Violência contra idosos no ambiente doméstico: prevalência e fatores associados (Recife/PE)

Victimization and perpetration of intimate partner violence among elderly people: a cross-sectional study, Florianópolis, Santa Catarina, Brazil, 2013/2014

OBJECTIVE

VTo verify prevalence of intimate partner violence among elderly people and to identify associated factors.

METHODS

This was a cross-sectional population-based study using data from the EpiFloripa Idoso Study, with elderly people living in Florianópolis, Santa Catarina, Brazil, between 2013 and 2014. Prevalence rates were described and factors associated using Poisson regression were analyzed, for violence suffered and perpetrated, stratified by sex.

RESULTS

Among 651 elderly people, 48.3% of males and 46.4% of females suffered intimate partner violence. Psychological violence suffered (48.3% and 44.8%) and perpetrated (49.8% and 44.5%) predominated in males and females, respectively. Perpetrated violence was associated with poor/very poor self-perceived health (PR=1.74) among males, and with regular self-perceived health (PR=1.53) and separated/divorced marital status (PR=1.86) among females.

CONCLUSION

Symmetry was found between the sexes for prevalence of intimate partner violence, for all directionalities of violence analyzed.

Elder Abuse in the Iberian Peninsula and Bolivia: A Multicountry Comparative Study

The objective of this study is to determine the prevalence of abuse of vulnerable older persons in the family and community environment in the following regions-Spain (Andalusia-Córdoba), Portugal (Azores), and Bolivia (Santa Cruz de la Sierra)-and to identify risk factors and delineate a profile of abused older persons. For this, a descriptive cross-sectional study was conducted. The sample consisted of people in the age group 65 years plus living in the catchment areas of health centers. The following were used as instruments to collect data: the medical record of the patients of relevant health centers, Mini-Mental State Examination (MMSE), daily activities autonomy test, adaptability, partnership, growth, affection, and resolve (APGAR) familiar test, The Elder Abuse Suspicion Index (EASI) and the Social Work Evaluation Form. Multivariable logistic regression was performed to identify factors associated with abuse. Suspected abuse was identified in 6.9% of the elderly who participated in the study in Spain, 39% in Bolivia, and 24.5% in Azores. In all areas, studied psychological abuse was the most common type of abuse. In conclusion, although the prevalence of abuse to older people in the family and community environment differs in the areas studied, it is present in all countries and the data are comparable with other developing and European countries. The profile of the abused older persons appears to be similar in all countries.

Violência contra mulheres idosas em Manaus

A violência contra a pessoa idosa é um grave problema mundial, cujas manifestações têm profundos impactos na saúde e na qualidade de vida dessas pessoas. Como problema sócio-histórico, a violência faz parte da história da humanidade e tem se manifestado de forma crescente contra mulheres, incluindo as idosas. O objetivo deste artigo é analisar as experiências sociais de mulheres idosas que sofreram violência e buscaram a rede de proteção, e a perspectiva dos profissionais que atuam nos serviços de atendimento à violência contra a pessoa idosa em Manaus. Os resultados apontam para a compreensão de violência associada à violência física predominantemente, seguida da violência verbal e moral, todas vivenciadas no âmbito das relações interpessoais. Apontam também para a necessidade de divulgar os instrumentos de proteção legal e capacitar melhor os profissionais para tratar as especificidades desse grupo.

Profile of violence against older individuals registered at the Dial 100 in the period 2011-2015 in Brazil

OBJECTIVE: To analyze the profile of the reports of violence and abuse against older people registered in the Dial 100 helpline from 2011 to 2015. METHODS: This was a descriptive, retrospective study, based on a sample of 130 164 denunciation reports of the Dial 100. The data collection considered the following variables: city, sex, age, race, place of abuse, type of abuse, and the victim’s relationship with the suspect. RESULTS: The greatest number of reports was registered in the Southeast (42.27%), and the lowest in the North (6.79%). When we analyze the complaints per 100 000 inhabitants, we found as leading states in the ranking of complaints of violence against older people: Amazonas, Federal District, and Rio Grande do Norte. The main profile of possible victims was age from 76 to 80 years, predominantly women, and white. The main abusers were the victim’s children and grandchildren. The most frequent type of abuse was negligence (36.72%), followed by psychological abuse (28.46%), and financial abuse (20.45%). CONCLUSION: The Dial 100 helpline is one of the most effective tools for breaking the silence and invisibility of abuse and violence against older adults, offering a panorama of abuse denunciation in our country.

Action plan for tackling violence against older adults in Brazil: analysis of indicators by states

Abstract Objective :to analyze the indicators of the action plan for tackling violence against older adults in Brazil, through temporal and spatial trends. Method: all nine indicators that form the plan were taken from the Sistema de Indicadores de Saúde e Acompanhamento de Políticas do Idoso (the Indicators of Health and Monitoring of Policies for Older Adults System). Time trend analysis was applied by Joinpoint Regression (CI95%), spatial distribution by states and clusters by Ward’s hierarchical agglomerative method, using quadratic Euclidean distance. Results: the study indicated a significant trend of an increase in notifications of cases of violence against older adults, of the hospitalization of older adults because of abuse, of the hospitalization of older adults because of femur fractures, of the mortality rate of older adults because of falls and of the hospitalization of older adults because of falls. Five clusters were formed, with two cluster formations standing out: that of the states of Rondonia, Roraima and Tocantins, because of their high levels of hospitalization and mortality by traffic accidents and high levels of mortality by abuse; and that of the states of Espírito Santo, Goias, Mato Grosso do Sul, Parana, Rio Grande do Sul, Sao Paulo and Sergipe, because of their high levels of hospitalization and mortality by falling and fractures, as well as their high level of violence against older adults. Conclusion :records of violence against older adults are increasing in Brazil, with specific types of violence concentrated in specific regions of the country.

Violência doméstica contra idosos assistidos na atenção básica

RESUMO Este artigo objetiva investigar a prevalência de violência doméstica contra idosos assistidos na atenção básica e possíveis fatores associados. Estudo descritivo de corte transversal, com 169 indivíduos de 60 anos ou mais, de ambos os sexos, cadastrados nas Unidades de Saúde da Família (USF) da microrregião 4.1 da cidade do Recife (PE). Idosos com agravo à saúde que comprometesse a comunicação e/ou cognição foram excluídos. Os dados foram coletados por meio de entrevistas nos domicílios ou nas USF, com questões sociodemográficas, saúde autopercebida e instrumento de pesquisa para avaliar possíveis situações de violência, que foi desenvolvido e validado em Porto Rico e adotado pelo Ministério da Saúde. Verificou-se a existência de 133 idosos com sinais indicativos de pelo menos um tipo de violência em seu ambiente doméstico, representando uma prevalência de 78,7%, sendo a negligência o tipo mais prevalente (58,5%), seguida de violência psicológica (21,5%) e financeira (14%). Os idosos entrevistados que classificaram sua saúde como regular/ruim têm esse risco aumentado. O estudo reforça a hipótese da existência de violência doméstica contra os idosos. Assim, identificar a sua prevalência é o primeiro passo para o enfrentamento desse problema de saúde pública.

Abuse in Colombian elderly and its association with socioeconomic conditions and functionality

Objective:

To describe the presence of abuse in elderly people in Colombia and its association with socio-demographic and functional conditions.

Methods:

Cross-sectional and descriptive research. Data were taken from the SABE Colombia Survey, a population study, with a national representative sample of 23,694 adults aged over 60 years. Presence and type of abuse by partners or family members, members were investigated. Generalized linear models with Poisson link function were used to estimate the causes of the prevalence of abuse by area of residence, region, age, sex, dependence on activities of daily living and living arrangements.

Results:

15.1% of the elderly in Colombia reported some type of abuse, and over 50% reported more than one form of abuse. Abuse proportion is greater in people who are aged 60-69, in women, people with lower levels of education, people who belong to lower socioeconomic status, people who live alone, people who live with children, and people in urban areas. The most frequent abuse form is psychological, followed by neglect and physical abuse. Dependence on basic and instrumental daily living activities increases the probabilities of suffering abuse.

Conclusions:

Home is a risky place for the elderly people, especially for those with functional dependence, those who belong to low socioeconomic strata and women. Results should encourage debate among researchers, professionals and decision makers on public policy about necessary actions and means to change violent family dynamics in homes with elderly people.

Report of multiple abuse against older adults in three Brazilian cities

This study analyses the multiple abuse against older adults reported to the elder abuse police units of three Brazilian cities from 2009 to 2013. This is a longitudinal and retrospective study carried out through the analysis of police reports (PRs) in the elder abuse police units of three Brazilian cities: Ribeirão Preto (SP), Teresina (PI), and João Pessoa (PB). Descriptive statistical analysis consisted of absolute and percentage frequencies. The chi-square test, Fisher's Exact test, and Relative Risk (RR) were used to analyze the data, with a 95% Confidence Interval (CI) and a significance of 5%. A total of 2,313 reports of older adult abuse were analyzed, of which 245 (10.6%) were related to reports of multiple abuse, 49.4% in Ribeirão Preto, São Paulo, 22.9% in João Pessoa, Paraíba, and 27.8% in Teresina, Piauí. Most of the victims of recurrent older adult abuse are female and younger elderly. Psychological abuse was the most recurrent, followed by financial abuse, occurring in the victim's own home. In João Pessoa, older women and elderly living with their abusers were at a higher risk of report of multiple abuse acts. In Ribeirão Preto, living with the aggressor was a risk factor for multiple violent acts. In the total population of the study, living without companion and not living with the aggressor were identified as protective factors against recurrent violence. The need to implement social and legal actions to improve safety for the more vulnerable groups is emphasized.

Violência contra idosos em um município do sul de minas gerais: uma análise documental

Objetivo: analizar los casos de violencia contra ancianos en un municipio del sur de Minas Gerais (Brasil), en un periodo de 13 años. Materiales y método: estudio cuantitativo, retrospectivo, documental y analítico, que utilizó datos del Consejo Municipal del Anciano. La recolección de los datos referentes al periodo de 2004 a 2016 se dio en el primer semestre de 2017. Para el análisis de tendencia de los casos de violencia, se empleó la regresión lineal simple. Resultados: se registraron 389 denuncios; sin embargo, solo 273 caracterizaban denuncios de violencia contra el adulto mayor. En cuanto al agresor, el 39,56 % era de sexo masculino y el 43,59 % eran hijos de las víctimas. En relación con el tipo de violencia, se destacó la negligencia (34,80 %), seguida de la violencia psicológica (16,12 %) y financiera (8,79 %). Se evidenció una relación estadísticamente significativa entre el sexo de la víctima (p = 0,017), la relación entre víctima y denunciante (p < 0,001) y la relación entre víctima y agresor (p < 0,001), con el tipo de violencia. Conclusión: la violencia contra el adulto mayor en tal municipio implica, sobre todo, a los familiares de los individuos. Hay necesidad de capacitar a los profesionales que atienden estos casos y hay que elaborar una herramienta completa y estandarizada para el registro de incidencias y ampliación de investigaciones en el área, con el fin de que se implanten acciones que combatan la violencia contra el anciano.

Factors associated with elder abuse: a systematic review of the literature

Elder abuse is a complex public health problem. It is of fundamental importance to ascertain which factors are associated with each specific type of abuse, as a way of enabling the creation of evidence-based public policies. The aim of the present study was to systematically review the literature regarding analytical epidemiological studies of factors associated with elder abuse. Four databases were used for the bibliographic search: Pubmed, Scopus, Web of Science and Lilacs, with no limitations regarding year of publication. Articles were selected by pairs of researchers in two stages: reading of abstracts (3.121) and reading of complete articles (64). The total number of articles selected was 27. The risk of bias was evaluated. The factors associated with general violence were age, sex, marital status, educational level, income, family arrangement, social support, solitude, mental disorder, depression, suicide attempt, dependence on others in daily activities, cognitive function, chronic diseases, alcohol or drug abuse, among others. Elder abuse was found to be a multifactorial and complex phenomenon that should not therefore be viewed in a partial one-dimensional manner, but in such a way as to take into account all dimensions and the interdependence of these.

Elder Abuse in a Developing Area in Bolivia

In many parts of the world, elder abuse happens almost unnoticed. Until recently, this serious social problem was hidden from public view and was regarded as an essentially private matter. However, there is growing evidence that elder abuse is an important problem of public health and in the society. The objective of this study is to determine the degree of abuse of elder and vulnerable people in the families and communities of Eastern Bolivia. With this end in mind, we conducted a cross-sectional descriptive study with a sample size of 210 60-year-old people coming from different health care areas. Elder Abuse Suspicion Index (EASI) and Yaffe's Evaluation Form of Social Work were used. An abuse rate of 39% of the older adults was identified. The most common type of abuse observed was psychological abuse (32.4% of cases), followed by neglect (21.9%). Children were identified as triggers of the abuse in 66.7% of cases of abuse. The prevalence of elder abuse was similar to the prevalence of other types of abuse that exist in Bolivia, such as the gender-based abuse. Also, this prevalence is comparable to other developing countries and European countries. The profile of abused older adult is as follows: woman, widow, 70 years old, incomplete primary education, without an occupation, and an average of 4.59 children. The information obtained shows that dysfunctional families have a higher percentage of elder abuse.

Prevalence and Correlates of Elder Abuse in São Paulo and Rio de Janeiro

OBJECTIVES

To assess the prevalence of elder abuse and to investigate potential sociodemographic, health behavior, and medical correlates.

DESIGN

Cross-sectional data were collected in face-to-face assessments.

SETTING

São Paulo and Rio de Janeiro, Brazil.

PARTICIPANTS

Individuals aged 60 to 75.

MEASUREMENTS

Information on elder abuse was obtained using the Brazil-adapted, nine-item Hwalek-Sengstock Elder Abuse Screening Test. Sampling design-adjusted descriptive statistics and logistic regression were used in analyses.

RESULTS

The overall prevalence of abuse was 14.4% (n = 46/259, 95% confidence interval (CI) = 9.82-20.61) in São Paulo and 13.3% (n = 27/197, 95% CI = 8.76-19.74) in Rio de Janeiro. Unadjusted analyses indicated that poor education, low physical activity, unemployment, heart disease, and psychiatric problems were associated with abuse, but in adjusted analyses, self-reported elder abuse was significantly associated only with psychiatric problems (São Paulo: OR = 4.48, 95% CI = 1.75-11.45; Rio de Janeiro: OR = 21.61, 95% CI = 6.39-73.14).

CONCLUSION

Elder abuse is prevalent in São Paulo and Rio de Janeiro, but whether concomitants of abuse are cause, effect, or both is unclear because this was a cross-sectional study. These findings highlight the importance of the problem, as well as the need to develop measures to increase awareness, facilitate prevention, and fight against abuse of elderly adults.

Prevalência de violência por parceiro íntimo em idosos e fatores associados: revisão sistemática

Resumo Este artigo tem por objetivo identificar a prevalência de violência por parceiro íntimo (VPI) em idosos e seus fatores associados. Realizou-se revisão sistemática de estudos transversais de base populacional nas bases de dados PubMed, Lilacs e PsycInfo, sem restrições quanto ao período e idioma de publicação. Dois revisores independentes conduziram a seleção, extração dos dados e análise de qualidade metodológica. Dezenove artigos foram selecionados para análise. Houve variação do tipo de violência, sexo dos entrevistados e instrumentos utilizados. A maioria dos estudos apresentou qualidade metodológica moderada ou alta. A VPI ocorreu em homens e mulheres idosos, sendo mais prevalentes a violência psicológica e o abuso econômico. Os fatores associados mais frequentes foram o consumo de álcool, depressão, baixa renda, comprometimento funcional e exposição pregressa à violência.

Psychometric evidence of the transcultural adaptation of the Vulnerability Abuse Screening Scale (VASS) for the detection of violence against the elderly

Abstract Objective: to present preliminary psychometric evidence of the cross-cultural adaptation of the Vulnerability to Abuse Screening Scale. Method: The steps of cultural adaptation verified conceptual, item, semantic and measurement equivalence. For measurement equivalence and verification of the psychometric data of the study samples of 30 and 66 elderly persons, respectively, were used. Descriptive and inferential statistics (KR-20, T-Student Test, Pearson correlation, univariate ANOVA and the Fleiss’ Kappa Index) were used for analysis of results. Results: It was found that the age of the participants ranged between 60 and 84 years, with a majority of older women participants (n=38). The KR-20 value for the overall score of the instrument was 0.688. The values for the four dimensions proposed by the authors of the instrument were 0.528, 0.289, 0.552 and 0.303, respectively. Only the values of the subscales Vulnerability and Coercion proved to be close to those of the original study (0.550 and 0.390). Conclusion: The internal consistency values found in the present study ranged from moderate to good, indicating that the results were satisfactory, despite being initial findings.

Identification and management of elder physical abuse in the routine of dentistry - a systematic review

OBJECTIVE

To perform a systematic search in the literature in order to verify whether the dentists are able to identify and manage cases elder physical abuse.

BACKGROUND

Dentists may play an important legal role contributing to the management of abused patients through the identification of injuries in their face, head and neck.

MATERIALS AND METHODS

The present systematic review was performed following the PRISMA Statement and was registered in the PROSPERO database. A search was conducted in the following electronic databases: PubMed, LILACS, SciELO, Embase, Web of Science, OpenGrey, Google Scholar. Specifically, the last two databases were used to search the 'grey literature'. The research question was based on the PVO strategy for systematic exploratory review. Two examiners determined the eligibility criteria for selecting the studies and performed all the research steps.

RESULTS

The initial search resulted in 842 studies, from which eight were considered eligible. Six studies used questionnaires to assess the perception, knowledge and attitudes of dentists towards the identification and management of cases of elder abuse, while two studies assessed this information through personal interviews. Two studies were rated as high quality, while six studies reached moderate quality. Male and female dentists were assessed separately in six studies. Only three studies specified the aggressor.

CONCLUSION

The dentists revealed insufficient knowledge on elder abuse. Most of the dentists are not able to identify and manage these cases in the clinical routine.

Prevalence of violence against the elderly and associated factors - a population based study in Florianópolis, Santa Catarina

Abstract Objective: To estimate the prevalence of violence among the elderly and to analyze its association with demographic, socioeconomic and health conditions. Method: A cross sectional population-based study was conducted of 1,705 individuals aged 60 years or older living in the city of Florianópolis in the state of Santa Catarina, between 2009 to 2010. Verbal, psychological, physical and financial violence was evaluated with a questionnaire used in the Pesquisa Saúde Bem-estar e Envelhecimento (Health and Well-being in Aging Survey) (SABE). Prevalence was calculated for each type of violence and the overall prevalence of violence was identified using the categories of the explanatory variables. Logistic regression was used to identify the factors associated with violence. Results: The general prevalence of violence was approximately 13.0%, while verbal violence occurred among 11.0% of respondents. The adjusted analysis showed that being female (OR=2.08) and elderly persons who were single or divorced were 66% more likely to suffer violence. Those who lived with their children or grandchildren were twice as likely to suffer violence (95% CI: 1:40 to 3:40). Conclusions: Although the results showed that the prevalence of violence against the elderly was greater than predicted by the WHO, we suspect that this number may be even higher. Due to the complexity of the theme, it is possible that elderly persons are afraid to reveal that they are victims of violence, as in most cases, the aggressors are family members.

[Prevalence of overburden in caregivers of dependent elderly and associated factors in a poor area of Rio de Janeiro, Brazil]

Population aging has led to increased dependency and overburden of family caregivers of dependent elderly. The aim was to verify prevalence of family caregivers overburden and associated factors in a poor and violent area of Rio de Janeiro, Brazil. This was a cross-sectional study of 140 elderly and family caregivers, focusing on social support, abuse, cohabitation, and family caregivers overburden, in addition to dependency, cognitive decline, and depression in the elderly. Multiple logistic models were constructed to explain family caregivers overburden. The following characteristics of the elderly were associated with family caregivers overburden: age (OR = 0.94; p < 0.002), depression (OR = 2.59; p < 0.005), and cognitive decline (OR = 3.19; p < 0.03). As for family caregivers characteristics, only social support remained relevant (OR = 2.35; p < 0.005). In conclusion, investigating and treating depression and dementia in the elderly and promoting support for their caregivers can contribute to the effective management of family caregivers overburden and improve quality of care for both.

Socioeconomic status, social relations and domestic violence (DV) against elderly people in Canada, Albania, Colombia and Brazil

PURPOSE

To determine whether gender, socioeconomic conditions, and/or social relations are related to recent experiences of DV in older adult populations.

MATERIALS AND METHODS

Data on socioeconomic status and social relations were collected in 2012 from 1995 community-dwelling older adults in Canada, Colombia, Brazil, and Albania. Violence experienced in the last 6 months was measured using the Hurt, Insulted, Threatened with harm, or Screamed at (HITS) scale and classified according to type (physical or psychological) and perpetrator (partner or family member). Binary logistic regression analyses were used to assess associations between experiences of violence and gender, socioeconomic conditions, and social relations.

RESULTS

Physical violence (by partner or family member) was reported by 0.63-0.85% of participants; the prevalence of psychological violence (by partner or family member) ranged from 3.2% to 23.5% in men and 9% to 26% in women. After adjustment for socioeconomic status, social relations, age and site, women experienced more psychological violence perpetrated by family members than did men (odds ratio (OR): 1.8; 95% CI: 1.2-2.6). Social relations, such as multifamily living arrangements and low levels of support from partners, children, and family, were associated with psychological DV. Current working status was associated with greater odds of victimization by partners among men (OR: 2.35 95% CI: 1.34-1.41), but not among women.

CONCLUSIONS

Gender and social relations are important determinants of experiencing violence in older adults. The findings of this study demonstrate the importance of a gender-based approach to the study of DV in older adults.