PSYCHOSOCIAL DEFINITIONS AND DETERMINANTS OF HANDICAP: A STUDY OF PHSYSICALLY DISABLED PEOPLE IN LEBANON

Khouzama H. SHA'AR

Researchers in the field of social epidemiology have sug­gested that handicap is a psychosocial change that may ac­company or follow a disability state. This study attempted to define handicap from a psychosocial perspective, and to identify some of its determinants among physically disabled people.

Six areas of handicap were selected for study, namely, education, work, income, marital status, housing and mental state. Disability level, personal and family characteris­tics were selected as the agent, host and social environment factors, and were tested for their relationship to the state of  being handicapped.

The study was undertaken in Lebanon. Using a geographical sampling design, a group of  234 persons disabled from polio in childhood and their matched siblings were identified and interviewed in a field survey of selected sectors in West Beirut and the Southern Suburb of Beirut.

Handicap was assessed by differences between each index case and his/her sibling. Four of the six indicators showed sig­nificant degrees of  difference, namely, work, income, mari­tal status and housing.

Results from bivariate and multivariate analyses, undertaken to identify factors related to developing handicap, indicated that the agent factor, severity of disability, was only related to educational handicap: an area where the dis­abled and the siblings did not show significant differences.

Education, gender and income were among the host factors that were related to the handicaps. Educational disadvan­tage was related to disadvantage in social class and depres­sion. Disabled women were more at risk of remaining single. Material resources, such as income, were noted to ameliorate marital status and crowding handicap.

Of  the social environmental, factors, educational attainment, which is a family responsibility, was similar for the dis­abled group and their siblings. Family resources were also related to housing conditions.

The study concludes that aspects of handicap can be defined and measured in disabled people and psychosocial deter­minants are proposed.