWD, whereas PWD’s and caregivers’ experiences originate in their personal daily lives coping with disability. While a large share of research has assessed the attitude of the general public to reflect the level of social inclusion, it is to be noted that the degree of inclusion of or discrimination against PWD perceived by the general public and the caregiver/PWD can vary greatly. For example, the general public may perceive more inclusion and less discrimination against PWD, but PWD/caregivers with immediate experience of disability may perceive the opposite to be true. The difference of attitudes has not been sufficiently examined, and as a result one goal of our study was to identify discrepancies which could suggest the gaps between attitudes perceived by the public and PWD/caregivers who are living in the same society and hint at whether community participation-related interventions would be enhanced among caregivers/PWD.

Differences in the type of disability-related activities PWD and caregivers perform, the perceived difficulty of caregiving for daily living tasks, emotional and nonmedical needs, and so forth, suggest that attitudes toward disability and PWD also vary among PWD and caregivers [ 25 , 26 ]. The important disparities in the attitudes of these two groups must be addressed to develop tailored educational interventions for PWD and caregivers that foster hope, positive attitudes, and healthy individual and cooperative behaviors for coping with disability and contributing toward improved PWD social inclusion and better quality of life for PWD and their caregivers.

The primary purpose of this study was to investigate the attitudes of all three groups— PWD, caregivers, and the public— toward disability in China and to compare these attitudes among the three groups. To accomplish this, we used the global assessment Attitudes to Disability Scale [ 27 ] developed by the World Health Organization Quality of Life-Disability Group (WHOQOL-DIS) in order to identify discrepancies in attitudes. The potential influencing factors of the attitudes about disability were also examined within each group. The hypothesis of this study is that the attitudes toward disability and PWD differ among the three groups, and that among them PWD may not hold the most negative attitude toward disability.

Recruitment and participants

Some contents of our study methods have been previously described [ 19 ]. Briefly, from March to August 2008, a cross-sectional survey was conducted in Guangzhou, the capital of Guangdong Province in southern China. Guangzhou has 8 million permanent residents, 60 % of whom reside in urban areas and 40 % in suburban areas [ 28 ]. Of Guangzhou’s permanent residents, 5.86 % live with some form of disability [ 29 ]. The sampling frame of PWD in this study was restricted to all PWDs who held the Disabled Person Card (DPC) in Guangzhou. The DPC, which is issued and managed by the Disabled Persons’ Federation (DPF), is PWD’s permit to access disability benefits and allowances [ 30 ]. PWD in this survey were recruited with a three-stage sampling. According to the ratio of urban and suburban populations in Guangzhou, the first stage involved a random selection of three urban districts and two suburban districts from the total of the 12 districts of Guangzhou. The second stage involved a random selection of three sub-districts from each district, generating 15 sub-districts. At the final stage, four communities per sub-district were randomly selected; 60 communities were then finally chosen. All PWD residing in the selected communities were invited to participate in this study. Eligibility criteria of PWD included being a Guangzhou permanent resident, aged 18 or above, and being legally certified as disabled which is operationalized as those PWD with the DPC. Furthermore, eight caregivers of the abovementioned PWD were randomly selected and recruited from each community. For the general public, six general residents were recruited from each selected community as well. Eligibility criteria for each group were as follows. For caregivers, each participant had to be aged 18 or above, have more than 1 year of experience in taking care of a person with a disability, and have no form of disability him- or herself. Participants chosen from the general public had to be aged 18 or above and neither PWD nor caregivers. The response rates were 99.2, 99.8, and 88.5 % among PWD, caregivers, and the public, respectively. Overall, 2912 PWD, 507 caregivers, and 354 members of the public were recruited in the survey.

A DPF staff member and a doctor confirmed eligibility and obtained informed consent from participants. The questionnaire was administered in person by an experienced research interviewer in a private room in each community. The interview was conducted in Chinese and took around 10 min. All the participants were given a gift for their participation. The study protocol was approved by the Institutional Review Boards of Sun Yat-sen University and Guangzhou DPF.

Three questionnaires were prepared for the PWD, caregivers, and the public, respectively. Each questionnaire had two parts:

Part I recorded personal information: gender, age, education, and marital status for every respondent; occupations, income levels, types of disability, disability duration, disability visibility, and comorbidity (comorbid with other health problems, including musculoskeletal problems, cardiovascular diseases, respiratory problems, neuropsychological problems, digestive problems, diabetes, sensory organ damage, cancer, and others) among PWD respondents; duration of care-giving and relationship to the PWD among caregivers respondents.

Part II was the ADS. This scale has been verified as accurate in the global assessment of attitudes toward disability and people with disability in both disabled people and in healthy respondents [ 27 ]. It is also valid for versions in different languages, including Chinese [ 31 ].

The ADS [ 31 ] assessed personal attitudes toward disability and people with disability. The 16-item measure was developed by the WHOQOL-DIS [ 27 ]. The scale includes the “personal” set of questions for the PWD and “general” set of questions for those without disability. The two sets have the same questions and scoring method but different forms of personal pronouns. PWD’s questions used the first person ( I ) while the caregivers and the public used the third person ( he/she/they ). The measure was scored on a five-point Likert scale, and the total score (range: 16–80) was based on a summation of all 16 items. A higher total score indicates more positive attitudes. Attitude toward disability was explained in four domains: Inclusion (relationships, inclusion, burden to society, burden to family), Discrimination (ridicule, exploitation, irritation, ignorance), Gains (emotional strength, maturity, achievement, determination), and Prospects (sexuality, underestimation, optimism, future prospects) (Table  2 ). Higher mean scores for each domain were indicative of better inclusion, less discrimination, more gains, and better prospects. The total Cronbach’s alphas in the current study were 0.77; the Cronbach’s alphas of the domain were 0.76, 0.74, 0.75, and 0.72, respectively.

Statistics analysis

Each domain and the total score of the ADS among the three groups was calculated. One-way ANOVA was applied to compare the domains and total scores of the three groups (the variances were equal among the three groups), and ANCOVA was used to compare the domains and total scores of the three groups after controlling for gender, age, education, and marital status [ 32 ]. Bonferroni correction was applied for multiple-group comparisons. Within each group, simple linear regression analysis was used to investigate the relationship between the ADS and each background factor (gender, age, education, and marital status), which was intended to present the difference in the ADS among participants with different background factors. Other than background factors, simple and multiple linear regression analyses were also used to investigate the relationship between the ADS and occupations, income levels, types of disability, disability duration, disability visibility, and comorbidity among PWD, as well as ADS and duration of care-giving and relationship to the PWD among caregivers. Multiple linear regression analysis here was applied to investigate the effects of other factors (employment, comorbidity, types of disability, etc.) on ADS after adjusting the effects of background factors (gender, education, and marital status). The exclusion of age in the multiple linear regression analysis was due to collinearity occurring when age was in the model.

Data were double-entered and cross-checked using the EpiData software (EpiData 3.1 for Windows, The EpiData Association Odense, Denmark). Statistical Product and Service Solutions was used for data analysis (SPSS 20.0 for Windows, IBM Corp, USA). Statistical significance was defined by p value <0.05.

Social-demographic characteristics of the participants

Sociodemographic characteristics (age, gender, education, and marital status) broken down by the three groups are presented in Table  1 . All group differences were statistically significant ( p  < 0.001).

Comparison of attitudes toward disability among PWD, caregivers, and the public

As described in Fig.  1 , after controlling the socio-demographic characteristics (age, gender, education, and marital status), PWD had the highest total scores of ADS (52.3), significantly higher than caregivers (47.7) and the public (50.5). Caregivers’ total score of ADS was the lowest among the three groups.

Comparison of attitude to disability after controlling for socio-demographic characteristics (gender, age, education, and marital status) among PWD, caregivers, and the public

For specific domains, caregivers again showed the lowest scores in the domains of Inclusion (8.8) and Prospects (12.3). Furthermore, PWD showed the highest scores in the domains of Discrimination (12.7) and Gains (13.3). The public was the group with the lowest scores in Gains (11.0), and caregivers were in the middle (12.9) (Fig.  1 ). The comparisons of each item across the three groups are tabulated in Table  2 .

Sub-group analysis: total ADS scores on characteristics

The results are shown in Fig.  2 and Table  3 . The effects of age on ADS were significant and the coefficients were negative within all three groups, indicating that no matter whether the group was PWD (beta = −0.27, p  = 0.025), caregivers (beta = −1.27, p  < 0.001), or the public (beta = −0.49, p  = 0.005), those who were older held a more negative attitude toward disability (Fig.  2 ). For PWD, those who were male (beta = 0.63, p  = 0.021) with a higher educational level (beta = 1.50, p  < 0.001) or currently married (beta = 0.71, p  = 0.011) had a more positive attitude toward disability (Fig.  2 ). No significant association was found between gender, educational level, marital status, and ADS within either the groups of caregivers or the public (Fig.  2 ).

Simplelinear regression analysis to investigate the difference of attitudes to disability depending on socio-demographic characteristics within each group of participants

With regard to disability duration, compared with PWD who had been disabled less than 10 years (ADS = 49.1), those who had been disabled for longer periods had a more positive attitude toward disability (50.0 - 50.5); whereas caregivers who had taken care of PWD for longer durations of time had a more negative attitude toward disability (Table  3 ). PWD who were employed (51.2 vs . 49.6) and with higher income levels (51.2 vs . 49.9) also had a more positive attitude toward disability. In addition, PWD’s ADS scores decreased with their levels of disability visibility (not at all: 52.7, a little: 51.4, moderately: 50.5, mostly: 49.7, totally: 48.2). Moreover, compared with other types of disability (49.7 - 50.7), PWD with multiple disability (46.1) had the most negative attitude toward disability (Table  3 ).

This study was the first of its kind to use the global and cross-population ADS scale to evaluate attitudes toward disability among PWD, caregivers, and the public, as well as compare the levels of attitudes of PWD among three groups.

The longer caregivers cared for PWD, the more negative their psychological state and attitude, thus the more negative influence on the quality of caregiving [ 19 ]. Our research showed that caregivers held less favorable attitudes toward disability than the other two groups, and, furthermore, supported earlier study findings that the longer the time caregivers cared for PWD, the more negative their attitudes were. In this study, the average duration of care-taking was 17.7 years. In other words, caregivers bore the responsibility for providing personal assistance to PWD for one third of their lifetime. In China, almost all caregivers of PWD are PWD family members, and most of them are PWD’s direct relatives [ 33 , 34 ]. Our study also showed that over 90 % of caregivers were family members, and more than half of them were parents/children of PWDs. In China, family caregivers provide uncompensated care to the PWD along with emotional support, and with tangible support that includes the performance of physical living tasks. Mastering these tasks and providing the timely and emotional support for PWD is a challenge for caregivers, and numbers of researchers have reported that caregivers had higher levels of depression, anxiety, and guilt [ 35 – 37 ]. Given the increased strains on caregivers in China, these psychological levels may particularly impact caregivers’ negative attitudes toward disability and PWD. For this situation, government support for PWD’s family is needed. However, most government financial support policy for PWD in China is based on the family unit, known as the “PWD-family” or those families having family members with disabilities. Social assistance and subsidies are usually only provided to eligible PWD-families, and not to individual persons with a disability [ 33 ]. In addition, generally the criteria for PWD-family eligibility depends upon stringent economic conditions, and financial support would be provided, for example, “only for [the] lowest level income PWD-family” [ 33 , 38 ]. As a result, government provides financial support to a PWD-family only when PWDs have very limited financial support from their family. The majority of family caregivers are not eligible for government support, and therefore usually shoulder PWD’s costs of living expenses and therapy for several years, as well as devote significant amounts of time to care-taking [ 33 ]. All of these burdens may influence caregivers’ attitudes toward disability and PWD. As Chinese policy and law have bound caregivers to PWD in the unit of a PWD-family to financially and physically support PWD, this family-based care model, while obviating a financial burden for the government, results in overwhelming financial and mental pressures on caregivers [ 39 ], thus influencing the quality of PWD care [ 19 ]. Studies to evaluate the burden of PWD-family diseases due to disability among both PWD and caregivers in China should be undertaken to determine the actual extent of the burden. Moreover, with the speed of economic growth in the country, a new health-care or social insurance model is called for, one which is able to reduce catastrophic costs for PWD individuals and their families.

In contrast to our expectation, PWD, compared with the other two groups, hold the most favorable attitudes toward disabilities. The possible reason for PWD’s more positive attitudes is that most PWD in our study had been disabled for more than 10 years and perhaps had adapted to their disabilities and generally accepted them after years of living with them. Previous studies verified that positive attitudes toward disability are associated with greater acceptance of disability in oneself [ 22 ]. Therefore, as in the results, the longer the duration of disability, the more tolerant and accepting a PWD may be of his/her disability. The results also imply that PWD with shorter durations of disability hold more negative attitudes compared with longer ones, and that these individuals need mentoring or support to assist them in coping and adapting to their disability.

Regarding results for the public, this group’s Discrimination and Gains were the most negative domains compared with PWD and caregivers, indicating that discrimination toward disabled persons is a common phenomenon based on the public’s perception, and also that the public perceives that PWD may not be able to achieve and gain as much as those without disabilities. Public discrimination toward disability is well documented in developed countries [ 8 ]. Because “disability is viewed as a punishment for the disabled person’s sins in a past life or the sins of the person’s parents” [ 14 , 15 ] in traditional Chinese culture, Chinese people may demonstrate less compassion for PWD and fail to accept or appreciate the need for integration of PWD into society. Given the prevalence of the belief, anti-discrimination campaigns for PWD will need to take this factor into consideration.

Older age was also associated with negative attitudes toward disability among PWD, caregivers, and the public. With the increase in life expectancy in most countries in the world, the challenge of ageing populations with disability has become a pressing global health issue [ 40 ]. Elders with disability suffer not only disability but also the health-related problems caused by ageing, including physical, psychological, and social function degeneration [ 41 ]. As our results indicated, elder caregivers, most of whom are PWD’s parents, must provide both physical and financial support for their disabled children, which becomes more demanding and difficult as ageing occurs. Without the capacity for independent living, PWD in China are cared for by their parents for several years and/or throughout their lifetime. The results suggest that ageing exhibits a negative impact on the attitudes toward disability and PWD. Therefore, in policy-making and in medical research, more focus should be placed on elderly PWD and caregivers, who make up the vulnerable subgroups among the disability-related population.

Finally, this study had a number of limitations. First, because it was a cross-sectional study, an observed association cannot be interpreted as causality. Second, the present study was limited to Guangzhou permanent residents and did not include other groups such as migrants from other cities. Finally, among this sample, many participants reported a long duration of years of disability; thus, their attitude toward disability may differ from that of people newly experiencing a disability. Further research needs to be conducted on larger samples of the population to include migrants and more newly-disabled persons.

Acknowledging its limitations, this is nonetheless one of the first studies that has applied the cross-population ADS among both people with disability and healthy respondents. It provides valuable information about the different levels of attitudes toward disability among three groups in China. Under the PWD-families care model in China, evidence suggests that PWD’s family-member caregivers who bear major financial, emotional, and psychological burdens related to disability need more empowerment. The current model may deteriorate caregivers’ wellbeing and also undermine PWD’s independent living capacity. The development of an improved health-care model for PWD is essential. A suggested model would replace the current PWD-family unit base in which government social assistance and subsidies for disabled persons’ requirement is based on the low income level of PWD’s family. A revised model would use PWD’s individual situations as a unit base to alleviate some of the burden on family caregivers, and thus lead to positive behaviors for PWD’s caregiving and to improved quality life for PWD.

Abbreviations

Attitude to Disability Scale

Disabled Person Card

Disabled Persons’ Federation

Millennium Development Goals

• People with disability

World Health Organization

United Nations. Momentum builds to achieve more Millennium Development Goals by end of 2015: UN report. 2014. http://www.un.org/millenniumgoals/pdf/MDGReport2014_PR_Global_English.pdf . Accessed 17 Feb 2015.

World Health Organization. World report on disability. Geneva: World Health Organization; 2011.

Google Scholar  

Morin D, RivardM CAG, Boursier CP, Caron J. Public attitudes towards intellectual disability: a multidimensional perspective. J Intellect Disabil Res. 2013;57:279–92.

Article   CAS   PubMed   Google Scholar  

Verdonschot MM, de Witte LP, Reichrath E, Buntinx WH, Curfs LM. Impact of environmental factors on community participation of persons with an intellectual disability: a systematic review. J Intellect Disabil Res. 2009;53:54–64.

Sharac J, McCrone P, Clement S, Thornicroft G. The economic impact of mental health stigma and discrimination: a systematic review. Epidemiol Psichiatr Soc. 2010;19:223–32.

Article   PubMed   Google Scholar  

Myers F, Ager A, Kerr P, Myles S. Outside looking in? Studies of the community integration of people with learning disabilities. Disabil Soc. 1998;13:389–413.

Article   Google Scholar  

Carter J, Markham N. Disability discrimination. BMJ. 2001;323:178–9.

Article   CAS   PubMed   PubMed Central   Google Scholar  

National Disability Authority. Literature Review on Attitudes towards Disability. 2007. http://www.ucd.ie/issda/static/documentation/nda/nda-literature-review.pdf . Accessed 15 Mar 2015.

China Disabled Persons Federation. The total number of persons with disabilities and number of different kinds and levels of disability by the end of 2010. 2010. http://www.cdpf.org.cn/sjzx/cjrgk/201206/t20120626_387581.shtml . Accessed 21 Mar 2015.

Nolen-Hoeksema S, Fredrickson B, Loftus G, Wagenaar W. Atkinson and Hildegard’s introduction to psychology. London: Cengage Learning; 2009.

United Nations. Convention on the Rights of Persons with Disabilities. 2006. http://www.un.org/disabilities/convention/conventionfull.shtml#topic . Accessed 19 Feb 2015.

Office for Disability Issues. Public Perceptions of Disabled People: Evidence from the British Social Attitudes Survey. 2011. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/325989/ppdp.pdf . Accessed 19 Feb 2015.

Kleintjes S, Lund C, Swartz L. Barriers to the participation of people with psychosocial disability in mental health policy development in South Africa: a qualitative study of perspectives of policy makers, professionals, religious leaders and academics. BMC Int Health Hum Rights. 2013;13:17.

Article   PubMed   PubMed Central   Google Scholar  

Holroyd EE. Chinese cultural influences on parental caregiving obligations toward children with disabilities. Qual Health Res. 2003;13:4–19.

Huang YT, Fried JH, Hsu TH. Taiwanese mothers’ attitude change toward individuals with disabilities. J Soc Work Disabil Rehabil. 2009;8:82–94.

Ali A, Hassiotis A, Strydom A, King M. Self stigma in people with intellectual disabilities and courtesy stigma in family carers: a systematic review. Res Dev Disabil. 2012;33:2122–40.

Corrigan PW, Miller FE, Watson AC. Blame, shame, and contamination: the impact of mental illness and drug dependence stigma on family members. J Fam Psychol. 2006;20:239–46.

Mak WWS, Cheung RYM. Affiliate stigma among caregivers of people with intellectual disability or mental illness. J Appl Res Intellect Disabil. 2008;21:532–45.

Zheng QL, Tian Q, Hao C, Gu J, Lucas-Carrasco R, Tao JT, Liang ZY, Chen XL, Fang JQ, Ruan JH, Ai QX, Hao YT. The role of quality of care and attitude towards disability in the relationship between severity of disability and quality of life: findings from a cross-sectional survey among people with physical disability in China. Health Qual Life Outcomes. 2014;12:25.

Helland CB, Holmøy T, Gulbrandsen P. Barriers and Facilitators Related to Rehabilitation Stays in Multiple Sclerosis: A Qualitative Study. Int J MS Care. 2015;17:122–9.

Compton M, Kaslow N, Walker E. Observations on parent/family factors that may influence theduration of untreated psychosis among African-American first-episode schizophrenia-spectrum patients. Schizophr Res. 2004;68:383–5.

Snead SL, Davis JR. Attitudes of individuals with acquired brain injury towards disability. Brain Inj. 2002;16:947–53.

Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211.

Murchison C. “Attitudes,” in A Handbook of Social Psychology. Worcester: Clark University Press; 1935.

Brimblecombe N, Pickard L, King D, Knapp M. Perceptions of unmet needs for community social care services in England. A comparison of working carers and the people they care for. Health Soc Care Community. 2016. [Epub ahead of print].

Onor ML, Trevisiol M, Negro C, Aguglia E. Different perception of cognitive impairment, behavioral disturbances, and functional disabilities between persons with mild cognitive impairment and mild Alzheimer’s disease and their caregivers. Am J Alzheimers Dis Other Demen. 2006;21:333–8.

Power MJ, Green AM, Group TW. The Attitudes to Disability Scale (ADS): development and psychometric properties. J Intellect Disabil Res. 2010;54:860–74.

Propaganda Department of Guangzhou. Population, land area, population density. 2012. http://www.gddpf.org.cn/xxtj/sytj/tjsj/200707/t20070731_650920.htm . Accessed 15 Apr 2015.

Guangdong Disabled Persons’ Federation. Results of the second national survey among persons with disabilities in Guangdong Province. 2007. http://www.gddpf.org.cn/xxtj/sytj/tjsj/200707/t20070731_650920.htm . Accessed 25 Apr 2015.

China Disabled Persons’ Federation. Announcement of issuing Disabled Person Card. 2008. http://www.cdpf.org.cn/ggtz/200806/t20080627_410207.shtml . Accessed 28 Apr 2015.

Tian Q, Hao Y, Tao J, Chen X, Fang J, Liang Z, Ruan J, Ai Q. Reliability and validity of World Health Organization-disability attitudes scales in Chinese version. J Clin Rehab Tissue Eng Res. 2010;14:8681–5.

Rosner B. Fundamentals of Biostatistics. Boston: Cengage Learning; 2010.

Karen F, Li J. Chinese disability independent living policy. Disabil Soc. 2008;23:171–85.

Hung LC, Liu CC, Kuo HW. Unmet nursing care needs of home-based disabled patients. J Adv Nurs. 2002;40:96–104.

Chen D, Guo X, Zheng Z, Wei Q, Song W, Cao B, Huang R, Yang R, Shang H. Depression and anxiety in amyotrophic lateral sclerosis: correlations between the distress of patients andcaregivers. Muscle Nerve. 2015;51:353–7.

Almansour MA, Alateeq MA, Alzahrani MK, Algeffari MA, Alhomaidan HT. Depression and anxiety among parents and caregivers of autistic spectral disorder children. Neurosciences (Riyadh). 2013;18:58–63.

Graneheim UH, Johansson A, Lindgren BM. Family caregivers’ experiences of relinquishing the care of a person with dementia to a nursing home: insights from a meta-ethnographic study. Scand J Caring Sci. 2014;28:215–24.

Guangzhou Disabled Persons’ Federation. Manual of the rehabilitation funding for the disabled in Guangzhou. 2012. http://www.gzdpf.org.cn/Article/B2/7545.html . Accessed 28 Apr 2015.

Alfaro N, Lazaro P, Gabriele G, Garcia-Vicuna R, Jover JA, Sevilla J. Perceptions, attitudes and experiences of family caregivers of patients with musculoskeletal diseases: a qualitative approach. Reumatol Clin. 2013;9:334–9.

Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet. 2009;374:1196–208.

Lollar D, Andresen E. Public Health Perspectives on Disability: Epidemiology to Ethics and Beyond. New York: Springer; 2010.

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Acknowledgements

The authors would like to thank the participants and their caregivers, without whom we could not have carried out this project. The study also benefited from the work of WHOQOL-DIS Group, who developed ADS scales used in our study, and the Guangzhou Disabled Person’s Federation, who helped to select neighborhood committees. We greatly appreciate the efforts of all the staff from the Guangzhou Service and Delivery Center of Assistive Devices, who gave considerable assistancein the field. Thanks are also due to all the investigators, who consistently demonstrate a great sense of responsibility, ensuring the quality of investigation.

Authors’ contributions

All authors contributed to this work. QZ performed the data analysis, and carried out results interpretation and writing of the manuscript. QT participated in the study design, protocol development, data collection, and drafting of the manuscript. CH contributed to the writing, reviewing, and final editing of the manuscript. JG participated in the study design, protocol development and results interpretation. JT participated in the protocol development and data collecting. ZL participated in the study design and protocol development. XC participated in the study design and data collecting. JF participated in the study design and protocol development. JR participated in the study design and protocol development. QA participated in the study design and protocol development. YH carried out the study design and manuscript revision, and also supervised the project progress. YH takes full responsibility for the integrity of the data and the accuracy of the data analysis with CH. All authors read and approved the final manuscript.

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Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China

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Guangzhou Disabled Person’s Federation, Guangzhou, Guangdong, People’s Republic of China

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Department of Preventive Medicine and Health Statistics, College of Fundamental Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China

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Zheng, Q., Tian, Q., Hao, C. et al. Comparison of attitudes toward disability and people with disability among caregivers, the public, and people with disability: findings from a cross-sectional survey. BMC Public Health 16 , 1024 (2016). https://doi.org/10.1186/s12889-016-3670-0

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Received : 28 May 2015

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DOI : https://doi.org/10.1186/s12889-016-3670-0

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