Background

The war conflict between Russia and Ukraine, that had escalated since February 2022, has significantly impacted various aspects of social life in Ukraine, in addition to its direct adverse military consequences1, including the perception and integration of people with disabilities and limited mobility2. The trend in social attitudes toward people with disabilities3, especially those who use wheelchairs, is one of the less discussed, yet extremely important aspects of the said situation4. In the face of war, the number of individuals who have suffered limb injuries and other severe wounds is dramatically increasing. Although there is a lack of precise data on the number of wheelchair users, there is indirect evidence indicating a significant increase in demand for them, reflecting the depth of the issue5.

In the context of the Russian-Ukrainian war, the causative and age structure of people with disabilities has significantly changed. Between 2022 and 2024, there has been a notable increase in the number and composition of wheelchair users. Previously, up to 2022, they were primarily elderly individuals, children with congenital defects, and adults with chronic diseases. Only a small portion of that group consisted of patients who needed wheelchairs due to spinal disorders or limb amputations resulting from traffic accidents, work-related incidents, or sports injuries. Currently, the main contingent comprises military personnel and civilians who acquired their disabilities as a result of combat injuries leading to amputations or disorders of the central or peripheral nervous system6. The sight of wounded veterans returning from the front, as well as civilians injured during shelling or clashes, has become a daily occurrence in the country7. Those dramatic images could not fail to impact the social attitudes of Ukrainian citizens. Young people have had to confront a new reality that has significantly influenced their empathy, social engagement, and approach to individuals with limited mobility. Increasing exposure to the issues faced by those individuals may result in greater understanding and acceptance within society8.

Appropriate educational actions, the promotion of inclusion values, and the provision of proper support for people with disabilities may be crucial in shaping positive attitudes and building social solidarity9. It may also lead to increased engagement in integration efforts, such as volunteering10, educational campaigns or initiatives within the academic community11. During wartime, it is gratitude, readiness, awareness of responsibility, and the opportunity for personal involvement in the socialisation of those individuals. That is particularly important for certain social categories, considering their psychosocial status (student youth) and professional experience (future medical professionals).

Students, as a social group characterised by accelerated adaptation to new living conditions, may change their previously often stereotypical views upon observing the challenges faced by people with disabilities12,13. War, despite its tragic nature, has become a catalyst for social changes that may bring long-term benefits to the entire Ukrainian society. It is also important to consider the interconnected psychophysiological phenomena: adaptation to life in wartime conditions, psychoemotional exhaustion, and symptoms of post-traumatic stress disorder. The hope that the contemporary young generation will cultivate enduring values of solidarity and acceptance reinforces the belief that we are moving toward a more inclusive future. Those changes are already visible at the level of everyday interactions, where people who previously ignored the issues faced by individuals with disabilities are increasingly showing support through small but meaningful acts of assistance. It is also important to consider the interconnected psychophysiological phenomena: adaptation to life in wartime conditions, psychoemotional exhaustion, and symptoms of post-traumatic stress dis order14. Support in daily activities is becoming the standard approach, reflecting an increase in overall empathy and social responsibility.

Increased social engagement and changes in education and infrastructure contribute to a more inclusive and empathetic society, which may have long-lasting positive effects on social integration15. However, the risk that the increased number of individuals affected by the armed conflict may lead to a rise in negative attitudes, such as pity, indifference, or even aversion remains to be effectively addressed. In societies experiencing war trauma, issues related to disability may be perceived as an additional burden16. In such conditions, individuals in wheelchairs may be marginalised and excluded, and their needs and rights may be insufficiently addressed17. The challenges faced by the Ukrainian society require a multifaceted approach that includes education, increased awareness, psychological support, and concrete actions towards the integration of individuals with disabilities as accepted and respected full members of society18,19.

The aim of this study is to explore the evolving social attitudes towards people with disabilities in Ukraine during the ongoing conflict and to assess the effectiveness of initiatives aimed at promoting inclusion and support for this vulnerable group. Specifically, the study has focused on examination of the impact of the war on students’ social perceptions and attitudes toward individuals in wheelchairs, which may indicate changes in tolerance and empathy within society. We believe that our research will contribute to a deeper understanding of the complex interplay between war, disability, and social attitudes, and we aim to demonstrate how these factors influence each other throughout the conflict.

Methods

Participants and study design

The study was conducted twice, in 2022 and 2024, involving 1453 and 986 Ukrainian students respectively, from medical, humanities, and social sciences programs at universities in Kyiv, Ternopil, Ivano-Frankivsk, and Lviv. The power analysis indicated that a sample size of 79 participants would provide sufficient power (typically 0.90) to detect a significant effect at an alpha level of < 0.05. Participants were recruited through university announcements, social media platforms, and student organizations. We ensured diverse representation by reaching out to various faculties and departments within the selected universities. The recruitment process was designed to include students from different backgrounds and experiences, which may have influenced the characteristics of the sample.

Obtaining informed consent was a mandatory requirement for participation in the anonymous online survey, in accordance with ethical standards for conducting research. Written informed consent was obtained from all subjects involved in the study. Participation was entirely voluntary, and participants had the right to withdraw from the study at any time without providing any reason. The average time to complete the questionnaire was approximately 15 min, and all the completed questionnaires were subjected to a detailed statistical analysis.

Measure tools. Proprietary questionnaire

The section of the questionnaire created by the authors of the study focused on sociodemographic characteristics, including questions about gender, age, marital status, education, field of study, place of upbringing and residence, and attitude toward religion. For the purpose of the study, a diagnostic survey method with the standardised tool, the Multidimensional Attitudes Scale Toward Persons With Disabilities (MAS), was used20. The adapted Ukrainian version of the MAS-UA questionnaire21 was fully similar to the original version. The MAS questionnaire is a self-report instrument consisting of a total of 34 items (rated on a classical Likert scale with responses ranging from 1 [not at all] to 5 [very much]). It includes three diagnostic subscales that correspond to the classic components of attitude: the affective or emotional-evaluative component with 16 items, the cognitive component related to beliefs with 10 items, and the behavioural component that indicates behaviour based on 8 items22. The choice of the standardised questionnaire as the main research tool was based on its effectiveness in monitoring changes in social attitudes toward individuals with disabilities23. Affective Subscale: This subscale measures the emotional reactions of participants toward people with disabilities, including feelings such as tension, stress, helplessness, shame, and other emotions. It reflects how participants emotionally perceive their interactions with people with disabilities. Cognitive Subscale: This subscale assesses the beliefs and opinions of participants about people with disabilities. It includes statements regarding perceptions of interest, friendliness, and the potential for establishing relationships with individuals with disabilities. Behavioral Subscale: This subscale measures the participants’ anticipated behaviors toward people with disabilities, including actions such as initiating conversation or avoiding interaction.

Before commencement of the research, the consent was obtained from the authors of the original questionnaire20. Classical testing with the questionnaire is based on assessing situations within a scenario where a person in a wheelchair meets individuals without disabilities in an ordinary café. For the purpose of the Ukrainian version, the names used are Maria/Bogdan. That method involves fictional narratives, where the respondent takes on the role of the narrator, allowing for subtle projection of their own emotions, thoughts, and potential behaviour. Respondents are asked to assess the likelihood that Maria/Bogdan might have various attitudes in that situation. That approach provides more authentic responses that better reflect the respondents’ actual attitudes. The respondent does not feel evaluated, which minimises the risk of incorrect or socially desirable responses. This format is aimed at capturing intuitive reactions and spontaneous opinions that might be expressed under more natural circumstances. The proposed approach allows for a concurrent investigation of respondents’ emotions and thoughts, which is highly valuable in analysing complex social constructs such as prejudice or stereotypes. Results are presented in subscales, with higher values indicating more negative attitudes toward individuals with disabilities.

Procedure and ethical considerations

The consent was obtained from the governing bodies of the universities participating in the study in order to conduct an anonymous survey among students. The research was conducted in accordance with the Helsinki Declaration and its subsequent amendments. All procedures involving human participants were compliant with international ethical standards that include voluntary participation, informed consent, anonymity, confidentiality, the potential for harm, and the communication of results. The study was approved by the Bioethics Committee of the Ternopil National Medical University (Protocol No 72 dated January 6, 2023).

Statistical analysis

Advanced statistical techniques were used in the study to ensure reliable comparative analysis, utilising appropriate tools for assessing distribution normality and selecting statistical tests. Statistica v. 13.0 PL software was used as it allowed for effective execution of advanced statistical tests and presentation of results. Distribution normality of variables was tested using the Shapiro-Wilk test. Due to non-normal distribution, descriptive statistics (arithmetic means, standard deviations, median, minimum-maximum, IQR - interquartile range) for each subscale of the questionnaire and comparisons with selected sociodemographic variables were conducted using the non-parametric Mann-Whitney test. For the purpose of the univariate analyses, statistical significance was based on the Chi-square (χ²) test. We calculated the reliability of the subscales using Cronbach’s alpha, which yielded satisfactory values (e.g., α > 0.8) for all subscales. The results are as follows: for the Affective subscale, α = 0.75; for the Cognitive subscale, α = 0.91; and for the Behavioral subscale, α = 0.78. Overall, the Cronbach’s alpha for the entire questionnaire is α = 0.84. These values confirm the internal consistency and reliability of the subscales used. Statistical significance was set at a p-value < 0.05.

Results

Sample characteristics

Among the respondents, women predominated, constituting 76.6%, reflecting the overall trend of a higher number of female students as compared to male students in the selected fields of study. The respondents were aged between 18 and 30 years, with an average age of 20.4 ± 1.98 (median – 20 years). Most of the respondents lived in urban areas (88.8%). Table S1 presents the sociodemographic characteristics of the respondents based on the year of the study conducted.

Despite the lack of statistically significant differences in many variables such as gender, age, place of upbringing and residence, or marital status across both studies, notable differences have been observed in terms of attending undergraduate and graduate studies and balancing studies with additional work. In the 2024 survey, there has been a higher proportion of students enrolled in graduate programs, those identifying with the Greek-Catholic religion, and those more frequently engaging in visual and direct interactions with individuals using wheelchairs. The overall attitude toward people with disabilities has been positive in both studies but in the second survey respondents have demonstrated a greater acceptance of individuals using wheelchairs.

Descriptive statistics for MAS questionnaire subscales

Table 1; Fig. 1 presents a summary of descriptive statistics for the subscales used for assessing social attitudes, obtained from both studies.

The study results indicate the reliability and consistency of the MAS questionnaire, which has been confirmed through the comparison with international results, including the data from neighbouring Poland. The data were collected in Poland from November 2020 to January 202122,23.

The first subscale (affective component, emotions towards individuals with disabilities) has shown the most significant differences between the studies. The average scores have reached 39.94 ± 5.97 and 33.76 ± 10.07 (p <.001), suggesting more positive attitudes towards people with disabilities in the 2024 study. For the second sub scale (cognitive component - beliefs and knowledge), average scores have been similar in both studies (23.19 ± 7.76 vs. 24.09 ± 10.25) (p >.1). Similarly, the behavioural component subscale (intentional or observable behaviour) has not shown significant differences between the two studies (16.09 ± 5.08 vs. 16.17 ± 4.77, p >.1). Due to the differences in the context of the first subscale, the overall social attitude index reflects a significant difference between the two studies. The average scores have reached 79.22 ± 11.98 and 74.02 ± 18.31 (p <.001), indicating more positive attitudes towards people with disabilities among the students in the 2024 study.

Table 1 Descriptive statistics for scales applied to the Study.
Full size table
Fig. 1
figure 1

Results in Scores (Median) - Y-axis for the Three Subscales and the Overall MAS Score – X-axis, Calculated in 2022 and 2024 in Ukraine, along with Comparative Results from Poland (represented in black) from Similar Studies PL122 and PL223 in November 2020 to January 2021. 

Full size image

Table S2 presents detailed results for the three subscales, highlighting statistically significant differences between the studies.

Differences have been observed in several key emotional and behavioural items. In the 2024 study, values have indicated greater positivity in emotions such as reduced tension, stress, helplessness, and shame. Similarly, negative emotions like depression and anxiety have decreased, suggesting an improvement in the overall psychological well-being. That indicates that the results suggest a positive trend in the emotional well-being. However, despite those positive changes, some negative aspects have been noted. Respondents have reported a deterioration in their sense of relaxation, calmness, and composure.

Sociodemographic variables and related impact upon MAS-UA subscales

The impact of sociodemographic indicators on the MAS-UA subscale results and their overall outcome is a topic of significant importance in the social science research. Table S3 presents specific research findings that account for such variable dependencies. Ukrainian students’ social attitudes toward wheelchair users changed significantly as a result of the war (p <.01). The effect size measured using Cohen’s d was 0.85, indicating a large effect and emphasizing the significance of these changes in the context of social integration of disabled people in Ukrainian society.

As far as the affective (emotional) component is concerned, a statistically significant decrease in the median of the first subscale was observed within the period from the first to the second study, with scores dropping from 39 to 30 for men and from 40 to 32 for women. Since lower values indicate more positive attitudes, that trend may be considered positive. The cognitive subscale indicator has remained virtually unchanged for men (Me = 26–28), with a significantly positive indicator remaining for women (Me = 21). As far as the behavioural subscale is concerned, the results for both women and men have slightly changed, too. The analysis of the overall MAS indicator has revealed a decrease in values for both men and women, reflecting the general trend towards more positive results in the 2024 study. For men, the indicator has slightly decreased, from 83 to 81, while for women, the changes have been more significant (from 77 to 72). The overall changes in the MAS indicator highlight more positive attitudes towards people with disabilities in the second study.

Table 2 shows clear relationships between age and attitudes as well as changes in those trends over the two-year period. Despite the small differences in respondents’ age, there is a general positive trend in the measured attitudes. It is interesting and suggests that the overall more positive attitudes towards people with disabilities improve with age. The cognitive and behavioural components of attitudes appear to be more stable and independent of age.

Table 2 Relationship between age and the MAS-UA subscales.
Full size table

Younger students are most often enrolled in undergraduate programmes. In the 2022 study, respondents from this group had an average score of 40.1 ± 6.0 in the affective subscale, while those in postgraduate studies had an average of 39.5 ± 5.6 (p >.05). In 2024, both groups have shown a decrease in scores as compared to 2022, indicating an improvement in attitudes in the affective subscale. The average score for undergraduate respondents has reached 34.0 ± 10.0, and for postgraduate students it has reached 33.4 ± 10.1. In the cognitive subscale, the score has statistically significantly improved for undergraduate students as compared to postgraduate students (23.5 ± 10.3 vs. 25.2 ± 10.1). However, the overall MAS index has not shown any significant differences. The significant reduction in average scores in the affective subscale and the global MAS index for both groups in 2024 may suggest a partially changing dynamic of attitudes depending on the educational background.

Older students more frequently take on paid work during their studies, and postgraduate students often take on additional work. The analysis of data from both studies indicates that working while studying may impact social attitudes, although that relationship is not always strong or clear-cut. Differences in global and specific subscale results suggest that additional work burden may modify students’ experience. In 2022, the results for students who were only studying showed averages of 39.9 ± 5.9 for the affective subscale, 23.0 ± 7.7 for the cognitive subscale, 16.0 ± 5.1 for the behavioural subscale, and 78.9 ± 12.1 for the overall MAS index. For students who were also working, those values were 40.1 ± 6.3, 23.7 ± 8.0, 16.4 ± 4.9, and 80.2 ± 11.5, with no statistically significant differences observed. In the 2024 study, there have been some noticeable changes. Students, who were only studying, have had average scores of 33.9 ± 9.9 in the affective subscale, 24.2 ± 10.2 in the cognitive subscale, 16.3 ± 4.8 in the behavioural subscale, and 74.4 ± 17.8 for the overall MAS index. On the other hand, students, who were also working, have had scores of 33.4 ± 10.5, 23.8 ± 10.3, 16.0 ± 4.8, and 73.3 ± 18.6, respectively. It indicates that in the 2024 study there have been no statistically significant differences between the groups. However, over the two years the average scores across all of the subscales for both students who were only studying and those who were also working have decreased. It may suggest a positive impact of changing conditions on students’ attitudes.

In the 2022 study, only minor differences were observed between students living independently (N = 581) and those living with family (N = 872). The results for the affective subscale showed no statistically significant differences (39.6 ± 5.9 vs. 40.2 ± 6.0). Similarly, the cognitive and behavioural subscales, as well as the overall MAS index, did not show significant differences. In the follow-up study in 2024 there have been 814 students living independently and 172 living with family. For students living independently, the average score on the affective scale has dropped to 34.0 ± 9.9 (Me = 32, IQR = 27–40), while students living with family have achieved an even better result of 32.6 ± 10.7 (Me = 30, IQR = 25–38). The cognitive scale results have been very similar (24.0 ± 10.2 vs. 24.6 ± 10.5) (p >.05). Similarly, the behavioural scale scores have been 16.3 ± 4.8 for students living independently and 15.8 ± 4.6 for those living with family (p >.05). The overall MAS index has reached 74.4 ± 17.2 for those living independently and 73.0 ± 19.2 for those living with family (p >.05). The influence of students’ living status has been mainly noticeable in the affective scale, suggesting that significant differences are primarily observed in the emotional domain.

Using the data presented in Table S4, it is possible to thoroughly analyse the relationship between the marital status and MAS-UA scores, with particular attention to the differences between single individuals and those who are married. Additionally, a significant correlation has been identified between the living status (living alone vs. with family) and the marital status (rho = 0.534, p <.01).

The marital status has some impact on respondents’ attitudes, particularly in the affective subscale and the overall MAS score, though those changes have stabilised over time. The noticeable decrease in the scores in the emotional subscale among single individuals suggests a shift towards more positive moods. Similarly, the stability of results in the other two subscales indicates a relative constancy in the cognitive and behavioural attitudes regardless of the marital status.

In the study conducted in 2022 (the first study), statistically significant differences were observed between medical students and students from the humanities and social sciences in several subscales. Students from the humanities and social sciences had lower scores on the affective scale (40.4 ± 6.1 vs. 39.6 ± 5.9) and the behavioural scale (16.6 ± 5.0 vs. 15.8 ± 5.1). It was also reflected in the overall MAS score (80.2 ± 11.7 vs. 78.6 ± 12.1) (p <.05), in favour of medical students. In the study conducted in 2024 (the second study), the differences between the student groups in the affective and overall MAS subscales have shifted positively as compared to the previous results. In those subscales, students from the humanities and social sciences have scored 35.5 ± 11.8, while medical students have had a significantly better score of 33.5 ± 9.7. However, the two groups in the cognitive and behavioural scales have not shown any significant differences. The overall MAS score has also shown no statistically significant differences (74.1 ± 18.6 for the humanities and social sciences and 74.0 ± 18.3 for medical students). It indicates that more positive attitudes towards people with disabilities have been observed among future medical professionals in both the first and second studies. By 2024 those differences had diminished, which may suggest changes in the levels of attitudes in both student groups over the two years of the crisis period.

In the further research, the relationship between the religious affiliation and the MAS-UA scores has been analysed (Table S5). The study has included three groups: those with no religious practice, those belonging to the Orthodox Church, and those of Greek Catholic faith. The results show significant changes in the MAS-UA attitudes over the two-year period and indicate differences between groups practicing the major Christian religions in Ukraine.

In 2024, students, regardless of their religious affiliation, have achieved better results across all of the subscales. The highest scores have been observed among Orthodox and Greek Catholic students, particularly in the emotional subscale and the overall Global MAS score.

A daily indirect or direct contact with individuals with mobility impairments significantly affects the affective aspects of students’ attitudes. It may indicate a greater empathy and a better understanding of the situation of people with disabilities. Tables S5 and S6 presents the study results concerning the relationship between the frequency of daily visual or indirect contacts with individuals with mobility impairments and various aspects of attitudes measured by means of the MAS-UA subscales.

In 2024 amongst the individuals who had a daily contact with people with mobility impairments, the average scores in the affective subscale have reflected a more positive acceptance of those individuals, indicating a greater empathy and a better understanding of the situation of people with disabilities. However, in the cognitive and behavioural aspects, the daily contact has not yielded significant differences. Young people, who experienced a more significant presence of individuals with mobility impairments in their social environment during the crisis, have demonstrated more positive attitudes toward them, particularly in the emotional subscale.

Discussion

The aim of this study has been to empirically explain the changes in attitudes among the advanced education students in Ukraine towards individuals in wheelchairs, with reference to selected sociodemographic indicators at the onset of the Russian invasion of Ukraine and after two years of the active military conflict. The differences observed in the attitudes of Ukrainian students toward individuals with disabilities in the context of war can be attributed to several interrelated factors. First, the ongoing conflict has significantly influenced social perceptions, fostering heightened empathy and solidarity among students toward individuals with disabilities. This emotional shift is crucial, as it reflects the broader societal changes occurring amidst the crisis. Second, psychological mechanisms play a vital role in shaping these attitudes. In high-stress environments, individuals often exhibit defensive reactions that may hinder the evolution of cognitive and behavioral attitudes, even as emotional responses become more pronounced. This relationship is further explored in the study24, which highlights how societal stigma can exacerbate feelings of depression among wheelchair users, indicating the need for targeted interventions to address both stigma and mental health in this population. Affective component of attitudes may improve, cognitive and behavioral changes may require more deliberate interventions. Armed conflicts, such as the one in Ukraine, provoke significant social and psychological changes, both among those directly affected by the conflict and within the broader population. The research on attitudes towards individuals with disabilities in this context provides valuable insights into shifts in social norms and values under the conditions of extreme stress and crisis5.

The results of our research attitudes toward people with disabilities have generally been positive in both of the studies, but in the later study the respondents have shown better results in terms of acceptance of people with disabilities. It is favourable when compared with the earlier studies in other countries25– 26.

The results of the assessment of the three attitude subscales (affective, cognitive, and behavioural) and their relationships with sociodemographic factors (age, gender, place of residence, religious affiliation, and others) provide valuable insights for efforts to improve integration and understanding of individuals with mobility impairments in various social contexts27,28. In the face of the growing issue arising from ongoing armed conflicts that lead to the increased number of injured military personnel and civilians, including a rise in the number of individuals with mobility impairments, monitoring attitudes is crucial as far as building a more inclusive society is concerned. The inclusive society would offer a greater understanding and support to people with disabilities6.

Our results suggest a positive trend in the emotional well-being of respondents, with the reduction in tension, stress, helplessness, and shame. Similarly, negative emotions such as depression and anxiety have decreased, indicating an overall improvement in the psychological well-being of the participants. However, some negative aspects have been noted. Students have reported a decline in their feelings of relaxation, calmness, and composure when interacting with people in wheelchairs. The assumption that armed conflicts positively impact primarily the affective (emotional) component of attitudes is highly controversial. The study conducted among 625 students in Poland indicates that, in peaceful times, emotional attitudes are more negative as compared to other aspects29. Although war is an immensely destructive and traumatic phenomenon, the data obtained suggest that it may have a positive impact on the affective component of attitudes in a communal and emotional context. Those elements, shaped under extreme conditions, may paradoxically strengthen social structures and unity in response to the highlighted issue. Cognitive and behavioural components of attitudes play a mediating role, and no significant changes in those components have been observed between the two studies. The slowed dynamics of those subscale indicators in the case of a crisis are also noted by the researchers who have studied similar issues during the COVID-19 pandemic30,31. Although the overall societal attitude before and after the pandemic was assessed as slightly positive, significant differences emerged depending on the respondents’ age. The most favourable attitudes were observed among respondents aged 19–34 years. People around the age of 21 were rarely negatively inclined towards individuals with disabilities both before and during the pandemic32. The analysis of 84 studies during the COVID-19 pandemic33 has revealed that individuals with disabilities are more vulnerable to the negative health effects associated with the ongoing crisis. However, the COVID-19 pandemic has also brought some unexpected benefits such as increased social justice based on humanistic values and enhanced psychological resilience.

Women show a more positive attitude towards people with disabilities than men. Additionally, those differences are clearly apparent in the emotional sphere. Men, although they also show support, exhibit more varied attitudes. Those differences may stem from different social roles and cultural norms assigned to each gender29. In our first study, despite generally more positive attitudes, women also displayed negative emotions. The analysis in terms of emotions thus reveals a hidden dimension, and consequently a full spectrum of attitudes. Similar observations are characteristic of the authors of the original MAS questionnaire34. The results of our 2024 study clearly show that in the emotional sphere, women’s attitudes have been significantly more positive. The cognitive and behavioural spheres, although they have also indicated a more positive attitude among women, are not as definitive as the emotional sphere. The experiences of women with disabilities in wartime Ukraine, discussed in the article35, emphasize the importance of community care and solidarity in addressing these issues. The authors’ findings emphasize how the feminist and disability movements can intersect to help create a more inclusive society, which is critical in the context of ongoing conflict.

Older students, those raised and living in large cities, those who are married, pursuing graduate studies in medical fields, and those who identify with a religion, exhibit a more positive attitude in the affective component and the overall MAS score. Participants’ responses in both studies clearly indicate that religion as well as the context of marriage and family life significantly influence the positivity of social attitudes. The existing related literature confirms a positive correlation between the strength of religious faith and acceptance of illness36. Moreover, a daily visual or direct contact with individuals with physical disabilities positively influence affective attitudes, highlighting the importance of direct interactions in shaping empathy and understanding. People who regularly work with individuals with disabilities - who have been twice as numerous in the second study — gain a broader perspective and a deeper understanding of the challenges faced by their care recipients. Such professional experience enhances empathy and the ability to recognise each person’s individual needs, as indicated by other researchers in this field37,38. Attitudes towards people with disabilities in the context of wartime.

Social and cultural influences cannot be overlooked. In Ukrainian society, traditional roles and stereotypes may persist, affecting how students perceive individuals with disabilities. This underscores the necessity of educational initiatives that address both emotional and cognitive dimensions of attitudes, promoting a more inclusive understanding of disability. As shown by the results of the study39, creating conditions for social support and inclusion can lead to significant changes in perceptions and attitudes toward people with disabilities.

The role of education is paramount. Programs that enhance awareness and foster direct interactions with individuals with disabilities can significantly impact students’ attitudes, leading to more positive cognitive and behavioral responses over time. The authors of recent studies discuss the barriers to inclusion and the need to understand disability through the social model, which can further enrich educational programs40. The practical implications of this study for educational programmes across various disciplines are multifaceted: they should not only include substantive knowledge about disabilities, diversity, and inclusion but also support students in developing social and emotional competencies as well as in understanding and improving their own personalities. The findings from this study may serve as an important source of information for further actions aimed at supporting the integration of individuals with physical disabilities within both the Ukrainian and global contexts. Understanding these factors is essential for developing effective strategies aimed at supporting the social integration of individuals with disabilities. By addressing the complexities of attitude formation and change, we can work toward creating a more inclusive society that values and supports all individuals, regardless of their physical abilities.

Limitation

Despite significant achievements in developing and evaluating scales measuring attitudes towards individuals with disabilities, there is still a need for exclusive research results describing current situations. Our study aims to fill this gap by introducing novelty in the use of the MAS questionnaire in the context of the impact of ongoing military actions in Ukraine. This perspective is crucial for monitoring the situation and acquiring knowledge useful to both researchers and the society. When analysing the obtained results, certain limitations must be considered. All respondents were students majoring in medical, social, and humanities fields, which means the sample is not representative of other segments of the Ukrainian population. We have attempted to mitigate that issue by conducting surveys at universities in various regions of the country. Therefore, further research is needed to ensure more representative results and increase the universality of the findings. Since attitudes change under the influence of various factors, longitudinal studies would provide a better understanding of attitudes towards individuals with physical disabilities. Despite those limitations, the results of this study may be useful in practical and educational efforts and in supporting students in the context of determinants beyond just sociodemographic factors.

Conclusions

The direct effects of the armed conflict have led to a greater mobilisation of the Ukrainian youth to support individuals with physical disabilities, highlighting their importance in building social bonds.

The level of acceptance and social attitudes towards individuals in wheelchairs, especially regarding the affective and overall components, has risen. Cognitive and behavioural aspects of attitudes are more stable and change relatively slowly.

Positive emotions, such as reduced tension, stress, helplessness, and shame, indicating an improvement in mental well-being, have been noticeably rising. However, the experience of relaxation, calmness, and composure has notably declined.

It has been proven that the sociodemographic ‘profile’ plays a significant role in shaping emotional attitudes and the overall MAS score. Older students, women, those raised and living in large cities, those who are married, pursuing graduate studies in medical fields, and those who identify with a religion show a more positive attitude in both the emotional component and the overall MAS index.

A daily visual or direct contact with individuals with physical disabilities has a positive impact on affective attitudes, highlighting the importance of direct interactions in developing empathy and understanding.

Recommendations:

The findings of the study highlight the importance of actively engaging Ukrainian youth in supporting individuals with mobility disabilities, demonstrating significant progress in fostering social connections and improving social attitudes. However, it is crucial for stakeholders, including government bodies, NGOs, and educational institutions, to deepen their understanding of these changes. There is an urgent need for more comprehensive research on how sociodemographic factors influence emotional attitudes and overall perceptions of people with disabilities. This will facilitate the creation of targeted programs aimed at enhancing social inclusion and support for various groups. Despite the positive shifts in the emotional state of young people, there is a rise in mental tension and a decline in calmness. This underscores the necessity of developing programs to improve psycho-emotional well-being, which may be especially vital in a post-conflict society.

The results emphasize the importance of direct interaction with individuals with physical disabilities to foster empathy and understanding. Stakeholders should consider creating initiatives to encourage regular interaction between youth and individuals with disabilities, as this can greatly improve social attitudes and reduce stigmatization.