Development And Application Of An Assessment Tool For Elder Psychological Abuse In Domestic Setting

Objective1.Explore the connotation of elder psychological abuse and provide reference for the development of the scale.To develop an assessment scale for elder psychological abuse in the family,and to test its reliability and validity preliminarily.2.The assessment scale of elder psychological abuse in the family was applied to describe the current situation of elder psychological abuse in the domestic setting,and to analyze the influencing factors of elder psychological abuse.Method1.Rodgers evolutionary concept analysis The databases of CNKI,Wanfang,VIP,Pub Med,Web of Science,Psy INFO,CINAHL and Embase were systematically searched,literatures were screened according to the inclusion and exclusion criteria,and the evolution,attributes,antecedents,consequences and typical cases of elder psychological abuse were analyzed.2.Development of the scale Under the guidance of intraindividual theory,the item pool of the scale was formed through literature review,conceptual analysis,and delphi method.The initial version of the scale was formed after two rounds of delphi method and a small sample pre-survey.The initial version of the scale was used to conduct a questionnaire survey on 247 elderly people,and the formal version of the scale was formed through item analysis,reliability and validity analysis.3.Application of the scale The convenience sampling method was used to select the elderly in Shijiazhuang of Hebei Province,Jining of Shandong Province,and Dalian City of Liaoning Province.The survey tools included the General Information Questionnaire and the formal version of the Domestic elder psychological abuse Assessment Scale.Descriptive statistics,Mann-Whitney U Test,Kruskal-Wallis Test,Nemenyi Test and Multiple linear regression analysis methods were used to analyze the status and influencing factors of psychological abuse among the elderly in the family.Results1.Results of Rodgers evolutionary concept analysisA total of 3162 articles were retrieved,and 42 articles were finally included after strict screening.The attributes of psychological abuse of the elderly include four aspects: victim,abuser,psychological abusive behavior and injury facts.The antecedents include the characteristics of the elderly,the characteristics of caregivers,and the relationship between the two.The outcome can be extremely damaging to the physical and mental health and social relationships of older adults.2.Development of the scale(1)Combined with the results of literature review,conceptual analysis and delphi method,it was preliminarily determined that the scale for elder psychological abuse in the family included 4 dimensions of disrespect,isolation,threat,and control,with a total of 18 items.(2)Results of Delphi experts consulation The expert enthusiasm coefficient for the two rounds of experts consultation were 78.57% and 81.82%;the expert authority coefficients were 0.859 and 0.894;the expert opinion coordination coefficients were 0.208 and 0.339(P<0.001).After two rounds of expert correspondence,the scale includes 4 dimensions and 20 items.(3)Reliability and validity analysis Filter items by item analysis and delete item-20.The overall Scale-CVI(S-CVI)score for the assessment scale was 0.994,the Item-CVI(I-CVI)scores ranged from 0.889 to 1.Four common factors were extracted by exploratory factor analysis,and therefore the accumulative variance contribution rate was 60.682%.The Cronbach’s α coefficients of the scale was 0.788,and the Cronbach’s α coefficients of the four dimensions was 0.651～0.832.The test-retest reliability of the total scale was 0.954,and the test-retest reliability of each dimension was 0.847～0.960.The official version of the scale formed includes 4 dimensions of disrespect,isolation,threat,and control,with a total of 16 items.3.Application of the scaleThe total score of psychological abuse of the elderly in the family was 20(19,23),and the total average score was 1.25(1.19,1.44).The results of univariate analysis showed that age,place of residence,education level,marital status,living style,source of living economy,monthly income,and the number of chronic diseases all had an impact on the questionnaire scores(P<0.05);multiple linear regression analysis showed that the types of chronic diseases number,monthly income,marital status and residence are the influencing factors of mental abuse among the elderly.Conclusions1.The Domestic elder psychological abuse Assessment scale has good reliability and validity,which can be used to measure the psychological abuse of the elderly in the family in China.2.The psychological abuse of the elderly in the family is generally at a low level.The number of chronic diseases,monthly income,marital status and residence are the influencing factors of psychological abuse of the elderly.