Personal tolerance as a factor in counteracting handicapism and a component of the professional competence of nursing students

Abstract

Contemporary Ukrainian society, despite declared principles of equality and inclusion, maintains a considerable social distance toward people with disabilities. Within the social model of disability, increasing attention is paid to the concept of handicap as socially determined barriers and to handicapism as a system of prejudices that sustain inequality and foster the exclusion of groups of people with disabilities. Personal tolerance among healthcare professionals, particularly future nurses who provide the closest and longestlasting interaction with patients and largely shape the inclusiveness of the medical environment, plays a special role in counteracting handicapism. At the same time, Ukrainian studies insufficiently address tolerance as an internal resource for overcoming handicapped attitudes among nursing students. Purpose. To theoretically substantiate the role of personal tolerance in counteracting handicapism and to empirically assess its level among nursing students, taking into account components of social distance, communicative tolerance, readiness for change, and tolerance of uncertainty. Materials and methods. The study was conducted at Zhytomyr Medical Institute of Zhytomyr Regional Council among 114 nursing students (74 second-year and 40 fourth-year students; 106 women and 8 men aged 18–20 years). The following instruments were used: E. Bogardus’ Social Distance Scale, V. Boyko’s “Communicative Tolerance” method, the “Personal Readiness to Change” questionnaire (A. Dzherel, S. Hezer, M. Gold, K. Hall), a “Tolerance of Uncertainty” method, and the authors’ questionnaire “Tolerance as a Personality Trait”. Statistical processing included descriptive statistics, calculation of 95% confidence intervals, Pearson’s χ² test, Student’s t test for independent samples, and the Mann–Whitney U test (p < 0.05). Results. According to E. Bogardus’s scale, a high level of social acceptability of people with disabilities was revealed: none of the respondents supported the idea of their isolation, the vast majority were ready to live together in the same society, and senior students more often than second-year students admitted close personal contacts (friendship, marriage). At the same time, a latent social distance persists among a part of junior students, manifested in an orientation toward formalized, predominantly professional forms of interaction. In most respondents, the level of communicative tolerance is low: more than half of the sample is characterized by insufficient flexibility of communicative attitudes, a tendency toward categorical judgments, and difficulties in forgiving mistakes and overcoming their own stereotypes. At the same time, pronounced emotional and behavioral resources are preserved, including declared empathy, willingness to support people with disabilities, and intolerance of openly discriminatory language. Indicators of personal readiness for change and tolerance of uncertainty are moderately high and relatively stable across years of study: future nurses demonstrate energy, resourcefulness, and a positive attitude toward the future, but experience a certain discomfort in situations where clear action algorithms are lacking. Conclusions. Personal tolerance of future nurses is a key factor in counteracting handicapism; however, its structural components – communicative flexibility, the ability to accept another person’s individuality, overcoming categorical judgments, and readiness to act under conditions of uncertainty – remain underdeveloped and require targeted enhancement. The identified gap between declared values of equality and actual behavioral attitudes justifies the need to integrate special modules on tolerant and non-violent communication into educational programmes, training in interaction with people with disabilities, reflective practices, and regular assessment of tolerance levels. The obtained results can be used to update the content of nurse training, improve educational programs, and develop tools to strengthen the inclusive competence of healthcare professionals.