Dental aspects of stigma in relation to mental and physical handicap in a Chinese population of Hong Kong.

Abstract

The purpose of this study was to investigate the stigma of mental and physical handicap and its affects on the provision of dental care. Three groups of mentally and physically handicapped children, 4 year olds (n = 309), 14 year olds (n = 174) and 25 to 35 year olds (n = 265), were randomly selected from institutions in Hong Kong. The sample was dentally examined and dental status and treatment need assessed Their parents were also interviewed. Two psychometric scales, the Scale to Determine Attitudes Toward Disabled Persons (SADP), and the Parental Attitude Scale, a scale derived for this study, were used to assess attitude towards disabled persons in general, and specifically towards their own child. A questionnaire was also developed investigating parental experiences and feelings towards their handicapped child. Socioeconomic data was also collected and Information on the dental care delivery pattern experienced by their child. Dental practitioner members of the Hong Kong Dental Association were circulated with the SADP, the Dental Practitioner Attitude Scale, a scale derived for this study, and a questionnaire relating to qualifications and practice. A 62.5% response rate was achieved Canes experience was comparable to the non handicapped in the 4 year old group, lower in the other age groups, but with a high D component m the 25 to 35 year olds. Dental utilisation was low, the main reasons being financial, transport problems and a belief that the dentist would not treat. There was a gradation of parental attitude towards handicapped persons corresponding to education, age and socioeconomic factors. Dentists were not enthusiastic about treating handicapped patients for mainly financial reasons. Both parents and dentists felt strongly that government should provide facilities and be responsible for the treatment of handicapped individuals. The hypothesis of the study was mainly fulfilled. The stigma of handicap is a barrier to dental care, but is more socioeconomic than the way that handicapped persons present themselves.