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Cavuoto MG, Markusevska S, Stevens C, Reyes P, Renshaw G, Peters MDJ, Dow B, Feldman P, Gilbert A, Manias E, Mortimer D, Enticott J, Cooper C, Antoniades J, Appleton B, Nakrem S, O'Brien M, Ostaszkiewicz J, Eckert M, Durston C, Brijnath B. The impact of elder abuse training on subacute health providers and older adults: study protocol for a randomized control trial. Trials 2024; 25:338. [PMID: 38778386 PMCID: PMC11110438 DOI: 10.1186/s13063-024-08160-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers' recognition, response, and referral of elder abuse. METHODS This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e. clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training programme for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are change in health providers' knowledge of responding to elder abuse and older people's sense of safety and quality of life. We will include all inpatients at participating sites, aged 65 + (or aged 50 + if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses. DISCUSSION This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral. TRIAL REGISTRATION ANZCTR, ACTRN12623000676617p . Registered 22 June 2023.
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Affiliation(s)
- Marina G Cavuoto
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Simona Markusevska
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
| | | | - Patricia Reyes
- . Vincent's Health Sydney, Darlinghurst, NSW, Australia
- University of New South Wales, Kensington, NSW, Australia
- Uniting War Memorial Hospital, Waverley, NSW, Australia
| | - Gianna Renshaw
- Sir Charles Gairdner Osborne Park Health Care Group, Stirling and Nedlands, WA, Australia
| | - Micah D J Peters
- Rosemary Bryant AO Research Centre, Clinical Health Science, University of South Australia, Adelaide, South Australia, Australia
- Australian Nursing and Midwifery Federation (Federal Office), Melbourne, VIC, Australia
- Adelaide Nursing School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Health Evidence Synthesis, Recommendations, and Impact (HERSI), School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Briony Dow
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- The University of Melbourne, Parkville, VIC, Australia
- Deakin University, Waurn Ponds, Victoria, Australia
| | - Peter Feldman
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
| | - Andrew Gilbert
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- La Trobe University, Bundoora, VIC, Australia
| | - Elizabeth Manias
- Deakin University, Waurn Ponds, Victoria, Australia
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Duncan Mortimer
- Centre for Health Economics, Monash University, Caulfield East, VIC, Australia
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Claudia Cooper
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- East London NHS Foundation Trust, London, UK
| | - Josefine Antoniades
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, WA, Australia
| | | | - Sigrid Nakrem
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Joan Ostaszkiewicz
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- The University of Melbourne, Parkville, VIC, Australia
- Health and Innovation Transformation Centre, Federation University, Ballarat, VIC, Australia
| | - Marion Eckert
- Rosemary Bryant AO Research Centre, Clinical Health Science, University of South Australia, Adelaide, South Australia, Australia
- College of Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | - Bianca Brijnath
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia.
- The University of Melbourne, Parkville, VIC, Australia.
- The School of Social Sciences, The University of Western Australia, Perth, WA, Australia.
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Zhang Kudon H, Herbst JH, Richardson LC, Smith SG, Demissie Z, Siordia C. Prevalence estimates and factors associated with violence among older adults: National Intimate Partner and Sexual Violence (NISVS) Survey, 2016/2017. J Elder Abuse Negl 2024; 36:67-83. [PMID: 38129823 DOI: 10.1080/08946566.2023.2297227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Abuse of older adults is a public health problem. The National Intimate Partner and Sexual Violence Survey (NISVS) is a nationally-representative, telephone survey for non-institutionalized adults in the United States. To determine the prevalence and factors of intimate partner psychological aggression and physical violence and sexual violence by any perpetrator against older adults, we analyzed NISVS 2016/2017 data (n = 10,171, aged ≥ 60 years). Past 12-month prevalence of psychological aggression, physical violence, and sexual violence was 2.1%, 0.8%, and 1.7%, respectively. Odds of psychological aggression were significantly higher among those with hearing or vision impairment, and lower among those aged ≥70 years. Odds of physical violence were significantly higher for males and for those with hearing or vision impairment. Odds of sexual violence were significantly higher for unpartnered individuals and those with cognitive impairment; and lower for those aged ≥ 70 years. Epidemiologic studies of violence against older adults can inform population-specific prevention strategies.
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Affiliation(s)
- Hui Zhang Kudon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeffrey H Herbst
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - LaTonia C Richardson
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharon G Smith
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Zewditu Demissie
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Office of Health Equity and Health Disparities, Centers for Disease Control and Prevention, U.S. Public Health Service Commissioned Corps, Rockville, Maryland, USA
| | - Carlos Siordia
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Martinez JM, Homeier DC, Fowler C, Wilber KH. Conceptualizing Person-Centered Care in Elder Mistreatment Intervention: Use of a Well-Being Framework. THE GERONTOLOGIST 2023; 63:973-982. [PMID: 36434169 DOI: 10.1093/geront/gnac170] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Person-centered care (PCC) applied to elder mistreatment interventions is an approach to include victim priorities. Although PCC may improve outcomes by supporting choice, victim preferences are often difficult to support, especially in high-risk situations. We studied the adaptation of PCC structures and process to a pilot intervention, aimed at including client preferences in a multidisciplinary team's plans to address complex elder mistreatment. RESEARCH DESIGN AND METHODS Case study analysis was used to examine the process of integrating client priorities into a risk-reduction plan. A well-being framework was used to understand the relationship between safety and preferences. Purposive sampling identified a case study of a high-risk victim with history of refusing help who agreed to work with the Service Advocate, a member of a multidisciplinary team. RESULTS PCC required a relationship of trust, honed over several weeks by prioritizing the clients' perspective. Client preferences included remaining at home, continuing the relationship with the abuser, and maintaining a sense of mastery. Individualized definitions of "safety" were unrelated to elder mistreatment risk. Assistance included working with the suspected perpetrator, which is not offered by most elder mistreatment interventions, and resulted in some risk reduction. Reasons for refusing help were a desire for control and fear of loss of well-being assets. DISCUSSION AND IMPLICATIONS Individualized definitions of well-being should be considered in measuring intervention success. Future research could determine guidelines on what levels of elder mistreatment risk are acceptable, and how to monitor clients for safety while supporting autonomy.
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Affiliation(s)
- Julia M Martinez
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Diana C Homeier
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Cherie Fowler
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Kathleen H Wilber
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Kennedy B, Bugeja L, Olivier J, Johnson M, Hua P, Koppel S, Ibrahim JE. Epidemiology of Homicide in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:390-406. [PMID: 34253097 DOI: 10.1177/15248380211030250] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Empirical research investigating older adult homicide is sparse and rarely accumulated for greater insights. This systematic review and meta-analysis quantifies the prevalence and characteristics of homicide victimization among older adults (65 years and older) compared with younger adults (18-64 years). METHOD We searched Cumulative Index to Nursing and Allied Health Literature, Cochrane, Criminal Justice Abstracts, EMBASE, MEDLINE, ProQuest, PsycINFO, Scopus, and Web of Science for studies published before December 31, 2018 (International Prospective Register of Systematic Reviews registration: CRD42017054536). Included were English-language, original, peer-reviewed studies describing the homicide of older adults. Excluded were studies not meeting age criteria, residence as an institution, or with insufficient outcome variables. The review included 39 studies; 17 were included in the meta-analysis. Data were extracted via open access or from study authors. Heterogeneity was assessed through study-level random effects estimates. RESULTS Pooled homicide rates per 100,000 population were 2.02 (95% CI [1.23, 3.33]) for older adults (n = 35,325) and 3.98 (95% CI [2.42, 6.53]) for younger adults (n = 607,224; rate ratio = .51, 95% CI [0.37, 0.70], p < .001). Proportion estimates for older adults: victim female 46.3%, location home 71.4%, offender familiar 25.2%, compared to stranger, 24.2%, motive argument 36.1%, compared to felony 30.8%, and weapon firearm 24.5%. Older adults were significantly different to younger adult victims (p = <.001) for female (OR = 2.5, 95% CI [2.02, 3.10]), home (3.87, 95% CI [3.45, 4.35]), stranger (1.81, 95% CI [1.66, 1.98]), argument (0.33, 95% CI [0.28, 0.39]), felony (2.78, 95% CI [2.58, 2.99]), and firearm (0.38, 95% CI [0.36, 0.40]). CONCLUSIONS Homicide against older adults differs from younger adults and warrants specific research and tailored prevention strategies.
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Affiliation(s)
- Briohny Kennedy
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Jake Olivier
- School of Mathematics and Statistics, University of New South Wales, Sydney, New South Wales, Australia
| | - Marilyn Johnson
- Institute of Transport Studies, Monash University, Clayton, Victoria, Australia
| | - Phuong Hua
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Sjaan Koppel
- Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Joseph E Ibrahim
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
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Yurdakul ES, Veizi BGY, Avcı C, Yazır HT, Avaner E, Naharcı Mİ, Sarı O. Reliability and validity of the Turkish version of the elder abuse suspicion index in community-dwelling older adults. Turk J Med Sci 2023; 53:432-438. [PMID: 36945952 PMCID: PMC10388021 DOI: 10.55730/1300-0144.5600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/04/2022] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Elder abuse is among the most important ethical issue during the management of older population. The elder abuse suspicion index (EASI) was developed for evaluating abuse in older adults. We aimed to assess the reliability and validity of the Turkish version EASI-Türkiye (TR) among older adults. METHODS This study included 89 community-dwelling older adults. The EASI-TR and other scales, including HwalekSengstock Elder Abuse Screening Test-Türkiye (HS/EAST-TR), YGDS, Yesavage Geriatric Depression Scale (YGDS), Instrumental Activities of Daily Living (IADL), and Activities of Daily Living (ADL) were administered to all participants. Internal consistency and external validity were assessed. RESULTS EASI-TR revealed an excellent test-retest reliability and acceptable level of internal consistency (Cronbach's α = 0.711). The item-total correlations ranged between 0.296 and 0.701, except for the second item. This test showed significant correlations with the HS/EAST-TR and IADL (p < 0.05), demonstrating good external validity. DISCUSSION The EASI-TR appears to have acceptable reliability and validity in screening for abuse in older adults. This tool may recognize cases that require additional evaluation in managing of ethical issues.
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Affiliation(s)
- Eray Serdar Yurdakul
- Department of Medical History and Bioethics, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Betül Gülsüm Yavuz Veizi
- Division of Geriatrics, University of Health Sciences, Gülhane Faculty of Medicine and Gülhane Training and Research Hospital, Ankara, Turkey
| | - Candeniz Avcı
- Division of Geriatrics, University of Health Sciences, Gülhane Faculty of Medicine and Gülhane Training and Research Hospital, Ankara, Turkey
| | - Hatice Tuğba Yazır
- Division of Geriatrics, University of Health Sciences, Gülhane Faculty of Medicine and Gülhane Training and Research Hospital, Ankara, Turkey
| | - Elif Avaner
- Department of Medical History and Bioethics, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Mehmet İlkin Naharcı
- Division of Geriatrics, University of Health Sciences, Gülhane Faculty of Medicine and Gülhane Training and Research Hospital, Ankara, Turkey
| | - Oktay Sarı
- Department of Family Medicine, Gülhane Faculty of Medicine and Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Simmons J, Motamedi A, Ludvigsson M, Swahnberg K. Testing an educational intervention to improve health care providers' preparedness to care for victims of elder abuse: a mixed method pilot study. BMC MEDICAL EDUCATION 2022; 22:597. [PMID: 35922855 PMCID: PMC9351204 DOI: 10.1186/s12909-022-03653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Elder abuse is prevalent and associated with ill-health. However, health care providers often lack education about elder abuse and older patients' victimization often remains unknown to them. In this pilot study we performed initial testing of an educational model aiming at improving health care providers' preparedness to care for older adults subjected to abuse, or more specifically their self-reported propensity to ask older patients questions about abuse and perceived ability to manage the response. METHODS The educational model consisted of a full training day about elder abuse, including theory, group discussions and forum theatre. Forum theatre is an interactive form of drama in which participants are not only observers, but rather spect-actors, urged to participate in the scene. They are thereby given the opportunity to discuss and practise difficult health care encounters. Medical interns (intervention group n = 16, control group n = 14) in Sweden participated in the study and a mixed method convergent parallel design was used. Quantitative data was collected at baseline and 6 months post-intervention using a questionnaire (the REAGERA-P). Qualitative interviews were conducted with four of the participants in the intervention group and data was analysed using qualitative content analysis. RESULTS The reported frequency of asking older patients questions about abuse increased in the intervention group (p = 0.047), but not the control group (p = 0.38) post-intervention. Potential mediators for the improvement were an increased awareness of elder abuse and higher self-efficacy for asking questions about elder abuse. Participants also reported a higher perceived ability to manage cases of elder abuse, even though uncertainties concerning how to provide the best possible care remained. The qualitative interviews indicated that learning from each other in group discussions and forum theatre likely was an important contributor to the positive results. CONCLUSION This pilot test indicated that the educational model may be effective in improving health care providers' preparedness to care for older adults subjected to abuse. However, uncertainties about how to handle elder abuse cases remained post-intervention. In a future full-scale test of the model more focus needs to be put on how to manage cases of elder abuse.
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Affiliation(s)
- Johanna Simmons
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Atbin Motamedi
- Department of Emergency Medicine in Norrköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mikael Ludvigsson
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Psychiatry in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Katarina Swahnberg
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
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Neuberg M, Pudmej Ešegović V, Križaj M, Cikač T, Meštrović T. Abuse and neglect of older people in health facilities from the perspective of nursing professionals: A cross-sectional study from Croatia. Int J Older People Nurs 2022; 17:e12484. [PMID: 35713622 DOI: 10.1111/opn.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 04/27/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Abuse and neglect of older people represent a salient public health issue that remains understudied in the current literature. However, most studies have focused on estimating the prevalence of mistreatment of older people, while litter priority has been put on healthcare professionals and their role in addressing this problem. OBJECTIVES The aim of this paper was to determine nurses' perceptions of neglect and abuse of older persons within health facilities in Croatia. METHODS A cross-sectional survey with convenience sampling approach was conducted on 632 nursing professionals between 26 March and 26 April 2020. Participation was voluntary and anonymous. A questionnaire from Drennan et al. (NCPOP, University College Dublin, Dublin, 2012), previously adapted by Neuberg et al. (Arch Ind Hyg Toxicol, 68, 2017, 190), was used as a survey instrument. Descriptive and inferential statistics has been used, as well as multivariable methods (reliability analysis). Significance was set at p < .05 (two-tailed). RESULTS Abuse/neglect of older people was observed by 13.8% to 57.4% of nursing professionals, depending on the incident type. The most prevalent incidents observed were ignoring the call of an older person (57.4%), shouting at an older person in anger (41.1%) and force-feeding an older person (34.5%), while the least prevalent incidents observed were denial of food or some privileges as a form of punishment (13.8%). Male nursing professionals reported observing various forms of abuse significantly more often than their female counterparts (p = .038), without statistically significant age-related differences. Furthermore, mistreatment of older people was much more frequently observed in nursing homes (p = .013), with suboptimal the ratio of caregivers and care recipients, as well as by nursing professionals who work in shifts (p = .012). Reliability analysis demonstrated a satisfactory level of internal consistency for the used questionnaire. CONCLUSIONS This study reinforces neglect and abuse of older people as a growing public health problem and puts the emphasis on its perception; hence, there is a need for systematic and continuous training of nursing professionals on preventing, identifying and responding to such mistreatment, with the aim of enhancing the quality of life in this vulnerable group. IMPLICATIONS FOR PRACTICE This study contributes to the growing body of research on the quality of evidence-based nursing care of older people, most notably from providers' perspective - with direct implications for policy, practice, research and training.
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Affiliation(s)
| | | | - Mateja Križaj
- University North, University Centre Varaždin, Varaždin, Croatia
| | - Tina Cikač
- University North, University Centre Varaždin, Varaždin, Croatia
| | - Tomislav Meštrović
- University North, University Centre Varaždin, Varaždin, Croatia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle, Washington, USA
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Simmons J, Wiklund N, Ludvigsson M. Managing abusive experiences: a qualitative study among older adults in Sweden. BMC Geriatr 2022; 22:456. [PMID: 35619083 PMCID: PMC9137123 DOI: 10.1186/s12877-022-03143-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/17/2022] [Indexed: 12/28/2022] Open
Abstract
Background Elder abuse is prevalent, and is associated with poor health outcomes. How an older adult is affected by abusive experiences is dependent on myriad factors, including aspects of the abuse itself, other life circumstances, coping strategies, and what kind of help the older adults receive to manage the experience. In this study, we sought to investigate how older adults themselves describe how they manage abusive experiences. An increased understanding of this could help to tailor society’s response to older adults suffering from abuse. Method Participants (n = 30) were recruited from patients admitted to one acute geriatric and one acute internal medicine ward at a university hospital in Sweden. Patients over the age of 65 who reported experiences of elder abuse or who reported that they were still suffering from abuse that had occurred earlier in life were included. In-depth qualitative interviews were conducted, transcribed verbatim, and analyzed using qualitative content analysis. Results The analysis resulted in five themes, three pertaining to strategies used to manage abusive experiences (self-reliant coping, restoring dignity in relation to others, and needing formal and informal help) and two pertaining to the disclosure process (inner resistance to disclosure, and external barriers and facilitators for disclosure). Conclusion Older adults were found to use a combination of different strategies to manage abusive experiences. Some were self-reliant, but older adults often managed their experiences with the help of others. Health care professionals were generally in a position to facilitate disclosure, but some participants reported poor encounters with health care. The findings indicate a need to facilitate disclosure by, for example, training professionals on issues related to elder abuse and developing more easily navigated response systems that can respond to the complex needs of older adults trying to manage abusive experiences. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03143-y.
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Affiliation(s)
- Johanna Simmons
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Nicolina Wiklund
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mikael Ludvigsson
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Psychiatry in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Ludvigsson M, Motamedi A, Westerlind B, Swahnberg K, Simmons J. Responding to Elder Abuse in GERiAtric care (REAGERA) educational intervention for healthcare providers: a non-randomised stepped wedge trial. BMJ Open 2022; 12:e060314. [PMID: 35508341 PMCID: PMC9073413 DOI: 10.1136/bmjopen-2021-060314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Elder abuse is prevalent and associated with different forms of ill health. Despite this, healthcare providers are often unaware of abusive experiences among older patients and many lack training about elder abuse. The overall aim of this study is to determine the effectiveness of an educational intervention on healthcare providers' propensity to ask older patients questions about abusive experiences. METHODS AND ANALYSIS Healthcare providers at hospital clinics and primary healthcare centres in Sweden will undergo full-day education about elder abuse between the fall of 2021 and spring of 2023. The education consists of (1) theory and group discussions; (2) forum theatre, a form of interactive theatre in which participants are given the opportunity to practise how to manage difficult patient encounters; and (3) post-training reflection on changing practices.The design is a non-randomised cluster, stepped wedge trial in which all participants (n=750) gradually transit from control group to intervention group with 6-month interval, starting fall 2021. Data are collected using the Responding to Elder Abuse in GERiAtric care-Provider questionnaire which was distributed to all clusters at baseline. All participants will also be asked to answer the questionnaire in conjunction with participating in the education as well as at 6-month and 12-month follow-up. Main outcome is changes in self-reported propensity to ask older patients questions about abuse post-intervention compared with pre-intervention. Linear mixed models including cluster as a random effect will be used to statistically evaluate the outcome. ETHICS AND DISSEMINATION The study has been approved by the Swedish Ethical Review Authority. The results will be published in peer-reviewed journals and conference proceedings. If the intervention is successful, a manual of the course content will be published so that the education can be disseminated to other clinics. TRIAL REGISTRATION NUMBER NCT05065281.
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Affiliation(s)
- Mikael Ludvigsson
- Department of Psychiatry, and Department of Biomedical and Clinical Sciences, Linköping University, Linkoping, Sweden
- Department of Acute Internal Medicine and Geriatrics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Atbin Motamedi
- Department of Emergency Medicine in Norrköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Björn Westerlind
- Department of Geriatrics, County Hospital Ryhov, Region Jönköping County, Jonkoping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Katarina Swahnberg
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Johanna Simmons
- Department of Acute Internal Medicine and Geriatrics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
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Chen J, Zeng Y, He W, Yang J, Xu D, Li H. How Healthy Aging and Contact With Children Are Associated With Satisfaction in Middle-Aged and Older Parents in China: A Mediation Analysis. Front Public Health 2022; 10:836558. [PMID: 35359770 PMCID: PMC8963940 DOI: 10.3389/fpubh.2022.836558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/21/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives This study aims to examine the mediation role of satisfaction with children on the association between contact with children (CCT) and healthy aging among middle-aged and older parents in China. Methods Data from 9,575 parents over 45 years old were obtained from the 2018 China Health and Retirement Longitudinal Survey. A multinomial logistic regression model was applied to measure the association between contact, satisfaction, and healthy aging with potential confounders controlled. We used the Sobel-Goodman Mediation test to analyze the mediation role of satisfaction on the association between types of CCT and healthy aging. Results Parents with contact with adult children had higher satisfaction with children [for contact weekly (satisfied/unsatisfied): relative risk ratio (RRR) = 2.44, CI = 1.92-3.10] and higher healthy aging [for contact weekly (Q5/Q1): RRR = 1.41, CI = 1.13-1.77]. Satisfaction was strongly related to healthy aging [for satisfied (Q5/Q1): RRR = 3.44, CI = 2.14-5.51], and mediated 19.05% of healthy aging for weekly contact (Sobel test z = 4.338; indirect role = 0.014, CI = 0.011-0.018; direct role = 0.061, CI = 0.029-0.094). Subgroup analysis further revealed that satisfaction with contact played a partial mediating role between monthly contact and healthy aging in female and rural groups. Conclusions Monthly CCT is more appropriate for older parents. Satisfaction with children in older parents seems to act as a significant and partial mediator of the relationship between contact and healthy aging. The contribution of satisfaction to healthy aging could be important to be considered and promoted in women and rural older parents, independent of CCT.
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Affiliation(s)
- Jiangyun Chen
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China,ACACIA Labs of Southern Medical University Institute for Global Health (SIGHT) and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, China,Institute for Health Management, Southern Medical University, Guangzhou, China
| | - Yixin Zeng
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Wenjun He
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Jiao Yang
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Dong Xu
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China,ACACIA Labs of Southern Medical University Institute for Global Health (SIGHT) and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, China,Institute for Health Management, Southern Medical University, Guangzhou, China,Dong Xu
| | - Haomiao Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, China,*Correspondence: Haomiao Li
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11
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Hoyumpa G, Narro A, Law M, Ciavarra B, Phung V, Chiang S, Oyler T, Lydick H, Flores R, Lee J, Burnett J. Medical student-led social phone calls with elder mistreatment victims: Changes in loneliness, depression, and perspectives of aging. J Am Geriatr Soc 2022; 70:1876-1878. [PMID: 35211953 DOI: 10.1111/jgs.17713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Gabrielle Hoyumpa
- The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas, USA
| | - Analisa Narro
- The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas, USA
| | - Matthew Law
- The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas, USA
| | - Bronson Ciavarra
- The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas, USA
| | - Vanessa Phung
- The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas, USA
| | - Sarah Chiang
- The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas, USA
| | - Tyson Oyler
- The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas, USA
| | - Hayden Lydick
- The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas, USA
| | - Renee Flores
- The University of Texas Health Science Center at Houston (UTHealth), Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, Houston, Texas, USA.,UTHealth, The University of Texas Health Science Center at Houston, Department of Medical Humanities, McGovern Medical School, Houston, Texas, USA
| | - Jessica Lee
- The University of Texas Health Science Center at Houston (UTHealth), Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, Houston, Texas, USA.,Texas Elder Abuse and Mistreatment (TEAM) Institute, Houston, Texas, USA
| | - Jason Burnett
- The University of Texas Health Science Center at Houston (UTHealth), Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, Houston, Texas, USA.,Texas Elder Abuse and Mistreatment (TEAM) Institute, Houston, Texas, USA
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12
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Prevalence of Violence Perpetrated by Healthcare Workers in Long-Term Care: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042357. [PMID: 35206547 PMCID: PMC8877976 DOI: 10.3390/ijerph19042357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/27/2023]
Abstract
This systematic review and meta-analysis aimed to determine the prevalence of violence perpetrated by healthcare workers (HCWs) against patients in long-term care (LTC). For this purpose, five relevant databases were searched. Two reviewers extracted data from the included articles independently and assessed their quality. Overall and subgroup random-effects pooled prevalence meta-analyses were performed. A series of meta-analyses stratified by study quality were also performed due to high heterogeneity. Nineteen articles were included, physical restraint (22%; CI: 15-29), verbal abuse (22%; CI: 16-28), and neglect (20%; CI: 15-26) attained the highest overall prevalence, while sexual abuse was less reported (2%; CI: 1-3). The prevalence of witnessed violence is generally higher than those reported by HCWs, and patients and their relatives reported fewer cases of violence than HCWs. Differences in violence perpetrated among LTC settings were found. Neglect (64%; CI: 56-72) and financial abuse (7%; CI: 3-12) reported by HCWs were higher in home care, while verbal abuse (21%; CI: 7-39) reported by patients or their families was higher in nursing homes. Our findings highlight that violence perpetrated by HCWs toward patients represents a significant concern in LTC, suggesting the adoption of reliable monitoring approaches and provision of assistance to victims in reporting abuse.
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Types, characteristics and anatomic location of physical signs in elder abuse: a systematic review : Awareness and recognition of injury patterns. Eur Geriatr Med 2021; 13:53-85. [PMID: 34514555 PMCID: PMC8860961 DOI: 10.1007/s41999-021-00550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/28/2021] [Indexed: 11/05/2022]
Abstract
Aim Identify types, characteristics and anatomic location of physical signs in elder abuse. Findings Physical signs in elder abuse are most common bruises and anatomically predominantly located on the head, face/maxillofacial area, neck, upper extremities and torso. Message Increase knowledge on physical signs in elder abuse so as to enhance timely detection and intervention. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00550-z. Purpose Elder abuse is a worldwide problem with serious consequences for individuals and society. The recognition of elder abuse is complex due to a lack of awareness and knowledge. In this systematic review, types, characteristics and anatomic location of physical signs in elder abuse were identified. Methods Databases of MEDLINE, COCHRANE, EMBASE and CINAHL were searched. The publication dates ranged from March 2005 to July 2020. In addition to the electronic searches, the reference lists and citing of included articles were hand-searched to identify additional relevant studies. The quality of descriptive and mixed-methods studies was assessed. Results The most commonly described physical signs in elder abuse were bruises. The characteristics of physical signs can be categorized into size, shape and distribution. Physical signs were anatomically predominantly located on the head, face/maxillofacial area (including eyes, ears and dental area), neck, upper extremities and torso (especially posterior). Physical signs related to sexual elder abuse were mostly located in the genital and perianal area and often accompanied by a significant amount of injury to non-genital parts of the body, especially the area of the head, arms and medial aspect of the thigh. Conclusions Most common types, characteristics and anatomic location of physical signs in elder abuse were identified. To enhance (early) detection of physical signs in elder abuse, it is necessary to invest in (more) in-depth education and to include expertise from a forensic physician or forensic nurse in multidisciplinary team consultations. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00550-z.
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14
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Welch V, Mathew CM, Babelmorad P, Li Y, Ghogomu ET, Borg J, Conde M, Kristjansson E, Lyddiatt A, Marcus S, Nickerson JW, Pottie K, Rogers M, Sadana R, Saran A, Shea B, Sheehy L, Sveistrup H, Tanuseputro P, Thompson‐Coon J, Walker P, Zhang W, Howe TE. Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1175. [PMID: 37051456 PMCID: PMC8988637 DOI: 10.1002/cl2.1175] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background By 2030, the global population of people older than 60 years is expected to be higher than the number of children under 10 years, resulting in major health and social care system implications worldwide. Without a supportive environment, whether social or built, diminished functional ability may arise in older people. Functional ability comprises an individual's intrinsic capacity and people's interaction with their environment enabling them to be and do what they value. Objectives This evidence and gap map aims to identify primary studies and systematic reviews of health and social support services as well as assistive devices designed to support functional ability among older adults living at home or in other places of residence. Search Methods We systematically searched from inception to August 2018 in: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, PsycINFO, AgeLine, Campbell Library, ASSIA, Social Science Citation Index and Social Policy & Practice. We conducted a focused search for grey literature and protocols of studies (e.g., ProQuest Theses and Dissertation Global, conference abstract databases, Help Age, PROSPERO, Cochrane and Campbell libraries and ClinicalTrials.gov). Selection Criteria Screening and data extraction were performed independently in duplicate according to our intervention and outcome framework. We included completed and on-going systematic reviews and randomized controlled trials of effectiveness on health and social support services provided at home, assistive products and technology for personal indoor and outdoor mobility and transportation as well as design, construction and building products and technology of buildings for private use such as wheelchairs, and ramps. Data Collection and Analysis We coded interventions and outcomes, and the number of studies that assessed health inequities across equity factors. We mapped outcomes based on the International Classification of Function, Disability and Health (ICF) adapted categories: intrinsic capacities (body function and structures) and functional abilities (activities). We assessed methodological quality of systematic reviews using the AMSTAR II checklist. Main Results After de-duplication, 10,783 records were screened. The map includes 548 studies (120 systematic reviews and 428 randomized controlled trials). Interventions and outcomes were classified using domains from the International Classification of Function, Disability and Health (ICF) framework. Most systematic reviews (n = 71, 59%) were rated low or critically low for methodological quality.The most common interventions were home-based rehabilitation for older adults (n = 276) and home-based health services for disease prevention (n = 233), mostly delivered by visiting healthcare professionals (n = 474). There was a relative paucity of studies on personal mobility, building adaptations, family support, personal support and befriending or friendly visits. The most measured intrinsic capacity domains were mental function (n = 269) and neuromusculoskeletal function (n = 164). The most measured outcomes for functional ability were basic needs (n = 277) and mobility (n = 160). There were few studies which evaluated outcome domains of social participation, financial security, ability to maintain relationships and communication.There was a lack of studies in low- and middle-income countries (LMICs) and a gap in the assessment of health equity issues. Authors' Conclusions There is substantial evidence for interventions to promote functional ability in older adults at home including mostly home-based rehabilitation for older adults and home-based health services for disease prevention. Remotely delivered home-based services are of greater importance to policy-makers and practitioners in the context of the COVID-19 pandemic. This map of studies published prior to the pandemic provides an initial resource to identify relevant home-based services which may be of interest for policy-makers and practitioners, such as home-based rehabilitation and social support, although these interventions would likely require further adaptation for online delivery during the COVID-19 pandemic. There is a need to strengthen assessment of social support and mobility interventions and outcomes related to making decisions, building relationships, financial security, and communication in future studies. More studies are needed to assess LMIC contexts and health equity issues.
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Affiliation(s)
- Vivian Welch
- Methods CentreBruyère Research InstituteOttawaCanada
| | | | | | - Yanfei Li
- Evidence‐Based Social Science Research Center, School of Public HealthLanzhou UniversityLanzhouChina
| | | | | | - Monserrat Conde
- Cochrane Campbell Global Ageing Partnership FieldFaroPortugal
| | | | | | - Sue Marcus
- Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | | | | | - Morwenna Rogers
- NIHR ARC, South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | | | | | - Beverly Shea
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Lisa Sheehy
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Heidi Sveistrup
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
- Faculty of Health SciencesUniversity of OttawaOttawaCanada
| | | | - Joanna Thompson‐Coon
- NIHR ARC South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | - Peter Walker
- Faculty of MedicineUniversity of OttawaOttawaCanada
| | - Wei Zhang
- Access to Medicines, Vaccines and Health ProductsWorld Health OrganizationGenevaSwitzerland
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Kshatri JS, Bhoi T, Barik SR, Palo SK, Pati S. Is multimorbidity associated with risk of elder abuse? Findings from the AHSETS study. BMC Geriatr 2021; 21:413. [PMID: 34217225 PMCID: PMC8255025 DOI: 10.1186/s12877-021-02347-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With an increasing number of older adults in low- and middle-income countries (LMIC), the burden of multimorbidity and functional dependence is on the rise. At the same time, a higher prevalence of elder abuse is observed in these populations. There is scarce evidence on the interplay between elder abuse and multimorbidity with no reports from LMIC settings yet. Present study examined the association of multimorbidity with the risk of elder abuse and its correlates in a rural elderly population of Odisha, India. METHODS The data for this study was collected as a part of our AHSETS study comprising of 725 older adults residing in rural Odisha, India. Multimorbidity was assessed by the MAQ PC tool while Hwalek-Sengstock elder abuse screening test (HS-EAST) was used to assess the risk of elder abuse. Functional dependence was measured by the Lawton IADL questionnaire. We used ordinal logistic regression models to identify the correlates of elder abuse and test for mediation by functional dependence. RESULTS Around 48.8 % (95 % CI:45.13-52.53 %) older adults had multimorbidity while 33.8 % (95 % CI:30.35-37.35 %) had some form of dependence. Out of 725, 56.6 % (CI 52.85-60.19 %) were found to be at low-risk elder abuse and 15.9 % (CI 13.27-18.72 %) being at high-risk. The prevalence of higher risk of elder abuse was greater among females, non-literates, widowed persons, those not currently working and those belonging to lower socio-economic strata. The risk of elder abuse was significantly associated with multimorbidity (AOR = 1.68; 95 %CI: 1.11-2.57) and functional dependence (AOR = 2.08; 95 %CI: 1.41-3.06). Additionally, we found a partial mediation mechanism of functional dependency between the pathway of multimorbidity and elder abuse. CONCLUSIONS Elder abuse and multimorbidity are emerging as issues of significant concern among rural elderly in Odisha, India. Multimorbidity and functional dependence are associated with significantly higher odds of elder abuse among rural older adults. Further, we report the role of functional dependence as a partial mediator between multimorbidity and elder abuse. Therefore, potential interventions on reducing the economic, physical and care dependence among multimorbid patients may reduce the risk of elder abuse.
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Affiliation(s)
- Jaya Singh Kshatri
- Department of Health Research, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, 751023, India
| | - Trilochan Bhoi
- Department of Health Research, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, 751023, India
| | - Shakti Ranjan Barik
- Department of Health Research, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, 751023, India
| | - Subrata Kumar Palo
- Department of Health Research, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, 751023, India
| | - Sanghamitra Pati
- Department of Health Research, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, 751023, India.
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16
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Choo EK, Edwards C, Abuwandi M, Carlson K, Bonito J, Jubanyik K, Gill TM, Abujarad F. Perceptions of older adults and health professionals about digital screening tools for elder mistreatment in the emergency department. GERONTECHNOLOGY : INTERNATIONAL JOURNAL ON THE FUNDAMENTAL ASPECTS OF TECHNOLOGY TO SERVE THE AGEING SOCIETY 2021; 20:10.4017/gt.2021.20.2.33-476.11. [PMID: 36033550 PMCID: PMC9409338 DOI: 10.4017/gt.2021.20.2.33-476.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Healthcare settings represent a missed opportunity to systematically identify and address mistreatment. OBJECTIVE Our objective was to obtain perspectives of older adults, caregivers, and emergency care providers regarding screening and intervention for elder mistreatment in the emergency department (ED) with a focus on utilizing digital health tools to facilitate the process. These findings will inform the development of a Web-based, digital health tool optimized for a tablet device to educate, screen, and facilitate reporting of elder mistreatment among patients presenting to the ED. METHOD We conducted a qualitative study utilizing three in-person focus groups (N=31) with older adults from the community, caregivers for older adults, and clinicians and social workers who worked in the ED. Using a semi-structured interview guide, we identified attitudes about the process of divulging abuse, attitudes towards the ED as the location for screening and information delivery, and perceptions of digital tools for screening and information. RESULTS Participants identified numerous challenges to the disclosure of mistreatment, including feelings of vulnerability and concerns about losing their homes, social supports, and connection to caregivers. In contrast, they were uncertain about the benefits of disclosure. Digital tools were seen as helpful in terms of overcoming numerous challenges to screening, but participants suggested maintaining a human element to interactions. CONCLUSION While challenges to elder mistreatment screening were identified, participants had recommendations for optimizing such efforts and responded positively to digital health tools as a means of screening.
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Affiliation(s)
- Esther K. Choo
- Center for Policy & Research in Emergency Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Chelsea Edwards
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Kristina Carlson
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Jennifer Bonito
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Karen Jubanyik
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Thomas M. Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Fuad Abujarad
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
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17
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Shen Y, Sun F, Zhang A, Wang K. The Effectiveness of Psychosocial Interventions for Elder Abuse in Community Settings: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:679541. [PMID: 34122275 PMCID: PMC8187616 DOI: 10.3389/fpsyg.2021.679541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
As a global public health concern, elder abuse negatively affects health, psychosocial wellbeing, and mortality among elders. Research and practice efforts made to explore effective prevention and intervention strategies are growing. Despite the growing number of intervention studies on elder abuse, research synthesis on the empirical literature seems lacking. This study aims to identify the pooled effect size of prevention and interventions targeted ultimate and intermediate outcomes for elder abuse that occurred in community settings. Following the Cochrane guideline, our team searched across eight electronic databases and manually searched reference lists of eligible studies and existing systematic reviews for all potentially eligible studies. A random-effects model of 51 effect size estimates reported an overall positive and statistically significant treatment effect of psychosocial interventions for elder abuse, d = 0.63, p < 0.05. The overall treatment effect was approaching statistical significance at 0.1 level for ultimate outcomes, d = 0.32, p = 0.09, and intermediate outcomes, d = 0.75, p = 0.1. An overall significant effect size was found among family-based interventions, d = 0.59, p < 0.05, and interventions targeting older adults and their caregivers, d = 0.45, p < 0.05. Existing evidence supports an overall significant effect for psychosocial interventions for elder abuse. Interventions that used a family-based model, combined education and supportive services, and targeted both caregivers and elders, showed significant effect size, suggesting such features being considered in elder abuse intervention design. Future intervention research is needed to shed light on the link between intervention activities and ultimate change in elder abuse behaviors.
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Affiliation(s)
- Yan Shen
- School of Economic & Management and Law, Hubei Normal University, Huangshi, China
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, MI, United States
| | - Anao Zhang
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, CO, United States
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Kayser J, Morrow-Howell N, Rosen TE, Skees S, Doering M, Clark S, Hurka-Richardson K, Bin Shams R, Ringer T, Hwang U, Platts-Mills TF, Network TG. Research priorities for elder abuse screening and intervention: A Geriatric Emergency Care Applied Research (GEAR) network scoping review and consensus statement. J Elder Abuse Negl 2021; 33:123-144. [PMID: 33797344 PMCID: PMC8204570 DOI: 10.1080/08946566.2021.1904313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The Geriatric Emergency Care Applied Research (GEAR) Network (1) conducted a scoping review of the current literature on the identification of and interventions to address elder abuse among patients receiving care in emergency departments and (2) used this review to prioritize research questions for knowledge development. Two questions guided the scoping review: What is the effect of universal emergency department screening compared to targeted screening or usual practice on cases of elder abuse identified, safety outcomes, and health care utilization?; and What is the safety, health, legal, and psychosocial impact of emergency department-based interventions vs. usual care for patients experiencing elder abuse? We searched five article databases. Additional material was located through reference lists of identified publications, PsychInfo, and Google Scholar. The results were discussed in a consensus conference; and stakeholders voted to prioritize research questions. No studies were identified that directly addressed the first question regarding assessment strategies, but four instruments used for elder abuse screening in the emergency department were identified. For the second question, we located six articles on interventions for elder abuse in the emergency department; however, none directly addressed the question of comparative effectiveness. Based on these findings, GEAR participants identified five questions as priorities for future research - two related to screening, two related to intervention, and one encompassed both. In sum, research to identify best practices for elder abuse assessment and intervention in emergency departments is still needed. Although there are practical and ethical challenges, rigorous experimental studies are needed.
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Affiliation(s)
- Jay Kayser
- School of Social Work, University of Michigan - Ann Arbor, Ann Arbor, Michigan, USA.,Department of Developmental Psychology, University of Michigan - Ann Arbor, Ann Arbor, Michigan, USA
| | - Nancy Morrow-Howell
- Brown School of Social Work, Washington University, St. Louis, Missouri, USA
| | - Tony E Rosen
- Department of Emergency Medicine, Weill Cornell Medicine, New York - Presbyterian Hospital, New York, USA
| | - Stephanie Skees
- Brown School of Social Work, Washington University, St. Louis, Missouri, USA
| | - Michelle Doering
- Becker Medical Library, Washington University, St Louis, Missouri, USA
| | - Sunday Clark
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Karen Hurka-Richardson
- Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rayad Bin Shams
- Quantworks, Inc, Healthcare and Life Sciences, Carrboro, North Carolina, USA
| | - Thom Ringer
- Department of Emergency Medicine, Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, Ontario, Canada.,Department of Emergency Medicine, Schwartz/Reisman Emergency Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Emergency Medicine, University Health Network, Toronto, Ontario, Canada
| | - Ula Hwang
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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Botngård A, Eide AH, Mosqueda L, Blekken L, Malmedal W. Factors associated with staff-to-resident abuse in Norwegian nursing homes: a cross-sectional exploratory study. BMC Health Serv Res 2021; 21:244. [PMID: 33740965 PMCID: PMC7977325 DOI: 10.1186/s12913-021-06227-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/01/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Elder abuse is a public health problem that is gaining attention due to its serious impacts on people's health and well-being, and it is predicted to increase along with the world's rapidly ageing population. Staff-to-resident abuse in nursing homes is a complex and multifaceted phenomenon associated with multiple factors on different levels of the ecological model. This study aimed to explore individual, relational, and institutional characteristics associated with perpetrated staff-to-resident abuse in nursing homes, using a multilevel hierarchical approach. METHODS This was a cross-sectional exploratory study of 3693 nursing staff (response rate 60.1%) in 100 randomly selected nursing homes in Norway. We explored the characteristics of nursing staff, their relationship with residents, and institutional features associated with three types of abuse: psychological abuse, physical abuse, and neglect. These were modelled using multilevel mixed-effects logistic regression analyses. RESULTS Individual staff factors found to be associated with all three types of abuse were 1) being a registered nurse/social educator (OR 1.77-2.49) or licensed practical nurse (OR 1.64-1.92), 2) reporting symptoms of psychological distress (OR 1.44-1.46), 3) intention to leave the job (OR 1.35-1.40), and 4) reporting poor attitudes towards people with dementia (OR 1.02-1.15). Also, staff who reported poorer quality of childhood were more likely to perpetrate neglect (OR 1.14). Relational factors such as care-related conflicts (OR 1.97-2.33) and resident aggression (OR 1.36-2.09) were associated with all three types of abuse. Of institutional factors, lack of support from a manager was associated with perpetrating psychological abuse (OR 1.56). CONCLUSIONS We found several predictors of staff-to-resident abuse on different levels of the ecological model, which underlines the importance of using a multifaceted approach to identify risk factors of elder abuse in nursing homes. However, future studies should explore the underlying mechanism and causes with a prospective or qualitative design and target the multifaceted nature of risk factors when designing preventive interventions.
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Affiliation(s)
- Anja Botngård
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Arne Henning Eide
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Research, SINTEF Digital, Oslo, Norway
| | - Laura Mosqueda
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Lene Blekken
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Wenche Malmedal
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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Conrad KJ, Liu PJ, Hass Z, Conrad KM. Balancing practicality and validity of elder abuse identification measures: using data from adult protective services investigations. J Elder Abuse Negl 2021; 33:47-64. [PMID: 33535908 DOI: 10.1080/08946566.2021.1876579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background and Objectives. In testing a comprehensive decision support system for Adult Protective Services (APS), this study addressed two problems common in APS research and practice: the psychometric quality of the measures and measurement burden. Research Design and Methods. Data were generated on 1,472 APS cases over six months in two California counties using the Identification, Services and Outcomes (ISO) Matrix, a comprehensive decision support system for APS. The ISO Matrix uses Short-Forms developed from the Elder Abuse Decision Support System (EADSS). Mini-Forms were developed from the Short-Forms and tested in order to reduce measurement burden. Mini-Forms were developed on each measure using sensitivity and specificity of the items in predicting the criterion of substantiation (yes/no). Psychometric quality was addressed by estimating predictive validity and Cronbach's alpha of Short-Forms. Predictive validity and reliability were also estimated on the Mini-Forms as was their correlation with the Short-Forms. Results. On Short-Forms, good predictive validity was found for all measures except those that were very rare. Results for even shorter Mini-Forms were mixed, and some will require further research on their reliability and validity. Discussion and Implications. Short-Forms had good psychometric properties and some Mini-Forms did as well. Ongoing adoption by several California counties and Montana demonstrates the viability and sustainability of using the ISO Matrix for research and practice.
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Affiliation(s)
- Kendon J Conrad
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Pi-Ju Liu
- School of Nursing and Center on Aging and the Life Course, Purdue University, Indiana, West Lafayette, USA
| | - Zachary Hass
- Schools of Nursing and Industrial Engineering and Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Karen M Conrad
- School of Public Health, University of Illinois at Chicago, Program Metrics, LLC, Oak Park, Illinois, USA
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Interpersonal Violence: a Review of Elder Abuse. CURRENT TRAUMA REPORTS 2020. [DOI: 10.1007/s40719-020-00205-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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Van Royen K, Van Royen P, De Donder L, Gobbens RJ. Elder Abuse Assessment Tools and Interventions for use in the Home Environment: a Scoping Review. Clin Interv Aging 2020; 15:1793-1807. [PMID: 33061330 PMCID: PMC7533912 DOI: 10.2147/cia.s261877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/03/2020] [Indexed: 11/23/2022] Open
Abstract
Background and Aim Caregivers in the home environment have an important role in timely detecting and responding to abuse. The aim of this review was to provide insight into both the existing tools for the assessment of and interventions for elder abuse by formal and informal caregivers in the home environment, and to categorize them according to a public health perspective, into primary, secondary, tertiary or quaternary prevention. Methods We selected the assessment tools and interventions that can be used by caregivers in the home environment included in previous reviews by Gallione et al (2017) and Fearing et al (2017). To identify published studies after these reviews, a search was performed using PubMed, Cochrane Database, CINAHL and Web of Science. Results In total, fifteen assessment tools and twelve interventions were included. The number of assessment tools for elder abuse for use in the home environment is increasing; however, tools must be validated over different cultures and risk groups. In addition, the tools lack attention for the needs of vulnerable older persons such as persons with dementia. Existing interventions for caregivers in the home environment lack evidence for addressing elder abuse and do not address potential adverse effects (quaternary prevention). Conclusion Assessment tools for elder abuse need further testing for validity and reliability for use by caregivers in the home environment. For interventions, meaningful outcome measures are needed. Important to note is that quaternary prevention requires more attention. This argues for taking into account perspectives of (abused) older persons and caregivers in the development of assessment tools and interventions protocols.
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Affiliation(s)
- Kathleen Van Royen
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.,Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Paul Van Royen
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Liesbeth De Donder
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Robbert J Gobbens
- Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.,Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands.,Zonnehuisgroep Amstelland, Amstelveen, the Netherlands
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Marshall K, Herbst J, Girod C, Annor F. Do interventions to prevent or stop abuse and neglect among older adults work? A systematic review of reviews. J Elder Abuse Negl 2020; 32:409-433. [PMID: 32957832 DOI: 10.1080/08946566.2020.1819926] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Abuse and neglect among older adults impact everyone and are recognized internationally as significant and growing public health issues. A systematic review of reviews was conducted to identify effective strategies and approaches for preventing abuse and neglect among older adults. Eligible reviews were systematic or meta-analyses; focused on the older population as reported in the publications; reviewed prevention interventions; included relevant violence and abuse outcomes; written in English; and published in a peer-reviewed journal between January 2000 and May 2020. Eleven unique reviews (12 publications) met the eligibility criteria, including one meta-analysis. Included reviews mainly focused on general abuse directed toward older adults; and educational interventions for professional and paraprofessional caregivers, multidisciplinary teams of health care and legal professionals, and families. Interventions were implemented in a variety of community and institutional settings and addressed primary, secondary, and tertiary prevention. The reviews indicated weak or insufficient evidence of effectiveness in preventing or reducing abuse, yet several promising practices were identified. Future research is needed to evaluate emerging and promising strategies and approaches to prevent abuse among older adults. Effective interventions are also needed to prevent or reduce abuse and neglect among older adults.
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Affiliation(s)
- Khiya Marshall
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention , Atlanta, United States
| | - Jeffrey Herbst
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention , Atlanta, United States
| | - Candace Girod
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention , Atlanta, United States
| | - Francis Annor
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention , Atlanta, United States
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Briscoe S, Nunns M, Shaw L. How do Cochrane authors conduct web searching to identify studies? Findings from a cross‐sectional sample of Cochrane Reviews. Health Info Libr J 2020; 37:293-318. [DOI: 10.1111/hir.12313] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 05/07/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Simon Briscoe
- Exeter PRP Evidence Review Facility Institute of Health Research University of Exeter Medical School University of Exeter Exeter UK
| | - Michael Nunns
- Exeter PRP Evidence Review Facility Institute of Health Research University of Exeter Medical School University of Exeter Exeter UK
| | - Liz Shaw
- Exeter PRP Evidence Review Facility Institute of Health Research University of Exeter Medical School University of Exeter Exeter UK
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25
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Mileski M, Lee K, Bourquard C, Cavazos B, Dusek K, Kimbrough K, Sweeney L, McClay R. Preventing The Abuse Of Residents With Dementia Or Alzheimer's Disease In The Long-Term Care Setting: A Systematic Review. Clin Interv Aging 2019; 14:1797-1815. [PMID: 31695349 PMCID: PMC6816079 DOI: 10.2147/cia.s216678] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 08/20/2019] [Indexed: 01/21/2023] Open
Abstract
Purpose The main objective of this study was to investigate abuse of residents with either dementia or Alzheimer’s disease in long-term care settings, to identify facilitators and barriers surrounding implementation of systems to prevent such occurrences, and to draw conclusions on combating the issue of abuse. Patients and methods A systematic review was conducted using the Medline, CINAHL, and Academic Search Ultimate databases. With the use of key terms via Boolean search, 30 articles were obtained which were determined to be germane to research objectives. The review was conducted and structured based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Residents with dementia or Alzheimer’s disease are at greater risk of abuse. The growing population could increase this problem exponentially. The most common facilitators were the introduction of policies/programs in the facility, education, and working conditions. The most cited barriers were poor training, lack of research, and working conditions in the long-term care setting. Conclusion The examples given would be useful in minimizing the potential for abuse in the long-term care setting. Leadership can take an active role in the prevention of abuse of the elderly through their actions, education of employees, and changes in the work environment.
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Affiliation(s)
- Michael Mileski
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Kimberly Lee
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Curtis Bourquard
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Belinda Cavazos
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Kristopher Dusek
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | | | - Linda Sweeney
- School of Health Administration, Texas State University, San Marcos, TX, USA
| | - Rebecca McClay
- School of Science, Technology, Engineering, and Math, American Public University System, Charles Town, WV, USA
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Pereira C, Fertleman M. Elder abuse: a common problem, commonly missed in trauma and orthopaedics. Eur Geriatr Med 2019; 10:839-841. [DOI: 10.1007/s41999-019-00245-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 09/17/2019] [Indexed: 11/30/2022]
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Hoghton M, Lamb K. Whorlton Hall: substantial investment needed to protect vulnerable people. BMJ 2019; 366:l5293. [PMID: 31477586 DOI: 10.1136/bmj.l5293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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28
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Rosen T, Elman A, Dion S, Delgado D, Demetres M, Breckman R, Lees K, Dash K, Lang D, Bonner A, Burnett J, Dyer CB, Snyder R, Berman A, Fulmer T, Lachs MS. Review of Programs to Combat Elder Mistreatment: Focus on Hospitals and Level of Resources Needed. J Am Geriatr Soc 2019; 67:1286-1294. [PMID: 30901078 PMCID: PMC6561817 DOI: 10.1111/jgs.15773] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/13/2018] [Accepted: 12/15/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Elder mistreatment is common and has serious social and medical consequences for victims. Though programs to combat this mistreatment have been developed and implemented for more than three decades, previous systematic literature reviews have found few successful ones. OBJECTIVE To conduct a more comprehensive examination of programs to improve elder mistreatment identification, intervention, or prevention, including those that had not undergone evaluation. DESIGN Systematic review. SETTING Ovid MEDLINE, Ovid EMBASE, Cochrane Library, PsycINFO Elton B. Stephens Co. (EBSCO), AgeLine, CINAHL. MEASUREMENTS We abstracted key information about each program and categorized programs into 14 types and 9 subtypes. For programs that reported an impact evaluation, we systematically assessed the study quality. We also systematically examined the potential for programs to be successfully implemented in environments with limited resources available. RESULTS We found 116 articles describing 115 elder mistreatment programs. Of these articles, 43% focused on improving prevention, 50% focused on identification, and 95% focused on intervention, with 66% having multiple foci. The most common types of program were: educational (53%), multidisciplinary team (MDT) (21%), psychoeducation/therapy/counseling (15%), and legal services/support (8%). Of the programs, 13% integrated an acute-care hospital, 43% had high potential to work in low-resource environments, and 57% reported an attempt to evaluate program impact, but only 2% used a high-quality study design. CONCLUSION Many programs to combat elder mistreatment have been developed and implemented, with the majority focusing on education and MDT development. Though more than half reported evaluation of program impact, few used high-quality study design. Many have the potential to work in low-resource environments. Acute-care hospitals were infrequently integrated into programs.
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Affiliation(s)
- Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital
| | - Alyssa Elman
- Department of Emergency Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital
| | - Sarah Dion
- University of Cincinnati College of Medicine
| | - Diana Delgado
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medical College
| | - Michelle Demetres
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medical College
| | - Risa Breckman
- Division of Geriatrics and Palliative Care, Weill Cornell Medical College / NewYork-Presbyterian
| | | | | | - Debi Lang
- Department of Family Medicine and Community Health, University of Massachusetts Medical School
| | - Alice Bonner
- School of Nursing, Bouve College of Health Sciences, Northeastern University
- Executive Office of Elder Affairs, Commonwealth of Massachusetts
| | - Jason Burnett
- Department of Internal Medicine, University of Texas Medical School
| | - Carmel B. Dyer
- Department of Internal Medicine, University of Texas Medical School
| | | | | | | | - Mark S. Lachs
- Division of Geriatrics and Palliative Care, Weill Cornell Medical College / NewYork-Presbyterian
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Inelmen EM, Sergi G, Manzato E. Elder abuse: are we turning a blind eye to a crucial issue? Intern Emerg Med 2019; 14:503-505. [PMID: 30887403 DOI: 10.1007/s11739-019-02063-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 02/26/2019] [Indexed: 02/01/2023]
Affiliation(s)
| | - Giuseppe Sergi
- Department of Medicine, University of Padua, Padua, Italy
| | - Enzo Manzato
- Department of Medicine, University of Padua, Padua, Italy.
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30
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Corbi G, Grattagliano I, Sabbà C, Fiore G, Spina S, Ferrara N, Campobasso CP. Elder abuse: perception and knowledge of the phenomenon by healthcare workers from two Italian hospitals. Intern Emerg Med 2019; 14:549-555. [PMID: 30694436 DOI: 10.1007/s11739-019-02038-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/17/2019] [Indexed: 11/28/2022]
Abstract
With ageing population the number of elderly vulnerable to abuse is expected to grow. Hospital personnel play a crucial role in identifying mistreatment. The aim of this study was to establish the level of awareness and perception of elder abuse by healthcare workers, and to understand if they are able to recognize and properly report elder abuse, as well as to identify the physical signs of abuse and neglect. A 41-question survey was administered to healthcare professionals, working in the Internal Medicine and Geriatric Wards of two different University Hospitals of Southern Italy, representative of the Italian health public system. The data collection resulted in 98 questionnaires. For the majority, neglect represents a type of abuse, whereas 40% of physicians and 37% of nurses considered this concept false. All the professionals recognized the elder abuse as a violation of the human rights, but 46.94% were not sure about the existence of standard procedures for abuse reporting/treatment. The most of the nurses and the care assistants declared they never had suspected or witnessed abuse, while few physicians stated to have suspected/witnessed abuse 1-3 times in their career. In both the suspected and witnessed cases, the healthcare personnel did not made any action, neither reported them to public authorities nor adult protective service agencies. The level of awareness and perception of elder abuse by healthcare professionals are still poor especially regarding the reporting procedures. There is still strong need for education and specific training programs on elder abuse.
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Affiliation(s)
- Graziamaria Corbi
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via De Sanctis Snc, 86100, Campobasso, Italy.
| | - Ignazio Grattagliano
- Department of Educational Sciences, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Carlo Sabbà
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Giorgio Fiore
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Sabrina Spina
- Manchester Royal Infirmary, Manchester University Hospitals NHS Foundation Trust Manchester, Manchester, UK
| | - Nicola Ferrara
- Department of Medical and Translational Sciences, University of Naples "Federico II", Naples, Italy
| | - Carlo Pietro Campobasso
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Ramirez M, Solomon J, Riquelme M, Santoro B, Reingold D, Teresi JA. Development and Spanish translation of the Weinberg Center Risk and Abuse Prevention Screen (WC-RAPS). J Elder Abuse Negl 2018; 31:38-55. [PMID: 30406734 DOI: 10.1080/08946566.2018.1531099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Barriers for enhanced detection, identification, and reporting of elder abuse include the paucity of appropriate, valid, easily administered screening tools. This article describes the qualitative methods used in the development of the Weinberg Center Risk and Abuse Prevention Screen (WC-RAPS), and of its Spanish version. Focus groups and cognitive interviews were instrumental in identifying problematic items, underscoring potential response errors, and informing about putative causes for divergent interpretations of item-intent. Seven of the 11 original items were modified, a double-barreled item was segregated into two, one item deleted, and three additional items included to create the final 13 WC-RAPS items. The multi-step approach implemented for the Spanish conversion evidenced deviation from the original intended meaning for one item. The readability for English and Spanish versions was also assessed. Screening for elder abuse, if implemented systematically can be instrumental in identifying unrecognized abuse and preventing reoccurrence.
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Affiliation(s)
- Mildred Ramirez
- a Research Division , Hebrew Home at Riverdale, RiverSpring Health , Bronx , NY , USA
| | - Joy Solomon
- b The Harry and Jeanette Weinberg Center for Elder Justice, Hebrew Home at Riverdale , Bronx , NY , USA
| | - Marlene Riquelme
- b The Harry and Jeanette Weinberg Center for Elder Justice, Hebrew Home at Riverdale , Bronx , NY , USA
| | - Brooke Santoro
- b The Harry and Jeanette Weinberg Center for Elder Justice, Hebrew Home at Riverdale , Bronx , NY , USA
| | - Daniel Reingold
- c Hebrew Home at Riverdale, RiverSpring Health , Bronx , NY , USA
| | - Jeanne A Teresi
- a Research Division , Hebrew Home at Riverdale, RiverSpring Health , Bronx , NY , USA.,d Columbia University Stroud Center and New York State Psychiatric Institute , New York , NY , USA
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Ernst JS, Maschi T. Trauma-informed care and elder abuse: a synergistic alliance. J Elder Abuse Negl 2018; 30:354-367. [DOI: 10.1080/08946566.2018.1510353] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Joy Swanson Ernst
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | - Tina Maschi
- Graduate School of Social Service, Fordham University, New York, New York, USA
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Bartley MM, Suarez L, Shafi RMA, Baruth JM, Benarroch AJM, Lapid MI. Dementia Care at End of Life: Current Approaches. Curr Psychiatry Rep 2018; 20:50. [PMID: 29936639 DOI: 10.1007/s11920-018-0915-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE OF REVIEW Dementia is a progressive and life-limiting condition that can be described in three stages: early, middle, and late. This article reviews current literature on late-stage dementia. RECENT FINDINGS Survival times may vary across dementia subtypes. Yet, the overall trajectory is characterized by progressive decline until death. Ideally, as people with dementia approach the end of life, care should focus on comfort, dignity, and quality of life. However, barriers prevent optimal end-of-life care in the final stages of dementia. Improved and earlier advanced care planning for persons with dementia and their caregivers can help delineate goals of care and prepare for the inevitable complications of end-stage dementia. This allows for timely access to palliative and hospice care, which ultimately improves dementia end-of-life care.
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Affiliation(s)
| | - Laura Suarez
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Reem M A Shafi
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Joshua M Baruth
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Amanda J M Benarroch
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Maria I Lapid
- Center for Palliative Medicine, Mayo Clinic, Rochester, MN, USA. .,Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
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Neuberg M, Železnik D, Meštrović T, Ribić R, Kozina G. Is the burnout syndrome associated with elder mistreatment in nursing homes: results of a cross-sectional study among nurses. Arh Hig Rada Toksikol 2018; 68:190-197. [PMID: 28976883 DOI: 10.1515/aiht-2017-68-2982] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 09/01/2017] [Indexed: 11/15/2022] Open
Abstract
As this issue has not yet been addressed in Croatia, our aim was to explore the presence of the burnout syndrome in nurses and see how it is related to their perception of elder mistreatment in nursing homes and extended care units. The burnout syndrome was assessed in 171 nursing professionals with a standardised Maslach Burnout Inventory for Human Services Survey (MBI-HSS) for three dimensions: emotional exhaustion (EE), depersonalisation (DP), and personal accomplishment (PA). High EE was reported by 43.9 %, high DP by 22.2 %, and low PA by 39.8 % of the respondents. Their perception of elder abuse and neglect was investigated with two self-completion questionnaires. The answers suggest that elder mistreatment in Croatian nursing homes and extended care units is more common than expected: 55 % witnessed shouting at a resident in anger, 43 % insulting and swearing at a resident, 42 % force-feeding the resident, 39 % ignoring a resident when they called, and 38 % neglecting to turn or move a resident to prevent pressure sores. We also established associations between a number of questionnaire items on perceived abuse and neglect and the burnout syndrome dimensions and determined the items that predicted the type and level of burnout in our respondents. One way to avoid the pitfalls that lead to abuse and neglect is education in schools and at work. We believe our research could contribute to this end.
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Atinga A, Shekkeris A, Fertleman M, Batrick N, Kashef E, Dick E. Trauma in the elderly patient. Br J Radiol 2018; 91:20170739. [PMID: 29509505 DOI: 10.1259/bjr.20170739] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Major Trauma Centres and Emergency Departments are treating an increasing number of elderly trauma patients in the UK. Elderly patients, defined as those over the age of 65 years, are more susceptible to injury from lesser mechanisms of trauma than younger adults. The number of elderly trauma cases is rising yearly, accounting for >25% of all major trauma nationally. The elderly have different physiological reserves and a different response to trauma due to premorbid frailty, co-existing conditions and prescribed medication. These factors need to be appreciated in trauma triaging, radiological assessment and clinical management. A lower threshold for trauma-call activation is recommended, including a lower threshold for advanced imaging. We will review general principles of trauma in the elderly, outline injury patterns in this age group and illustrate the radiological features per anatomical site, from head to pelvis and the extremities. We advocate using contrast-enhanced computed tomography as the primary diagnostic imaging modality as concern about intravenous contrast agent-induced nephropathy is relatively minor. Prompt investigation and diagnosis leads to timely appropriate treatment, therefore the radiologist can discerningly improve morbidity and mortality in this vulnerable group.
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Affiliation(s)
- Angela Atinga
- 1 Department of Radiology, St Mary's Hospital, Imperial College Healthcare NHS Trust , London , UK
| | - Andreas Shekkeris
- 1 Department of Radiology, St Mary's Hospital, Imperial College Healthcare NHS Trust , London , UK
| | - Michael Fertleman
- 2 Department of Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust , London , UK
| | - Nicola Batrick
- 3 Department of Emergency Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust , London , UK
| | - Elika Kashef
- 1 Department of Radiology, St Mary's Hospital, Imperial College Healthcare NHS Trust , London , UK
| | - Elizabeth Dick
- 1 Department of Radiology, St Mary's Hospital, Imperial College Healthcare NHS Trust , London , UK
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Improving Quality of Care in Hospitals for Victims of Elder Mistreatment: Development of the Vulnerable Elder Protection Team. Jt Comm J Qual Patient Saf 2018; 44:164-171. [PMID: 29499813 DOI: 10.1016/j.jcjq.2017.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/31/2017] [Indexed: 11/22/2022]
Abstract
PROBLEM DEFINITION Hospitals have an opportunity to improve the quality of care provided to a particularly vulnerable population: victims of elder mistreatment. Despite this, no programs to prevent or stop elder abuse in the acute care hospital have been reported. An innovative, multidisciplinary emergency department (ED)-based intervention for elder abuse victims, the Vulnerable Elder Protection Team (VEPT), was developed at NewYork-Presbyterian / Weill Cornell Medical Center (New York City). APPROACH The VEPT is a consultation service available 24 hours a day/7 days a week to improve identification, comprehensive assessment, and treatment for potential victims of elder abuse or neglect. All ED providers have been trained on how to recognize signs of elder mistreatment. Any provider can activate the VEPT via a single page/telephone call, which triggers the VEPT's often time-consuming, complex assessment of the potential mistreatment victim. First, the ED social worker on duty performs the initial bedside assessment and separately interviews the potential perpetrator and/or caregiver. He or she then contacts the on-call VEPT medical provider to discuss next steps and other team members' potential involvement. For patients admitted to the hospital, the VEPT connects with the inpatient social workers and medical team to ensure appropriate follow-up and care planning. NEXT STEPS/PLANNED EVALUATION The VEPT program was launched in April 2017 after comprehensive training. Its impact will be measured by tracking the short-term and long-term mistreatment-related outcomes, as well as medical, mental health, functional, psychosocial, and legal outcomes of the vulnerable ED patients for whom the team provides care.
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Orfila F, Coma-Solé M, Cabanas M, Cegri-Lombardo F, Moleras-Serra A, Pujol-Ribera E. Family caregiver mistreatment of the elderly: prevalence of risk and associated factors. BMC Public Health 2018; 18:167. [PMID: 29357866 PMCID: PMC5778739 DOI: 10.1186/s12889-018-5067-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 01/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The detection of elder mistreatment is emerging as a public health priority; however, abusive behaviors exercised by caregivers are little known and rarely detected among primary health care professionals. This study aims to estimate the prevalence of risk of abuse against community-residing elderly with moderate to severe dependency whose caregivers are relatives. In addition, we aim to describe the association between such a risk and socio-demographic variables, cognitive and dependency state of the victim, and the scale of the caregiver's anxiety, depression, and burden. METHODS Cross-sectional study developed in 72 Primary Health Care teams from Barcelona, Spain. Participants were caregivers and their dependent care recipients (N = 829). Home interviews included the Caregiver Abuse Screen (CASE); self-reported abuse from care recipient; activities of daily living and cognitive state of the care recipient; anxiety and depression in caregivers and Caregiver Burden Scale. The relationship prior to the dependency, positive aspects of caregiving, and social support for the caregiver were also assessed. Multivariate analysis was performed using logistic regression with risk of abuse as dependent variable. RESULTS Caregivers were mainly women (82.8%) with a mean age of 63.3 years. Caregivers and care recipients lived in the same household in 87.4% of cases, and 86.6% had enjoyed a good previous relationship. Care recipients were women (65.6%), with a mean age of 84.2 years, and 64.2% had moderate to severe cognitive impairment. CASE demonstrated a prevalence of 33.4% (95% CI: 30.3-36.7) of abuse risk by the caregiver. Logistic regression showed as statistically significant: caregiver burden (OR = 2.75; 95% CI: 1.74-4.33), caregiver anxiety (OR = 2.06; 95% CI: 1.40-3.02), caregiver perception of aggressive behavior in the care recipient (OR = 7.24; 95% CI: 4.99-10.51), and a bad previous relationship (OR = 4.66; 95% CI: 1.25-17.4). CONCLUSIONS Prevalence of risk of abuse is high among family caregivers. Our study has found risk factors in family caregivers that are preventable to an extent, namely: anxiety and feelings of burden. It is essential to become aware of these risk factors and their causes to intervene and help primary as well secondary prevention.
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Affiliation(s)
- Francesc Orfila
- Institut Universitari d'Investigació en Atenció Primaria Jordi Gol (IDIAP Jordi Gol), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain. .,Gerència Territorial Barcelona Ciutat. Institut Catala de la Salut, Balmes 22, 08007, Barcelona, Spain.
| | - Montserrat Coma-Solé
- Centre d'Atenció Primària Les Planes. Gerència Territorial Metropolitana Sud. Institut Catala de la Salut, 08970, Sant Joan Despí, Spain
| | - Marta Cabanas
- Consorci Sanitari de Barcelona, Esteve Terradas, 30, 08023, Barcelona, Spain
| | - Francisco Cegri-Lombardo
- Centre d'Atenció Primària Sant Martí. Gerència Territorial Barcelona Ciutat. Institut Catala de la Salut, Fluvià, 211, 08020, Barcelona, Spain
| | - Anna Moleras-Serra
- Institut Universitari d'Investigació en Atenció Primaria Jordi Gol (IDIAP Jordi Gol), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitari d'Investigació en Atenció Primaria Jordi Gol (IDIAP Jordi Gol), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.,Gerència Territorial Barcelona Ciutat. Institut Catala de la Salut, Balmes 22, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain
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Alon S, Tuma N, Band-Winterstein T, Goldblatt H. Professionals' Awareness of Sexual Abuse in Late Life: An Exploratory Survey. J Am Psychiatr Nurses Assoc 2018; 24:53-61. [PMID: 28569089 DOI: 10.1177/1078390317712598] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The sexual abuse phenomenon is considered taboo. It has been discussed, to date, mainly in relation to children and young women, with insufficient attention to sexual abuse in a late-life context. OBJECTIVES The aim of this survey was to explore professionals' awareness of elder sexual abuse (ESA). DESIGN The survey was conducted among 161 Jewish and Arab professionals from health care and social services, who worked with older adults in Israel. RESULTS Of the entire sample, 70 professionals (only 43%) reported encountering at least one to three cases of ESA. A total of 98% of the victims were women, and the primary offender was the spouse (75%). In most cases (70%), the victim reported the abuse, which was mainly sexual assault (64%). All participants (100%) noted taking action. CONCLUSION This exploratory survey indicates that professionals are partially aware of the existence of and the need to address the ESA phenomenon.
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Affiliation(s)
- Sara Alon
- 1 Sara Alon, PhD, School of Social Work, Tel-Aviv University, Ramat Aviv, Tel-Aviv, Israel
| | - Niva Tuma
- 2 Niva Tuma, RN, PhD, Rambam Health Care Campus, Haifa, Israel
| | - Tova Band-Winterstein
- 3 Tova Band-Winterstein, PhD, Department of Gerontology, University of Haifa, Haifa, Israel
| | - Hadass Goldblatt
- 4 Hadass Goldblatt, PhD, Deaprtment of Nursing, University of Haifa, Haifa, Israel
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Briscoe S. A review of the reporting of web searching to identify studies for Cochrane systematic reviews. Res Synth Methods 2017; 9:89-99. [PMID: 29065246 DOI: 10.1002/jrsm.1275] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 09/11/2017] [Accepted: 10/09/2017] [Indexed: 11/08/2022]
Abstract
The literature searches that are used to identify studies for inclusion in a systematic review should be comprehensively reported. This ensures that the literature searches are transparent and reproducible, which is important for assessing the strengths and weaknesses of a systematic review and re-running the literature searches when conducting an update review. Web searching using search engines and the websites of topically relevant organisations is sometimes used as a supplementary literature search method. Previous research has shown that the reporting of web searching in systematic reviews often lacks important details and is thus not transparent or reproducible. Useful details to report about web searching include the name of the search engine or website, the URL, the date searched, the search strategy, and the number of results. This study reviews the reporting of web searching to identify studies for Cochrane systematic reviews published in the 6-month period August 2016 to January 2017 (n = 423). Of these reviews, 61 reviews reported using web searching using a search engine or website as a literature search method. In the majority of reviews, the reporting of web searching was found to lack essential detail for ensuring transparency and reproducibility, such as the search terms. Recommendations are made on how to improve the reporting of web searching in Cochrane systematic reviews.
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Affiliation(s)
- Simon Briscoe
- Exeter HS&DR Evidence Synthesis Centre, Institute of Health Research, University of Exeter Medical School, Exeter, UK
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Barraco RD. Trauma Prevention Activities for the Elderly. CURRENT TRAUMA REPORTS 2017. [DOI: 10.1007/s40719-017-0081-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Melchiorre MG, Di Rosa M, Barbabella F, Barbini N, Lattanzio F, Chiatti C. Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer's Disease. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3458372. [PMID: 28265571 PMCID: PMC5318638 DOI: 10.1155/2017/3458372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 11/20/2016] [Accepted: 12/27/2016] [Indexed: 11/24/2022]
Abstract
Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer's disease (AD) and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman's correlation coefficients, principal-component analysis, and Cronbach's alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach's alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD.
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Affiliation(s)
- Maria Gabriella Melchiorre
- Centre for Socioeconomic Research on Ageing, National Institute of Health and Science on Ageing (INRCA), 60124 Ancona, Italy
| | - Mirko Di Rosa
- Scientific Direction, National Institute of Health and Science on Ageing (INRCA), 60124 Ancona, Italy
| | - Francesco Barbabella
- Centre for Socioeconomic Research on Ageing, National Institute of Health and Science on Ageing (INRCA), 60124 Ancona, Italy
- Department of Health and Caring Sciences, Linnaeus University, 39182 Kalmar, Sweden
| | - Norma Barbini
- Epidemiological Observatory, National Institute of Health and Science on Ageing (INRCA), 60124 Ancona, Italy
| | - Fabrizia Lattanzio
- Scientific Direction, National Institute of Health and Science on Ageing (INRCA), 60124 Ancona, Italy
| | - Carlos Chiatti
- Scientific Direction, National Institute of Health and Science on Ageing (INRCA), 60124 Ancona, Italy
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Abstract
The production of systematic reviews is increasing, but their credibility is under threat. Although systematic reviews are an important tool for policymaking, their influence can be weakened by methodological problems and poor policy relevance. Using Cochrane as an example, I address standards for systematic reviews, the influence of special interests on these reviews, and ways to increase their relevance for policymakers.
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Affiliation(s)
- Lisa Bero
- Lisa Bero is with the Charles Perkins Centre and the Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia, and is also the co-chair of the Cochrane Steering Group, London, England
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