Citation
Attitudes of nursing students toward mental retardation before and after curricular experience with mentally retarded children

Material Information

Title:
Attitudes of nursing students toward mental retardation before and after curricular experience with mentally retarded children
Creator:
Baker, Amanda Sirmon, 1934- ( Dissertant )
Hensel, James W. ( Thesis advisor )
Hines, Vynce A. ( Reviewer )
Payne, Dorris B. ( Reviewer )
Place of Publication:
Gainesville, Fla.
Publisher:
University of Florida
Publication Date:
Copyright Date:
1974
Language:
English
Physical Description:
x, 122 leaves. : illus. ; 28 cm.

Subjects

Subjects / Keywords:
Child psychology ( jstor )
College students ( jstor )
Developmental disabilities ( jstor )
Disabled persons ( jstor )
Mental retardation ( jstor )
Nurses ( jstor )
Nursing ( jstor )
Nursing students ( jstor )
Psychological attitudes ( jstor )
Students ( jstor )
Children with mental disabilities -- Care ( lcsh )
Curriculum and Instruction thesis Ph. D
Dissertations, Academic -- Curriculum and Instruction -- UF
Pediatric nursing -- Study and teaching ( lcsh )
City of Gainesville ( local )
Genre:
bibliography ( marcgt )
non-fiction ( marcgt )

Notes

Abstract:
This study sought to determine whether or not the attitudes of nursing students toward mental retardation were different after a planned curricular experience with mentally retarded children. The sample consisted of 72 nursing students enrolled in the University of Florida College of Nursing, in the summer and fall quarters, 1974. There were 46 students who had not had the planned experience with mentally retarded children and 26 students who had already had the experience. The design of the study was the Static-Group Comparison discussed by Campbell and Stanley. The Attitude Behavior Scale Toward Mental Retardation (ABS-MR) developed by John E. Jordan was used to measure attitudes and information about mental retardation. The ABS-MR was divided into 10 subscales. Hypotheses were formulated for eight of these subscales. The hypotheses predicted that there would be a significant difference in the pretest and posttest groups in their attitudes toward mental retardation and in their knowledge about mental retardation. There was a difference in the mean scores for all eight hypotheses, but only two were statistically significant, one of which concerned the subjects' perceptions of what other people generally believe about interacting with the mentally retarded; the other dealt with the subjects' perceptions of aspects of life or life situations. The differences were all in a negative direction except for the difference on the subscale dealing with knowledge about mental retardation which was in a positive direction . It was concluded that there was a difference in attitudes after the planned curricular experience with mentally retarded children, factual information may increase as a result of planned curricular experience and attitudes tended to become more negative after such experience.
Thesis:
Thesis--University of Florida.
Bibliography:
Bibliography: leaves 117-120.
Additional Physical Form:
Also available on World Wide Web
General Note:
Typescript.
General Note:
Vita.

Record Information

Source Institution:
University of Florida
Holding Location:
University of Florida
Rights Management:
Copyright [name of dissertation author]. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
Resource Identifier:
029479648 ( AlephBibNum )
AEG8883 ( NOTIS )
014281275 ( OCLC )

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Full Text














ATTl-U': US C NURSliG STUDENTS TOWARD MENTAL
RETARDATION BEFORE AND AFTER CURRICULAR EXPERIENCE
WITH MENTALLY RETARDED CHILDREN












By

AMANDA SIRMON BAKER


A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL OF
THE UNIVERSITY OF FLORIDA IN PARTIAL
FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY


UNIVERSITY OF FLORIDA
1974


























































Copyright by
Amanda Sirmon Baker
1974



























To my husband and children
















ACKNOWLEDGMENTS


I am indebted to the students in the University of

Florida College of Nursing, and to their faculty, without

whose cooperation the research could not have been accom-

plished.

For continued support throughout my doctoral program,

I gratefully acknowledge the chairman of my committee,

James W. Hensel. His interest and sincere concern have been

appreciated.

To the other members of my committee, Vynce Hines and

Dorris Payne, I extend my genuine appreciation for the unique

contribution each has made. Vynce Hines contributed patience,

understanding and practical advice. Dorris Payne is especi-

ally recognized and valued for her unfailing support and

interest in my professional development. My success in the

doctoral program is largely due to her scholarly assistance

and personal interest.

Among others who have directly or indirectly influenced

the research, I wish to thank Professors Pauline Barton and

George Policello, doctoral colleague David Williams, and my

typist Nancy McDavid.









My doctoral venture would not have been possible without

the encouragement and loving support of my husband, Malcolm

Baker, and our children, Eric Baker and Michael Baker. I am

deeply grateful.

















TABLE OF CONTENTS

Page

ACKNOWLEDGMENTS . . . . . . . . ... . iv

LIST OF TABLES. . . . . . . . . ... . viii

ABSTRACT. . . . . . . . . ... . . .ix

CHAPTER

I INTRODUCTION . . . . . . . . . 1

Problem . . . . . . . . 3
The Purpose . . . . . . . . 5
Need for the Study. . . . . . . 5
Desire for Improving the Plight of the
Mentally Retarded in our Society. . 7
Experiential Inadequacies of
Professional Nurses . . . . . 7
The Need for Curriculum Revision in
Nursing Education . . . . . 8
Definition of Terms . . . . . . 9

II THE REVIEW OF THE LITERATURE . . . . .. .12

Related Literature. . . . . . .. .12
Definitions . . . . . . .. 13
Attitudes Toward the Mentally Retarded. 16
Family Attitudes. . . . . .. 17
Attitudes of Professionals. . . .. .19
Public Attitudes. . .'...... .22
Cross-Cultural Attitudes. . . .. .23
Conclusion. . . . . . . . .. .24

III METHODOLOGY. . . . . . . . . .. .26

Hypotheses. . . . . . . . .. .26
Sample. . . . . . . . . ... 29
Design. . . . . . . . . .. .30
Instrumentation . . . . . . .. 33
Procedure . . . . . . . .. 34
Assumptions and Limitations ...... 36











TABLE OF CONTENTS (continued)


CHAPTER Page

IV DATA ANALYSIS. . . . . . . .. 38

Discussion of the Results . . .. 47

V SUMMARY, CONCLUSIONS AND IMPLICATIONS. . 55

Summary . . . . .. . . .. 55
Purpose of the Study . . ... 55
Questions for Study . . . .. 55
Need for the Study. . . . . 56
Design of the Study . . . .. 56
The Sample. . . . . . ... 56
Instrumentation . . . ... 57
Analysis and Interpretation of
Data. . . . . . . .. 57
Conclusions . . . . . . .. 62
Implications. . . . .... . .. 62
Education Implications. . . .. 63
Nursing Practice Implications . 64
Research Implications . . .. 65

APPENDICES

A ATTITUDE BEHAVIOR SCALE-MENTAL RETARDATION 68

B COURSE OUTLINE . . . . . . .. 106

C GROUPS A AND B COMPARED ON EXPERIENCES OF
CONTACTS WITH HANDICAPPED PERSONS, INCLUDING
MENTALLY RETARDED PERSONS. . . . .. .114

BIBLIOGRAPHY. . . . ... . . . . . 117

BIOGRAPHICAL SKETCH .. .. ... .. ... . 121

















LIST OF TABLES

Table Page

1 SUBJECTS IN GROUP A AND GROUP B COMPARED FOR
SEX, AGE, MARITAL STATUS, RELIGION AND
EDUCATION. . . . . . . . . ... 31

2 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS I. 40

3 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS II 40

4 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS III. 42

5 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS IV 42

6 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS V. 44

7 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VI 44

8 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VII. 46

9 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS
VIII . . .. . . . . . . . .46

10 REGRESSION COEFFICIENTS (MEAN SCORES) FOR
GROUPS A AND B AND ON EACH SUBSCALE. ... .48

11 GROUPS A AND B COMPARED ON EXPERIENCES OR
CONTACTS WITH HANDICAPPED PERSONS. . . .. .51

12 REGRESSION COEFFICIENTS (MEAN SCORES) FOR
GROUPS A AND B ON INTENSITY FACTORS FOR
SUBSCALES. . . . . . . . . ... 54


viii









Abstract of Dissertation Presented to the Graduate Council
of the University of Florida in Partial Fulfillment
of the Requirements for the Degree of Doctor of Philosophy

ATTITUDES OF NURSING STUDENTS TOWARD MENTAL
RETARDATION BEFORE AND AFTER CURRICULAR EXPERIENCE
WITH MENTALLY RETARDED CHILDREN

By

Amanda Sirmon Baker

December, 1974

Chairman: Dr. James W. Hensel
Major Department: Curriculum and Instruction

This study sought to determine whether or not the

attitudes of nursing students toward mental retardation were

different after a planned curricular experience with men-

tally retarded children. The sample consisted of 72 nursing

students enrolled in the University of Florida College of

Nursing, in the summer and fall quarters, 1974. There were

46 students who had not had the planned experience with

mentally retarded children and 26 students who had already

had the experience.

The design of the study was the Static-Group Comparison

discussed by Campbell and Stanley. The Attitude Behavior

Scale Toward Mental Retardation (ABS-MR) developed by John E.

Jordan was used to measure attitudes and information about

mental retardation. The ABS-MR was divided into 10 sub-

scales. Hypotheses were formulated for eight of these

subscales. The hypotheses predicted that there would be

a significant difference in the pretest and posttest








groups in their attitudes toward mental retardation and

in their knowledge about mental retardation. There was a

difference in the mean scores for all eight hypotheses, but

only two were statistically significant, one of which con-

cerned the subjects' perceptions of what other people

generally believe about interacting with the mentally

retarded; the other dealt with the subjects' perceptions of

aspects of life or life situations.

The differences were all in a negative direction ex-

cept for the difference on the subscale dealing with knowl-

edge about mental retardation which was in a positive

direction.

It was concluded that there was a difference in atti-

tudes after the planned curricular experience with mentally

retarded children, factual information may increase as a

result of planned curricular experience and attitudes

tended to become more negative after such experience.















CHAPTER I


INTRODUCTION


Professionals, as well as parents, react differently

to the birth of a retarded child. Some of the reactions are

unpredictable; some are expected, but all reactions arise

from the individual differences of the people involved.

For nine months, parents dream dreams and the appear-

ance of a defective baby brings grief and mourning that

kill the dreams. At such critical moments the child must

still be cared for. Sometimes the family and/or the

community cannot provide adequate care.

Separation, or just the thought of separation, can

reawaken buried fears and anxieties. The retarded child

reminds parents and professionals of their own inadequacies

and the first impulse is to isolate the offender.

As Nichtern (1974) says:

The growth of our children not only moves
them away from us and out of the family
but brings them to the public marketplace
as products as well as consumers before
they may be ready. Their identification as
something special--retarded--makes them
both a special product and a special
consumer. . The special program for the
special child adds yet another dimension.
Often the participating individual acquires









the identity of the program. This is true
for child, family and professional alike.
Once given the identity of "retarded" or any
other similar designation, this classifica-
tion tends to track the individual. .
It helps make identification a broken promise
of dreams never to be achieved and goals
never to be fulfilled. (pp. 4-5)

Society is organized to provide common goals for

its members. The retarded cannot cope with such structure

and quickly become thorns in the sides of parents, pro-

fessionals and others. Because retardation is a function

of disturbances in development and displacements in time,

the child may behave in ways that appear immature for his

age or inappropriate to the time and place involved.

As the trend to conformity and standardized norms of

behavior increases, an increasing number of individuals

are labeled as retarded. The way these individuals are

treated, whether with neglect, kindness, cruelty,

ignorance, becomes a part of their very nature.

The history of retardation suggests that
it is as much a record of society's needs
and organization at any moment as it is
of the existence of the retarded.
(Nichtern, 1974, p. 11)

Few references exist that describe the care of the

retarded before 1800. During the nineteenth century the

Industrial Revolution revealed more and more people who were

too slow or incompetent to function at the complex level

required.








Mass-production moved from the factory to the institu-

tions and by the nineteenth century facilities for the re-

tarded were in operation throughout Western Europe and in

America.

At this same time, the professionals made their first

serious attempt to define mental retardation, the psycholo-

gist, the physician and the educator, however, had different

definitions.

The timing of this emerging interest and
the varying points of view suggest the con-
cept of retardation to be more dependent
on man's interpretation and prejudice than
an entity unto itself. (Nichtern, 1974, p. 30)


Problem


The professional judgment that labels an individual

as retarded not only identifies or defines behavior. Such

identification also categorizes that person as an inferior

member of a sub-group requiring control and external struc-

ture.

Much credence is given to the results of standardized

tests as "objective" and "concrete" measures of retardation.

With such tests normal is equated with average and the child

who tests below the average is labeled abnormal.

A child with a crippling orthopedic problem is not

ostracized. A child with a congenital heart defect is not

separated from home and family. Each is allowed to live

and grow to his ultimate limits. But a child who is









labeled retarded is considered immediately for institu-

tional care.

Once labeled as retarded an individual is rarely

reclassified. His only recourse is to relocate and lose

the label. For those who cannot lose their identities,

the only hope is in an interested and enlightened society

in which he may be allowed to achieve his maximum potential.

Nurses are members of that society and the attitudes

they have developed influence the care they plan and

provide. Individuals of differing abilities, in and out of

institutions, alone or in groups, all are included in a

nurse's patient load. The care any nurse can plan and

provide reflects not only her own attitudes but also the

attitudes of those who have taught her.

Experiences in the curriculum of nursing programs can

help shape the attitudes and prepare nurses more adequately

to plan nursing care that meets the needs of all individuals.

If these experiences are to meet the needs of both students

*and society, the curriculum must be constantly evaluated

and revised.

Most attitudes can be changed and modified but can

attitudes toward mental retardation be altered significantly?

The problem which has been addressed in this study

was the effect of planned learning experience with retarded

children on the attitudes of the nursing students towards

mental retardation.









The Purpose


The purpose of this study was to determine whether or

not the identified attitudes of baccalaureate nursing stu-

dents towards mental retardation were different after a

planned experience with retarded children.

The study was designed to answer such questions as:

1. Can attitude change be linked to specific

experiences?

2. Are attitudes of nursing students toward mental

retardation different after a planned experience

with retarded children?

3. If there are attitude differences, are they in a

positive or negative direction?


Need for the Study


Nurses are expected to plan and implement care for all

individuals in our society, yet few preparatory programs

include experiences with mentally retarded individuals as

part of the curriculum.

Mental retardation is one of the most serious handi-

capping conditions of individuals in the United States.

It affects the social, economic and personal welfare of all

Americans. Retarded individuals are denied opportunities

to develop or to plan for themselves and thus become a

burden to those who must assume responsibility for their

care, education and rehabilitation.










If the true measure of a civilization is reflected in

the value placed upon the least able in that civilization,

the United States measure is not commensurate with the

country's advancement in other areas. In the rush to

demonstrate "caring" for the mentally retarded, millions

of dollars were appropriated for programs in the 1960s.

In spite of these programs, however, the plight of the men-

tally retarded has been changed only slightly. Negative

social attitudes of individuals and groups toward the

mentally retarded inhibit change. Real change occurs when

attitudes reflect a positive view of the mentally retarded

individual as an individual. Social programs have demon-

strated that society can accept responsibility for handi-

capped individuals, but can society develop a positive

attitude towards them? Can institutional care be replaced

by something more effective?

Ignorance, prejudice and shortsightedness foster the

segregation of the retarded in family, school and institu-

tion. The cost of this segregation is inestimable in the

millions of dollars spent on care and in the untold anguish

of the retarded and of their families. If alternative

methods of care are to be developed, research in attitude

change toward the mentally retarded is needed.

The bases upon which this study was conceptualized

were: (1) a desire for improving the plight of the

mentally retarded in our society, (2) the experiential









inadequacies of professional nurses and (3) the need for

curriculum revision in nursing education.


Desire for Improving the Plight of the
Mentally Retarded in our Society


Mentally retarded individuals are at a critical dis-

advantage in a technologically advanced civilization.

Individuals who function at an adequate level in a simple

environment might find themselves identified as mentally

retarded in complex industrialized surroundings. The com-

plexity of the society, plus the advanced techniques for

identification of the mentally retarded by medicine, psy-

chology and education, increase the likelihood of these

individuals being singled out as "mentally retarded" and

becoming part of an abnormal subgroup, a subgroup too often

denied the rights and privileges of participating in the

normal activities and life of their community.


Experiential Inadequacies of
Professional Nurses


Often nurses are the persons to whom a family turns

first in a time of distress, however, nurses are usually

ill prepared to deal with problems related to mental

retardation. They confront this problem both in the

hospital and in the community and have difficulty dealing

with it in terms of their own feelings and in terms of

offering any assistance to the families or to the retarded










individual. Nursing has an obligation to meet the needs

of this group in our society. But it is difficult to

meet the needs of others until one's own needs are met.

Nurses are members of the general population and reflect

the social mores of the time, including the prevalent

attitudes about mental retardation. However, perhaps

social change could be facilitated by nurses who have

developed more positive attitudes toward the mentally

retarded. There has been little research done on attitudes

of nurses.


The Need for Curriculum Revision
in Nursing Education


Nursing is responsible for assisting in health

maintenance of all people, whether they be institutions

(hospitals, etc.) or in the community. Nursing care

is concerned with the health of individuals, of families

and of larger groups, whether they be normal or abnormal,

sick or well. However, the curriculum in nursing edu-

cation usually focuses on illness. If nurses are to meet

the needs of their clients, the curriculum must include

opportunities for nursing students to study and work

with many different individuals and groups, to focus on

wellness. The mentally retarded are included as indi-

vidual clients or in groups of clients.









Definition of Terms


For the purpose of this study, the following defini-

tions were used:

SAttitude (dependent variable).--"A mental and neural

state of readiness, organized through experience and exert-

ing a directive or dynamic influence upon the individual's

response to all objects and situations to which it is

related" (Allport, 1935, p. 799).

Nursing 340 experience (independent variable).--

Basic pediatric nursing course which includes a two-week

learning experience working with mentally retarded children

at Sunland Training Center, Gainesville, Florida.

Nursing student.--A student enrolled in junior or

senior courses in the University of Florida College of

Nursing.

R.N. student.--A student enrolled in the University of

Florida College of Nursing at the time of the study who

was already licensed as a Registered Nurse.

Generic student.--A student enrolled in the University

of Florida College of Nursing at the time of the study

who was not yet licensed as a Registered Nurse.

Mental retardation.--A societal concept by which members

of that society are categorized as mentally retarded or

slow (Gunzburg, 1958). A concept not easily definable being

more of "a social process than a clinical entity" (Nichtern,

1974, p.31).










ABS-MR (Attitude Behavior Scale-Mental Retardation).--

developed by John E. Jordan. Contains attitude subscales,

plus subscales on demographic factors, contact with handi-

capped persons, life situations, and information about

mental retardation (Appendix A).

Group A.--Those students who had not had Nursing 340

and the planned experience with retarded children at Sun-

land Training Center, Gainesville, Florida, and who were

administered the ABS-MR as a pretest only.

Group B.--Those students who had had Nursing 340 and

the planned experience with mentally retarded children at

Sunland Training Center, Gainesville, Florida, and who

were administered the ABS-MR as a posttest only.

Subscale I or ABS-I-MR.--The first section of the

ABS-MR which measures the subject's perception of how other

people compare the mentally retarded to those who are not

mentally retarded (Appendix A, pp. 70-72).

Subscale II or ABS-II-MR.--The second section of the

ABS-MR which deals with what the subject thinks other people

generally believe about interacting with the mentally

retarded (Appendix A, pp. 73-76).

Subscale III or ABS-III-MR.--The third section of the

ABS-MR which deals with what the subject feels is the right

or wrong way to behave toward mentally retarded persons for

himself (Appendix A, pp. 77-80).








Subscale IV or ABS-IV-MR.--The fourth section of the

ABS-MR which deals with how the subject would act toward

the mentally retarded individual in given situations

(Appendix A, pp. 81-84).

Subscale V or ABS-V-MR.--The fifth section of the ABS-

MR which deals with how the subject would act toward the

mentally retarded individual in given situations (Appendix

A, pp. 85-87).

Subscale VI or ABS-VI-MR.--The sixth section of the

ABS-MR which deals with the subjects actual experience

with mentally retarded persons (Appendix A, pp. 88-91).

Subscale VII or ABS-VII-MR.--The seventh section of the

ABS-MR which deals with demographic information (Appendix

A, pp. 92-96).

Subscale VIII or ABS-VIII-MR.--The eighth section of the

ABS-MR which deals with the subject's experiences or con-

tacts with handicapped persons (not specifically mentally

retarded)(Appendix A, pp. 97-100).

Subscale IX or ABS-IX-MR.--The ninth section of the

ABS-MR which deals with the subject's feelings about

several aspects of life or life situations (Appendix

A, pp. 101-102).

Subscale X or ABS-X-MR.--The tenth section of the

ABS-MR which deals with information about mental retarda-

tion (Appendix A, pp. 103-105).
















CHAPTER II


THE REVIEW OF THE LITERATURE


The idea of attitude change toward mental retardation

includes the concepts of attitude and attitude change per

se. Therefore, the review of the literature was divided

into research studies in attitude toward mental retardation

or toward the mentally retarded and related literature.


Related Literature


The concept of attitude has played a central role in

the development of American social psychology (Kiesler,

Collins and Miller, 1969). Studies in the area of attitude

theory and organization were numerous as reviewed by Rosen-

berg and Hovland (1960) and Kiesler et al., (1969).

Social psychologists before World War II concentrated

on attitude measurement and scaling while those after

World War II devoted their attention to theoretical and

empirical issues in attitude change (Kiesler et al., 1969).

In fact, as early as 1918 social psychology was defined as

the scientific study of attitude (Thomas and Znaniecki,

1918).









Definitions


Definitions of attitude vary according to the

theorist's orientation. Allport's (1935). definition was

found widely in the literature.

An attitude is a mental and neural state of
readiness, organized through experience,
exerting a directive or dynamic influence
upon the individuals response to all objects
and situations with which it is related. (p. 799)

Triandis (1971) proposed a definition that he felt included

many of the central ideas used by attitude theorists as

follows: "An attitude is an idea chargedwith emotion which

predisposes a class of actions to a particular class of

social situations" (p. 2).

Thurstone advocated a broad definition of attitude in

1928, but later modified that definition to "the intensity

of positive or negative affect for or against a psychologi-

cal object. A psychological object is any symbol, person,

phrase, slogan or idea toward which people can differ as

regards positive or negative affect" (Thurston, 1946, p. 39).

This definition was accepted by many theorists who developed

scales for measuring attitudes.

Guttman (1950) defined attitude as a "delimited total-

ity of behavior with respect to something" (p. 51). This

is a behavioral definition rather than a cognitive one and

lends itself to a facet theory analysis which Guttman

(1959) developed. Bastide and van den Berghe (1957) proposed










four types or levels of interaction with an attitude ob-

ject. Guttman (1959) elaborated these into a facet theory

analysis in which he defined four of these levels:

(a) Stereotype, (b) Norm, (c) Hypothetical Interaction,

and (d) Personal Interaction (Jordan, 1970).

Kerlinger (1964) defined attitude as "Predisposition

to think, feel, perceive and behave toward a cognitive

object" (p. 483). This definition or variations of it

recurred often in the literature and represents the cogni-

tive theorist's concept of attitude.

Attitudes and behavior were linked together by McGinnies

(1970) when he referred to attitudes as a class of perform-

ances under the control of a specified social referent--

much as any other learned behavior. Beatty (1969) also

linked behavior and attitudes. Kiesler et al. (1969)

proposed that it is not necessary to ask whether or not

attitudes and behavior are correlated, but rather we should

ask when are attitudes and behavior correlated and what

factors affect the size of the correlation. They further

discussed this point by stating

. our notions that a particular attitude
correlates with a particular behavior may be
incorrect, not because of a general failure
of attitudes to have any relationship to
behavior but because our intuitive notions
about which attitudinal factors are corre-
lated with which behavioral factors are incorrect.
While our theoretical analysis of attitudes
definitely commits us to a position that attitude
factors should, in general, be correlated with
some behavioral factors, it does not commit us









to a position that each attitude factor
should be correlated to all behavioral factors.
(Kiesler et al., 1969, p. 36)

A study often discussed in relation to behavior and

attitude was one by La Piere (1934), which dealt with the

apparent inconsistency exhibited by motel or restaurant

proprietors who actually served a Chinese couple even

though they had said they would not do so in response to a

letter query. Kiesler et al. (1969) maintained that these

were both behaviors in different situations, rather than

the letter representing only attitude and the response to

the couple as only behavior.

Attitude change was another area in the study of

attitudes. Theories of attitude change might be divided

into two types: a literary or conceptual definition and an

operational definition. An operational definition defines

a concept by specifying the procedures used to measure the

concept and is based on the conceptual or literary defini-

tion (Kiesler et al., 1969). Studies in attitude change

have often used the concept of dissonance as proposed by

Festinger (1957), "Two elements are in a dissonant relation

if, considering these two alone, the obverse of one element

would follow from the other" (p. 13). Although highly

controversial, dissonance theory and other consistency

theories have been useful to social psychology and the

study of attitude change (Kiesler et al., 1969).










Kiesler et al. (1969) summarized their critical review

of theoretical approaches to attitude change

S. for the most part theorizing in this area
is still at a relatively low level: assumptions
are not made explicit; relations between theore-
tical constructs are not spelled out; and the
details necessary for precise predictions are often
missing. Consequently, we feel that detailed
criticism is necessary and desirable at this
stage in the study of attitude change. (p. 343)

A comprehensive review of the literature (Jordan, 1968)

on attitude studies indicated that four classes of variables

seemed to be important determinants, correlates and/or pre-

dictors of attitude: (a) econ-demographic factors such

as age, sex and income; (b) socio-psychological factors such

as one's value orientation; (c) contact factors such as

amount, nature, perceived voluntariness, and enjoyment of

the contact; and (d) the knowledge factor, i.e., the

amount of factual information one has about the attitude

object. These variables are included in the Attitude

Behavior Scale Toward Mental Retardation (ABS-MR) developed

by Jordan and used in his study Attitude-Behavior Toward

Mentally Retarded Persons: A Cross-Cultural Analysis,

(1970).


Attitudes Toward the Mentally Retarded


The concept of attitude has played a central role in

the development of American social psychology (Kiesler

et al., 1969). Studies in the area of attitude theory and









organization were numerous as reviewed by Rosenberg and

Hovland (1960) and Kiesler et al. (1969).

Attitudes toward the disabled have been studied par-

ticularly since World War II in an effort to plan programs

to meet the needs of the physically handicapped. Jordan

(1968) and Yuker (1970) have conducted comprehensive studies

in this area and their studies serve as transition from the

study of attitude theory as a concept to the study of

attitudes toward a broadly defined group.

A review of the studies conducted and reported since

1960 which have focused specifically on attitudes toward

the mentally retarded could be classified in four primary

groups: (1) family attitudes, (2) attitudes of profes-

sionals, (3) public attitudes (nonspecific groups), and

(4) cross-cultural attitudes.


Family Attitudes


Attitudes of family members toward the retarded child

were reported in four studies. Early research in this area

usually concentrated on the reactions and perceptions of

the mother toward the child. Barber (1963) found that the

attitudes of mothers of mentally retarded children were not

influenced by the sex of the children but were influenced

by the child's intellectual capacity and behavior. The

influence of socioeconomic status was significant and was

one of the most important variables influencing the attitudes









of mothers of mentally retarded children. Barber surmised

that this research indicated that having a mentally retarded

child tended to intensify some of the corresponding attitudes

already held by parents of normal children of similar socio-

economic status. The study included only families where the

retarded child lived at home and therefore the findings

could not be generalized to mothers who had placed their

children in other living arrangements.

More recent research has included other family members.

Condell (1966) investigated the attitudes of parents of

retarded children, living in a rural setting. Some dis-

crepancy seemed to exist between the parents' attitudes and

the attitudes of the professionals involved. Such a dis-

crepancy may have arisen because of the different educa-

tional and socioeconomic background of the urban, academi-

cally oriented professional group. Parental attitudes .-&o,

varied in this sample. Although parents sought profes-

sional help they did not always accept it, especially when

professional goals and parental needs varied.

While many studies have concentrated on the relation-

ship between mother and child, very few have included the

father. Gumz and Gubrium (1972) examined the comparative

perceptions of mothers and fathers toward a mentally

retarded child of their own. The hypotheses of this study

asserted that the father's role is that of instrumental

leader while the mother's role is that of expressive









leader. The instrumental function focuses on relations of

the system with other systems; its goals are to achieve

adaptation, to maintain equilibrium and instrumentally to

establish the desired relations to external goal objects.

The expressive area concerns itself with the "internal"

affairs of the system; to maintain integrative relations

between members and to manage tension between component

parts of the social system. Although not consistently

statistically significant, evidence from a sample of 50

families with retarded children showed that there was a

tendency for fathers to perceive their child more instru-

mentally than mothers, the letters' perceptions being more

expressive.

Family attitudes were further studied by Adams (1965)

who looked at the comparison of attitudes of adolescents

toward both normal and retarded brothers. The results of

this study seemed to indicate that mentally retarded brothers

living at home did not adversely influence their siblings.


Attitudes of Professionals


Recognizing the importance of teachers and education in

the lives of the retarded, researchers have explored

various aspects of teachers' attitudes toward the retarded.

Legant (1966) did not find any significant differences

among the attitudes of regular classroom teachers, teachers

of the handicapped, and teachers who had been exposed to









professional courses in teaching handicapped children but

who were not actively engaged in doing so. The opposite

of this was found by Proctor (1967) in a dissertation which

investigated the relationships between the teachers' knowl-

edge of exceptional children, the kind and amount of their

teaching experience and their attitudes toward classroom

integration of retarded children. Differences were found

between groups of teachers which related directly to their

knowledge about mental retardation and the amount of their

teaching experience.

Teacher bias was explored by Soule (1972) in an attempt

to examine the effect of expectancy on the subsequent be-

havior of institutionalized severely retarded children.

No effects of experimentally induced teacher bias were

found in this study of 24 subjects. Blazovic (1973) demon-

strated that parents, teachers and retarded students differ

in their attitudes toward integrated programs for borderline

educable mentally retarded students. Regular class teachers

perceived special classes as being more beneficial to

borderline retardates than regular classes, the retarded

students did not recognize or acknowledge differences be-

tween regular and special classes and parents appeared

ambivalent toward preferences. Conversely Jones (1971)

found that mildly retarded students rejected the labels and

stigma associated with the special education, that teachers

held lowered expectations for these students and had not









developed strategies for the management of stigma in

classes for the educable mentally retarded.

There were references made in the literature to the

attitudes of nurses toward mental retardation (Steele,

1971; Koch, 1971; Nichtern, 1974), but no research was

found in this specific area. Steele emphasized the

necessity for the nurse to have worked through her own

feelings toward mental retardation before attempting to

help parents of a retarded child for her attitude and

behavior may serve as a guide for parents (Steele, 1971).

Koch (1971) presented the interdisciplinary approach toward

mental retardation involving many different professions;

nursing being one of these. The importance of attitudes was

stressed throughout the book. Nichtern (1974) wrote a book

for parents of a retarded child with emphasis on the im-

portance of attitudes, of society as a whole and especially

of parents and those professionals working directly with

the child. Nursing texts in pediatric nursing usually

included short section on mental retardation based on the

clinical aspects of the condition and the nurse's responsi-

bility in prevention, case finding and management with little

or no mention made of attitudes of the nurse (Marlow, 1973;

Blake, Wright and Waechter, 1970).









Public Attitudes


In spite of increased information about mental re-

tardation in the media, emphasis on programs and huge amounts

of money allocated by governmental and private agencies

during the 1960s, Gottwald (1970) found a tremendous naivete

in public awareness about mental retardation. Meyers,

Sitkei and Watts (1966) also found this lack of understanding

concerning the educable mentally retarded child's potential

by both groups in their study, one a random sample of an

urban population, the other a sample of families with a

child enrolled in special classes in public school. Their

study did reveal a more accepting attitude of home care and

public education for the educable mentally retarded (EMR)

as opposed to the trainable mentally retarded (TMR) and a

more accepting attitude by non-Caucasians and those of

"liberal-casual" religions. Edgerton and Darno (1972)

studied the attitudes of Anglo- and Mexican-Americans toward

the moderately retarded (TMR). The results indicated that

most Anglo- and Mexican-Americans from a large urban area

preferred home care as opposed to hospital care. As the

respondents became more."middle-class," however, they tended

to choose hospitalization.

Investigation of attitudes of the public in connection

with tours of institutions for the retarded indicatedthat

while the tours may produce attitude change, this change

is often in a positive direction toward the institution and









toward parents (Sellin and Mulchahay, 1965; Kimbrell and

Luckey, 1964; Warren, Turner and Brody, 1964) and in a

negative direction toward the retarded themselves or toward

working with the retarded (Sellin and Mulchahay, 1965;

Warren et al., 1964). Sartin (1965) found that while there

were fewer misconceptions following a unit of study which

included tours of institutions, the attitudes which the

students expressed were more negative toward the mentally

deficient, but more positive toward the slow learner and

toward other groups of children.


Cross-Cultural Attitudes


Mental retardation and the attitudes toward mentally

retarded persons are problems which are present in all

societies. In an attempt to investigate the attitude

behaviors toward retarded persons, Jordan (1970),using the

variables identified in 1968, conducted an extensive seven-

nation study of four classes of variables which he believed

to be important determinants, correlates and/or predictors

of attitudes: (1) econ-demographic factors such as age,

sex and income, (2) socio-psychological factors such as

one's value orientation, (3) contact factors such as amount,

nature, etc., of contact, and (4) the knowledge factor.

Jordan's results indicated that increased knowledge of

mental retardation did not necessarily indicate increased

positive attitudes, type of contact with the retarded was









related to the attitudes expressed, amount of education was

positively related to favorable attitudes toward mental re-

tardation, age was not related to attitudes toward mental

retardation, women scored higher on positive attitudes

toward mental retardation than men, those who scored high

in efficacy did not necessarily score high in positive

attitudes toward the mentally retarded.

Comparison of attitudes between the U.S. and

Europe was done by Lippman (1972). He found that European

countries, especially the Scandinavian countries, have a

more positive attitude toward the mentally retarded than

the U.S. The provisions made for the retarded reflected

this positive attitude.


Conclusion


The review of the literature indicated that research

in the area of attitudes has intrigued psychologists and

sociologists since the early 1900s. Although there has

been much controversy in the field, the results of the

studies help researchers to better understand attitudes and

attitude change. These findings have been widely used by

experts in communication and advertising and are beginning

to be used by experts in other fields.

The area of attitudes and attitude change as related

to behavior and behavior change was less clearly defined

and needs further research and study.





25



The area of nurses' attitudes toward mental retarda-

tion has only recently appeared in the literature (Steele,

1971; Nichtern, 1974; Koch, 1971). Research inthis area

has not been reported.















CHAPTER III


METHODOLOGY


Hypotheses


Jordan recommended that the ABS-MR be tabulated

as separate subscales, rather than as whole (Jordan,

1970). When the entire scale was differentiated into

subscales, eight hypotheses were formulated for this

study.

Hypothesis I:

There will be a significant difference between

nursing students who have not had a planned curricular

experience with mentally retarded children (Group A) and

nursing students who have had a planned curricular experi-

ence with mentally retarded children (Group B) in their

perception of how other people compare the mentally

retarded to those who are not retarded as measured by

the ABS-I-MR.

Hypothesis II:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing









students who have had a planned curricular experience with

mentally retarded children (Group B) in their perceptions

of what other people generally believe about interacting

with the mentally retarded as measured by the ABS-II-MR.

Hypothesis III:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with

mentally retarded children (Group B) in their feelings about

the right or wrong way to behave toward mentally retarded

persons as measured by the ABS-III-MR.

Hypothesis IV:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with

mentally retarded children (Group B) in the way they believe

they would act toward mentally retarded individuals in given

situations as measured by the ABS-IV-MR.

Hypothesis V:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with

mentally retarded children (Group B) in their identified









feelings toward the mentally retarded as measured by the

ABS-V-MR.

Hypothesis VI:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing

students who have had a planned curricular experience with

mentally retarded children (Group B) in their actual experi-

ence with mentally retarded individuals as measured by the

ABS-VI-MR.

Hypothesis VII:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing

students who have had a planned curricular experience with

mentally retarded children (Group B) in their expressed

feelings about life situations as measured by the ABS-IX-MR.

Hypothesis VIII:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing

students who have had a planned curricular experience

with mentally retarded children (Group B) in the amount

of information they possess about mental retardation as

measured by the ABS-X-MR.










Sample


Ninety-four students volunteered to participate,

but 22 did not return the ABS-MR. There was no way to

contact those who did not return the ABS-MR as anonymity

had been maintained. The study sample, therefore, con-

sisted of 72 students enrolled in the University of

Florida College of Nursing during the summer and fall

quarters, 1974. As part of their program pediatric nursing

was required, but the students could elect to take the

course at any point in their upper division work. The

students who participated in the study were, therefore, in

either their junior or senior year of a baccalaureate

program in nursing. The sample reflected the student

admissions to the College of Nursing and was predominantly

white, female and young. No attempt was made to control

such variables as age, sex, race, religion, or educational

background (i.e., R.N. or generic students).

The sample consisted of 70 females and 2 males, whose

ages ranged from under 21 years old to 50 years, with the

majority in the 21-30 age bracket. There were 56 who were

single, 14 married, 1 divorced and 1 widowed. Their religion

was predominantly Protestant (41 of the total 72), 14

Catholic, 2 Jewish, 12 other or none, while 3 preferred








not to answer. Fifty-three listed some college or

university level education, while 19 listed college

or university degree (see Table 1).


Design


The separate sample Pretest-Posttest Design proposed

by Campbell and Stanley (1963, p. 53) was the original

design of this study. Randomization could not be main-

tained; therefore, the design used was the Static-Group

Comparison (Campbell and Stanley, 1963, pp. 12-13). This

is considered a pre-experimental design by Campbell and

Stanley. The sources of internal invalidity are similar

on the two designs, but the Static-Group Comparison does

not control for threats to external validity (Campbell

and Stanley, 1963, p. 8 and p. 40). The design can be

illustrated by the diagram:



X 01

O2

The first threat to internal validity is that of

selection. If 01 and 02 differ, this difference could

have well come about because the groups were different to

begin with. In this particular study, there was a degree

of control for this; as the two groups were all in the

junior or senior year of the same baccalaureate nursing










Table 1

SUBJECTS IN GROUP A AND GROUP B
COMPARED FOR SEX, AGE, MARITAL STATUS, RELIGION AND EDUCATION


Group A Group B


Under 21
21-30
31-40
41-50


Marital Status

Married
Single
Divorced
Widowed


Religion

Prefer not to Answer
Catholic
Protestant
Jewish
Other or none


Education

Some college or university
College or university degree








program, and were all volunteers in the sample. This would

assume a certain amount of similarity in age, educational

level and occupational interests. They were all anonymous

and did not receive any external rewards or recognition

for participating in the study.

Mortality (loss of subjects) is another threat to

internal validity. There were 22 students who volunteered

to participate but who failed to complete the ABS-MR.

Their anonymity had been maintained, so there was no way

to determine who they were. It can only be assumed that

participants from both groups failed to return the ABS-MR.

Interaction of selection and maturation is another

threat to internal validity. It is assumed that the volun-

tary selection, the similarity of age and educational

backgrounds and the short time span of the testing con-

trolled for this in some degree.

The Static-Group Comparison design has no controls

for threats to external validity; but, many of the experi-

mental designs and quasi-experimental designs proposed by

Campbell and Stanley have no controls in this area. The

results, then, are not considered generalizable to any

population other than the one involved in the study.

The design does control for threats to internal

validity for history (external events not related to

effects of X), testing, instrumentation and regression.










These controls, plus the ones imposed by the anonymity of

subjects, the similarity of subjects and the absence of

external rewards for participation make this a strong

enough design to warrant its use in this particular

study.

Instrumentation represents a hazard when interviewers

are used. This was not the case in this study, as all

information was obtained through a written instrument where

the subjects remained anonymous.


Instrumentation


Attitudes (the dependent variable) were measured using

the Attitude Behavior Scale-Mental Retardation (Appendix A)

developed by Jordan (1970) for use in a cross-cultural

analysis of seven nations. Jordan (1970) described the

Attitude Behavior Scale-Mental Retardation (ABS-MR):

The construction of the ABS-MR was guided
by the facet design which makes it possible
to construct items by the method of intuition
or by the use of judges. Facet theory (Guttman,
1959, 1971, 1970) specifies that the attitude
universe represented by the item content can
be substructured into semantic profiles which
are systematically related according to the
number of identical conceptual that they hold
in common. The substructuring of an attitude
universe into profiles facilitates a sampling
of items within each of the derived profiles,
and also enables the prediction of relation-
ships between various profiles of the attitude
universe. This should provide a set of clearly
defined profiles for cross-national, cross-
cultural, and sub-cultural comparisons. (p. 5)








Reliability for the ABS-MR test development samples

as determined by the Hoyt analysis of variance method

ranged from .60 to .85. Reliability estimates obtained

by the sample procedures on the seven-nation data indicate

the reliabilities are equal to or, in many instances,

better than those obtained on the test development samples

(Jordan, 1970). Validity of the ABS-MR was assessed by

the "Known Group" method and by the results of a simplex

test. The groups scored approximately as expected.

The ABS-MR, as developed by Jordan (1970), was divided

into six subscales, plus sections on demographic factors,

contact with handicapped persons, life situations, and

information about mental retardation. For the purpose of

this study, the ABS-MR was used as developed by Jordan with

the original subscales (I-VI), and the sections on demo-

graphic factors, life situations, and information about

mental retardation were given subscale numbers VII-X for

tabulation purposes. The ABS-MR was administered as a

total instrument, then analyzed as subscales.

Jordan (1970) strongly recommended maintaining the

anonymity of subjects in an effort to control for social

desirability pressures.


Procedure


The ABS-MR was administered to students enrolled in

the College of Nursing during the summer and fall quarters,









1974. Participation was voluntary and all those students

who had not had the Sunland experience were designated as

Group A. Those students who had completed the Sunland

experience were designated as Group B.

The curricular experience (or independent variable)

for this study consisted of a two-week period when nursing

students worked with mentally retarded children as part of

their course in pediatric nursing. The pediatric nursing

course was required for graduation and the two-week experi-

ence was a required part of the course. The students

participated in the care of children in Willow Cottage at

Sunland Training Center, Gainesville, Florida. These chil-

dren ranged in age from 4 through 14 years and ranged in de-

velopment from 6 months through 4 years; therefore, they

are classified as severely retarded. They are dependent on

others for most of their care. The nursing students were

responsible for completing developmental assessments of these

children, for planning and implementing care based on these

assessments and for either writing a paper or developing and

evaluating a project related to the care of the children

(Appendix B, Course Outline). Students spent at least 12

hours weekly in the cottage. In addition there were weekly

seminars with participating students and instructors.

Daily conferences were held as needed. Instructor(s)

assistance was available at all times from either the

instructor who regularly worked in the cottage with the









students or from other instructors in the pediatric nurs-

ing course.

Students were allowed to modify the course outline

requirements when necessary to meet their own learning

needs. A minimum level of competence was required, however,

in order to receive credit for the experience.

Those students who had completed the experience and

those students who had not yet been assigned to Sunland

were tested during the same six-week period. Because of the

length of the ABS-MR and the time required to answer the

questions, the students were allowed to complete the tests

at home. The subjects were assured of anonymity and were

asked to be honest in their answers. No other directions

were given. The completed tests were returned to the

researcher immediately and all data were available for

analysis within one day of the last testing session.


Assumptions and Limitations


Analysis of data was influenced by underlying assump-

tions and limitations identified early in the study.

It was assumed that

1. The ABS-MR accurately tested attitudes toward MR.

2. The students were truthful in answering the ques-

tions of the ABS-MR.

3. Students chosen during the time period involved

were comparable to students in any other time period.









Certain limitations had to be considered when in-

terpreting the data:

1. Many students had preconceived ideas of what

"nursing" was. Working with mentally retarded children

at Sunland did not always fit this preconception and

biases were formed.

2. The curricular experience was required, not

elective, and students sometimes developed a set against

it for this very reason.

3. The limited period involved (two weeks) did not

afford time to resolve the emotional impact or the stress

of cognitive learning requirements compounded by that emo-

tional impact.

4. The environment of a state institution may have

contributed to reactions that might not have occurred or

might have been different in another setting.

5. Participation in the study was voluntary and

thus involved a select or particular group of individuals

whose attitudes may have influenced their volunteering.

6. The same instructor did not teach the curricular

experience to all the sample involved and individual

instructor biases may have influenced student attitudes.















CHAPTER IV


DATA ANALYSIS


This study investigated the effects of a planned

curricular experience upon the attitudes of baccalaureate

nursing students toward mental retardation.

Eight hypotheses were formulated for the study and

were tested with computer analysis using multivariate general

linear hypothesis procedures.

Hypothesis I:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with

mentally retarded children (Group B) in their perception of

how other people compare the mentally retarded to those

who are not retarded as measured by the ABS-I-MR.

Analysis of data revealed no significant difference

between the groups in their perception of how other people

compare the mentally retarded to those who are not retarded

as measured by the ABS-I-MR. An F statistic of 3.982'was

necessary for significance at the .05 level. The F statistic










for this hypothesis, however, was .641 and therefore

not significant (see Table 2).

Hypothesis II:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with

mentally retarded children (Group B) in their perceptions

of what other people generally believe about interacting

with the mentally retarded as measured by the ABS-II-MR.

Analysis of data revealed a significant difference

between the groups in their perceptions of what other

people generally believe about interacting with the men-

tally retarded as measured by the ABS-II-MR. An F statistic

of 3.982 was necessary for significance at the .05 level.

The F statistic for this hypothesis was 5.067 and, there-

fore, was significant (see Table 3).

Hypothesis III:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with

mentally retarded children (Group B) in their feelings about

the right or wrong way to behave toward mentally retarded

persons as measured by the ABS-III-MR.











Table 2

ANALYSIS OF VARIANCE TABLE


FOR HYPOTHESIS I


Source SS df MS F

Between

Groups (BG) 28.043 1 28.043 .641

Within i ,

Groups (WG) 3061.831 70 43.740










Table 3

ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS II



Source SS df MS F

Between

Groups (BG) 191.043 1 191.043 5.067

Within

Groups (WG) 2638.956 70 37.699









Analysis of data revealed no significant difference

between the groups in their feelings about the right or

wrong way to behave toward mentally retarded persons as

measured by the ABS-III-MR. An F statistic of 3.982 was

necessary for significance at the .05 level. The F statis-

tic for this hypothesis, however, was .010 and therefore

not significant (see Table 4).

Hypothesis IV:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with

retarded children (Group B) in the way they believe they

would act toward mentally retarded individuals in given

situations as measured by the ABS-IV-MR.

Analysis of data revealed no significant difference

between groups in the way they believed they would act

toward mentally retarded individuals in given situations

as measured by the ABS-IV-MR. An F statistic of 3.982 was

necessary for significance at the .05 level. The F statis-

tic for this hypothesis, however, was only 2.435 and there-

fore not significant (see Table 5).

Hypothesis V:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing











Table 4

ANALYSIS OF VARIANCE TABLE FOR



Source SS df

Between

Groups (BG) 0.312 1

Within

Groups (WG) 2017.632 70


HYPOTHESIS III



MS



0.312



28.823


Table 5

ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS IV



Source SS df MS F

Between

Groups (BG) 100.786 1 100.786 2.435

Within

Groups (WG) 2897.088 70 41.386


F



0.010









students who have had a planned curricular experience with

mentally retarded children (Group B) in their identified

feelings toward the mentally retarded as measured by the

ABS-V-MR.

Analysis of data revealed no significant difference

between the two groups in their identified feelings toward

the mentally retarded as measured by the ABS-V-MR. An F

statistic of 3.982 was necessary for significance at the

.05 level. The F statistic for this hypothesis was 0.726

and therefore not significant (see Table 6).

Hypothesis VI:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with men-

tally retarded children (Group B) in their actual experience

with mentally retarded individuals as measured by the ABS-

VI-MR.

Analysis of data revealed no significant difference

between the groups in their actual experience with mentally

retarded individuals as measured by the ABS-VI-MR. An F

statistic of 3.982 was necessary for significance at the

.05 level. The F statistic for this hypothesis was 0.022

and therefore not significant (see Table 7).

Hypothesis VII:

There will be a significant difference between nursing

students who have not had a planned curricular experience












Table 6

ANALYSIS OF VARIANCE TABLE FOR



Source SS df

Between

Groups (BG) 41.833 1

Within

Groups (WG) 4028.152 70


HYPOTHESIS V



MS



41.833



57.545


Table 7

ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VI



Source SS df MS F

Between

Groups (BG) 0.483 1 0.483 .022

Within

Groups (WG) 1533.016 70 21.900


F



0.726









with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with

mentally retarded children (Group B) in their expressed

feelings about life situations as measured by the ABS-IX-MR.

Analysis of data revealed a significant difference

between the two groups in their expressed feelings about

life situations as measured by the ABS-IX-MR. An F statis-

tic of 3.982 was necessary for significance at the .05

level. The F statistic was 7.082 for this hypothesis and

therefore was significant (see Table 8).

Hypothesis VIII:

There will be a significant difference between nursing

students who have not had a planned curricular experience

with mentally retarded children (Group A) and nursing stu-

dents who have had a planned curricular experience with

mentally retarded children (Group B) in the amount of

information they possess about mental retardation as

measured by the ABS-X-MR.

Analysis of data revealed no significant difference

between the two groups in the amount of information they

possess about mental retardation as measured by the

ABS-X-MR. An F statistic of 3.982 was necessary for

significance at the .05 level. The F statistic for this

hypothesis was 0.616 and therefore not significant (see

Table 9).











Table 8

ANALYSIS OF VARIANCE TABLE FOR


HYPOTHESIS VII


Source SS df MS F

Between

Groups (BG) 61.859 1 61.859 7.082

Within

Groups (WG) 611.418 70 8.734


Table 9

ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VIII


Source SS df MS F

Between

Groups (BG) 2.087 1 2.087 0.616

Within

Groups (WG) 237.023 70 3.386










Of the eight hypotheses formulated for the study, six

were rejected and two were supported.

Although the differences could not be totally attributed

to the planned curricular experience at Sunland, significant

change did occur in two areas, and some change occurred in

all areas.

In the ABS-MR, a high score denotes a more positive

attitude. On all subscales measuring attitude the mean pre-

test scores were higher than the mean posttest scores (sub-

scales I-VI, IX). On subscale X measuring information about

mental retardation possessed by the individual, the mean of

the posttest scores was higher than the mean of the pretest

scores (see Table 10). The difference was not significant,

but the subjects did apparently acquire a little more factual

information about mental retardation from their curricular

experience.

However, on the attitude subscales, the differences

were all in a negative direction. Subscales I and IX were

significantly in a negative direction (see Tables 3 and 8).


Discussion of the Results


The negative change in attitudes after the planned

curricular experience in this study implies that attitudes

can be changed with experiences. The results of this study

are in agreement with the studies involving tours of













Table 10

REGRESSION COEFFICIENTS (MEAN SCORES) FOR
GROUPS A AND B AND ON EACH SUBSCALE


Subscale Group A

I 33.260-

II 32.891'

III 48.021'

IV 48.347r

V 38.086

VI 30.478-

IX 23.891

X 9.250

*p=<.05

Note: The higher the score the
measured.


Group B

31.961

29.500

47.884

45.884

36.500

30.307

21.961

9.6517


Difference

1.299

3.391

0.137

2.463

1.586

0.170

1.929

-0.354


more positive the attitude









institutions in which the subjects' attitudes toward the

mentally retarded changed in a negative direction after tours

of institutions (Sellin and Mulchahay, 1965; Kimbrell and

Luckey, 1964; Warren et al., 1964). These were discussed

in Chapter II--The Review of the Literature. The results

are also in agreement with the study by Sartin (1965) who

found that while there were fewer misconceptions following a

unit of study which included tours of institutions, the

attitudes which the students expressed were more negative

toward the mentally deficient (see Chapter II).

Jordan (1970) discussed the problem of deciding between

the more realistic answer and the more positive answer on

the ABS-MR. This may account for part of the negative change

in this study. Nursing students are usually assumed to have

altruistic feelings or attitudes. These feelings may have

to adapt to reality when the student participates in actual

experiences. Interpretation of this change could be done

using Festinger's concept dissonance: "Two elements are in a

dissonant relation if, considering these two alone, the

obverse of one element would follow from the other" (Festinger,

1957, p. 13). The actual experience with the mentally re-

tarded children in Willow Cottage becomes the element which

causes dissonance in the attitudes of the student. The

attitudes towards mental retardation are brought into agree-

ment with the behavior of the student toward the mentally

retarded. Thus, if the student feels repulsed, helpless,









angry, etc., toward the retarded individuals or toward the

experience, the attitudes related to this concept will

change in a negative direction to agree with feelings.

Actual experience working with mentally retarded individuals

introduces many more possible dissonant elements than a

classroom learning experience might.

The background experience with handicapped individuals

revealed by the questions on subscale VIII (Appendix A,

pp. 97) may also account for some of the differences in

attitudes between the two groups. Subscale VIII (Appendix

A, p. 97) begins by asking for handicapping condition with

which the subject has had the most actual experience; 35

percent of Group A listed mental retardation, 62 percent of

Group B listed mental retardation (see Table 11). The

types of experiences indicated by subjects were similar in

both groups as 52 percent of Group A listed work experience

and 57 percent of Group B listed work experience (see Table

11). The negative differences begin to show up on ability

to avoid contact, where 13 percent of Group A indicated they

could not have avoided the contact while 30 percent of

Group B could not have avoided contact. Responses to other

opportunities available also show differences as 28 percent

of Group A indicated that other jobs were available which

were fully acceptable to them when they chose to work with

handicapped individuals. No subjects in Group B indicated

this (see Table 11).









Table 11

GROUPS A AND B COMPARED ON EXPERIENCES
OR CONTACTS WITH HANDICAPPED PERSONS


Handicapping Condition: Group A Group B

Blind/partially blind 1 1
Deaf/partially deaf, speech impairment 4 2
Crippled/spastic 10 3
Mentally retarded 16 16
Social or emotional 15 4

Total 46 26


Types of Experiences: Group A Group B

Read or studied 12 8
Friend or relative 9 3
Worked with personally handicapped 24 15
No answer 1

Total 46 26


Ability to Avoid Contact: Group A Group B

Couldn't avoid 6 8
Could have avoided with great difficulty 3 3
Could have avoided with considerable
difficulty 4 4
Could have avoided with some inconvenience 6 6
Could have avoided without any difficulty 27 5

Total 46 26


What Other Opportunities for
Employment Were Available: Group A Group B

No experience 28 17
No other job available 2 8
Other jobs--not at all acceptable to me 1 1
Other jobs--not quite acceptable 2
Other jobs--fully acceptable 13

Total 46 26









Table 11 (continued)


Feelings About Experience or
Contact With Mentally Retarded Persons:

No experience
Definitely disliked
Did not like very much
Liked it scrrewhat
Definitely enjoyed it

Total


Group A Group B









Feelings about experiences or contacts with mentally

retarded persons also reveal differences (see Table 11). While

no subjects in Group A indicated that they definitely disliked

their contacts, 15 percent of Group B indicated this. Also

48 percent of Group A indicated they liked the experience

somewhat, only 27 percent of Group B so indicated.

These data imply that Group A had had more positive

experiences with handicapped individuals including mentally

retarded individuals than Group B. The fact that Group B's

curricular experience was in a state institution and was a

required part of a course for academic credit rather than a

voluntary experience over which the volunteer has a certain

amount of control may account for some of these differences.

The intensity scores were also subjected to computer

analysis using multivariate general hypothesis procedures.

No significant differences were found between the two groups.

The mean scores for the posttest groups were higher than the

mean scores for the pretest group on all subscales except

subscale VI (see Table 12). These higher scores imply that

the posttest group was more certain of responses on all

subscales except subscale VI.

These intensity scores were not dealt with in depth in

this study, but will be used in future research.















Table 12

REGRESSION COEFFICIENTS (MEAN SCORES) FOR
GROUPS A AND B ON INTENSITY FACTORS FOR SUBSCALES



Subscale Group A Group B Difference

I 40.086 42.307 -2.220

II 42.043 44.000 -1.956

III 45.304 46.692 -1.387

IV 47.630 48.000 -0.369

V 47.652 47.769 -0.117

VI 34.000 32.038 1.961

IX 28.108 28.346 -0.237



Note: The higher score denotes that subjects were more
certain of their responses.
















CHAPTER V


SUMMARY, CONCLUSIONS AND IMPLICATIONS


Summary


Purpose of the Study


The purpose of this study was to determine whether

or not the identified attitudes toward mental retardation

of baccalaureate nursing students were different after

a curricular experience with mentally retarded children.


Questions for Study


This study sought to answer the following questions:

1. Can attitude change be linked to specific

experiences?

2. Are attitudes of nursing students toward

mental retardation different after a planned

experience with retarded children?

3. If there are attitude differences, are they

in a positive or a negative direction?









Need for the Study


There was a need for nurses to plan and implement

better nursing care for mentally retarded individuals

and their families. It was assumed that nursing care

reflected the attitudes of nurses, and awareness of at-

titudes of nursing students toward mental retardation could

help faculty in planning preparatory programs. The bases

upon which the study was conceptualized were a desire for

improving the plight of the mentally retarded in our

society, the experiential inadequacies of professional

nurses and the need for revision of curriculum in nursing

education.


Design of the Study


The design of this study was the Static-Group Com-

parison discussed by Campbell and Stanley (1963).


The Sample


The sample consisted of 72 nursing students in the

junior or senior year of a baccalaureate program during

the summer and fall quarters in the University of Florida

College of Nursing. Of these 72 students, 46 had not

yet had the planned curricular experience with mentally

retarded children and were designated as Group A, while

26 had had the experience and were designated as Group B.










Instrumentation


The Attitude Behavior Scale Toward Mental Retardation

(ABS-MR) developed by Jordan (1970) was used to assess

attitudes toward mental retardation and knowledge about

mental retardation of Group A who had not yet had the

planned curricular experience and Group B who had had the

experience. The ABS-MR was divided into subscales I-X

for tabulation purposes and for hypothesis testing (see

Definition of Terms for description of subscales).


Analysis and Interpretation of Data


The ABS-MR was divided into 10 subscales, each

involving different data related to attitudes, demographic

factors, and knowledge possessed by the individual about

mental retardation (see Definition of Terms).

The following hypotheses were formulated for the

study:

Hypothesis I:

There will be a significant difference between

nursing students who have not had a planned curricular

experience with mentally retarded children (Group A) and

nursing students who have had a planned curricular ex-

perience with mentally retarded children (Group B) in

their perception of how other people compare the mentally

retarded to those who are not retarded as measured by

the ABS-I-MR.









Hypothesis II:

There will be a significant difference between

nursing students who have not had a planned curricular

experience with mentally retarded children (Group A) and

nursing students who have had a planned curricular experi-

ence with mentally retarded children (Group B) in their

perceptions of what other people generally believe about

interacting with the mentally retarded as measured by

the ABS-II-MR.

Hypothesis III:

There will be a significant difference between

nursing students who have not had a planned curricular

experience with mentally retarded children (Group A) and

nursing students who have had a planned curricular experi-

ence with mentally retarded children (Group B) in their

feelings about the right or wrong way to behave toward

mentally retarded persons as measured by the ABS-III-

MR.

Hypothesis IV:

There will be a significant difference between

nursing students who have not had a planned curricular

experience with mentally retarded children (Group A)

and nursing students who have had a planned curricular

experience with mentally retarded children (Group B)

in the way they believe they would act toward mentally

retarded individuals in given situations as measured by

the ABS-IV-MR.









Hypothesis V:

There will be a significant difference between

nursing students who have not had a planned curricular

experience with mentally retarded children (Group A) and

nursing students who have had a planned curricular

experience with mentally retarded children (Group B) in

their identified feelings toward the mentally retarded

as measured by the ABS-V-MR.

Hypothesis VI:

There will be a significant difference between

nursing students who have not had a planned curricular

experience with mentally retarded children (Group A)

and nursing students who have had a planned curricular

experience with mentally retarded children (Group B) in

their actual experience with mentally retarded individuals

as measured by the ABS-VI-MR.

Hypothesis VII:

There will be a significant difference between

nursing students who have not had a planned curricular

experience with mentally retarded children (Group A)

and nursing students who have had a planned curricular

experience with mentally retarded children (Group B) in

their expressed feelings about life situations as

measured by the ABS-IX-MR.








Hypothesis VIII:

There will be a significant difference between

nursing students who have not had a planned curricular

experience with mentally retarded children (Group A)

and nursing students who have had a planned curricular

experience with mentally retarded children (Group B)

in the amount of information they possess about mental

retardation as measured by the ABS-X-MR.

The data were subjected to computer analysis using

multivariate general hypothesis procedures. The mean

score of Group A was higher than the mean score of Group

B on all subscales except subscale X. Only two were

statistically significant at the .05 level, however.

Those with significant differences were subscales II and

IX which dealt with the subject's perception of what

other people generally believed about mentally retarded

persons and how the subject perceived certain life situ-

ations. The higher score denoted a more positive attitude

on the ABS-MR; therefore, the attitude difference was

in a negative direction on seven of the eight subscales;

significantly so on two of these. Subscale X dealt

with factual information about mental retardation; there

was a difference in the positive direction on the mean

scores on subscale X of the two groups, but it was not

significant.










The data indicated that there was a significant

difference in attitudes on subscale II which involved

perceptions of what other people generally believed

about interacting with the mentally retarded and on sub-

scale IX which dealt with life situations. These

differences were to a more negative attitude after

the experience.

The intensity factors on the ABS-MR were subjected

to computer analysis also. No significant changes occurred

here. There were higher mean scores for the posttest

group which implied that the subjects were more certain

of their responses.

Differences between the groups were revealed in

the demographic data on subscales VII and VIII. These

data indicated that Group A had had more voluntary

contact with mentally retarded persons and had enjoyed

it more. These data were analyzed for frequency of

response.

Both the intensity factors and the demographic

data will be used in further research.

The negative difference in attitudes might'be attributed

to subjects having brought their idealistic attitudes more

into agreement with reality and might be interpreted

according to Festinger's theory of dissonance (see Dis-

cussion of the Results, p. 47).









Conclusions


The results of the study were stated in the follow-

ing conclusions:

1. There were differences in attitudes after this

planned curricular experience.

2. Factual information may increase as a result of

the planned curricular experience.

3. Attitudes tended to become more negative after

such experience.


Implications


Basic to this study were certain assumptions and

limitations: It was assumed that the ABS-MR accurately

tested attitudes toward mental retardation, that students

were truthful in answering the questions on the ABS-MR and

that the students chosen during the time period involved

were comparable to students in any other time period.

Limitations included (1) many students had preconceived

ideas of what "nursing" was, (2) the curricular experience

was required,not elective, and students sometimes developed

a set against it for this very reason, (3) the limited period

involved did not afford time to resolve the emotional impact

or the stress of cognitive learning requirements compounded

by that emotional impact, (4) the environment of a state

institution may have contributed to reactions that might

not have occurred or might have been different in another







setting, (5) participation in the study was voluntary and

thus involved a select or particular group of individuals

whose attitudes may have influenced their volunteering, and

(6) the same instructor did not teach the curricular experi-

ence to all the sample involved and individual instructor

biases may have influenced student attitudes.

Implications can be made based on the data obtained

and the conclusions drawn.

Education Implications

1. Since the data indicated that there was a difference

in attitudes after planned curricular experiences, these ex-

periences should be planned to allow the student the time and

opportunity to deal with her own personal feelings and atti-

tudes while preparing to be a practitioner in a helping re-

lationship.

2. Curricular experiences which include positive inter-

actions with mentally retarded individuals in the community

and in the institution, could be planned for and with students.

3. Faculty attitudes toward mental retardation need to

be assessed and dealt with in an effort to help them help

students.

4. Changes in attitudes in the negative direction may

very well indicate that the student is facing reality and

adjusting to it. This is better accomplished in the student

status with faculty and peer support, than as a graduate in

a helping role to others.









5. If the nursing needs of society are to be met, the

curricula in preparatory programs for nurses must include

learning experiences with the groups within that society.

The mentally retarded are one such group.

6. If nursing care is to be effective, it has to be

based on knowledge of the client, his needs and the clini-

cal entities affecting the client. This knowledge base is

obtained as a student and through clinical practice and

further study. Nursing care for the mentally retarded

require this knowledge base and needs to be included in

the curricular of preparatory programs for nurses.

7. If preparatory programs for nurses are to include

curricula relative to mental retardation, there must be

faculty prepared to teach in this area. Teacher prepara-

tory programs for faculty in nursing need to include the

area of mental retardation in their programs.

8. Nurses encounter mentally retarded individuals in

almost all areas of nursing practice. The nurse's own needs

must be dealt with before she can meet the needs of her

clients. Learning experiences which recognize these

individual needs are important in all preparatory programs

for nurses and in continuing education for nurses.


Nursing Practice Implications

1. One of the nurse's primary roles at this time, in the

area of mental retardation, is that of prevention. In order









to understand the importance of this role and the consequences

of lack of prevention, nurses need information about mental

retardation.

2. Case finding or identification is part of the nurse's

responsibility in prevention. In order to identify, the

nurse must be able to assess development. Knowledge about

mental retardation is essential for this also.

3. If nurses are to be competent to plan and implement

care for all individuals in our society, they need learning

experiences that involve many different groups, including

the mentally retarded. These experiences could help nurses

to identify the many similarities between individuals and

groups and yet the uniqueness of each one.

4. If nurses' attitudes are reflected in the care

they plan and implement, learning experiences which provide

opportunities for positive interactions are important, keep-

ing in mind that realistic attitudes are also important.

Nursing care must be based in reality to be effective.


Research Implications

1. Research in education and the effects of curricular

experiences on students' attitudes is needed. These re-

search data could assist in planning programs to prepare

nurses more effectively.

2. Research in nursing practice in the area of mental

retardation would enable nurses to evaluate more accurately

the nursing care they plan and provide.









3. Reports of research being done in the area of

prevention of mental retardation would assist nurses

in their roles in prevention. Studies specifically dealing

with.nursing and prevention need to be conducted and made

available for use by practitioners.

4. This study should be repeated after revision of

the curricular experience to document any changes in

attitudes. A longitudinal study would be helpful, also,

to ascertain whether or not time makes a difference in

attitude change.

5. A research study in individual coping behaviors

correlated with this study might give insights into

attitude change of students.

6. This study could be refined and itemized by

subject, rather than by groups and perhaps reveal some

significant findings.

7. A study correlating attitude change of individual

subjects with other measures of personality might make it

possible to predict attitude change and plan for it more

effectively in education and in practice.







































APPENDICES































APPENDIX A

ATTITUDE BEHAVIOR SCALE-
MENTAL RETARDATION






69




ATTITUDE BEHAVIOR SCALE--MR


DIRECTIONS

This booklet contains statements of how people feel about certain
things. In this section you are asked to indicate for each of these
statements how most other people believe that mentally retarded people
compare to people who are not retarded. Here is a sample statement.

Sample 1.

1. Chance of being blue-eyed

1. less chance
2. about the same
3. more chance

If other people believe that mentally retarded people have less
chance than most people to have blue eyes, you should circle the
number 1 as shown above.

If other people believe the mentally retarded have more chance
to have blue eyes, you should circle the number 3 as shown below.

1. Chance of being blue-eyed

1. less chance
2. about the same
3. more chance

After each statement there will also be a question asking you to
state how certain or sure you were of your answer. Suppose you
answered the sample question about "blue eyes" by marking about the
same.

Next you should then indicate how sure you were of this answer.
If you felt sure of this answer, you should circle the number 3 as
shown in Sample 2.

Sample 2

1. Chance of being blue-eyed 2. How sure are you of this
answer?

1. less chance 1. not sure
2. about the same 2. fairly sure
3. more chance 3. sure




Source: John E. Jordan, College of Education, Michigan State University.








APPENDIX A (continued)


ABS-I-MR


Directions: Section I

In the statements that follow you are to circle the number that
indicates how other people compare mentally retarded persons to those
who are not mentally retarded, and then to state how sure you felt
about your answer. Usually people are sure of their answers to some
questions, and not sure of their answers to other questions. It is
important to answer all questions, even though you may have to guess
at the answers to some of them.

Other people generally believe the following
things about the mentally retarded as compared
to those who are not retarded:


1. Energy and vitality

1. less energetic
2. about the same
3. more energetic

3. Ability to do school work


less ability
about the same
more ability


5. Memory


not as good
same
better


7. Interested in unusual sex 8.
practices
1. more interested
2. about the same
3. less interested


2. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

4. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

6. How sure are you of this answer?


1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure


9. Can maintain a good marriage 10. How sure are you of this answer?


1. less able
2. about the same
3. more able


1. not sure
2. fairly sure
3. sure


11. Will have too many children 12. How sure are you of this answer?


1. more than most
2. about the same
3. less than most


1. not sure
2. fairly sure
3. sure









APPENDIX A (continued)


ABS-I-MR


Other people generally believe the following
things about the mentally retarded as compared
to those who are not mentally retarded:


13. Faithful to spouse

1. less faithful
2. about the same
3. more faithful

15. Will take care of their
children
1. less than most
2. about the same
3. better than most

17. Likely to obey the law


less likely
about the same
more likely


19. Does steady and dependable
work
1. less likely
2. about the same
3. more likely

21. Works hard

1. not as much
2. about the same
3. more than most

23. Makes plans for the future

1. not as likely
2. about the same
3. more likely

25. Prefers to have fun now
rather than to work for
the future
1. more so than most people
2. about the same
3. less so than most people


14. How sure are you of this answer?


not sure
fairly sure
sure


16. How sure are you of this answer?


not sure
fairly sure
sure


18. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

20. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

22. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

24. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

26. How sure are you of this answer?


1. not sure
2. fairly sure
3. sure









APPENDIX A (continued)


ABS-I-MR

Other people generally believe the following
things about the mentally retarded as compared
to those who are not retarded:

27. Likely to be cruel to 28. How sure
others
1. more likely 1. not s
2. about the same 2. fairly'
3. less likely 3. sure

29. Mentally retarded are 30. How sure
sexually
1. more loose than others 1. not si
2. about the same 2. fairly
3. less loose than others 3. sure

31. Amount of initiative 32. How sure

1. less than others 1. not sl
2. about the same 2. fairly
3. more than others 3. sure

33. Financial self-support 34. How sure

1. less able than others 1. not s
2. about the same 2. fairly
3. more able than others 3. sure

35. Mentally retarded prefer 36. How sure

1. to be by themselves 1. not s[
2. to be only with normal 2. fairly
people 3. sure
3. to be with all people
equally

37. Compared to others, educa- 38. How sure
tion
1. is not very important 1. not st
2. is of uncertain importance 2. fairly
3. is an important social 3. sure
goal

39. Strictness of rules for 40. How sure
mentally retarded
1. must be more strict 1. not su
2. about the same 2. fairly
3. need less strict rules 3. sure


are you

ure
y sure



are you

ure
y sure



are you

ure
y sure



are you

ure
y sure



ire you

ire
y sure





ire you

ire
Assure




ire you


of this answer?







of this answer?







of this answer?







of this answer?







of this answer?









of this answer?








of this answer?


ire
sure










APPENDIX A (continued)


ABS-II-MR


Directions: Section II

This section contains statements of ways in which other people
sometimes act toward people. You are asked to indicate for each of
these statements what other people generally believe about interacting
with the mentally retarded in such Ways. You should then indicate how
sure you feel about your answer.

Other people generally believe that
mentally retarded persons ought:


41. To play on the school play-
ground with other children
who are not mentally
retarded
1. usually not approved
2. undecided
3. usually approved

43. To visit in the homes of
other children who are not
mentally retarded
1. usually not approved
2. usually undecided
3. usually approved

45. To go on camping trips with
other children who are not
mentally retarded
1. usually not approved
2. undecided
3. usually approved

47. To be provided with simple
tasks since they can learn
very little
1. usually believed
2. undecided
3. not usually believed

49. To stay overnight at the
homes of children who are
not mentally retarded
1. usually not approved
2. undecided
3. usually approved


42. How sure are you of this answer?


not sure
fairly sure
sure


44. How sure are you of this answer?


not sure
fairly sure
sure


46. How sure are you of this answer?



1. not sure
2. fairly sure
3. sure

48. How sure are you of this answer?


1. not sure
2. fairly sure
3. sure

50. How sure are you of this answer?


1. not sure
2. fairly sure
3. sure










APPENDIX A (continued

ABS-II-MR

Other people generally believe that
mentally retarded persons ought:


51. To go to parties with
other children who are
not mentally retarded
1. usually not approved
2. undecided
3. usually approved

53. To be hired for a job only
if there are no qualified
non-mentally retarded
people seeking the job
1. usually approved
2. undecided
3. usually not approved

55. To live in the same neigh-
borhood with people who are
not mentally retarded
1. usually not approved
2. undecided
3. usually approved

57. To date a person who is not
mentally retarded
1. usually not approved
2. undecided
3. usually approved

59. To go to the movies with
someone who is not
mentally retarded
1. usually not approved
2. undecided
3. usually approved

61. To marry a person who is
not mentally retarded
1. usually not approved
2. undecided
3. usually approved


52. How sure are you of this answer?


1. not sure
2. fairly sure
3. sure

54. How sure are you of this answer?


not sure
fairly sure
sure


56. How sure are you of this answer?



1. not sure
2. fairly sure
3. sure ,

58. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

60. How sure are you of this answer?


1. not sure
2. fairly sure
3. sure

62. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure










APPENDIX A (continued)


ABS-II-1

Other people generally believe that
mentally retarded persons ought:

63. To be sterilized (males) 64.

1. usually approved
2. undecided
3. usually not approved

65. To be sterilized (females) 66.

1. usually approved
2. not sure
3. usually not approved

67. To be desirable as friends 68.

1. not usually approved
2. not sure
3. usually approved

69. To be regarded as having sex 70.
appeal
1. not usually so
2. not sure
3. usually so

71. To be regarded as dangerous 72.

1. usually so regarded
2. not sure
3. not usually regarded so

73. To run machines that drill 74.
holes in objects
1. usually not approved
2. not sure
3. usually approved

75. To be trusted with money 76.
for personal expenses
1. not usually so
2. not sure
3. usually so


How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of'this answer?

1. not sure
2. fairly sure
3. sure










APPENDIX A (continued)

ABS-II-MR

Other people generally believe that
mentally retarded persons ought:


77. To work at jobs he can do
even if he has almost no
speech
1. not usually so
2. not sure
3. usually so

79. To be forced to totally
provide for themselves
1. usual
2. not sure
3. not usual


78. How sure are you of this answer?



1. not sure
2. fairly sure
3. sure

80. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure









APPENDIX A (continued)


ABS-III-MR


Directions: Section III

This section contains statements of the "right" or "moral" way of
acting toward people. You are asked to indicate whether you yourself
agree or disagree with each statement according to how you personally
believe you ought to behave toward mentally retarded persons. You
should then indicate how sure you feel about your answer.

In respect to people who are mentallyretarded, do you
believe that it is usually right or usually wrong:


81. To take a mentally retarded 82.
child on a camping trip
with normal children
1. usually wrong
2. undecided
3. usually right

83. To permit a mentally 84.
retarded child to go to the
movies with children who
are not mentally retarded
1. usually wrong
2. undecided
3. usually right


How sure are you of this answer?


not sure
fairly sure
sure


How sure are you of this answer?


not sure
fairly sure
sure


85. To allow a mentally retarded 86.
child to visit overnight
with a child who is not
mentally retarded
1. usually wrong
2. undecided
3. usually right

87. To take a mentally retarded 88.
child to a party with children
who are not mentally
retarded
1. usually wrong
2. undecided
3. usually right

89. For the government to pay 90.
part of the cost of elementary
education for mentally
retarded children
1. usually wrong
2. undecided
3. usually right


How sure are you of this answer?




1. not sure
2. fairly sure
3. sure

How sure are you of this answer?


not sure
fairly sure
sure


How sure are you of this answer?




1. not sure
2. fairly sure
3. sure









APPENDIX A (continued)

ABS-III-MR

In respect to people who are mentally retarded, do you
believe that it is usually right or usually wrong:


91. For the government to pay 92.
the full cost of elementary
education for mentally
retarded children
1. usually wrong
2. undecided
3. usually right


How sure are you of this answer?




1. not sure
2. fairly sure
3. sure


93. For the government to pay
the full cost of a high
school education for mentally
retarded children
1. usually wrong
2. undecided
3. usually right

95. For the government to pay
part of the medical costs
related to the disability
1. usually wrong
2. undecided
3. usually right


94. How sure are you of this answer?


not sure
fairly sure
sure


)6. How sure are you of this answer?



1. not sure
2. fairly sure
3. sure


97. For the government to pay '98.
all of the medical costs
related to the disability
1. usually wrong
2. undecided
3. usually right

99. To be given money for food 100.
and clothing by the
government
1. usually wrong
2. undecided
3. usually right

101. To mix freely with people 102.
who are not mentally
retarded at parties
1. usually wrong
2. undecided
3. usually right


How sure are you of this answer?


1. not sure
2. fairly sure
3. sure

How sure are you of this answer?



1. not sure
2. fairly sure
3. sure

How sure are you of this answer?


1. not sure
2. fairly sure
3. sure










APPENDIX A (continued)

ABS-III-MR

In respect to people who are mentally retarded, do you
believe that it is usually right or usually wrong:


103. To go on dates with someone 104. How sure are you of this answer?


is not mentally retarded
usually wrong
undecided
usually right


105. To go to the movies with
someone who is not mentally
retarded
1. usually wrong
2. undecided
3. usually right

107. To marry someone who is not
mentally retarded
1. usually wrong
2. undecided
3. usually right

109. To be a soldier in the
army
1. usually wrong
2. undecided
3. usually right

111. To provide special laws
for their protection
1. usually wrong
2. undecided
3. usually right

113. To provide special help
to get around the city
1. usually wrong
2. not sure
3. usually right

115. To sterilize the mentally
retarded
1. usually right
2. not sure
3. usually right


1. not sure
2. fairly sure
3. sure

106. How sure are you of this answer?



1. not sure
2. fairly sure
3. sure

108. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

110. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

112. How sure are you of this answer?


not sure
fairly sure
sure


114. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

116. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure











APPENDIX A (continued)

ABS-III-MR

In respect to people who are mentally retarded, do you
believe that it is usually right or usually wrong:

117. To put all mentally retarded 118. How sure are you
in separate classes, away
from normal children
1. usually right 1. not sure
2. not sure 2. fairly sure
3. usually wrong 3. sure


119. To reserve certain jobs
for the mentally retarded
1. usually wrong
2. not sure
3. usually right


of this answer?


120. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure










APPENDIX A (continued)




Directions: Section IV


ABS-IV-MR


This section contains statements of ways in which people sometimes
act toward other people. You are asked to indicate for each of these
statements whether you personally would act toward mentally retarded
people according to the statement. You should then indicate how sure
you feel about this answer.

In respect to a mentally retarded
person, would you:


121. Share a seat on a train
for a long trip
1. no
2. don't know
3. yes

123. Have such a person as a
fellow worker
1. no
2. don't know
3. yes

125. Have such a person working
for you
1. no
2. don't know
3. yes

127. Live in the next-door house
or apartment
1. no
2. don't know
3. yes

129. Extend an invitation to a
party at your house
1. no
2. don't know
3. yes

131. Accept a dinner invitation
at his house
1. no
2. don't know
3. yes


122. How sure are you of this answer?


not sure
fairly sure
sure


124. How sure are you of this answer?


not sure
fairly sure
sure


126. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

128. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

130. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

132. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure











APPENDIX A (continued)

ABS-IV-MR

In respect to a mentally retarded
person, would you:


133. Go to the movies together


no
don't know
yes


134. How sure are you of this answer?


1. not sure
2. fairly sure
3. sure


135. Go together on a date


no
don't know
yes


137. Permit a son or daughter
to date this person
1. no
2. don't know
3. yes

139. Permit a son or daughter
to marry this person
1. no
2. don't know
3. yes

141. Feel sexually comfortable
together
1. no
2. don't know
3. yes

143. Enjoy working with the
mentally retarded
1. no
2. don't know
3. yes

145. Enjoy working with the
mentally retarded as much
as other handicapped
1. no
2. don't know
3. yes


136. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

138. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

140. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

142. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

144. How sure are you of this answer?


not sure
fairly sure
sure


146. How sure are you of this answer?


not sure
fairly sure
sure










APPENDIX A (continued)


ABS-IV-MR

In respect to a mentally retarded
person, would you:


147. Enjoy working with mentally 148. How sure are you of this answer?
retarded who also have
emotional problems
1. no 1. not sure
2. don't know 2. fairly sure
3. yes 3. sure


149. Hire the mentally retarded
if you were an employer
1. no
2. don't know
3. yes

151. Want the mentally retarded
in your class if you were
a teacher
1. no
2. don't know
3. yes

153. Require the mentally
retarded to be sterilized
if you were in control
1. yes
2. don't know
3. no

155. Separate the mentally
retarded from the rest of
society if you were in
control
1. yes
2. don't know
3. no

157. Believe that the care of the
mentally retarded is an
evidence of national social
development
1. no
2. don't know
3. yes


150. How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

152. How sure are you of this answer?



1. not sure
2. fairly sure
3. sure

154. How sure are you of this answer?



1. not sure
2. fairly sure
3. sure

156. How sure are you of this answer?




1. not sure
2. fairly sure
3. sure

158. How sure are you of this answer?




1. not sure
2. fairly sure
3. sure








APPENDIX A (continued)

ABS-IV-MR


In respect to a mentally retarded
person, would you:


159. Provide, if you could
special classes for the
mentally retarded in
regular school
1. no
2. don't know
3. yes


160. How sure are you of this answer?




1. not sure
2. fairly sure
3. sure










APPENDIX A (continued




Directions: Section V


ABS-V-MR


This section contains statements of actual feelings that people
may hold toward the mentally retarded. You are asked to indicate how
you feel toward people who are mentally retarded compared to people who
are not mentally retarded. You should then indicate how sure you feel
of your answer.

How do you actually feel toward persons
who are mentally retarded compared to
others who are not mentally retarded:


1. Disliking


2. How sure are you of this answer?


1. more
2. about the same
3. less


3. Fearful


1. not sure
2. fairly sure
3. sure


4. How sure are you of this answer?


1. more
2. about the same
3. less


5. Horrified


1. not sure
2. fairly sure
3. sure


6. How sure are you of this answer?


1. more
2. about the same
3. less


7. Loathing


1. not sure
2. fairly sure
3. sure


8. How sure are you of this answer?


more
about the same
less


1. not sure
2. fairly sure
3. sure


10. How sure are you of this answer?


more
about the same
less


1. not sure
2. fairly sure
3. sure


12. How sure are you of this answer?


1. more
2. about the same
3. less


1. not sure
2. fairly sure
3. sure


9. Dismay


11. Hating










APPENDIX A (continued)


ABS-V-MR

How do you actually feel toward persons
who are mentally retarded compared to
others who are not mentally retarded:

13. Revulsion 14.

1. more
2. about the same
3. less

15. Contemptful 16.

1. more
2. about the same
3. less

17. Distaste 18.

1. more
2. about the same
3. less

19. Sickened 20.

1. more
2. about the same
3. less

21. Confused 22.

1. more
2. about the same
3. less

23. Negative 24.

1. more
2. about the same
3. less

25. At ease 26.

1. less
2. about the same
3. more


How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

I. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure










APPENDIX A (continued)


ABS-V-MR

How do you actually feel toward persons
who are mentally retarded compared to
others who are not mentally retarded:

27. Restless 28.

1. more
2. about the same
3. less

29. Uncomfortable 30.

1. more
2. about the same
3. less

31. Relaxed 32.

1. less
2. about the same
3. more

33. Tense 34.

1. more
2. about the same
3. less

35. Bad 36.

1. more
2. about the same
3. less

37. Calm 38.

1. less
2. about the same
3. more

39. Happy 40.

1. less
2. about the same
3. more


How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure

How sure are you of this answer?

1. not sure
2. fairly sure
3. sure









APPENDIX A (continuedO




Directions: Section VI


ABS-VI-MR


This section contains statements of different kinds of actual
experiences you have had with mentally retarded persons. If the state-
ment applies to you, circle yes. If not, you should circle no.


41. Shared a seat on a bus,
train or plane
1. no
2. uncertain
3. uncertain



43. Eaten at the same table
together in a restaurant
1. no
2. uncertain
3. yes



45. Lived in the same neighborhood

1. no
2. uncertain
3. yes



47. Worked in the same place

1. no
2. uncertain
3. yes



49. Had such a person as my boss
or employer
1. no
2. uncertain
3. yes



51. Worked to help such people
without being paid for it
1. no
2. uncertain
3. yes


42. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

44. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

46. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

48. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

50. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

52. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant










APPENDIX A (continued)


ABS-VI-MR


Experiences or contacts with
the mentally retarded:

53. Have acquaintance like this

1. no
2. uncertain
3. yes



55. Have good friends like this

1. no
2. uncertain




57. Donated money, clothes, etc.,
for people like this
1. no
2. uncertain
3. yes



59. Have a husband (or wife) like
this
1. no
2. uncertain




61. I am like this, myself


no
uncertain
yes


63. My best friend is like this


no
uncertain
yes


54. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

56. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

58. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

60. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

62. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant

64. Has this experience been mostly
pleasant or unpleasant?
1. no such experience
2. unpleasant
3. in between
4. pleasant




Full Text

PAGE 1

xTT I?tJ SO NURSING S'UDENTS TOWARD MENTAL REYARDATIOii BEFORE AND AFTER CURRICULAR EXPERIENCE WITH MENTALLY RETARDED CHILDREN By AMANDA SIRMON BAKER A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY UNIVERSITY OF FLORIDA 1974

PAGE 2

UNIVERSITY OF FLORIDA 3 1262 08552 3628

PAGE 3

Copyright by Amanda Sirmon Baker 1974

PAGE 4

To my husband and children

PAGE 5

ACKNOWLEDGMENTS I am indebted to the students in the University of Florida College of Nursing, and to their faculty, without whose cooperation the research could not have been accomplished. For continued support throughout my doctoral program, I gratefully acknowledge the chairman of my committee, James W. Hensel. His interest and sincere concern have been appreciated. To the other members of my committee, Vynce Hines and Dorris Payne, I extend my genuine appreciation for the unique contribution each has made. Vynce Hines contributed patience, understanding and practical advice. Dorris Payne is especially recognized and valued for her unfailing support and interest in my professional development. My success in the doctoral program is largely due to her scholarly assistance and personal interest. Among others who have directly or indirectly influenced the research, I wish to thank Professors Pauline Barton and George Policello, doctoral colleague David Williams, and my typist Nancy McDavid.

PAGE 6

My doctoral venture would not have been possible without the encouragement and loving support of my husband, Malcolm Baker, and our children, Eric Baker and Michael Baker. I am deeply grateful.

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TABLE OF CONTENTS Page ACKNOWLEDGMENTS lv LIST OF TABLES viii ABSTRACT 1X CHAPTER I INTRODUCTION 1 Problem 3 II The Purpose 5 Need for the Study 5 Desire for Improving the Plight of the Mentally Retarded in our Society. ... 7 Experiential Inadequacies of Professional Nurses ... 7 The Need for Curriculum Revision in Nursing Education 8 Definition of Terms 9 THE REVIEW OF THE LITERATURE 12 Related Literature 12 Definitions 13 Attitudes Toward the Mentally Retarded. . . 16 Family Attitudes 17 Attitudes of Professionals 19 Public Attitudes ' 22 Cross-Cultural Attitudes 23 Conclusion 24 III METHODOLOGY, 26 Hypotheses 26 Sample 2 9 Design JU Instrumentation J J Procedure ^ 4 Assumptions and Limitations 36

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TABLE OF CONTENTS (continued) CHAPTER Page IV DATA ANALYSIS 38 Discussion of the Results 47 V SUMMARY, CONCLUSIONS AND IMPLICATIONS. ... 55 Summary 55 Purpose of the Study 55 Questions for Study 55 Need for the Study 56 Design of the Study 56 The Sample 5 6 Instrumentation 57 Analysis and Interpretation of Data 57 Conclusions 62 Implications 62 Education Implications 63 Nursing Practice Implications ... 64 Research Implications 65 APPENDICES A ATTITUDE BEHAVIOR SCALE-MENTAL RETARDATION . 6 8 B COURSE OUTLINE 106 C GROUPS A AND B COMPARED ON EXPERIENCES OF CONTACTS WITH HANDICAPPED PERSONS, INCLUDING MENTALLY RETARDED PERSONS 114 BIBLIOGRAPHY 117 BIOGRAPHICAL SKETCH 121 vi 1

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LIST OF TABLES Table Page 1 SUBJECTS IN GROUP A AND GROUP B COMPARED FOR SEX, AGE, MARITAL STATUS, RELIGION AND EDUCATION 31 2 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS I. . 4 3 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS II . 40 4 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS III. 42 5 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS IV . 4 2 6 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS V. . 44 7 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VI . 44 8 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VII. 46 9 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VIII 4 6 10 REGRESSION COEFFICIENTS (MEAN SCORES) FOR GROUPS A AND B AND ON EACH SUBSCALE 4 8 11 GROUPS A AND B COMPARED ON EXPERIENCES OR CONTACTS WITH HANDICAPPED PERSONS 51 12 REGRESSION COEFFICIENTS (MEAN SCORES) FOR GROUPS A AND B ON INTENSITY FACTORS FOR SUBSCALES 54

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Abstract of Dissertation Presented to the Graduate Council of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy ATTITUDES OF NURSING STUDENTS TOWARD MENTAL RETARDATION BEFORE AND AFTER CURRICULAR EXPERIENCE WITH MENTALLY RETARDED CHILDREN By Amanda Sirmon Baker December, 1974 Chairman: Dr. James W. Hensel Major Department: Curriculum and Instruction This study sought to determine whether or not the attitudes of nursing students toward mental retardation were different after a planned curricular experience with mentally retarded children. The sample consisted of 72 nursing students enrolled in the University of Florida College of Nursing, in the summer and fall quarters, 1974. There were 46 students who had not had the planned experience with mentally retarded children and 26 students who had already had the experience. The design of the study was the Static-Group Comparison discussed by Campbell and Stanley. The Attitude Behavior Scale Toward Mental Retardation (ABS-MR) developed by John E. Jordan was used to measure attitudes and information about mental retardation. The ABS-MR was divided into 10 subscales. Hypotheses were formulated for eight of these subscales. The hypotheses predicted that there would be a significant difference in the pretest and posttest

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groups in their attitudes toward mental retardation and in their knowledge about mental retardation. There was a difference in the mean scores for all eight hypotheses, but only two were statistically significant, one of which concerned the subjects' perceptions of what other people generally believe about interacting with the mentally retarded; the other dealt with the subjects' perceptions of aspects of life or life situations. The differences were all in a negative direction except for the difference on the subscale dealing with knowledge about mental retardation which was in a positive direction . It was concluded that there was a difference in attitudes after the planned curricular experience with mentally retarded children, factual information may increase as a result of planned curricular experience and attitudes tended to become more negative after such experience.

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CHAPTER I INTRODUCTION Professionals, as well as parents, react differently to the birth of a retarded child. Some of the reactions are unpredictable; some are expected, but all reactions arise from the individual differences of the people involved. For nine months, parents dream dreams and the appearance of a defective baby brings grief and mourning that kill the dreams. At such critical moments the child must still be cared for. Sometimes the family and/or the community cannot provide adequate care. Separation, or just the thought of separation, can reawaken buried fears and anxieties. The retarded child reminds parents and professionals of their own inadequacies and the first impulse is to isolate the offender. As Nichtern (1974) says: The growth of our children not only moves them away from us and out of the family but brings them to the public marketplace as products as well as consumers before they may be ready. Their identification as something special — retarded--makes them both a special product and a special consumer. . . . The special program for the special child adds yet another dimension. Often the participating individual acquires

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the identity of the program. This is true for child, family and professional alike. Once given the identity of "retarded" or any other similar designation, this classification tends to track the individual. . . . It helps make identification a broken promise of dreams never to be achieved and goals never to be fulfilled. (pp. 4-5) Society is organized to provide common goals for its members. The retarded cannot cope with such structure and quickly become thorns in the sides of parents, professionals and others. ' Because retardation is a function of disturbances in development and displacements in time, the child may behave in ways that appear immature for his age or inappropriate to the time and place involved. As the trend to conformity and standardized norms of behavior increases, an increasing number of individuals are labeled as retarded. The way these individuals are treated, whether with neglect, kindness, cruelty, ignorance, becomes a part of their very nature. The history of retardation suggests that it is as much a record of society's needs and organization at any moment as it is of the existence of the retarded. (Nichtern, 1974, p. 11) Few references exist that describe the care of the retarded before 1800. During the nineteenth century the Industrial Revolution revealed more and more people who were too slow or incompetent to function at the complex level required.

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Mass-production moved from the factory to the institutions and by the nineteenth century facilities for the retarded were in operation throughout Western Europe and in America. At this same time, the professionals made their first serious attempt to define mental retardation, the psychologist, the physician and the educator, however, had different definitions . The timing of this emerging interest and the varying points of view suggest the concept of retardation to be more dependent on man's interpretation and prejudice than an entity unto itself. (Nichtern, 1974, p. 30) Problem The professional judgment that labels an individual as retarded not only identifies or defines behavior. Such identification also categorizes that person as an inferior member of a sub-group requiring control and external structure . Much credence is given to the results of standardized tests as "objective" and "concrete" measures of retardation. With such tests normal is equated with average and the child who tests below the average is labeled abnormal. A child with a crippling orthopedic problem is not ostracized. A child with a congenital heart defect is not separated from home and family. Each is allowed to live and grow to his ultimate limits. But a child who is

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labeled retarded is considered immediately for institutional care. Once labeled as retarded an individual is rarely reclassified. His only recourse is to relocate and lose the label. For those who cannot lose their identities, the only hope is in an interested and enlightened society in which he may be allowed to achieve his maximum potential. Nurses are members of that society and the attitudes they have developed influence the care they plan and provide. Individuals of differing abilities, in and out of institutions, alone or in groups, all are included in a nurse's patient load. The care any nurse can plan and provide reflects not only her own attitudes but also the attitudes of those who have taught her. Experiences in the curriculum of nursing programs can help shape the attitudes and prepare nurses more adequately to plan nursing care that meets the needs of all individuals. If these experiences are to meet the needs of both students and society, the curriculum must be constantly evaluated and revised. Most attitudes can be changed and modified but can attitudes toward mental retardation be altered significantly? The problem which has been addressed in this study was the effect of planned learning experience with retarded children on the attitudes of the nursing students towards mental retardation.

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The Purpose The purpose of this study was to determine whether or not the identified attitudes of baccalaureate nursing students towards mental retardation were different after a planned experience with retarded children. The study was designed to answer such questions as: 1. Can attitude change be linked to specific experiences? 2. Are attitudes of nursing students toward mental retardation different after a planned experience with retarded children? 3. If there are attitude differences, are they in a positive or negative direction? Need for the Study Nurses are expected to plan and implement care for all individuals in our society, yet few preparatory programs include experiences with mentally retarded individuals as part of the curriculum. Mental retardation is one of the most serious handicapping conditions of individuals in the United States. It affects the social, economic and personal welfare of all Americans. Retarded individuals are denied opportunities to develop or to plan for themselves and thus become a burden to those who must assume responsibility for their care, education and rehabilitation.

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If the true measure of a civilization is reflected in the value placed upon the least able in that civilization, the United States measure is not commensurate with the country's advancement in other areas. In the rush to demonstrate "caring" for the mentally retarded, millions of dollars were appropriated for programs in the 1960s. In spite of these programs, however, the plight of the mentally retarded has been changed only slightly. Negative social attitudes of individuals and groups toward the mentally retarded inhibit change. Real change occurs when attitudes reflect a positive view of the mentally retarded individual as an individual. Social programs have demonstrated that society can accept responsibility for handicapped individuals, but can society develop a positive attitude towards them? Can institutional care be replaced by something more effective? Ignorance, prejudice and shortsightedness foster the segregation of the retarded in family, school and institution. The cost of this segregation is inestimable in the millions of dollars spent on care and in the untold anguish of the retarded and of their families. If alternative methods of care are to be developed, research in attitude change toward the mentally retarded is needed. The bases upon which this study was conceptualized were: (1) a desire for improving the plight of the mentally retarded in our society, (2) the experiential

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inadequacies of professional nurses and (3) the need for curriculum revision in nursing education. Desire for Improving the Plight of the Mentally Retarded in our Society Mentally retarded individuals are at a critical disadvantage in a technologically advanced civilization. Individuals who function at an adequate level in a simple environment might find themselves identified as mentally retarded in complex industrialized surroundings. The complexity of the society, plus the advanced techniques for identification of the mentally retarded by medicine, psychology and education, increase the likelihood of these individuals being singled out as "mentally retarded" and becoming part of an abnormal subgroup, a subgroup too often denied the rights and privileges of participating in the normal activities and life of their community. Experiential Inadequacies of Professional Nurses Often nurses are the persons to whom a family turns first in a time of distress, however, nurses are usually ill prepared to deal with problems related to mental retardation. They confront this problem both in the hospital and in the community and have difficulty dealing with it in terms of their own feelings and in terms of offering any assistance to the families or to the retarded

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individual. Nursing has an obligation to meet the needs of this group in our society. But it is difficult to meet the needs of others until one's own needs are met. Nurses are members of the general population and reflect the social mores of the time, including the prevalent attitudes about mental retardation. However, perhaps social change could be facilitated by nurses who have developed more positive attitudes toward the mentally retarded. There has been little research done on attitudes of nurses . The Need for Curriculum Revision in Nursing Education Nursing is responsible for assisting in health maintenance of all people, whether they be institutions (hospitals, etc.) or in the community. Nursing care is concerned with the health of individuals, of families and of larger groups, whether they be normal or abnormal, sick or well. However, the curriculum in nursing education usually focuses on illness. If nurses are to meet the needs of their clients, the curriculum must include opportunities for nursing students to study and work with many different individuals and groups, to focus on wellness. The mentally retarded are included as individual clients or in groups of clients.

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Definition of Terms For the purpose of this study, the following definitions were used: Attitude (dependent variable) . --"A mental and neural state of readiness, organized through experience and exerting a directive or dynamic influence upon the individual's response to all objects and situations to which it is related" (Allport, 1935, p. 799). Nursing 340 experience (independent variable ) . — Basic pediatric nursing course which includes a two-week learning experience working with mentally retarded children at Sunland Training Center, Gainesville, Florida. Nursing student . --A student enrolled in junior or senior courses in the University of Florida College of Nursing. R.N, student . --A student enrolled in the University of Florida College of Nursing at the time of the study who was already licensed as a Registered Nurse. Generic student . --A student enrolled in the University of Florida College of Nursing at the time of the study who was not yet licensed as a Registered Nurse. Mental retardation . — A societal concept by which members of that society are categorized as mentally retarded or slow (Gunzburg, 1958). A concept not easily definable being more of "a social process than a clinical entity" (Nichtern, 1974, p. 31) .

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10 ABS-MR (Attitude Behavior Scale-Mental Retardation) . — developed by John E. Jordan. Contains attitude subscales, plus subscales on demographic factors, contact with handicapped persons, life situations, and information about mental retardation (Appendix A) . Group A . --Those students who had not had Nursing 340 and the planned experience with retarded children at Sunland Training Center, Gainesville, Florida, and who were administered the ABS-MR as a pretest only. Group B . --Those students who had had Nursing 340 and the planned experience with mentally retarded children at Sunland Training Center, Gainesville, Florida, and who were administered the ABS-MR as a posttest only. Subscale I or ABS-I-MR . --The first section of the ABS-MR which measures the subject's perception of how other people compare the mentally retarded to those who are not mentally retarded (Appendix A, pp. 70-72). Subscale II or ABS-II-MR . --The second section of the ABS-MR which deals with what the subject thinks other people generally believe about interacting with the mentally retarded (Appendix A, pp. 73-76). Subscale III or ABS-III-MR . — The third section of the ABS-MR which deals with what the subject feels is the right or wrong way to behave toward mentally retarded persons for himself (Appendix A, pp. 77-80) .

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11 Subscale IV or ABS-IV-MR . — The fourth section of the ABS-MR which deals with how the subject would act toward the mentally retarded individual in given situations (Appendix A, pp. 81-84) . Subscale V or ABS-V-MR . — The fifth section of the ABSMR which deals with how the subject would act toward the mentally retarded individual in given situations (Appendix A, pp. 85-87) . Subscale VI or ABS-VI-MR . — The sixth section of the ABS-MR which deals with the subjects actual experience with mentally retarded persons (Appendix A, pp. 88-91) . Subscale VII or ABS-VII-MR . — The seventh section of the ABS-MR which deals with demographic information (Appendix A, pp. 92-96) . Subscale VIII or ABS-VIII-MR . — The eighth section of the ABS-MR which deals with the subject's experiences or contacts with handicapped persons (not specifically mentally retarded) (Appendix A, pp. 97-100) . Subscale IX or ABS-IX-MR . — The ninth section of the ABS-MR which deals with the subject's feelings about several aspects of life or life situations (Appendix A, pp. 101-102) . Subscale X or ABS-X-MR . — The tenth section of the ABS-MR which deals with information about mental retardation (Appendix A, pp. 103-105) .

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CHAPTER II THE REVIEW OF THE LITERATURE The idea of attitude change toward mental retardation includes the concepts of attitude and attitude change per se. Therefore, the review of the literature was divided into research studies in attitude toward mental retardation or toward the mentally retarded and related literature. Related Literature The concept of attitude has played a central role in the development of American social psychology (Kiesler, Collins and Miller, 1969) . Studies in the area of attitude theory and organization were numerous as reviewed by Rosenberg and Hovland (1960) and Kiesler et al., (1969). Social psychologists before World War II concentrated on attitude measurement and scaling while those after World War II devoted their attention to theoretical and empirical issues in attitude change (Kiesler et al., 1969). In fact, as early as 1918 social psychology was defined as the scientific study of attitude (Thomas and Znaniecki, 1918) . 12

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13 Definitions Definitions of attitude vary according to the theorist's orientation. Allport ' s (1935). definition was found widely in the literature. An attitude is a mental and neural state of readiness, organized through experience, exerting a directive or dynamic influence upon the individuals response to all objects and situations with which it is related, (p. 799) Triandis (1971) proposed a definition that he felt included many of the central ideas used by attitude theorists as follows: "An attitude is an idea charged with emotion which predisposes a class of actions to a particular class of social situations" (p. 2) . Thurstone advocated a broad definition of attitude in 1928, but later modified that definition to "the intensity of positive or negative affect for or against a psychological object. A psychological object is any symbol, person, phrase, slogan or idea toward which people can differ as regards positive or negative affect" (Thurston, 1946, p. 39). This definition was accepted by many theorists who developed scales for measuring attitudes. Guttman (1950) defined attitude as a "delimited totality of behavior with respect to something" (p. 51) . This is a behavioral definition rather than a cognitive one and lends itself to a facet theory analysis which Guttman (1959) developed. Bastide and van den Berghe (1957) proposed

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14 four types or levels of interaction with an attitude object. Guttman (1959) elaborated these into a facet theory analysis in which he defined four of these levels: (a) Stereotype, (b) Norm, (c) Hypothetical Interaction, and (d) Personal Interaction (Jordan, 1970). Kerlinger (1964) defined attitude as "Predisposition to think, feel, perceive and behave toward a cognitive object" (p. 483). This definition or variations of it recurred often in the literature and represents the cognitive theorist's concept of attitude. Attitudes and behavior were linked together by McGinnies (1970) when he referred to attitudes as a class of performances under the control of a specified social referent-much as any other learned behavior. Beatty (1969) also linked behavior and attitudes. Kiesler et al. (1969) proposed that it is not necessary to ask whether or not attitudes and behavior are correlated, but rather we should ask when are attitudes and behavior correlated and what factors affect the size of the correlation. They further discussed this point by stating . . . our notions that a particular attitude correlates with a particular behavior may be incorrect, not because of a general failure of attitudes to have any relationship to behavior but because our intuitive notions about which attitudinal factors are correlated with which behavioral factors are incorrect. While our theoretical analysis of attitudes definitely commits us to a position that attitude factors should, in general, be correlated with some behavioral factors, it does not commit us

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15 to a position that each attitude factor should be correlated to all behavioral factors. (Kiesler et al., 1969, p. 36) A study often discussed in relation to behavior and attitude was one by La Piere (1934), which dealt with the apparent inconsistency exhibited by motel or restaurant proprietors who actually served a Chinese couple even though they had said they would not do so in response to a letter query. Kiesler et al . (1969) maintained that these were both behaviors in different situations, rather than the letter representing only attitude and the response to the couple as only behavior. Attitude change was another area in the study of attitudes. Theories of attitude change might be divided into two types: a literary or conceptual definition and an operational definition. An operational definition defines a concept by specifying the procedures used to measure the concept and is based on the conceptual or literary definition (Kiesler et al., 1969). Studies in attitude change have often used the concept of dissonance as proposed by Festinger (1957) , "Two elements are in a dissonant relation if, considering these two alone, the obverse of one element would follow from the other" (p. 13) . Although highly controversial, dissonance theory and other consistency theories have been useful to social psychology and the study of attitude change (Kiesler et al., 1969).

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16 Kiesler et al. (1969) summarized their critical review of theoretical approaches to attitude change . . . for the most part theorizing in this area is still at a relatively low level: assumptions are not made explicit; relations between theoretical constructs are not spelled out; and the details necessary for precise predictions are often missing. Consequently, we feel that detailed criticism is necessary and desirable at this stage in the study of attitude change. (p. 343) A comprehensive review of the literature (Jordan, 1968) on attitude studies indicated that four classes of variables seemed to be important determinants, correlates and/or predictors of attitude: (a) econ-demographic factors such as age, sex and income; (b) socio-psychological factors such as one's value orientation; (c) contact factors such as amount, nature, perceived voluntariness, and enjoyment of the contact; and (d) the knowledge factor, i.e., the amount of factual information one has about the attitude object. These variables are included in the Attitude Behavior Scale Toward Mental Retardation (ABS-MR) developed by Jordan and used in his study Attitude-Behavior Toward Mentally Retarded Persons: A Cross-Cultural Analysis , (1970) . Attitudes Toward the Mentally Retarded The concept of attitude has played a central role in the development of American social psychology (Kiesler et al. , 1969) . Studies in the area of attitude theory and

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17 organization were numerous as reviewed by Rosenberg and Hovland (1960) and Kiesler et al. (1969). Attitudes toward the disabled have been studied particularly since World War II in an effort to plan programs to meet the needs of the physically handicapped. Jordan (1968) and Yuker (1970) have conducted comprehensive studies in this area and their studies serve as transition from the study of attitude theory as a concept to the study of attitudes toward a broadly defined group. A review of the studies conducted and reported since 1960 which have focused specifically on attitudes toward the mentally retarded could be classified in four primary groups: (1) family attitudes, (2) attitudes of professionals, (3) public attitudes (nonspecific groups), and (4) cross-cultural attitudes. Family Attitudes Attitudes of family members toward the retarded child were reported in four studies. Early research in this area usually concentrated on the reactions and perceptions of the mother toward the child. Barber (1963) found that the attitudes of mothers of mentally retarded children were not influenced by the sex of the children but were influenced by the child's intellectual capacity and behavior. The influence of socioeconomic status was significant and was one of the most important variables influencing the attitudes

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18 of mothers of mentally retarded children. Barber surmised that this research indicated that having a mentally retarded child tended to intensify some of the corresponding attitudes already held by parents of normal children of similar socioeconomic status. The study included only families where the retarded child lived at home and therefore the findings could not be generalized to mothers who had placed their children in other living arrangements. More recent research has included other family members. Condell (1966) investigated the attitudes of parents of retarded children, living in a rural setting. Some discrepancy seemed to exist between the parents' attitudes and the attitudes of the professionals involved. Such a discrepancy may have arisen because of the different educational and socioeconomic background of the urban, academically oriented professional group. Parental attitudes | varied in this sample. Although parents sought professional help they did not always accept it, especially when professional goals and parental needs varied. While many studies have concentrated on the relationship between mother and child, very few have included the father. Gumz and Gubrium (1972) examined the comparative perceptions of mothers and fathers toward a mentally retarded child of their own. The hypotheses of this study asserted that the father's role is that of instrumental leader while the mother's role is that of expressive

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19 leader. The instrumental function focuses on relations of the system with other systems; its goals are to achieve adaptation, to maintain equilibrium and instrumentally to establish the desired relations to external goal objects. The expressive area concerns itself with the "internal" affairs of the system; to maintain integrative relations between members and to manage tension between component parts of the social system. Although not consistently statistically significant, evidence from a sample of 50 families with retarded children showed that there was a tendency for fathers to perceive their child more instrumentally than mothers, the latters' perceptions being more expressive. Family attitudes were further studied by Adams (1965) who looked at the comparison of attitudes of adolescents toward both normal and retarded brothers. The results of this study seemed to indicate that mentally retarded brothers living at home did not adversely influence their siblings. Attitudes of Professionals Recognizing the importance of teachers and education in the lives of the retarded, researchers have explored various aspects of teachers' attitudes toward the retarded. Legant (1966) did not find any significant differences among the attitudes of regular classroom teachers, teachers of the handicapped, and teachers who had been exposed to

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20 professional courses in teaching handicapped children but who were not actively engaged in doing so. The opposite of this was found by Proctor (1967) in a dissertation which investigated the relationships between the teachers' knowledge of exceptional children, the kind and amount of their teaching experience and their attitudes toward classroom integration of retarded children. Differences were found between groups of teachers which related directly to their knowledge about mental retardation and the amount of their teaching experience. Teacher bias was explored by Soule (1972) in an attempt to examine the effect of expectancy on the subsequent behavior of institutionalized severely retarded children. No effects of experimentally induced teacher bias were found in this study of 24 subjects. Blazovic (1973) demonstrated that parents, teachers and retarded students differ in their attitudes toward integrated programs for borderline educable mentally retarded students. Regular class teachers perceived special classes as being more beneficial to borderline retardates than regular classes, the retarded students did not recognize or acknowledge differences between regular and special classes and parents appeared ambivalent toward preferences. Conversely Jones (1971) found that mildly retarded students rejected the labels and stigma associated with the special education, that teachers held lowered expectations for these students and had not

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21 developed strategies for the management of stigma in classes for the educable mentally retarded. There were references made in the literature to the attitudes of nurses toward mental retardation (Steele, 1971; Koch, 1971; Nichtern, 1974), but no research was found in this specific area. Steele emphasized the necessity for the nurse to have worked through her own feelings toward mental retardation before attempting to help parents of a retarded child for her attitude and behavior may serve as a guide for parents (Steele, 1971) . Koch (1971) presented the interdisciplinary approach toward mental retardation involving many different professions; nursing being one of these. The importance of attitudes was stressed throughout the book. Nichtern (1974) wrote a book for parents of a retarded child with emphasis on the importance of attitudes, of society as a whole and especially of parents and those professionals working directly with the child. Nursing texts in pediatric nursing usually included a short section on mental retardation based on the clinical aspects of the condition and the nurse's responsibility in prevention, case finding and management with little or no mention made of attitudes of the nurse (Marlow, 1973; Blake, Wright and Waechter, 1970).

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22 Public Attitudes In spite of increased information about mental retardation in the media, emphasis on programs and huge amounts of money allocated by governmental and private agencies during the 1960s, Gottwald (1970) found a tremendous naivete in public awareness about mental retardation. Meyers, Sitkei and Watts (1966) also found this lack of understanding concerning the educable mentally retarded child's potential by both groups in their study, one a random sample of an urban population, the other a sample of families with a child enrolled in special classes in public school. Their study did reveal a more accepting attitude of home care and public education for the educable mentally retarded (EMR) as opposed to the trainable mentally retarded (TMR) and a more accepting attitude by non-Caucasians and those of "liberal-casual" religions. Edgerton and Darno (1972) studied the attitudes of Angloand Mexican-Americans toward the moderately retarded (TMR) . The results indicated that most Angloand Mexican-Americans from a large urban area preferred home care as opposed to hospital care. As the respondents became more "middle-class , " however, they tended to choose hospitalization. Investigation of attitudes of the public in connection with tours of institutions for the retarded indicated that while the tours may produce attitude change, this change is often in a positive direction toward the institution and

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23 toward parents (Sellin and Mulchahay, 1965; Kimbrell and Luckey, 1964; Warren, Turner and Brody , 1964) and in a negative direction toward the retarded themselves or toward working with the retarded (Sellin and Mulchahay, 1965; Warren et al., 1964). Sartin (1965) found that while there were fewer misconceptions following a unit of study which included tours of institutions, the attitudes which the students expressed were more negative toward the mentally deficient, but more positive toward the slow learner and toward other groups of children. Cross-Cultural Attitudes Mental retardation and the attitudes toward mentally retarded persons are problems which are present in all societies. In an attempt to investigate the attitude behaviors toward retarded persons, Jordan (1970), using the variables identified in 1968, conducted an extensive sevennation study of four classes of variables which he believed to be important determinants, correlates and/or predictors of attitudes: (1) econ-demographic factors such as age, sex and income, (2) socio-psychological factors such as one's value orientation, (3) contact factors such as amount, nature, etc., of contact, and (4) the knowledge factor. Jordan's results indicated that increased knowledge of mental retardation did not necessarily indicate increased positive attitudes, type of contact with the retarded was

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24 related to the attitudes expressed, amount of education was positively related to favorable attitudes toward mental retardation, age was not related to attitudes toward mental retardation, women scored higher on positive attitudes toward mental retardation than men, those who scored high in efficacy did not necessarily score high in positive attitudes toward the mentally retarded. Comparison of attitudes between the U.S. and Europe was done by Lippman (1972). He found that European countries, especially the Scandinavian countries, have a more positive attitude toward the mentally retarded than the U.S. The provisions made for the retarded reflected this positive attitude. Conclusion The review of the literature indicated that research in the area of attitudes has intrigued psychologists and sociologists since the early 1900s. Although there has been much controversy in the field, the results of the studies help researchers to better understand attitudes and attitude change. These findings have been widely used by experts in communication and advertising and are beginning to be used by experts in other fields. The area of attitudes and attitude change as related to behavior and behavior change was less clearly defined and needs further research and study.

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25 The area of nurses' attitudes toward mental retardation has only recently appeared in the literature (Steele, 1971; Nichtern, 1974; Koch, 1971). Research inthis area has not been reported.

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CHAPTER III METHODOLOGY Hypotheses Jordan recommended that the ABS-MR be tabulated as separate subscales, rather than as whole (Jordan, 1970) . When the entire scale was differentiated into subscales, eight hypotheses were formulated for this study. Hypothesis I: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their perception of how other people compare the mentally retarded to those who are not retarded as measured by the ABS-I-MR. Hypothesis II: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing 26

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27 students who have had a planned curricular experience with mentally retarded children (Group B) in their perceptions of what other people generally believe about interacting with the mentally retarded as measured by the ABS-II-MR. Hypothesis III: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their feelings about the right or wrong way to behave toward mentally retarded persons as measured by the ABS-III-MR. Hypothesis IV: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in the way they believe they would act toward mentally retarded individuals in given situations as measured by the ABS-IV-MR. Hypothesis V: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their identified

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28 feelings toward the mentally retarded as measured by the ABS-V-MR. Hypothesis VI: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their actual experience with mentally retarded individuals as measured by the ABS-VI-MR. Hypothesis VII: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their expressed feelings about life situations as measured by the ABS-IX-MR. Hypothesis VIII: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in the amount of information they possess about mental retardation as measured by the ABS-X-MR.

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29 Sample Ninety-four students volunteered to participate, but 22 did not return the ABS-MR. There was no way to contact those who did not return the ABS-MR as anonymity had been maintained. The study sample, therefore, consisted of 72 students enrolled in the University of Florida College of Nursing during the summer and fall quarters, 1974. As part of their program pediatric nursing was required, but the students could elect to take the course at any point in their upper division work. The students who participated in the study were, therefore, in either their junior or senior year of a baccalaureate program in nursing. The sample reflected the student admissions to the College of Nursing and was predominantly white, female and young. No attempt was made to control such variables as age, sex, race, religion, or educational background (i.e., R.N. or generic students). The sample consisted of 70 females and 2 males, whose ages ranged from under 21 years old to 50 years, with the majority in the 21-30 age bracket. There were 56 who were single, 14 married, 1 divorced and 1 widowed. Their religion was predominantly Protestant (41 of the total 72) , 14 Catholic, 2 Jewish, 12 other or none, while 3 preferred

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30 not to answer. Fifty-three listed some college or university level education, while 19 listed college or university degree (see Table 1) . Design The separate sample Pretest-Posttest Design proposed by Campbell and Stanley (1963, p. 53) was the original design of this study. Randomization could not be maintained; therefore, the design used was the Static-Group Comparison (Campbell and Stanley, 1963, pp. 12-13). This is considered a pre-experimental design by Campbell and Stanley. The sources of internal invalidity are similar on the two designs, but the Static-Group Comparison does not control for threats to external validity (Campbell and Stanley, 1963, p. 8 and p. 40). The design can be illustrated by the diagram: °1 °2 The first threat to internal validity is that of selection. If 0, and differ, this difference could have well come about because the groups were different to begin with. In this particular study, there was a degree of control for this; as the two groups were all in the junior or senior year of the same baccalaureate nursing

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31 Table 1 SUBJECTS IN GROUP A AND GROUP B COMPARED FOR SEX, AGE, MARITAL STATUS, RELIGION AND EDUCATION Sex Group A Group B 2 44 26 Age Under 21 21-30 31-40 41-50 16 1 28 24 1 1 1 Marital Status Married Single Divorced Widowed 10 35 1 4 21 Religion Prefer not to Answer Catholic Protestant Jewish Other or none 2

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32 program, and were all volunteers in the sample. This would assume a certain amount of similarity in age, educational level and occupational interests. They were all anonymous and did not receive any external rewards or recognition for participating in the study. Mortality (loss of subjects) is another threat to internal validity. There were 22 students who volunteered to participate but who failed to complete the ABS-MR. Their anonymity had been maintained, so there was no way to determine who they were. It can only be assumed that participants from both groups failed to return the ABS-MR. Interaction of selection and maturation is another threat to internal validity. It is assumed that the voluntary selection, the similarity of age and educational backgrounds and the short time span of the testing controlled for this in some degree. The Static-Group Comparison design has no controls for threats to external validity; but, many of the experimental designs and quasi-experimental designs proposed by Campbell and Stanley have no controls in this area. The results, then, are not considered generalizable to any population other than the one involved in the study. The design does control for threats to internal validity for history (external events not related to effects of X), testing, instrumentation and regression.

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33 These controls, plus the ones imposed by the anonymity of subjects, the similarity of subjects and the absence of external rewards for participation make this a strong enough design to warrant its use in this particular study . Instrumentation represents a hazard when interviewers are used. This was not the case in this study, as all information was obtained through a written instrument where the subjects remained anonymous. Instrumentation Attitudes (the dependent variable) were measured using the Attitude Behavior Scale-Mental Retardation (Appendix A) developed by Jordan (1970) for use in a cross-cultural analysis of seven nations. Jordan (1970) described the Attitude Behavior Scale-Mental Retardation (ABS-MR) : The construction of the ABS-MR was guided by the facet design which makes it possible to construct items by the method of intuition or by the use of judges. Facet theory (Guttman, 1959, 1971, 1970) specifies that the attitude universe represented by the item content can be substructured into semantic profiles which are systematically related according to the number of identical conceptual that they hold in common. The substructuring of an attitude universe into profiles facilitates a sampling of items within each of the derived profiles, and also enables the prediction of relationships between various profiles of the attitude universe. This should provide a set of clearly defined profiles for cross-national, crosscultural, and sub-cultural comparisons. (p. 5)

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34 Reliability for the ABS-MR test development samples as determined by the Hoyt analysis of variance method ranged from .60 to .85. Reliability estimates obtained by the sample procedures on the seven-nation data indicate the reliabilities are equal to or, in many instances, better than those obtained on the test development samples (Jordan, 1970). Validity of the ABS-MR was assessed by the "Known Group" method and by the results of a simplex test. The groups scored approximately as expected. The ABS-MR, as developed by Jordan (1970) , was divided into six subscales, plus sections on demographic factors, contact with handicapped persons, life situations, and information about mental retardation. For the purpose of this study, the ABS-MR was used as developed by Jordan with the original subscales (I-VI) , and the sections on demographic factors, life situations, and information about mental retardation were given subscale numbers VII-X for tabulation purposes. The ABS-MR was administered as a total instrument, then analyzed as subscales. Jordan (1970) strongly recommended maintaining the anonymity of subjects in an effort to control for social desirability pressures. Procedure The ABS-MR was administered to students enrolled in the College of Nursing during the summer and fall quarters,

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35 1974. Participation was voluntary and all those students who had not had the Sunland experience were designated as Group A. Those students who had completed the Sunland experience were designated as Group B. The curricular experience (or independent variable) for this study consisted of a two-week period when nursing students worked with mentally retarded children as part of their course in pediatric nursing. The pediatric nursing course was required for graduation and the two-week experience was a required part of the course. The students participated in the care of children in Willow Cottage at Sunland Training Center, Gainesville, Florida. These children ranged in age from 4 through 14 years and ranged in development from 6 months through 4 years; therefore, they are classified as severely retarded. They are dependent on others for most of their care. The nursing students were responsible for completing developmental assessments of these children, for planning and implementing care based on these assessments and for either writing a paper or developing and evaluating a project related to the care of the children (Appendix B, Course Outline) . Students spent at least 12 hours weekly in the cottage. In addition there were weekly seminars with participating students and instructors. Daily conferences were held as needed. Instructor (s) assistance was available at all times from either the instructor who regularly worked in the cottage with the

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36 students or from other instructors in the pediatric nursing course. Students were allowed to modify the course outline requirements when necessary to meet their own learning needs. A minimum level of competence was required, however, in order to receive credit for the experience. Those students who had completed the experience and those students who had not yet been assigned to Sunland were tested during the same six-week period. Because of the length of the ABS-MR and the time required to answer the questions, the students were allowed to complete the tests at home. The subjects were assured of anonymity and were asked to be honest in their answers. No other directions were given. The completed tests were returned to the researcher immediately and all data were available for analysis within one day of the last testing session. Assumptions and Limitations Analysis of data was influenced by underlying assumptions and limitations identified early in the study. It was assumed that 1. The ABS-MR accurately tested attitudes toward MR. 2. The students were truthful in answering the questions of the ABS-MR. 3. Students chosen during the time period involved were comparable to students in any other time period.

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37 Certain limitations had to be considered when interpreting the data: 1. Many students had preconceived ideas of what "nursing" was. Working with mentally retarded children at Sunland did not always fit this preconception and biases were formed. 2. The curricular experience was required, not elective, and students sometimes developed a set against it for this very reason. 3. The limited period involved (two weeks) did not afford time to resolve the emotional impact or the stress of cognitive learning requirements compounded by that emotional impact. 4. The environment of a state institution may have contributed to reactions that might not have occurred or might have been different in another setting. 5. Participation in the study was voluntary and thus involved a select or particular group of individuals whose attitudes may have influenced their volunteering. 6 . The same instructor did not teach the curricular experience to all the sample involved and individual instructor biases may have influenced student attitudes.

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CHAPTER IV DATA ANALYSIS This study investigated the effects of a planned curricular experience upon the attitudes of baccalaureate nursing students toward mental retardation. Eight hypotheses were formulated for the study and were tested with computer analysis using multivariate general linear hypothesis procedures. Hypothesis I: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their perception of how other people compare the mentally retarded to those who are not retarded as measured by the ABS-I-MR. Analysis of data revealed no significant difference between the groups in their perception of how other people compare the mentally retarded to those who are not retarded as measured by the ABS-I-MR. An F statistic of 3. 982 was necessary for significance at the .05 level. The F statistic 38

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39 for this hypothesis, however, was .641 and therefore not significant (see Table 2). Hypothesis II: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their perceptions of what other people generally believe about interacting with the mentally retarded as measured by the ABS-II-MR. Analysis of data revealed a significant difference between the groups in their perceptions of what other people generally believe about interacting with the mentally retarded as measured by the ABS-II-MR. An F statistic of 3.982 was necessary for significance at the .05 level. The F statistic for this hypothesis was 5.067 and, therefore, was significant (see Table 3). Hypothesis III: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their feelings about the right or wrong way to behave toward mentally retarded persons as measured by the ABS-III-MR.

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40 Table 2 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS I Source SS df MS F Between Groups (BG) 28.043 1 28.043 .641 Within . Groups (WG) 3061.831 70 43.740 Table 3 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS II Source SS df MS F Between Groups (BG) 191.043 1 191.043 5.067 Within Groups (WG) 2638.956 70 37.699

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41 Analysis of data revealed no significant difference between the groups in their feelings about the right or wrong way to behave toward mentally retarded persons as measured by the ABS-III-MR. An F statistic of 3.982 was necessary for significance at the .05 level. The F statistic for this hypothesis, however, was .010 and therefore not significant (see Table 4) . Hypothesis IV: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with retarded children (Group B) in the way they believe they would act toward mentally retarded individuals in given situations as measured by the ABS-IV-MR. Analysis of data revealed no significant difference between groups in the way they believed they would act toward mentally retarded individuals in given situations as measured by the ABS-IV-MR. An F statistic of 3.982 was necessary for significance at the .05 level. The F statistic for this hypothesis, however, was only 2.435 and therefore not significant (see Table 5) . Hypothesis V: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing

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42 Table 4 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS III Source SS df MS F Between Groups (BG) 0.312 1 0.312 0.010 Within Groups (WG) 2017.632 70 28.823 Table 5 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS IV Source SS df MS F Between Groups (BG) 100.786 1 100.786 2.435 Within Groups (WG) 2897.088 70 41.386

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43 students who have had a planned curricular experience with mentally retarded children (Group B) in their identified feelings toward the mentally retarded as measured by the ABS-V-MR. Analysis of data revealed no significant difference between the two groups in their identified feelings toward the mentally retarded as measured by the ABS-V-MR. An F statistic of 3.982 was necessary for significance at the .05 level. The F statistic for this hypothesis was 0.726 and therefore not significant (see Table 6) . Hypothesis VI: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their actual experience with mentally retarded individuals as measured by the ABSVI-MR. Analysis of data revealed no significant difference between the groups in their actual experience with mentally retarded individuals as measured by the ABS-VI-MR. An F statistic of 3.982 was necessary for significance at the .05 level. The F statistic for this hypothesis was 0.022 and therefore not significant (see Table 7) . Hypothesis VII: There will be a significant difference between nursing students who have not had a planned curricular experience

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44 Table 6 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS V Source SS df MS F Between Groups (BG) 41.833 1 41.833 0.726 Within Groups (WG) 4028.152 70 57.545 Table 7 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VI Source SS df MS F Between Groups (BG) 0.483 1 0.483 .022 Within Groups (WG) 1533.016 70 21.900

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45 with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their expressed feelings about life situations as measured by the ABS-IX-MR. Analysis of data revealed a significant difference between the two groups in their expressed feelings about life situations as measured by the ABS-IX-MR. An F statistic of 3.982 was necessary for significance at the .05 level. The F statistic was 7.082 for this hypothesis and therefore was significant (see Table 8). Hypothesis VIII: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in the amount of information they possess about mental retardation as measured by the ABS-X-MR. Analysis of data revealed no significant difference between the two groups in the amount of information they possess about mental retardation as measured by the ABS-X-MR. An F statistic of 3.982 was necessary for significance at the .05 level. The F statistic for this hypothesis was 0.616 and therefore not significant (see Table 9) .

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46 Table 8 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VII Source SS df MS F Between Groups (BG) 61.859 1 61.859 7.082 Within Groups (WG) 611.418 70 8.734 Table 9 ANALYSIS OF VARIANCE TABLE FOR HYPOTHESIS VIII Source SS df MS F Between Groups (BG) 2.087 1 2.087 0.616 Within Groups (WG) 237.023 70 3.386

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47 Of the eight hypotheses formulated for the study, six were rejected and two were supported. Although the differences could not be totally attributed to the planned curricular experience at Sunland, significant change did occur in two areas, and some change occurred in all areas. In the ABS-MR, a high score denotes a more positive attitude. On all subscales measuring attitude the mean pretest scores were higher than the mean posttest scores (subscales I-VI , IX). On subscale X measuring information about mental retardation possessed by the individual, the mean of the posttest scores was higher than the mean of the pretest scores (see Table 10) . The difference was not significant, but the subjects did apparently acquire a little more factual information about mental retardation from their curricular experience . However, on the attitude subscales, the differences were all in a negative direction. Subscales I and IX were significantly in a negative direction (see Tables 3 and 8) . Discussion of the Results The negative change in attitudes after the planned curricular experience in this study implies that attitudes can be changed with experiences. The results of this study are in agreement with the studies involving tours of

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Table 10 REGRESSION COEFFICIENTS (MEAN SCORES) FOR GROUPS A AND B AND ON EACH SUBSCALE Subscale

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49 institutions in which the subjects' attitudes toward the mentally retarded changed in a negative direction after tours of institutions (Sellin and Mulchahay, 1965; Kimbrell and Luckey, 1964; Warren et al., 1964). These were discussed in Chapter II — The Review of the Literature. The results are also in agreement with the study by Sartin (1965) who found that while there were fewer misconceptions following a unit of study which included tours of institutions, the attitudes which the students expressed were more negative toward the mentally deficient (see Chapter II) . Jordan (1970) discussed the problem of deciding between the more realistic answer and the more positive answer on the ABS-MR. This may account for part of the negative change in this study. Nursing students are usually assumed to have altruistic feelings or attitudes. These feelings may have to adapt to reality when the student participates in actual experiences. Interpretation of this change could be done using Festinger's concept dissonance: "Two elements are in a dissonant relation if, considering these two alone, the obverse of one element would follow from the other" (Festinger, 1957, p. 13) . The actual experience with the mentally retarded children in Willow Cottage becomes the element which causes dissonance in the attitudes of the student. The attitudes towards mental retardation are brought into agreement with the behavior of the student toward the mentally retarded. Thus, if the student feels repulsed, helpless,

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50 angry, etc., toward the retarded individuals or toward the experience, the attitudes related to this concept will change in a negative direction to agree with feelings. Actual experience working with mentally retarded individuals introduces many more possible dissonant elements than a classroom learning experience might. The background experience with handicapped individuals revealed by the questions on subscale VIII (Appendix A, pp. 97) may also account for some of the differences in attitudes between the two groups. Subscale VIII (Appendix A, p. 97) begins by asking for handicapping condition with which the subject has had the most actual experience ; 35 percent of Group A listed mental retardation, 62 percent of Group B listed mental retardation (see Table 11) . The types of experiences indicated by subjects were similar in both groups as 52 percent of Group A listed work experience and 57 percent of Group B listed work experience (see Table 11) . The negative differences begin to show up on ability to avoid contact, where 13 percent of Group A indicated they could not have avoided the contact while 30 percent of Group B could not have avoided contact. Responses to other opportunities available also show differences as 28 percent of Group A indicated that other jobs were available which were fully acceptable to them when they chose to work with handicapped individuals. No subjects in Group B indicated this (see Table 11) .

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Table 11 GROUPS A AND B COMPARED ON EXPERIENCES OR CONTACTS WITH HANDICAPPED PERSONS 51 Handicapping Condition : Blind/partially blind Deaf /partially deaf, speech impairment Crippled/spastic Mentally retarded Social or emotional Group A Group B 1

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52 Table 11 (continued) Feelings About Experience or Contact With Mentally Retarded Persons : Group A Group B No experience 1 Definitely disliked 4 Did not like very much 13 7 Liked it somewhat 22 11 Definitely enjoyed it ,10_ _4_ Total 46 26

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53 Feelings about experiences or contacts with mentally retarded persons also reveal differences (see Table 11) . While no subjects in Group A indicated that they definitely disliked their contacts, 15 percent of Group B indicated this. Also 48 percent of Group A indicated they liked the experience somewhat, only 27 percent of Group B so indicated. These data imply that Group A had had more positive experiences with handicapped individuals including mentally retarded individuals than Group B. The fact that Group B's curricular experience was in a state institution and was a required part of a course for academic credit rather than a voluntary experience over which the volunteer has a certain amount of control may account for some of these differences. The intensity scores were also subjected to computer analysis using multivariate general hypothesis procedures. No significant differences were found between the two groups. The mean scores for the posttest groups were higher than the mean scores for the pretest group on all subscales except subscale VI (see Table 12). These higher scores imply that the posttest group was more certain of responses on all subscales except subscale VI. These intensity scores were not dealt with in depth in this study, but wi]l be used in future research.

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54 Table 12 REGRESSION COEFFICIENTS (MEAN SCORES) FOR GROUPS A AND B ON INTENSITY FACTORS FOR SUBSCALES Group B Difference 42.307 -2.220 44.000 -1.956 46.692 -1.387 48.000 -0.369 47.769 -0.117 32.038 1.961 28.346 -0.237 Note: The higher score denotes that subjects were more certain of their responses. Subscale

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CHAPTER V SUMMARY, CONCLUSIONS AND IMPLICATIONS Summary Purpose of the Study The purpose of this study was to determine whether or not the identified attitudes toward mental retardation of baccalaureate nursing students were different after a curricular experience with mentally retarded children. Questions for Study This study sought to answer the following questions: 1. Can attitude change be linked to specific experiences? 2. Are attitudes of nursing students toward mental retardation different after a planned experience with retarded children? 3. If there are attitude differences, are they in a positive or a negative direction? 55

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56 Need for the Study There was a need for nurses to plan and implement better nursing care for mentally retarded individuals and their families. It was assumed that nursing care reflected the attitudes of nurses, and awareness of attitudes of nursing students toward mental retardation could help faculty in planning preparatory programs. The bases upon which the study was conceptualized were a desire for improving the plight of the mentally retarded in our society, the experiential inadequacies of professional nurses and the need for revision of curriculum in nursing education. Design of the Study The design of this study was the Static-Group Comparison discussed by Campbell and Stanley (1963) . The Sample The sample consisted of 72 nursing students in the junior or senior year of a baccalaureate program during the summer and fall quarters in the University of Florida College of Nursing. Of these 72 students, 46 had not yet had the planned curricular experience with mentally retarded children and were designated as Group A, while 26 had had the experience and were designated as Group B.

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57 Instrumentation The Attitude Behavior Scale Toward Mental Retardation (ABS-MR) developed by Jordan (1970) was used to assess attitudes toward mental retardation and knowledge about mental retardation of Group A who had not yet had the planned curricular experience and Group B who had had the experience. The ABS-MR was divided into subscales I-X for tabulation purposes and for hypothesis testing (see Definition of Terms for description of subscales) . Analysis and Interpretation of Data The ABS-MR was divided into 10 subscales, each involving different data related to attitudes, demographic factors, and knowledge possessed by the individual about mental retardation (see Definition of Terms) . The following hypotheses were formulated for the study: Hypothesis I: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their perception of how other people compare the mentally retarded to those who are not retarded as measured by the ABS-I-MR.

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58 Hypothesis II: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their perceptions of what other people generally believe about interacting with the mentally retarded as measured by the ABS-II-MR. Hypothesis III: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their feelings about the right or wrong way to behave toward mentally retarded persons as measured by the ABS-IIIMR. Hypothesis IV: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in the way they believe they would act toward mentally retarded individuals in given situations as measured by the ABS-IV-MR.

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59 Hypothesis V: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their identified feelings toward the mentally retarded as measured by the ABS-V-MR. Hypothesis VI: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their actual experience with mentally retarded individuals as measured by the ABS-VI-MR. Hypothesis VII: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in their expressed feelincs about life situations as measured by the ABS-IX-MR.

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60 Hypothesis VIII: There will be a significant difference between nursing students who have not had a planned curricular experience with mentally retarded children (Group A) and nursing students who have had a planned curricular experience with mentally retarded children (Group B) in the amount of information they possess about mental retardation as measured by the ABS-X-MR. The data were subjected to computer analysis using multivariate general hypothesis procedures. The mean score of Group A was higher than the mean score of Group B on all subscales except subscale X. Only two were statistically significant at the .05 level, however. Those with significant differences were subscales II and IX which dealt with the subject's perception of what other people generally believed about mentally retarded persons and how the subject perceived certain life situations. The higher score denoted a more positive attitude on the ABS-MR; therefore, the attitude difference was in a negative direction on seven of the eight subscales; significantly so on two of these. Subscale X dealt with factual information about mental retardation; there was a difference in the positive direction on the mean scores on subscale X of the two groups, but it was not significant.

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61 The data indicated that there was a significant difference in attitudes on subscale II which involved perceptions of what other people generally believed about interacting with the mentally retarded and on subscale IX which dealt with life situations. These differences were to a more negative attitude after the experience. The intensity factors on the ABS-MR were subjected to computer analysis also. No significant changes occurred here. There were higher mean scores for the posttest group which implied that the subjects were more certain of their responses. Differences between the groups were revealed in the demographic data on subscales VII and VIII. These data indicated that Group A had had more voluntary contact with mentally retarded persons and had enjoyed it more. These data were analyzed for frequency of response. Both the intensity factors and the demographic data will be used in further research. The negative difference in attitudes might • be attributed to subjects having brought their idealistic attitudes more into agreement with reality and might be interpreted according to Festinger's theory of dissonance (see Discussion of the Results, p. 47).

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62 Cdnclusions The results of the study were stated in the following conclusions: 1. There were differences in attitudes after this planned curricular experience. 2. Factual information may increase as a result of the planned curricular experience. 3. Attitudes tended to become more negative after such experience. Implications Basic to this study were certain assumptions and limitations: It was assumed that the ABS-MR accurately tested attitudes toward mental retardation, that students were truthful in answering the questions on the ABS-MR and that the students chosen during the time period involved were comparable to students in any other time period. Limitations included (1) many students had preconceived ideas of what "nursing" was, (2) the curricular experience was required, not elective, and students sometimes developed a set against it for this very reason, (3) the limited period involved did not afford time to resolve the emotional impact or the stress of cognitive learning requirements compounded by that emotional impact, (4) the environment of a state institution may have contributed to reactions that might not have occurred or might have been different in another

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63 setting, (5) participation in the study was voluntary and thus involved a select or particular group of individuals whose attitudes may have influenced their volunteering, and (6) the same instructor did not teach the curricular experience to all the sample involved and individual instructor biases may have influenced student attitudes. Implications can be made based on the data obtained and the conclusions drawn. Education Implications 1. Since the data indicated that there was a difference in attitudes after planned curricular experiences, these experiences should be planned to allow the student the time and opportunity to deal with her own personal feelings and attitudes while preparing to be a practitioner in a helping relationship. 2. Curricular experiences which include positive interactions with mentally retarded individuals in the community and in the institution, could be planned for and with students 3. Faculty attitudes toward mental retardation need to be assessed and dealt with in an effort to help them help students . 4. Changes in attitudes in the negative direction may very well indicate that the student is facing reality and adjusting to it. This is better accomplished in the student status with faculty and peer support, than as a graduate in a helping role to others.

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64 5. If the nursing needs of society are to be met, the curricula in preparatory programs for nurses must include learning experiences with the groups within that society. The mentally retarded are one such group. 6. If nursing care is to be effective, it has to be based on knowledge of the client, his needs and the clinical entities affecting the client. This knowledge base is obtained as a student and through clinical practice and further study. Nursing care for the mentally retarded require this knowledge base and needs to be included in the curricular of preparatory programs for nurses. 7. If preparatory programs for nurses are to include curricula relative to mental retardation, there must be faculty prepared to teach in this area. Teacher preparatory programs for faculty in nursing need to include the area of mental retardation in their programs. ' 8. Nurses encounter mentally retarded individuals in almost all areas of nursing practice. The nurse's own needs must be dealt with before she can meet the needs of her clients. Learning experiences which recognize these individual needs are important in all preparatory programs for nurses and in continuing education for nurses. Nursing Practice Implications 1. One of the nurse's primary roles at this time, in the area of mental retardation, is that of prevention. In order

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65 to understand the importance of this role and the consequences of lack of prevention, nurses need information about mental retardation . 2. Case finding or identification is part of the nurse's responsibility in prevention. In order to identify, the nurse must be able to assess development. Knowledge about mental retardation is essential for this also. 3. If nurses are to be competent to plan and implement care for all individuals in our society, they need learning experiences that involve many different groups, including the mentally retarded. These experiences could help nurses to identify the many similarities between individuals and groups and yet the uniqueness of each one. 4. If nurses' attitudes are reflected in the care they plan and implement, learning experiences which provide opportunities for positive interactions are important, keeping in mind that realistic attitudes are also important. Nursing care must be based in reality to be effective. Research Implications 1. Research in education and the effects of curricular experiences on students' attitudes is needed. These research data could assist in planning programs to prepare nurses more effectively. 2. Research in nursing practice in the area of mental retardation would enable nurses to evaluate more accurately the nursing care they plan and provide.

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66 3. Reports of research being done in the area of prevention of mental retardation would assist nurses in their roles in prevention. Studies specifically dealing with .nursing and prevention need to be conducted and made available for use by practitioners. 4. This study should be repeated after revision of the curricular experience to document any changes in attitudes. A longitudinal study would be helpful, also, to ascertain whether or not time makes a difference in attitude change. 5. A research study in individual coping behaviors correlated with this study might give insights into attitude change of students. 6. This study could be refined and itemized by subject, rather than by groups and perhaps reveal some significant findings. 7. A study correlating attitude change of individual subjects with other measures of personality might make it possible to predict attitude change and plan for it more effectively in education and in practice.

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APPENDICES

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APPENDIX A ATTITUDE BEHAVIOR SCALEMENTAL RETARDATION

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69 ATTITUDE BEHAVIOR SCALE — MR DIRECTIONS This booklet contains statements of how people feel about certain things. In this section you are asked to indicate for each of these statements how most other people believe that mentally retarded people compare to people who are not retarded. Here is a sample statement. Sample 1 . 1. Chance of being blue-eyed 1. less chance 2. about the same 3. more chance If other people believe that mentally retarded people have less chance than most people to have blue eyes, you should circle the number 1 as shown above. If other people believe the mentally retarded have more chance to have blue eyes, you should circle the number 3 as shown below. 1. Chance of being blue-eyed 1. less chance 2 . about the same 3. more chance After each statement there will also be a question asking you to state how certain or sure you were of your answer . Suppose you answered the sample question about "blue eyes" by marking about the same . Next you should then indicate how sure you were of this answer. If you felt sure of this answer, you should cir c le the number 3 as shown in Sample 2. Sample 2 1. Chance of being blue-eyed 2. How sure are you of this answer? 1. less chance 1. not sure 2. about the same 2. fairly sure 3. more chance 3. sure Source: John E. Jordan, College of Education, Michigan State University.

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APPENDIX A (continued) 70 ABS-I-MR Directions : Section I In the statements that follow you are to circle the number that indicates how other people compare mentally retarded persons to those who are not mentally retarded, and then to state how sure you felt about your answer. Usually people are sure of their answers to some questions, and not sure of their answers to other questions. It is important to answer all questions, even though you may have to guess at the answers to some of them . Other people generally believe the following things about the mentally retarded as compared to those who are not retarded: Energy and vitality How sure are you of this answer? 1. less energetic 2 . about the same 3. more energetic 1. not sure 2. fairly sure 3 . sure Ability to do school work How sure are you of this answer? 1. less ability 2 . about the same 3. more ability 1. not sure 2. fairly sure 3. sure 5 . Memory How sure are you of this answer? 1. not as good 2 . same 3. better 1. not sure 2. fairly sure 3. sure 7. Interested in unusual sex practices 1. more interested 2. about the same 3. less interested How sure are you of this answer? 1 . not sure 2 . fairly sure 3 . sure 9. Can maintain a good marriage 10. How sure are you of this answer? 1. less able 2. about the same 3. more able 1 . not sure 2. fairly sure 3 . sure 11. Will have too many children 12. How sure are you of this answer? 1. more than most 2 . about the same 3. less than most 1. not sure 2. fairly sure 3 . sure

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71 APPENDIX A (continued) ABS-I-MR Other people generally believe the following things about the mentally retarded as compared to those who are not mentally retarded: 13. Faithful to spouse 1. less faithful 2. about the same 3. more faithful 14 . How sure are you of this answer? 1 . not sure 2. fairly sure 3 . sure 15. Will take care of their children 1. less than most 2. about the same 3. better than most 17. Likely to obey the law 1. less likely 2 . about the same 3. more likely 19. Does steady and dependable work 1. less likely 2 . about the same 3. more likely 21. Works hard 1 . not as much 2. about the same 3. more than most 16. How sure are you of this answer? 1 . not sure 2. fairly sure 3 . sure 18. How sure are you of this answer: 1 . not sure 2. fairly sure 3 . sure 20. How sure are you of this answer? 1. not sure 2. fairly sure 3. sure 22. How sure are you of this answer? 1. not sure 2 . fairly sure 3 . sure 23. Makes plans for the future 24. How sure are you of this answer: 1. not as likely 2. about the same 3. more likely 1. not sure 2 . fairly sure 3 . sure 25. Prefers to have fun now rather than to work for the future 1. more so than most people 2. about the same 3. less so than most people 26. How sure are you of this answer? 1 . not sure 2 . fairly sure 3. sure

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72 APPENDIX A (continued) ABS-I-MR Other people generally believe the following things about the mentally retarded as compared to those who are not retarded: 27. Likely to be cruel to others 1. more likely 2. about the same 3. less likely 28. How sure are you of this answer? 1. not sure 2. fairly sure 3. sure 29. Mentally retarded are sexually 1. more loose than others 2. about the same 3. less loose than others 30. How sure are you of this answer? 1 . not sure 2. fairly sure 3 . sure 31. Amount of initiative 32. How sure are you of this answer? 1. less than others 2. about the same 3 . more than others 1. not sure 2. fairly sure 3. sure 33. Financial self-support 34. How sure are you of this answer? 1. less able than others 2. about the same 3. more able than others 1. not sure 2 . fairly sure 3 . sure 35. Mentally retarded prefer 1. to be by themselves 2. to be only with normal people 3. to be with all people equally 36. How sure are you of this answer? 1. not sure 2 . fairly sure 3 . sure 38. How sure are you of this answer? 1. not sure 37. Compared to others, educa tion 1. is not very important 2. is of uncertain importance 2. fairly sure 3. is an important social 3. sure goal 39. Strictness of rules for mentally retarded 1. must be more strict 2 . about the same 3. need less strict rules 40. How sure are you of this answer? 1 . not sure 2. fairly sure 3 . sure

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73 APPENDIX A (continued) ABS-II-MR Directions : Section II This section contains statements of ways in which other people sometimes act toward people. You are asked to indicate for each of these statements what other people generally believe about interacting wit h the mentally retarded in such ways. You should then indicate how sure you feel about your answer. Other people generally believe that mentally retarded persons ought: 41. To play on the school playground with other children who are not mentally retarded 1. usually not approved 2. undecided 3. usually approved 42. How sure are you of this answer? not sure fairly sure sure 43. To visit in the homes of other children who are not mentally retarded 1. usually not approved 2. usually undecided 3. usually approved 44. How sure are you of this answer? 1. 2. 3. not sure fairly sure sure 45. To go on camping trips with other children who are not mentally retarded 1. usually not approved 2. undecided 3. usually approved 46. How sure are you of this answer? not sure fairly sure sure 47. To be provided with simple tasks since they can learn very little 1. usually believed 2. undecided 3. not usually believed 48. How sure are you of this answer? not sure fairly sure sure 49. To stay overnight at the homes of children who are not mentally retarded 1. usually not approved 2. undecided 3. usually approved 50. How sure are you of this answer? 1. not sure 2. fairly sure 3 . sure

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74 APPENDIX A (continued ABS-II-MR Other people generally believe that mentally retarded persons ought: 51. To go to parties with other children who are not mentally retarded 1. usually not approved 2. undecided 3. usually approved 53. To be hired for a job only if there are no qualified non-mental ly retarded people seeking the job 1. usually approved 2. undecided 3. usually not approved 55. To live in the same neighborhood with people who are not mentally retarded 1. usually not approved 2. undecided 3. usually approved 52. How sure are you of this answer? 1. not sure 2 . fairly sure 3. sure 54. How sure are you of this answer? not sure fairly sure sure 56. How sure are you of this answer? not sure fairly sure sure • 57. To date a person who is not mentally retarded 1. usually not approved 2. undecided 3. usually approved 59. To go to the movies with someone who is not mentally retarded 1. usually not approved 2. undecided 3. usually approved 61. To marry a person who is not mentally retarded 1. usually not approved 2. undecided 3. usually approved 58. How sure are you of this answer? not sure fairly sure sure 60. How sure are you of this answer? 1. not sure 2 . fairly sure 3. sure 62. How sure are you of this answer? 1 . not sure 2. fairly sure 3. sure

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75 APPENDIX A (continued) ABS-II-MR Other people generally believe that mentally retarded persons ought: 63. To be sterilized (males) 64. How sure are you of this answer? 1. usually approved 2. undecided 3. usually not approved not sure fairly sure sure 65. To be sterilized (females) 66. How sure are you of this answer? 1. usually approved 2. not sure 3. usually not approved 1. 2. 3. not sure fairly sure sure 67. To be desirable as friends 68. How sure are you of this answer? 1. not usually approved 1. 2. not sure 2. 3. usually approved 3. 69. To be regarded as having sex 70. appeal 1. not usually so 1. 2. not sure 2. 3. usually so 3. not sure fairly sure sure How sure are you of this answer? not sure fairly sure sure 71. To be regarded as dangerous 72. How sure are you of this answer? 1. usually so regarded 1. not sure 2. not sure 2. fairly sure 3. not usually regarded so 3. sure 73. To run machines that drill 74 holes in objects 1. usually not approved 1. not sure 2. not sure 2. fairly sure 3. usually approved 3. sure How sure are you of this answer? 75. To be trusted with money for personal expenses 1. not usually so 2. not sure 3. usually so 76. How sure are you of 'this answer? 1. 2. 3. not sure fairly sure sure

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76 APPENDIX A (continued) ABS-II-MR Other people generally believe that mentally retarded persons ought: 77. To work at jobs he can do even if he has almost no speech 1. not usually so 2. not sure 3. usually so 78. How sure are you of this answer? 1. not sure 2. fairly sure 3 . sure 79. To be forced to totally provide for themselves 1. usual 2. not sure 3. not usual 80. How sure are you of this answer? 1. not sure 2. fairly sure 3. sure

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APPENDIX A (continued) ABS-III-MR 77 Directions : Section III This section contains statements of the "right" or "moral" way of acting toward people. You are asked to indicate whether you yourself agree or disagree with each statement according to ho'w you personally believe you ought to behave toward mentally retarded persons . You should then indicate how sure you feel about your answer. In respect to people who are mentally retarded, do you believe that it is usually right or usually wrong : To take a mentally retarded child on a camping trip with normal children 1. usually wrong 2. undecided 3. usually right 82. How sure are you of this answer? 1. 2. 3. not sure fairly sure sure 83. To permit a mentally retarded child to go to the movies with children who are not mentally retarded 1. usually wrong 2. undecided 3. usually right 84. How sure are you of this answer? not sure fairly sure sure 85. To allow a mentally retarded 86. child to visit overnight with a child who is not mentally retarded 1. usually wrong 2. undecided 3. usually right How sure are you of this answer? not sure fairly sure sure 87. To take a mentally retarded 8£ child to a party with children who are not mentally retarded 1. usually wrong 2. undecided 3. usually right How sure are you of this answer? not sure fairly sure sure 89. For the government to pay 90, part of the cost of elementary education for mentally retarded children 1. usually wrong 2. undecided 3. usually right How sure are you of this answer? not sure fairly sure sure

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78 APPENDIX A (continued) ABS-III-MR In respect to people who are mentally retarded, do you believe that it is usually right or usually wrong : 91. For the government to pay the full cost of elementary education for mentally retarded children 1. usually wrong 2. undecided 3. usually right 92. How sure are you of this answer? 93. For the government to pay the full cost of a high school education for mentally retarded children 1. usually wrong 2 . undecided 3. usually right not sure fairly sure sure 94. How sure are you of this answer? not sure fairly sure sure 95. For the government to pay part of the medical costs related to the disability 1. usually wrong 2. undecided 3. usually right 96. How sure are you of this answer? 1 . not sure 2. fairly sure 3 . sure 97. For the government to pay all of the medical costs related to the disability 1. usually wrong 2. undecided 3. usually right 99. To be given money for food and clothing by the government 1. usually wrong 2. undecided 3. usually right How sure are you of this answer? 1. not sure 2. fairly sure 3 . sure 100 . How sure are you of this answer^ 1. 2. 3. not sure fairly sure sure 101. To mix freely with people who are not mentally retarded at parties 1. usually wrong 2. undecided 3. usually right 102. How sure are you of this answer? not sure fairly sure sure

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79 APPENDIX A (continued) ABS-III-MR In respect to people who are mentally retarded, do you believe that it is usually right or usually wrong : 103. To go on dates with someone 104. How sure are you of this answer? who is not mentally retarded 1. usually wrong 1. not sure 2. undecided 2. fairly sure 3. usually right 3. sure 105. To go to the movies with 106. How sure are you of this answer? someone who is not mentally retarded 1. usually wrong 1. not sure 2. undecided 2. fairly sure 3. usually right 3. sure 107. To marry someone who is not 108. How sure are you of this answer? mentally retarded 1. usually wrong 1. not sure 2. undecided 2. fairly sure 3. usually right 3. sure 109. To be a soldier in the army 1. usually wrong 2. undecided 3. usually right 110. How sure are you of this answer? 1 . not sure 2. fairly sure 3 . sure 111. To provide special laws for their protection 1. usually wrong 2. undecided 3. usually right 112. How sure are you of this answer? 1. not sure 2. fairly sure 3 . sure 113. To provide special help to get around the city 1. usually wrong 2. not sure 3. usually right 114. How sure are you of this answer? 1 . not sure 2 . fairly sure 3 . sure 115. To sterilize the mentally retarded 1. usually right 2. not sure 3. usually right 116. How sure are you of this answer? 1 . not sure 2 . fairly sure 3 . sure

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80 APPENDIX A (continued) ABS-III-MR In respect to people who are mentally retarded, do you believe that it is usually right or usually wrong : 117. 119, To put all mentally retarded 118. How sure are you of this answer? in separate classes, away from normal children 1. usually right 1. not sure 2. not sure 2. fairly sure 3. usually wrong 3. sure To reserve certain jobs for the mentally retarded 1. usually wrong 2. not sure 3. usually right 120. How sure are you of this answer? 1. not sure 2. fairly sure 3 . sure

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APPENDIX A (continued) ABS-IV-MR Directions : Section IV This section contains statements of ways in which people sometimes act toward other people. You are asked to indicate for each of these statements whether you personally would act toward mentally retarded people according to the statement. You should then indicate how sure you feel about this answer. In respect to a mentally retarded person, would you: 121. Share a seat on a train for a long trip 1. no 2 . don ' t know 3. yes 122. How sure are you of this answer? 1. not sure 2. fairly sure 3. sure 123. Have such a person as a fellow worker 1. no 2 . don ' t knov; 3. yes 124. How sure are you of this answer? 1 . not sure 2 . fairly sure 3 . sure 125. Have such a person working 126. How sure are you of this answer? for you 1 . no 1 . not sure 2. don't know 2. fairly sure 3 . yes 3 . sure 127. Live in the next-door house 128. How sure are you of this answer? or apartment 1no 1. not sure 2. don't know 2. fairly sure 3. yes 3. sure 129. Extend an invitation to a 130. How sure are you of this answer? party at your house 1. no 1. not sure 2. don't know 2. fairly sure 3. yes 3. sure 131. Accept a dinner invitation 132. How sure are you of this answer? at his house 1. no 1. not sure 2. don't know 2. fairly sure 3. yes 3. sure

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82 APPENDIX A (continued) ABS-IV-MR In respect to a mentally retarded person, would you : 133. Go to the movies together 134. How sure are you of this answer? 1. no 2 . don ' t know 3. yes 1. 2. 3. not sure fairly sure sure 135. Go together on a date 136. How sure are you of this answer: 1. no 2. don't know 3. yes 1. 2. 3. not sure fairly sure sure 137. Permit a son or daughter to date this person 1. no 2 . don ' t know 3. yes 138. How sure are you of this answer? 1. 2. 3. not sure fairly sure sure 139. Permit a son or daughter to marry this person

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APPENDIX A (continued) ABS-IV-MR In respect to a mentally retarded person, would you : 147. Enjoy working with mentally 148 retarded who also have emotional problems 1 . no 2 . don ' t know 3 . yes 149. Hire the mentally retarded if you were an employer 1. no 2 . don ' t know 3. yes 151. Want the mentally retarded in your class if you were a teacher 1 . no 2. don't know 3 . yes How sure are you of this answer? 1. 2. 3. not sure fairly sure sure 150. How sure are you of this answer? 1. not sure 2. fairly sure 3 . sure 152. How sure are you of this answer? 153. Require the mentally retarded to be sterilized if you were in control 1. yes 2. don't know 3. no 155. Separate the mentally retarded from the rest of society if you were in control 1. yes 2 . don ' t know 3. no 157. Believe that the care of the 15J mentally retarded is an evidence of national social development 1 . no 2 . don ' t know 3 . yes 1. not sure 2 . fairly sure 3 . sure 154. How sure are you of this answer? 1 . not sure 2 . fairly sure 3. sure 156. How sure are you of this answer? 1. not sure 2. fairly sure 3 . sure How sure are you of this answer? not sure fairly sure sure

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84 APPENDIX A (continued) ABS-IV-MR In respect to a mentally retarded person, would you : 159. Provide, if you could special classes for the mentally retarded in regular school 1. no 2 . don ' t know 3. yes 160. How sure are you of this answer? 1. not sure 2 . fa: rly sure 3. sure

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APPENDIX A (continued Directions : Section V ABS-V-MR This section contains statements of actual feelings that people may hold toward the mentally retarded. You are asked to indicate how you feel toward people who are mentally retarded compared to people who are not mentally retarded. You should then indicate how sure you feel of your answer. How do you actually feel toward persons who are mentally retarded compared to others who are not mentally retarded: 1. Disliking How sure are you of this answer? 1 . more 2. about the same 3. less 1. not sure 2. fairly sure 3. sure Fearful How sure are you of this answer? 1 . more 2. about the same 3. less 1. not sure 2 . fairly sure 3 . sure 5. Horrified 6. How sure are you of this answer? 1 . more 2. about the same 3. less 1. not sure 2 . fairly sure 3 . sure Loathing How sure are you of this answer? 1 . more 2 . about the same 3. less 1. not sure 2. fairly sure 3 . sure 9. Dismay 10. How sure are you of this answer? 1 . more 2 . about the same 3. less 1 . not sure 2 . fairly sure 3. sure 11. Hating 12. How sure are you of this answer? more about the same less 1. not sure 2. fairly sure 3. sure

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APPENDIX A (continued) ABS-V-MR How do you actually feel toward persons who are mentally retarded compared to others who are not mentally retarded: 86 13. Revulsion 14. How sure are you of this answer? 1 . more 2. about the same 3. less not sure fairly sure sure 15. Contemptful 16. How sure are you of this answer? 1. more 2. about the same 3. less 1. 2. 3. not sure fairly sure sure 17. Distaste 18. How sure are you of this answer? 1 . more 2 . about the same 3. less not sure fairly sure sure 19. Sickened 20. How sure are you of this answer? 1 . more 2. about the s
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87 APPENDIX A (continued) ABS-V-MR How do you actually feel toward persons who are mentally retarded compared to others who are not mentally retarded: 27. Restless 28. How sure are you of this answer? 1 . more 2. about the same 3. less 1. not sure 2. fairly sure 3. sure 29. Uncomfortable 30. How sure are you of this answer? more about the same less 1 . not sure 2. fairly sure 3. sure 31. Relaxed 32. How sure are you of this answer? 1. less 2 . about the same 3 . more 1. not sure 2. fairly sure 3 . sure 33. Tense 34. How sure are you of this answer? 1 . more 2 . about the same 3. less 1. not sure 2. fairly sure 3 . sure 35. Bad 36. How sure are you of this answer? more about the same less 1 . sure 2. fairly sure 3. sure 37. Calm 38. How sure are you of this answer? 1. less 2. about the same 3 . more 1. not sure 2. fairly sure 3 . sure 39. Happy 40. How sure are you of this answer? 1. less 2. about the same 3 . more 1. not sure 2 . fairly sure 3. sure

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APPENDIX A (continuedO ABS-VI-MR Directions: Section VI This section contains statements of different kinds of actual experiences you have had with mentally retarded persons. If the statement applies to you, circle yes . If not, you should circle no . 41. Shared a seat on a bus, train or plane 1. no 2. uncertain 3. uncertain 42. Has this experience been mostly pleasant or unpleasant? 1 . no such experience 2. unpleasant 3 . in between 4. pleasant 43. Eaten at the same table together in a restaurant 1. no 2. uncertain 3. yes 44 . Has this experience been mostly pleasant or unpleasant? 1. no such experience 2 . unpleasant 3. in between 4 . pleasant 45. Lived in the same neighborhood 46, 1. no 2. uncertain 3. yes Has this experience been mostly pleasant or unpleasant? 1. no such experience 2. unpleasant 3 . in between 4 . pleasant 47. Worked in the same place 1. no 2. uncertain 3 . yes 48. Has this experience been mostly pleasant or unpleasant? 1. no such experience 2 . unpleasant 3 . in between 4. pleasant 49. Had such a person as my boss 50, or employer 1. no 2 . uncertain 3. yes Has this experience been mostly pleasant or unpleasant? 1 . no such experience 2. unpleasant 3 . in between 4. pleasant 51. Worked to help such people without being paid for it 1. no 2 . uncertain 3. yes 52. Has this experience been mostly pleasant or unpleasant? 1. no such experience 2. unpleasant 3 . in between 4. pleasant

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89 APPENDIX A (continued) Experiences or contacts with the mentally retarded: ABS-VI-MR 53. Have acquaintance like this 54, 1 . no 2. uncertain 3. yes 55. Have good friends like this 56, 1. no 2. uncertain 57. Donated money, clothes, etc., 58. for people like this 1. no 2. uncertain 3. yes 59. Have a husband (or wife) like 60. this 1 . no 2. uncertain 61. I am like this, myself 62, 1. no 2. uncertain 3. yes 63. My best friend is like this 64 1. no 2. uncertain 3. yes Has this experience been mostly pleasant or unpleasant? 1. no such experience 2. unpleasant 3. in between 4. pleasant Has this experience been mostly pleasant or unpleasant? 1. no such experience 2 . unpleasant 3. in between 4. pleasant Has this experience been mostly pleasant or unpleasant? 1 . no such experience 2. unpleasant 3. in between 4 . pleasant Has this experience been mostly pleasant or unpleasant? 1. no such experience 2. unpleasant 3. in between 4. pleasant Has this experience been mostly pleasant or unpleasant? 1. no such experience 2. unpleasant 3. in between 4. pleasant Has this experience been mostly pleasant or unpleasant? 1 . no such experience 2. unpleasant 3. in between 4. pleasant

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APPENDIX A (continued) ABS-VI-MR Experiences or contacts with the mentally retarded: 90 65. Received pay for working with people like this 1 . yes 2 . no 66. Has thie experience been mostly pleasant or unpleasant? 1. no such experience 2 . unpleasant 3. in between 4. pleasant 67. My children have played with 68. children like this 1. no 2. uncertain 3. yes 69. My children have attended 70. school with children like this 1. no 2 . uncertain 3. yes 71. Voted for extra taxes for 72. their education 1 . no 2. not certain 3. yes 73. Worked to get jobs for them 74, 1. no 2. not certain 3. yes Has thie experience been mostly pleasant or unpleasant? 1 . no such experience 2. unpleasant 3. in between 4. pleasant Has thie experience been mostly pleasant or unpleasant 1. no such experience 2. unpleasant 3 . in between 4. pleasant Has this experience been mostly pleasant or unpleasant? 1. no such experience 2. unpleasant 3 . in between 4. pleasant Has this experience been mostly pleasant or unpleasant? 1. no such experience 2. unpleasant 3. in between 4. pleasant 75. Have you sexually enjoyed such 76. people 1. no 2. no answer 3 . yes Has this experience been mostly pleasant or unpleasant? 1. no such experience 2 . unpleasant 3. in between 4. pleasant

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APPENDIX A (continued) ABS-VI-MR Experiences or contacts with the mentally retarded: 91 77. Studied about such people 1 . no 2. yes 79. Have worked as a teacher with such people 1. no 2. yes 78. Has this experience been mostly pleasant or unpleasant? 1. no such experience 2. unpleasant 3. in between 4. pleasant 80. Has this experience been mostly pleasant or unpleasant? 1 . no such experience 2. unpleasant 3. in between 4. pleasant

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92 APPENDIX A (continued) ABS-VII-MR* This part of the booklet deals with many things. For the purpose of this study, the answers of all persons are important . Part of the questionnaire, has to do with personal information about you. Since the questionnaire is completely ano n ymous or confidential , you may answer all of the questions freely without any concern about being identified. It is important to the study to obtain your answer to every question . Please read each question carefully and do not omit any questions. Please answer by circling the answer you choose. 81. Please indicate your sex. 1. Female 2. Male 82. Please indicate your age as follows: 1. 20 years of age 2. 21-30 3. 31-40 4. 41-50 5. 50 over 83. Below are listed several different kinds of schools or educational divisions. In respect to these various kinds or levels of education, which one ha v e you had the most professional or work experience with, or do you have the mo s t knowledge about ? This does not refer to yo u r own education , but to your professional work or related experiences with education. 1. I have had no such experience 2. Elementary school (Grade school) 3. Secondary school (High school) 4. College or University *Subscale VII not identified by number in original instrument developed by Jordan.

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93 APPENDIX A (continued) ABS-VII-MR 84. What is your marital status? 1. Married 2. Single 3. Divorced 4 . Widowed 5. Separated 85. What is your religion? 1. I prefer not to answer 2. Catholic 3. Protestant 4 . Jewish 5. Other or none 86. About how important is your religion to you in your daily life? 1. I prefer not to answer 2. I have no religion 3. Not very important 4. Fairly important 5 . Very important 87. About how much education do you have? 1. 6 years of school or less 2. 9 years of school or less 3. 12 years of school or less 4. Some college or university 5. A college or university degree

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94 APPENDIX A (continued) ABS-VII-MR 88. Some people are more set in their ways than others. How would you rate yourself? 1. I find it very difficult to change 2. I find it slightly difficult to change 3. I find it somewhat easy to change 4. I find it very easy to change my ways 89. Some people feel that in bringing up children, new ways and methods should be tried whenever possible. Others feel that trying out new methods is dangerous. What is your feeling about the following statement? "New methods of raising children should be tried out whenever possible. " 1. Strongly disagree 2. Slightly disagree 3. Slightly agree 4. Strongly agree 90. Family planning on birth control has been discussed by many people. What is your feeling about a married couple practicing birth control? Do you think they are doing something good or bad? If you had to decide, would you say that they are doing wrong, or that they are doing right? 1. It is always wrong 2. It is usually wrong 3. It is probably all right 4. It is always right

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95 APPENDIX A (continued) ABS-VII-MR 91. People have different ideas about what should be done concerning automation and other new ways of doing things. How do you feel about the following statement? "Automation and similar new procedures should be encouraged (in government, business, and industry) since eventually they create new jobs and raise the standard of living." 1. Strongly disagree 2. Slightly disagree 3. Slightly agree 4. Strongly agree 92. Running a village, city, town, or any governmental organization is an important job. What is your feeling on the following statement? "Political leaders should be changed regularly, even if they are doing a good job." 1. Strongly disagree 2. Slightly disagree 3. Slightly agree 4. Strongly agree 93. Some people believe that more local government income should be used for education even if doing so means raising the amount you pay in taxes. What are your feelings on this? 1. Strongly disagree 2. Slightly disagree 3. Slightly agree 4. Strongly agree

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96 APPENDIX A (continued) ABS-VII-MR 94. Some people believe that more federal government income should be used for education even if doing so means raising the amount you pay in taxes. What are your feelings on this? 1. Strongly disagree 2. Slightly disagree 3. Slightly agree 4. Strongly agree 95. People have different ideas about planning for education in their nation. Which one of the following do you believe is the best way? 1. Educational planning should be primarily directed by the church 2. Planning for education should be left entirely to the parents 3. Educational planning should be primarily directed by the individual city or other local governmental unit 4. Educational planning should be primarily directed by the national government 96. In respect to your religion, about to what extent do you observe the rules and regulations of your religion? 1. I prefer not to answer 2. I have no religion 3. Sometimes 4. Usually 5. Almost always 97. I find it easier to follow rules than to do things on my own. 1. Agree strongly 2. Agree slightly 3. Disagree slightly 4. Disagree strongly

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97 APPENDIX A (continued) ABS-VIII-MR * QUESTIONNAIRE : HP This part of the questionnaire deals with your experiences or contacts with handicapped persons. Perhaps you have had much contact with handicapped persons, or you may have studied about them. On the other hand, you may have had little or no contact with handicapped persons, and may have never thought much about them at all. 98. Some handicapped conditions are listed below. In respect to these various handicaps, with which one have you had the most actual experience ? 1. blind and partially blind 2. deaf, partially deaf, or speech impaired 3. crippled or spastic 4. mental retardation 5. social or emotional disorders In the following questions, 99 through 103, you are to refer to the category of the handicapped persons you have just indicated. 99. The following questions have to do with the kinds of experiences you have had with the category of handicapped person you indicated in the previous question. If more than one category of experience applies, please choose the answer with the highest number. 1. I have read or studied about handicapped persons through reading, movies, lectures, or observations 2. A friend or relative is handicapped 3. I have personally worked with handicapped persons as a teacher, counselor, volunteer, child care, etc. 4. I, myself, have a fairly serious handicap "Subscale VIII not identified by number in original instrument developed by Jordan.

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98 APPENDIX A (continued) ABS-VIII-MR 100. Considering all of the times you have talked, worked, or in some other way had personal contact with the category of handicapped persons indicated in question 98, about how many times has it been altogether? 1. Less than 10 occasions 2. Between 10 and 50 occasions 3. Between 50 and 100 occasions 4. Between 100 and 500 occasions 5. More than 500 occasions 101. When you have been in contact with this category of handicapped people how easy for you, in general, would it have been to have avoided being with these handicapped persons? 1. I could not avoid the contact 2. I could generally have avoided these personal contacts only at great cost or difficulty 3. I could generally have avoided these personal contacts only with considerable difficulty 4. I could generally have avoided these personal contacts but with some inconvenience 5. I could generally have avoided these personal contacts without any difficulty or inconvenience 102. During your contact with this category of handicapped persons, did you gain materially in any way through these contacts, such as being paid, or gaining academic credit, or some such gain? 1. No, I have never received money, credit, or any other material gain 2. Yes, I have been paid for working with handicapped persons 3. Yes, I have received academic credit or other material gain 4. Yes, I have both been paid and received academic credit

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99 APPENDIX A (continued) ABS-VIII-MR 103. If you have been paid for working with handicapped persons, about what percent of your income was derived from contact with handicapped persons during the actual period when working with them? 1. No work experience 2. Less than 25% 3. Between 26 and 50% 4. Between 51 and 75% 5. More than 76% 104. If you have ever worked with any category of handicapped persons for personal gain (for example, for money or some other gain), what opportunities did you have (or do you have) to work at something else instead; that is, something else that was (or is) acceptable to you as a job? 1. No such experience 2. No other job was available 3. Other jobs available were not at all acceptable to me 4. Other jobs available were not quite acceptable to me 5. Other jobs available were fully acceptable to me 105. Have you had any experience with mentally retarded persons? Considering all of the times you have talked, worked, or in some other way had personal contact with mentally retarded persons, about how many times has it been altogether? 1. Less than 10 occasions 2. Between 10 and 50 occasions 3. Between 50 and 100 occasions 4. Between 100 and 500 occasions 5. More than 500 occasions

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100 APPENDIX A (continued) ABS-VIII-MR 106. How have you generally felt about your experiences with mentally retarded persons? 1 . No experience 2. I definitely disliked it 3. I did not like it very much 4. I liked it somewhat 5. I definitely enjoyed it

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101 APPENDIX A (continued) ABS-IX-MR* LIFE SITUATIONS This section of the booklet deals with how people feel about several aspects of life or life situations. Please indicate how you feel about each situation by circling the answer you choose. 107. It should be possible to eliminate war once and for all 1. strongly disagree 2. disagree 3. agree 4. strongly agree 109. Success depends to a large part on luck and fate 1. strongly agree 2 . agree 3. disagree 4. strongly disagree 111. Some day most of the mysteries of the world will be revealed by science 1. strongly disagree 2. disagree 3. agree 4. strongly agree 113. By improving industrial and agricultural methods, poverty can be eliminated in the world 1. strongly disagree 2. disagree 3. agree 4. strongly agree 108. How sure do you feel about your answer? 1. not sure at all 2. not very sure 3. fairly sure 4. very sure 110. How sure do you feel about your answer? 1. not sure at all 2. not very sure 3. fairly sure 4. very sure 112. How sure do you feel about your answer? 1. not sure at all 2. not very sure 3. fairly sure 4. very sure 114. How sure do you feel about your answer? 1. not sure at all 2 . not very sure 3. fairly sure 4. very sure *Subscale IX not identified by number in original instrument developed by Jordan.

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APPENDIX A (continued) ABS-IX-MR 102 115. With increased medical knowledge it should be possible to lengthen the average life span to 100 years or more 1. strongly disagree 2. disagree 3. agree 4. strongly agree 116. How sure do you feel about your answer? 1. not sure at all 2. not very sure 3. fairly sure 4 . very sure 117. Someday the deserts will be converted into good farming land by the application of engineering and science 1. strongly disagree 2 . disagree 3. agree 4. strongly agree 118. How sure do you feel about your answer? 1. not sure at all 2 . not very sure 3. fairly sure 4 . very sure 119. Education can only help 120, people develop their natural abilities; it cannot change people in any fundamental way 1. strongly agree 1. 2. agree 2. 3. disagree 3. 4. strongly disagree 4. How sure do you feel about your answer? not sure at all not very sure fairly sure very sure 121. With hard work anyone can succeed 1. strongly disagree 2. disagree 3. agree 4. strongly agree 122 . How sure do you feel about your answer? 1. not sure at all 2 . not very sure 3. fairly sure 4. very sure 123. Almost every present human problem will be solved in the future. 1. strongly disagree 2. disagree 3 . agree 4. strongly agree 124. How sure do you feel about your answer? 1. not sure at all 2. not very sure 3. fairly sure 4. very sure

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103 APPENDIX A (continued) ABS-X-MR * MENTAL RETARDATION This section of the questionnaire deals with information about mental retardation. Please circle your answer. 1 125. Which of the following is a preferred method of educating mentally handicapped children: 1. to give the child work he can do with his hands (handicraft, weaving) . 2. to place the child in a vocational training school 3. to make the program practical and less academic 4. to present the same material presented to the average child but allowing more time for practice. 126. In educating the mentally handicapped (iq 50-75) child, occupational training should begin: 1. upon entering high school 2. the second year of high school 3. the last year of high school 4. when the child enters school 127. The major goal of training the mentally handicapped is: 1 . social adequacy 2. academic proficiency 3. occupational adequacy 4. occupational adjustment 128. Normal children reject mentally handicapped children because: 1. of their poor learning ability 2. of unacceptable behavior 3. they are usually dirty and poor 4. they do not "catch on" 129. The emotional needs of mentally handicapped are: 1. stronger than normal children 2. the same as normal children 3. not as strong as normal children 4. nothing to be particularly concerned with "Correct" answers are circled on key. *Subscale X not identified by number in original instrument developed by Jordan.

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104 APPENDIX A (continued) ABS-X-MR 130. The proper placement for the slow learner (IQ 75-90) is in: 1. the regular classroom 2. special class 3. vocational arts 4. regular class until age of 16 and then dropped out of school 131. In school, the slow learner usually: 1. is given a lot of successful experiences 2. meets with a great many failures 3. is a leader 4. is aggressive 132. In grading the slow learner, the teacher should: 1. be realistic, if the child is a failure, fail him 2. grade him accordingto his achievement with relation to his ability 3. not be particularly concerned with a grade 4. grade him according to his IQ 133. The studies with regard to changing intelligence of pre-school children indicate that: 1. intellectual change may be accomplished 2 . no change can be demonstrated 3. change may take place more readily with older children 4. the IQ can be increased at least 20 points if accelerated training begins early enough 134. The development and organization of a comprehensive educational program for the mentally handicapped is dependent upon: 1. adequate diagnoses 2. proper training facilities 3. a psychiatrist 4. parent-teacher organizations 135. The mentally handicapped are physically: 1. markedly taller 2. markedly shorter 3. heavier 4. about the same as the average child of the same age

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105 APPENDIX A (continued) ABSX -MR 136. The mentally handicapped child: 1. looks quite different from other children 2. is in need of an educational program especially designed for his needs and characteristics 3. can never be self-supporting 4. cannot benefit from any educational program 137. The mentally handicapped individual usually becomes: 1. a skilled craftsman 2. a professional person 3. a semi-skilled laborer 4. unemployable 138. The educationally handicapped have: 1. at least average intelligence 2. superior intelligence only 3. always have retarded intelligence 4. may have somewhat retarded, average, or superior intelligence 139. The mentally handicapped have: 1. markedly inferior motor development 2. superior motor development 3. superior physical development 4. about average motor development 140. The reaction of the public toward the retarded child seems to be: 1. rejecting 2. somewhat understanding but not completely accepting 3. accepting 4. express feelings of acceptance but really feel rejecting

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APPENDIX B COURSE OUTLINE

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107 UNIVERSITY OF FLORIDA COLLEGE OF NURSING Nursing 340 Pediatric Nursing Sunland Rotation We wish to welcome you to a unique, at times frustrating, and hopefully a rewarding and meaningful experience. You will be working with children who are first of all children with all the basic needs of all children, who also have handicaps (mental, orthopedic, visual, auditory, and emotional) . Although you may not see the results of what you do for these children during the two short weeks that you are at Sunland, your nursing care, together with that of all the other students who preceded or follow you, will greatly influence the lives of these children. Through your efforts, they can learn to trust and relate to people, develop the potential that they have and lead richer, happier lives. Our major objectives can only be evaluated in the years to come and by you. We hope that you will: 1. Learn to evaluate, care for, and communicate with mentally handicapped individuals on the basis of their level of developmental functioning regardless of chronological age. 2. Lose any stereotypes that you may have of the mentally retarded. 3. Gain an appreciation of the problems and needs of handicapped children and their families. 4. Apply the knowledge and skills that you acquire in the care of future mentally and physically handicapped patients that you may care for in the hospital and the community. UNIT OBJECTIVES ; The student will be able to: 1. Assess the development, behavior and health of children with handicaps. 2. Develop objectives based on the above assessment. 3. Implement nursing intervention and activity programs to attain nursing objectives and evaluate results .

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108 APPENDIX B (continued) 4. Communicate with children on their level of development. 5. Function as a contributing member of the nursing team and the interdisciplinary team. UNIT REQUIREMENTS : A. Pass-Fail Requirements: 1. Spend a minimum of 12 hours weekly in laboratory practice in Willow Cottage. Schedules are to be arranged with instructor. 2. Make a nursing assessment of one child, revise nursing objectives and orders as required, and implement orders. 3. Carry out assigned orders for three other children . 4. Write progress note (maximum length 1/2 page) on major assignment (see #2 above) and on other children if indicated at end of second week. 5. Attend weekly interdisciplinary team conferences. (Tuesday 10:00-11:00) 6. Present one child in nursing seminar. Presentation will include social and medical aspect, nursing assessment, pertinent information from other discipline assessments, and plan of care. Each student will choose one of the following : B. Paper or Project 15% of course grade Paper Select one of the following topics for study and written presentation. For each paper you are expected to review the literature, state your position or conclusions, and discuss the implications for nursing. Don't be afraid to express your own ideas, but do support your statements with readings, your own observations, or other source materials. Papers are due two weeks after leaving Sunland, with one exception—papers for final group are due one week after leaving.

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109 APPENDIX B (continued) PROJECT: Identify and discuss at least 5 basic psychological needs of mentally retarded children that are synonymous with those of children of normal intelligence . State and defend your position on the question, "Should Mentally Retarded Children be Institutionalized?" At least two references should be from literature written since 1950. Identify at least 4 areas in cottage life of mentally retarded children where nurses could develop and implement programs to improve the health of the children. Plan and describe one of these programs. Identify at least 3 areas in cottage life of mentally retarded children where nurses could develop and implement programs to improve the opportunities for growth and development. Plan and describe one of these programs. Define the role of nursing in the care of the mentally retarded child in an institution. Include (1) health standards, (2) growth and development, and (3) service education for institutional staff. Discuss possible areas of stress and conflict in a family with a mentally retarded child (1) while the child is in the family, (2) when decision is made to institutionalize the child, and (3) after institutionalization. You may choose a project as an alternative to the paper. Your objectives must be approved by the instructor before starting work on the project. Just to give you an idea of what is possible, below are some of the projects that we have thought about. We are sure that you can think of dozens more. Projects should have theoretical base. Project reports are due the final week of classes. 1. Materials and methods for providing sensory and tactile stimulation to blind or deaf-blind children.

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110 APPENDIX B (continued) 2. Development of safe durable play materials from common objects which are designed to promote specific developmental skills. 3. Teaching a deaf child to communicate through the use of sign language. 4. Situational doll play program for an emotionally disturbed child. SUGGESTIONS: If you have small portable tape recorders and radios, you will find them very helpful in working with almost all of the children. DRESS CODE: You may wear uniforms if you wish, but, we prefer that you wear sport dresses or pant suits. (No shorts, sweat shirts, halters, etc.) Please wear your name tag any time you are in the cottage. FINAL NOTE: Carol Wilson and I want to help you in every way possible. Please don't hesitate to let us know if you need help with assignments, need to talk out some of your feelings about your experiences or whatever. Amanda Baker Office: Home : 392-6848 468-1656 5/24/74

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Ill APPENDIX B (continued) BIBLIOGRAPHY All University Libraries are sources for reading materials related to mental retardation. The libraries in Norman Hall, on 3rd floor, and in basement, Room 43, plus the Health Center Library are especially good. There are many books in my office for students' use also. The following are just suggestions to get you started. Barnard, Kathryn (Editor) . "Symposium on Mental Retardation," Nursing Clinics of North America , Philadelphia, December, 1966. Barnard, Kathryn. "Teaching the Retarded Child is a Family Affair," American Journa l of Nursing , 1968, 68, 305-311. Barnard, Kathryn and Mallene Powell Teaching the Men tally Retarded Child: A Family Approach . St. Louis: C.V. Mosby, 1972 (On Reserve — Health Center Library) . Baumeister, Alfred. Mental Retardation . New York: Aldine Publishing Co., 1967. Blatt, Burton. Exodus From Pandemonium . Boston, Mass: Allyn and Bacon, Inc . , 1970 . Boyd, D. "The Three Stages in the Growth of a Parent of a Mentally Retarded Child," American Journal of Mental Deficiency , 1951, 55, 608-611. Caldwell, Bettye and Samuel Geize. "A Study of the Adjustments of Parents and Siblings of the Institutionalized and Non-institutionalized Retarded Children," American Journal of Mental Deficiency , 1960, 64, 845-861"! *Carver, J.N. and N.E. Carver. The Family of the Retarded Child. Syracuse: University Press, 1972 . Cruickshank, W.M. (Editor). Cerebral Palsy . Syracuse: University Press, 1966. Farber, Barnard. "Family Organization and Crisis: Maintenance of Integration in Families with a Severely Mentally Retarded Child," Society for Research and Child Development, Monograph, 196 0.

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112 APPENDIX B (continued) Farber, Bernard. "Effects of a Severely Retarded Child on Family Integration," Society for Research and Child Development , Monograph, 1959. Forbes, L. "Some Psychiatric Problems Related to Mental Retardation," American Journal o f Mental D eficiency , 1958, 62, 637-641. Grebler, A.M. "Parental Attitudes Toward Mentally Retarded Children," American Journal of Menta l Deficiency , 1952, 56, 475-483. Grossman, Frances. Brothers and Sisters of Retarded Children: An Exploratory Study . Syracuse: University Press, 1972. Heitt, M.L. and R.G. Gibby. The Mentally Retarded Child, Development, Education and Treatment . 2nd Edition. Boston, Mass: Allyn and Bacon, 1965. *Koch, Richard and James Dobson. The Mentally Retarded Child and His Family . New York: Brunner/Mazel , 1972. Lippman, Leopold D. Attitudes Toward the Handicapped . Springfield, Illinois: Charles C. Thomas, 1972. *Provence, Sally and R.C. Lipton. Infants in Institutions . New York City: International University Press, 1962. *Robinson, H.B. and N.M. Robinson. The Mentally Retarded Child . New York: McGraw-Hill Book Company, 1965. Salnit, A.J. and M.H. Stark. "Mourning and the Birth of a Defective Child," Psychoanalytic Study of the Child , 1961, 16, 523-537. Stevens, H. and R. Helber (Editors). Mental Retardation . New York: Holt, Rinehardt , and Winston, 1971. *Wolff, Use. Nursing Role in Counseling Parents of Men tall y Retarded Children . Washington: U.S. Department of Health, Education and Welfare, Children's Bureau, 1964. *Wright, Beatrice A. Physical Disability--A Psychological Approach . New York: Harper and Row, Publishers, 1960. *Available in my office (also in libraries) .

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113 APPENDIX B (continued) FACT SHEET — SUNLAND ROTATION 1. Students are welcome in Willow Cottage. You are an important addition in these children's lives. 2. The children in Willow Cottage are not ill. You may play with them, go for walks with them, etc. 3. There are record books in the cottage which contain assessments of the children. Use these as guidelines; but trust your own observations and judgment. If you disagree with assessment, speak up. (After you have done your own assessment.) 4. If you can't work with the child assigned to you, please discuss it with Mrs. Baker. Give yourself a chance ,first — also givethe child a chance. Relationships take time to build. 5. Dress your child each morning as attractively as possible. (Help child learn to dress himself while doing this.) Comb hair and put shoes on child before going out. 6. When going to play yard (attached to cottage) tell cottage parent responsible for child. When going to outside to other places, for walks, to animal farm, etc. , sign out in from lobby. It upsets Cottage Parents to lose a child and upsets Mrs. Baker to lose a student. 7. Most of the children have foster grandparents. These grandparents spend 2 hours each day with "their" child— either 8:30-10:30 A.M., 10:30-12:30 P.M., or 1:30-3:30 P.M. They are paid for this time and are quite interested in "their" child's progress, well-being, etc. Feel free to talk to them and help them; but don't keep "their" child during the 2 hours they are with the child. Schedules of foster grandparent's time are on bulletin board in day room, in Mrs. Baker's notebook, or you can ask Cottage Parents. 8. Cottage Parents do not live at Sunland. They work 3 shifts, 6:00-2:30, 2:00-10:30 P.M. and 10:30 P.M.6:00 A.M. The work is hard and pay scale often low. They are responsible for cleanliness of cottage, feeding, cleaning and caring for the children.

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APPENDIX C GROUPS A AND B COMPARED ON EXPERIENCES OR CONTACTS WITH HANDICAPPED PERSONS, INCLUDING MENTALLY RETARDED PERSONS

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115 Group A Group B Handicapping Condition: Blind/partially blind 1 1 Deaf /partially deaf, speech impariment 4 2 Crippled/spastic 10 3 Mental retardation 16 16 Social or emotional 15 4 Types of Experiences : Read or studied Friend or relative Worked with Personally handicapped No answer Frequency of Contacts with Handicapped Individuals : 0-10 11-50 51-100 101-500 501 or more Ability to Avoid Contact : Couldn't avoid 6 8 Could have avoided only with great difficulty 3 3 Could have avoided with considerable difficulty 4 4 Could have avoided with some inconvenience 6 6 Could have avoided without any difficulty or inconvenience 27 5 Any Material Gain from Contact : No 27 6 Yes, paid 6 1 Yes, academic credit 8 19 Yes, both paid and academic credit 5 12

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28

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BIBLIOGRAPHY Adams, Frederick Karl. Comparison of Attitudes of Adolescents Toward Normal and Toward Retarded Brothers . Doctoral dissertation, University of Florida, 1965. Allport, G.W. "Attitudes." In C. Murchison (ed.), Handbook of Social Psychology . Worcester, Mass.: Clark University Press, 1935, pp. 798-884. Barber, Bernard. "A Study of the Attitudes of Mothers of Mentally Retarded Children as Influenced by Socioeconomic Status," Dissertation Abstracts , XXIV, No. 1 (July, 1963) , 415. Bastide, R. and van denBerghe,P. "Stereotypes, Norms and Interracial Behavior in Sao Paulo, Brazil." American Psychological Review , 1957, 22, 689-694. Beatty, Walcott H. "Emotions: The Missing Link in Education." In Wallcott H. Beatty (ed.), Improving Educa tion Assessment and an Inventory of Measures of Affective Behavior . Washington: Association for Supervision and Curriculum Development, 1969. Blake, F., Wright, F.N. and Waechter, E.H. Nursing Care of Children . Eighth Edition. Philadelphia: J.B. Lippincott, Co., 1970. Blazovic, Ronald Richard. "The Attitudes of Teachers, Parents, and Students Toward Integrated Programs for Borderline Educable Mentally Retarded Students," Dissertation Abstracts , XXXIII, No. 7 (January, 1973), 3431-A. Campbell, Donald T. and Stanley, J.C. Experimental and Quasi-Expe r imental Designs for Research . Chicago: Rand McNally & Co., 1963. Condell, James F. "Parental Attitudes Toward Mental Retardation," American Journal of Mental Deficiency , 1966, 71, 95-92. 117

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118 Edgerton, Robert B. and Darno, Marvin. "Community Attitudes Toward the Hospital Care of the MR," Mental Retarda tion , 1972, 10, 3-5. Festinger, L. A Theory of Cognitive Diss o nance . Stanford, California: Stanford University Press, 1957. Gottwald, Henry. Public Awareness About Mental Retardation . CEC Research Monograph, East Michigan University, Ypsilanti, Michigan, 1970 (ERIC No. ED 041 440). Gumz, Edward J. and Gubrium, Jaber F. "Comparative Parental Perceptions of a Mentally Retarded Child," Americ an Journal of Mental Deficiency , 1972, 77(2), 175-180. Gunzberg, H.C. "Vocational and Social Rehabilitation of the Feeble-Minded. " In A.M. and A.D.B. Clark (eds.), Mental Deficiency: The Changing O utlook . Glencoe , Illinois: The Free Press, 1958, pp. 334-364. Guttman, L. "The Problem of Attitude and Opinion Measurement." In S.A. Stouffer (ed.), Measurement and Prediction . Princeton: Princeton University Press, 1950, pp. 46-59. Guttman, L. "A Structual Theory for Intergroup Beliefs and Actions," American Psychological Review , 1959, 24, 318-328. Jones, Reginald L. Labels and Stigma in Spec i al Education , (n.p.), May, 1971 (ERIC No. ED 054 279). Jordan, John E. Attit udes Toward Education and Physically Disabled Perso ns in Eleven Nations . Research Report No. T~. Latin American Studies Center, Michigan State University, East Lansing, Michigan, 1968. Jordan, John E. Attitude Be hav iors Toward Me n tally Retarded Persons: A Cross-Cultural Analysis . A Study of Seven Nations. College of Education, Michigan State University, East Lansing, Michigan, 1970 (ERIC No. ED 051 602) Kerlinger, Fred N. Foundations of Behavioral Research . New York: Holt, Rinehart & Winston, 1964. Kiesler, Charles A., Collins, Barry E. and Miller, Norman. Attitude Change: A Critical Analysis of Theoretical Approaches . New York: John Wiley & Sons, Inc., 1969. Kimbrell, Don L. and Luckey, Robert E. "Attitude Change Resulting from Open House Guided Tours in a State School for Mental Retardates," American Journal of Mental Deficiency, 1964, 69, 21-23.

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119 Koch, Richard and Dobson , James C. The Mentally Retarded Child and His Family . New York! Brunner-Mazel Publishers , 1971 . La Piere, R.T. '"Attitudes vs. Action," Social Forces, 1934 13, 230-237. Legant, Jean Luse. "A Comparison of Attitudes Toward Handicapped Children Between Three Groups of Teachers as Expressed on a Q-Sort," Dissertation Abstracts, XXVI No. 10 (April, 1966), 5872": Lippman, Leopold D. Attitudes Toward the Handicapped: A Comparison Between Europe and the United States Springfield, Illinois: Charles C. Tho mas, Publ isher, Marlow, Dorothy R. Textbook of Pediatric Nursing. Fourth Edition. Philadelphia: W.B. Saunders Co. , 1973. McGinnies, E. Social Behavior: A Functio nal Analysis Boston: Houghton-Mifflin, 1970. ~" Meyers, C.E., Sitkei, E.G. and Watts, C.A. "Attitudes Toward Special Education and the Handicapped in Two Community Groups," American Jo urnal of Mental Deficiency, 1966, 71, 78-84. Nichtern, Sol. Helping the Retarded Child . New York: Grosset & Dunlap, Publishers, 1974. Proctor, Doris lone. "An Investigation of the Relationships Between Knowledge of Exceptional Children, Kind and Amount of Experience, and Attitudes Toward Their Classroom Integration," Dissertation A bstracts. XXVIII, No. 1 (November, 1967) , 172 1-A. Rosenberg, Milton J. and Hovland, Carl I. (Eds.). Attitude Organization and Change . New Haven: Yale Universitv Press, 1960. Sartin, James Lewis. "A Study of the Modification of Students* Attitudes Toward Mentally Retarded Children " Dissertation Abstracts , XXV, No. 10 (April 1965) 5748. Sellin, Donald and Mulchahay, Robert. "The Relationship of an Institutional Tour Upon Opinions About Mental Retardation," American Journal of Menta l Deficiency, 1965, 70, 408-41X ' L

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120 Soule, Donald. "Teacher Bias Effects with Severely Retarded Children," American Journal of Mental Def i ciency , 1972, 77 (2) , 208-211. Steele, Shirley. Nursing Care of the Child with Long-term Illness . New York: Appleton-Century-Crof ts , 1971. Thomas, W.I. and Znaniecki, F. The Polish Peasant in Europe and America . Vol. 1. Boston: Badger, 1918. Thurstone, L.L. "Comment," American Journal in Sociology , 1964, 52, 39-40. Triandis, Harry C. Attitude and Attitude Change New York: John Wiley & Sons, Inc., 1971. Warren, Sue Allen, Turner, Dale R. and Brody , David S. "Can Education Students ' Attitudes Toward the Retarded Be Changed?", Mental Retardation , 1964, 2, 235-242. Yuker, Harold E. and others. The Measurement of Attitudes Toward Disabled Persons . Human Resources Center, Albertson, N.Y., 1970 (ERIC No. ED 044 853).

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BIOGRAPHICAL SKETCH Amanda Sirmon Baker was born in Daphne, Alabama, on April 3, 1934, the fifth child of Joel and Edna Sirmon. She attended public schools in Belforest, Daphne and Fairhope, Alabama. After graduating from Fairhope High School in 1951, Amanda attended the University of Alabama. Following graduation in 1955 with a Bachelor of Science in Nursing, she moved to Valparaiso, Florida, where she worked as a professional nurse for three years. From 1958 to 1971, Amanda traveled widely with her husband, who was in the U.S. Air Force. During this time, she worked in many different positions as a public health nurse, in private duty nursing, staff nursing, supervisory work, intensive care nursing and working with handicapped children as the developer of a program for United Cerebral Palsy. She taught for one year at Albany Junior College, Albany, Georgia. In 1971, when her husband retired from the Air Force, they moved to Gainesville, Florida, where Amanda received her Master of Nursing degree in pediatric nursing from the University of Florida in 1972. She then entered the doctoral program in Curriculum and Instruction at the University of 121

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122 Florida. Amanda held teaching assistantships for three quarters in the College of Nursing, where she was involved in clinical teaching with nursing students working with mentally retarded children. She was appointed as a graduate teaching associate in the College of Nursing in May, 1974, and has continued in that position while completing degree requirements for the Doctor of Philosophy in December, 1974. Amanda married Malcolm Baker of Eden, North Carolina, in 1957. They have two children, Eric and Michael. They are residing near Gainesville, where Amanda will be an Associate Professor in the College of Nursing, University of Florida. Her professional memberships include the American Nurses Association, the Association for Supervision and Curriculum Development, Phi Kappa Phi, Pi Lambda Theta, and Sigma Theta Tau.

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I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality, as a dissertation for the degree of Doctor of Philosophy. aames W. Hensel, Chairman Professor of Education I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality, as a dissertation for the degree of Doctor of Philosophy. Vy^ce A. Hines Professor of Education I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality, as a dissertation for the degree of Doctor of Philosophy. Dorris B. Payne Assistant Professor of Nursing This dissertation was submitted to the Graduate Faculty of the College of Education and to the Graduate Council, and was accepted as partial fulfillment of the requirements for the degree of Doctor of Philosophy. December, 1974 6 i]J^\, aw* fati* Dean, College//of Education Dean, Graduate School

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