Leap Over Barriers: A Study On Barriers to Addressing Personal Assistance (PA) Providers' Abuse Among Men with Disabilities

Purpose: Although many men with disabilities (MWD) experience various forms of abuse by personal assistance (PA) providers (Oktay & Tompkins, 2004), societal views toward disability and masculinity, and fears of losing independence makes it difficult in reporting such abuse (Saxton et al, 2006). Understanding the degree to which various types of behaviors by PA providers are viewed as hurtful, particularly in the context of disability (made complex with gendered norms relating to independence and masculinity), may help social workers and other professionals address this hidden problem of abuse by PA providers. Further, the nature and severity of one's disability may also be a moderator on the relationship between perception of hurtfulness by PA providers and type of barriers in reporting such abuse. The purpose of this study was two-fold. First, we sought to determine the degree to which various types of behaviors by PA providers were viewed as hurtful by MWD. Second, we examined the ‘severity of disability' as a moderator on the relationship between perceived hurtfulness and barriers to addressing the abuses.

Method: This study utilized data from the Personal Assistant Service Abuse (PASA) study (Powers et al, 2006), which included demographics on disability type and severity for 342 MWD. The PASA data, based upon qualitative findings (Saxton, et al, 2006), asked respondents to rate the degree to which 25 abusive behaviors hurtful as well as to rate 22 barriers to reporting PA abuse on 4-point Likert scale. A principal-components factor analysis tested for factorial validity for items related to barriers. Internal consistency (Cronbach's á) for each factor was analyzed. Hierarchical multiple regression analyses tested the moderating effect of severity of disability on the relationship between perceived hurtfulness of abuse and each factor of barriers, using Aiken and West' (1991) centering procedure and interaction term (hurtfulness X severity of disability).

Result: Factor analysis produced three factors, including masculinity/gender roles (9 items, á=.89), PA providers/services (11 items, á=.90), and family/friend as a PA provider (2 items, á=.55). The interaction term of hurtfulness X ‘severity of disability' was significant for two factors, including masculinity/gender roles and PA providers/services. All MWD who perceived greater hurtfulness of abusive behaviors by PA providers were more likely to report barriers relating to masculinity/gender role and PA providers/services. For men with less severe disabilities, the slopes of the perceived hurtfulness-barriers relationship were steeper, compared to those with severe disabilities, indicating that perceived hurtfulness was more strongly related to two types of barriers (masculinity/gender roles and PA providers/services).

Implication: Men with less severe disabilities may be more influenced by the gendered norms in that they may be more reluctant to complain or report abusive experiences. There may be an expectation by professionals and others that men with less severe disabilities can manage and control PA providers' behaviors, compared to men with severe disabilities, and thus assumed not be experience abuse. Therefore, men with less severe disabilities may be more likely to experience the barriers for addressing or reporting abuse by PA providers.