Prevalence and Factors Associated With Elder Abuse in Community-Dwelling Elderly in Korea: Mediation Effects of Social Support

Profiles in neglect of older adult care workers in a long-term care facility: a latent profile analysis

Background

Neglect is a common form of abuse, and long-term care facilities record higher incidences of this abuse. Given that older adult care workers are the main workforce in these facilities, their neglectful behavior requires public health attention. Internal individual characteristics can lead to older adult abuse, and managing workers who abuse older adults may require various methods. This study aimed to identify the profiles of neglect among older adult care workers in long-term care facilities and explore the influencing factors of neglect.

Methods

In this cross-sectional study, a convenience sample of older adult care workers from 15 long-term care facilities in Shandong Province (N = 421) completed a questionnaire on the characteristics associated with neglect. Latent profile analysis was used to identify distinct neglect profiles and promote the understanding of individual characteristics associated with varying levels of neglect. One-way analysis of variance and multivariate logistic regression analyses were used to examine the population characteristic differences.

Results

Older adult care workers exhibited three neglect profiles, namely, the "low-risk group," "medium-risk group," and "high-risk group." Males, participants with no employment qualification certificate, and those who did not attend regular training represented the majority of those in the "high-risk group." Participants with a monthly income of more than ¥ 4,000 and nursing 1-2 older adults simultaneously represented the majority of those in the "low-risk group."

Conclusion

Long-term care facility administrators should tailor interventions to individual care worker profiles to reduce neglect behaviors and improve care levels.

Modeling suicidal ideation in Korean older adults based on their social relationships and mental health: a meta-analytic path analysis

OBJECTIVES

Elder suicide is a serious concern in many countries, including South Korea. Various policies and programs to prevent elder suicide are essential; however, further understanding of this phenomenon is necessary. The current study, therefore, developed a model for understanding the underlying mechanism of suicidal ideation in older adults in South Korea. The model was based on Andersen's theory (2021), which explains the path from social relationships to mental health.

METHODS

This study was conducted utilizing meta-analytic structural equation modeling in accordance with a pooled correlation matrix. We used data from 93 existing studies systematically identified in nine academic databases.

RESULTS

The fit statistics show that our model fits the data well. The results demonstrated that suicidal ideation was directly affected by abuse, depression, and self-esteem but not by family relationships. Depression significantly mediated the relationship between abuse and suicidal ideation and between family relationships and suicidal ideation.

CONCLUSION

Social relationships play an important role in determining mental health among Korean older adults, consistent with Andersen's theory. Prevention of elder abuse and depression is essential in preventing suicide among older adults in South Korea.

Education program promoting report of elder abuse by nursing students: a pilot study

BACKGROUND

Elder abuse is an important public health concern that requires urgent attention. One main barrier to active responses to elder abuse in clinical settings is a low level of relevant knowledge among nurses. This study aims to develop an educational program to promote an intent to report elder abuse among nursing students and assess its effectiveness, with a focus on the rights of older adults.

METHODS

A mixed method design was used with the Analyze, Design, Develop, Implement, and Evaluate model. Twenty-five nursing students from Chungbuk Province participated in the study. Attitude toward older adults and knowledge of, awareness of, attitude towards, and intent to report elder abuse were assessed quantitatively and analyzed using paired t-test. The feasibility of the program and feedback were collected qualitatively through group interviews and analyzed using content analysis.

RESULTS

After the education program, attitude toward older adults (Cohen's d = 1.08), knowledge of (Cohen's d = 2.15), awareness of (Cohen's d = 1.56), attitude towards (Cohen's d = 1.85), and intent to report elder abuse (Cohen's d = 2.78) increased, confirming the positive effects of this program. Overall, all participants were satisfied with the contents and method of the program.

CONCLUSIONS

The method of program delivery should be improved and tailored strategies to boost program engagement among nursing students should be explored to implement and disseminate the program.

Predictors of Physical Abuse in Elder Patients With Fracture

INTRODUCTION

Elder abuse is a public health issue requiring attention. Unlike abuse in the pediatric population, predictors of elder abuse in patients with fracture have not been well defined.

METHODS

Elderly patients with physical abuse and fracture were abstracted using the 2007 to 2017 National Emergency Department Sample database. Univariate comparisons, multivariate regression, and adjusted odds ratios were used to determine independent predictors of elder abuse compared with nonabuse fracture controls.

RESULTS

Thirteen percent of elder physical abuse patients presenting to the emergency department had fracture. Of all patients with fracture, elder abuse patients tended to be younger; be female; belong to lower income quartiles; and have codiagnoses of volume depletion, mental disorders, dementia, and intellectual disability. Presentation with other forms of elder abuse, such as psychological abuse, neglect, and sexual abuse, and multiple fractures were also associated with elder physical abuse. Multivariate regression found elder abuse to be more likely in the setting of skull and rib fractures and less likely in the setting of femur and foot and ankle fractures.

DISCUSSION

This study identified predictors of elder physical abuse in fracture patients older than 60 years. As with pediatric abuse, heightened awareness of potential physical abuse should be considered, especially in higher risk patients.