Associations of Disability Type and Visibility with Social Exclusion, Life Satisfaction, and Forgiveness among People with Disabilities: A Comparative Study

Year 2026, Volume: 16 Issue: 1, 80 - 89, 27.03.2026

Müjde Kerkez , Mehmet Emin Şanlı

https://doi.org/10.33808/clinexphealthsci.1753676

https://izlik.org/JA55DA28RD

Abstract

Objective: The type and visibility of disability significantly influence individuals' daily lives and their social integration. This study aimed to examine the associations of disability type and its visibility with social exclusion, life satisfaction, and forgiveness.
Method: This cross-sectional comparative study was performed with a total of 344 disabled individuals who the state hospital inpatient and outpatient clinics between January and February 2023. Data were gathered through the use of a Sociodemographic Information Form, the Social Exclusion Scale, the Life Satisfaction Scale, and the Forgiveness Scale. Analyses included chi-square, Mann-Whitney U, and regression tests.
Results: The majority of participants (59.9%) had visible disabilities, and 68.6% were classified as having a first-degree disability. The results indicated significant differences in the mean scores of individuals with invisible psychiatric disabilities and individuals with visible physical disabilities on the Social Exclusion Scale's "Exclusion from Access to Basic Services" sub-dimension (p<.05). Also, a significant difference was found between the groups in terms of total Forgiveness Scale scores (p<.05). Multiple linear regression analysis revealed that disability type, visibility, and sociodemographic characteristics significantly explained the variance in social exclusion (R²=0.133; p<0.001), life satisfaction (R²=0.138; p<.001), and forgiveness level (R²=0.077; p<.05).
Conclusions: This study reveals that the experience of social exclusion, life satisfaction and forgiveness among individuals with disabilities is associated with the type and visibility of their disability. The findings emphasise the importance of a holistic nursing approach that considers the physical and psychosocial aspects of disability.

Keywords

Disability , forgiveness , life satisfaction , social exclusion

References

• Hackett RA, Steptoe A, Lang RP, Jackson SE. Disability discrimination and well-being in the United Kingdom: a prospective cohort study. BMJ Open. 2020 Mar 12;10(3):e035714. https://doi.org/10.1136/bmjopen-2019-035714
• Wang Z, Xu X, Han Q, Chen Y, Jiang J, Ni GX. Factors associated with public attitudes towards persons with disabilities: a systematic review. BMC Public Health. 2021 Jun 3;21(1):1058. https://doi.org/10.1186/s12889-021-11139-3.
• Turkish Statistical Institute (TurkStat). Statistical data portal. Published [2021]. Accessed [29 November 2022]. https://data.tuik.gov.tr.
• Lawson A, Beckett AE. The social and human rights models of disability: towards a complementarity thesis. Int J Hum Rights. 2021;25(2):348–79. https://doi.org/10.1080/13642987.2020.1783533.
• Lindsay S, Fuentes K, Ragunathan S, Li Y, Ross T. Accessible independent housing for people with disabilities: A scoping review of promising practices, policies and interventions. PLoS One. 2024;19(1):e0291228. https://doi.org/10.1371/journal.pone.0291228..
• Richter D, Hoffmann H. Social exclusion of people with severe mental illness in Switzerland: Results from the Swiss Health Survey. Epidemiol Psychiatr Sci. 2019;28(4):427–35. https://doi.org/10.1017/S2045796017000786.
• Ruggeri K, Garcia-Garzon E, Maguire Á, Matz S, Huppert FA. Well-being is more than happiness and life satisfaction: a multidimensional analysis of 21 countries. Health Qual Life Outcomes. 2020 Jun 19;18(1):192. https://doi.org/10.1186/s12955-020-01423-y.
• Okoro CA, Hollis ND, Cyrus AC, Griffin-Blake S. Prevalence of disabilities and health care access by disability status and type among adults — United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(32):882–7. https://doi.org/10.15585/mmwr.mm6732a3..
• Ahmad S, Islam M, Zada M, Khattak A, Ullah R, Han H, Ariza-Montes A, Araya-Castillo L. The influence of decision making on social inclusion of persons with disabilities: A Case Study of Khyber Pakhtunkhwa. International Journal of Environmental Research and Public Health. 2022; 19(2):858. https://doi.org/10.3390/ijerph19020858
• Shariq S, Cardoso Pinto AM, Budhathoki SS, Miller M, Cro S. Barriers and facilitators to the recruitment of disabled people to clinical trials: a scoping review. Trials. 2023;24(1):171. https://doi.org/10.1186/s13063-023-07142-1
• Hasson-Ohayon I, Hason-Shaked M, Silberg T, Shpigelman CN, Roe D. Attitudes towards motherhood of women with physical versus psychiatric disabilities. Disabil Health J [Internet]. 2018;11(4):612–7. https://doi.org/10.1016/j.dhjo.2018.05.002.
• Forber-Pratt AJ, Mueller CO, Andrews EE. Disability identity and allyship in rehabilitation psychology: Sit, stand, sign, and show up. Rehabil Psychol. 2019 May;64(2):119-129. https://doi.org/10.1037/rep0000256.
• Bayın Ü, Kaya M. Forgiveness and perceived social support in teenagers. Educ Q Rev. 2021;4(3):73–82. https://doi.org/10.31219/osf.io/3wk8e.
• Yan S, Wang W, Kuang S, Wu Y, Zhang Y, Li H. The relationships between trait anger, forgiveness, and subjective well-being during the COVID-19 pandemic: a moderated mediating model under lockdown situation. Curr Psychol. 2023 Mar 21:1-10. https://doi.org/10.1007/s12144-023-04500-9.
• Kupferberg A, Hasler G. The social cost of depression: Investigating the impact of impaired social emotion regulation, social cognition, and interpersonal behavior on social functioning. Journal of Affective Disorders Reports. 2023, 14, 100631. https://doi.org/10.1016/j.jadr.2023.100631.
• Stuntzner S, MacDonald A. Disability and forgiveness: An intervention to promote positive coping for persons with disabilities. Ann Psychother Integr Health. 2016;25(4):36-61
• Toussaint L, Worthington EL Jr, Van Tongeren DR, Hook J, Berry JW, Shivy VA, Miller AJ, Davis DE. Forgiveness Working: Forgiveness, Health, and Productivity in the Workplace. Am J Health Promot. 2018 Jan;32(1):59-67. https://doi.org/10.1177/0890117116662312.
• Stuntzner S, Dalton JA, MacDonald A. Application of forgiveness in rehabilitation psychology: a positive option for change. Int Phys Med Rehabil J. 2019;4(4):184–91. https://doi.org/10.15406/ipmrj.2019.04.00196
• Tüccar E, Şar A. The levels of forgiveness and quality of life based on various variables among the disabled. SUJE. 2022;12(2):431-46. https://doi.org/10.19126/suje.1140860
• Ljubičić M, Burčul I, Gusar I, Šare S. Are They the same for all people? Nurses’ knowledge about the basic human needs of people with disabilities. Behav Sci (Basel). 2023;13(1):68. https://doi.org/10.3390/bs13010068.
• Alexander S, Rajamani S, Austin RR. Promoting health equity: The role of nurses in addressing social determinants of health. Clin Nurse Spec. 2023;37(6):262–5.
• Kara E, Beyazoğlu Bacı G, Tatar ST. Comparison of life satisfaction levels of sedentary individuals with physical disabilties and individuals actively engaged insport. Gaziantep University Journal of Sports Science. 2020;5(2):154-65. https://doi.org/10.31680/gaunjss.643966
• Mercan Y, Tarı Selçuk K, Arıkan SH, Sayılan AA, Eser E. Quality of life among persons with intellectual and physical disability in northwestern Turkey. Cukurova Med J. 2020;45(4):1482-92. https://doi.org/10.17826/cumj.735333
• Serdar CC, Cihan M, Yücel D, Serdar MA. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochem medica. 2021;31(1):27–53. https://doi.org/10.11613/BM.2021.010502..
• Bucuka Y. Developing the Social Exclusion Scale for the Persons with Disabilities (SESPD): Validity and Reliability Study. Turk Stud Soc. 2020;15(5):2427-43. https://doi.org/10.47356/TurkishStudies.43181.
• Diener ED, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess. 1985;49(1):71–5. https://doi.org/10.1207/s15327752jpa4901_13
• Dağlı A, Baysal N. Adaptation of the Satisfaction with Life Scale into Turkish: The Study of Validity and Reliability.Electronic Journal of Social Sciences. 2016;15(59). https://doi.org/10.17755/esosder.263229
• Kaya ÖS. The Scale of Forgiveness on Interpersonal Relationships: A Validity and Reliability Study. Elementary Education Online 2019;18(3):1244-59. https://dergipark.org.tr/tr/pub/ilkonline/article/611538
• Temple JB, Kelaher M. Is disability exclusion associated with psychological distress? Australian evidence from a national cross-sectional survey. BMJ Open. 2018;8(5):1– https://doi.org/10. 10.1136/bmjopen-2017-020829.
• Cho S. The effects of physical and psychological health on life satisfaction among older adults with a physical disability in South Korea: Focus on gender differences. Asia Pacific J Soc Work Dev [Internet]. 2015;25(3):133–44. http://dx.doi.org/10.1080/02185385.2015.1027951
• Balcı S. Analysıs of social exclusion perception of disabled people according to some sociodemographic variables. Journal of Medical Social Work. 2019;(14):59-79. https://doi.org/10.46218/tshd.1139360.
• Öztabak MÜ. Investigation of Life Expectations of Disabled Persons. FSM Journal of Scientific Research Human and Social Sciences. 2017(9):355-7. https://doi.org/10.16947/fsmia.323388
• Blaise M, Schroeder M, Suhrcke M, Komenda-Schned S, Zeilinger EL, Weber G. Exploring self-determination and satisfaction with life and services of people with disabilities. Int J Dev Disabil. 2025;1–11. https://doi.org/10.1080/20473869.2025.2470168
• Lin CY, Cheng TC. Health status and life satisfaction among people with disabilities: Evidence from Taiwan. Disabil Health J. 2019 Apr;12(2):249-56. https://doi.org/10.1016/j.dhjo.2018.10.008.
• Kahraman S, Bulut C, Aydın E. Disability-accessibility at workplace: A research from Turkey. Bus Econ Res J. 2019;10(4):1005-13.
• Kalaycı S. Kalaycı S. The role of municipalities in enabling disabled individuals to access public services. Journal of Social Policy Studies. 2020;83–104. https://doi.org/10.21560/spcd.vi.817709.
• Şen M. Employment policies for people with disabilities in Turkey: problems and suggestions. Social Security Journal. 2018, 8(2), 129-152.
• Azarkan E, Benzer E. The united nations conventıon on the rights of persons with disabilities and disability rights in Turkey. Dicle University Journal of Law Faculty 2018;23(38):3–29.
• Russell M, Ames H, Dunn C, Beckwith S, Holmes SA. Appraisals of disability and psychological adjustment in veterans with spinal cord injuries. J Spinal Cord Med. 2021;44(6):958–65. https://doi.org/10.1080/10790268.2020
• Kim JJ, Payne ES, Tracy EL. Indirect effects of forgiveness on psychological health through anger and hope: A parallel mediation analysis. J Relig Health. 2022;61(5):3729–46. https://doi.org/10.1007/s10943-022-01518-4.
• Ramluggun P. Forgiveness in mental health nursing practice. Ment Heal Pract. 2024;28(2): 28-34. https://doi.org/ 10.7748/mhp.2024.e1719