Rehabilitation counselors’ comfort, attitudes, and perceived preparedness, to work with diverse populations with chronic illness & disabilities

Khadidra Natasha Washington

doi:10.25820/etd.006780

The purpose of this descriptive quantitative study was to examine the relationship between comfort level, attitudes, and perceived preparedness among rehabilitation counselors’ who provide services to individuals living with chronic illnesses and disabilities, particularly African Americans living with HIV/AIDS. The leading research question for this research was What are rehabilitation counselors’ reported comfort levels to work with diverse populations living with a chronic illness and disability? The dependent variable investigated was rehabilitation counselors’ comfort level with individuals living with a chronic illness and disability diagnosis. The two independent variables measured were (1) rehabilitation counselors’ self-reported attitudes toward disabilities and (2) perceived preparedness based on their academic curriculum. Results of the correlation and stepwise multiple linear regression of the two independent variables (attitudes and perceived preparedness). Additionally, the study highlighted how limited experiences and inadequate preparation of rehabilitation counselors who work with diverse populations with chronic illness and disabilities, especially those with a HIV/AIDS diagnosis, warrants recommended counselor education training for those who will work with diverse populations. A review of literature on comfortability resulting from counselors’ attitudes and perceived preparedness when working with diverse populations are presented. Kolcaba’s Theory Comfort, as well as findings of the Pearson’s moment correlation and stepwise multiple linear regression analysis are presented. A sample of Certified Rehabilitation Counselors (CRC) were recruited from a portion of the database owned by the Commission on Rehabilitation Counseling Certification (CRCC). Although 8,122 CRCs were invited to participate of this study, with a total of 434 agreeing to participate in the study research yielded a total of 328 completed surveys. This included 250 females, 67 males, 1 transgender, 4 gender variant/non-conforming, 1 not listed, and 4 who chose not to refer to answer ranging from age 24 to 56 years of age. Participants completed the General Information Form (GIF) and the researcher developed instrument Rehabilitation Counselors’ Perceived Preparedness and Comfort Level Questionnaire (RCPPCQ). The study examined two independent variables (attitudes and perceived preparedness), and one dependent variable rehabilitation counselors’ comfort level with individuals living with a chronic illness and disability diagnosis. The results of the GIF, moment correlation and stepwise multiple linear regression analysis provided major findings and implications for this study. In terms of participants who self-reported of working with African Americans living with HIV/AIDS, rehabilitation counselors’ preparedness, age, and some of the attitudinal variables were identified as variables that contribute to overall comfort among counselors who may work with African Americans diagnosed with HIV/AIDS. As for those who self-reported of not knowing that they provided services to this population, the combination of preparedness, and attitudinal items best predicted comfort for these counselors. These findings have important implications that highlight areas in which rehabilitation counselors’ educators, and individuals within the helping professions can develop to improve the comfort level of rehabilitation counselors who provide services to diverse populations living with chronic illness and disability and HIV/AIDS. Additionally, participants of this study perceived themselves as been well prepared to work with individuals with chronic illness and disabilities from diverse backgrounds and reported feeling comfortable to provide services to this population. Pearson’s correlations were calculated to evaluate the degree of association among the variables of attitudes, comfort, and preparedness among rehabilitation counselors who reported working with African Americans diagnosed with HIV/AIDS. Data suggests that from the total sample, 29% (n=95) indicated yes and 49.4% (n=162) indicated no to be working with African Americans diagnosed with HIV/AIDS at the time of this study. Twenty-one percent (n=71) indicated that they did not knew. Results of the Pearson’s correlation analysis between comfort, attitudes, and preparedness yielded only a low positive relationship (r=.22) between comfort and preparedness for those counselors who reported working with African Americans diagnosed with HIV/AIDS. Results also suggested a low positive relationship (r=.27) between comfort and preparedness for those counselors who reported not working with this population. The later one was significant at p.01 level. A multiple stepwise linear regression was used to assess which variables (gender, race/ethnicity, age, education level, attitudes, and preparedness) best predicted comfort in working with individuals with chronic illness and disabilities, between those rehabilitation counselors who did and did not provided services to African Americans diagnosed with HIV/AIDS. The participants demographic factors (gender, race/ethnicity, age, education level, and employment setting), as well as attitudes and preparedness were used as potential predictors for this multiple linear regression analysis. Table 4 presents the summary table for the stepwise multiple linear regression analysis conducted. Of the 11 predictor variables entered into the initial model, the combination of preparedness and age best predicted comfort for those counselors who reported working with African Americans diagnosed with HIV/AIDS at the time of this study. This model was significant F (2. 86) = 6.26, p<.003 and accountable for 13 % (Adjusted R2) of the variance of comfort for participants in this subgroup. Overall, results from this study suggest that rehabilitation counselors demonstrated having general positive attitudes toward African Americans with chronic illness and disabilities. Rehabilitation counselors’ indicated higher levels of association with individuals with diagnosis related to physical disabilities like cardiac conditions and lower levels of association with individuals with diagnosis of HIV/AIDS, mental illness, and substance and alcohol abuse. Results of this study identified a low relationship between comfort and preparedness for those counselors who reported working with African Americans diagnosed with HIV/AIDS and identified the variables of preparedness, age, and some of the attitudinal variables were identified as variables that contribute to overall comfort among counselors who may work with African Americans diagnosed with HIV/AIDS. Rehabilitation counselors’ preparedness, age, and some of the attitudinal variables were identified as variables that contribute to overall comfort among counselors who may work with African Americans diagnosed with HIV/AIDS. Limitations of the findings, and suggestions are offered for future research and rehabilitation counselor preparation. Additionally, implications for practice were identified. Future research can also be beneficial to explore how an individual’s level of comfortability can be achieved as defined by Kolcaba’s Theory of Comfort of to further enhance rehabilitation counselors’ level of comfort when working with diverse populations living with chronic illness and disability especially individuals’ African American individuals living with HIV/AIDS. Despite rehabilitation counselor’s training in cultural competencies when working with individuals of diverse backgrounds, research has suggested that this may not be enough when working with African American individuals living with a HIV/AIDS diagnosis. When counselors are culturally competent, they are able to understand and work with clients who are culturally diverse. “Therapists who are culturally competent develop the capacities to value diversity and manage the dynamics of differences” (Comas-Diaz, 2011, p. 251). As rehabilitation counselors become culturally competent in working with individuals from diverse backgrounds, this will increase their level of self-efficacy to feel more comfortable in working with African American individuals living with a HIV/AIDS diagnosis.

Rehabilitation counselors’ comfort, attitudes, and perceived preparedness, to work with diverse populations with chronic illness & disabilities

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