Development and validation of a Screening Questionnaire of Family Mistreatment against Older Adults for use in primary care settings in Mexico

The domestic elder abuse in China: Scale development and psychometric properties

An effective screening tool is essential to elder abuse research. Although several instruments have been developed in China to measure elder abuse, they present several limitations. The instrument development involved three components: (1) generating questionnaire items; (2) questionnaire testing and data collection in older adults; and (3) psychometric evaluation of the Domestic Elder Abuse Scale (DEAS). We collected questionnaire responses from 3725 community-dwelling Chinese older adults. The 26-item DEAS showed good reliability and validity across five dimensions: physical abuse, psychological abuse, financial exploitation, neglect, and abandonment. These five factors accounted for 78.432 % of the total variance, and model fitting results were acceptable. The Cronbach's alpha coefficient of the scale was 0.975, and the test-retest intraclass correlation coefficient (ICC) was 0.934 after 2 weeks. This study developed a five-dimension instrument to measure elder abuse, with good psychometric properties, which can play an essential role in community-based studies in China.

Development and usability evaluation of VOICES: A digital health tool to identify elder mistreatment

BACKGROUND/OBJECTIVES

A major barrier for society in overcoming elder mistreatment is an inability to accurately identify victims. There are several barriers to self-reporting elder mistreatment, including fear of nursing home placement or losing autonomy or a caregiver. Existing strategies to identify elder mistreatment neglect to empower those who experience it with tools for self-reporting. In this project, we developed and evaluated the usability of VOICES, a self-administrated digital health tool that screens, educates, and motivates older adults to self-report elder mistreatment.

DESIGN

Cross-sectional study with User-Centered Design (UCD) approach.

SETTING

Yale School of Medicine and the Agency on Aging of South-Central Connecticut.

PARTICIPANTS

Thirty eight community-dwelling and cognitively intact older adults aged 60 years and older, caregivers, clinicians, and social workers.

INTERVENTION

A tablet-based self-administrated digital health tool that screens, educates, and motivates older adults to self-report elder mistreatment.

MEASUREMENTS

Qualitative and quantitative data were obtained from: (1) focus groups participants including: feedback from open-ended discussion, demographics, and a post-session survey; (2) usability evaluation including: demographics, usability measures, comfortability with technology, emotional state, and open-ended feedback.

RESULTS

Focus group participants (n = 24) generally favored using a tablet-based tool to screen for elder mistreatment and expressed comfort answering questions on elder mistreatment using tablets. Usability evaluation participants (n = 14) overall scored VOICES a mean System Usability Scale (SUS) score of 86.6 (median = 88.8), higher than the benchmark SUS score of 68, indicating excellent ease of use. In addition, 93% stated that they would recommend the VOICES tool to others and 100% indicated understanding of VOICES' information and content.

CONCLUSION

Our findings show that older adults are capable, willing, and comfortable with using the innovative and self-administrated digital tool for elder mistreatment screening. Our future plan is to conduct a feasibility study to evaluate the use of VOICES in identifying suspicion of mistreatment.

Elder Abuse Assessment Tools and Interventions for use in the Home Environment: a Scoping Review

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.