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Study On Evaluation Of Elder Abuse Of Caregiver

Posted on:2011-10-02Degree:MasterType:Thesis
Country:ChinaCandidate:R X FengFull Text:PDF
GTID:2167360308970167Subject:Nursing
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Background:Elder Abuse is a global social problem and health problem. It is very common both in developed and developing countries, and its occurrence rate from 1% to 20%. Elder abuse led the elderly to physical and mental injury. It would make motality significantly increased, medical costs increased, and affect the life of the elderly in their twilight years seriously. At present, China has entered the aging society, with that the elderly population aged 60 and above has reached to 149 million, more than 11% of the total population. China is the most populous country of old age in the world. The incidents of elder abuse closely associated with social and cultural background, so that different countries have different understanding of it. In China, the main related research of elder abuse were the legal discipline and moral aspects of education. There was not a sure definition of elder abuse, classification and the research of solving methods. And it was lack of any specific survey data and case studies of elder abuse also. The incidents of elder abuse were hidden and difficult to define. Detection of elder abuse depends on the people's awareness of elder abuse. If you think that the behavior and physical condition of the elderly is due to old age or poor health simply, it may fail to detect abuse. In addition, the situation and psychological barriers affected the self-report of elderly abuse. Therefore, different ways of assessments and screening were very important, such as by the assessment of caregivers, the third parties to conduct surveys and assessments. Canadian gerontologist experts Reis, M and Nahmiash, D prepared an elder abuse assessment scale The Caregiver Abuse Screen (CASE). It was dedicated to assess the elderly caregivers. It was a simple abuse assessment screening questionnaire, a total of 8 items, for caregivers to fill out, which can be completed within 5 minutes. Its score can distinguish the existence of abuse of risky behavior of caregivers, for applying in the community (family), nursing homes, and hospitals. It would help the medical personnel in early identification of abusive caregivers, found the elderly who may be abused, in time for intervention effectively. CASE researchers in different countries has proved it had a good reliability and validity. Agreed by the authors of CASE, this study will introduce CASE to China and provide an effective and convenient tool for investigation in the China's elder abuse research.Objectives:The purposes of this study were to (1) gain a better understanding to the opinion of concept of "elder abuse" between different people under the Chinese cultural background, (2) evaluate the reliability and validity of the Chinese version of "The Caregiver Abuse Screen (CASE)", provide an effective tool for the assessment of elder abuse in China; (3) application of Chinese version of CASE scale: survey the risk of abuse scores of caregiver for elderly persons in community, identify and analysis the influencing factors of elder abuse.Methods:(1)Preparing the questionnaire of the opinion about " elder abuse " according to the Hong Kong Christian Service in February 2002, "the prevention of elderly abuse program" to investigate the nurses who working in the emergency department and Geriatrics department, the volunteers of community services for the elderly in Haizhu District Zhaoguang Jun volunteer network of studio, the youngs and the retired elderly accepted medical examination and treatment in the Out patient department in a hospital from August to September 2008, four groups, a total of 201 people on-site survey. (2)Translating CASE from English to Chinese and determining the reliability and validity of CASE; (3)CASE Scale Applications:Investigating 104 caregivers of the elderly who has self-care disability in Guangzhou City, SPSS13.0 software for the statistical analysis.Results:(1) The opinion of concept of "elder abuse" between different people under the Chinese cultural background were homologous about physical abuse, psychological abuse, economic exploitation and neglect to the definition of "elder abuse" in 2002 United Nations Economic and Social Council.35.8% and 54.8% of the respondents did not agree routine neglect and self-neglect elder abuse. The comparison of different gender groups awareness:awareness of sexual abuse of the elderly had significant differences between men and women (P<0.001). The perception of different ages groups:the "neglect of the elderly in their daily lives" between the young and the elderly were significantly different (P<0.000). The comparison of different education groups:"old people care for themselves or give up their own negligence," "neglect of the elderly in daily life" and "abandonment of the elderly" are different between different education lever populations (P<0.05). (2)The Cronbach's alpha reliability coefficient of CASE is 0.77.Test-retest Spearman correlation coefficient 0.542 (P<0.05) paired t-test P> 0.05. Factor analysis three public factor, can explain the total variance of 65.471%. The corresponding factors of the projects have a more satisfied with the amount of factor loading (>0.4), to be a good construct validity. (3)The mean score (3.45±2.516) of the investigation statistically significant (P<0.000) compared with non-abused group. The score is different the different educational background of the Caregivers, the elderly's marital status and self-care ability (P<0.05). Logistic regression analysis:educational lever of the Caregivers, the elderly's marital status and self-care ability are the influencing factors of the risks of elder abuse (R2= 0.408,2.524 and 2.979).Conclusions:(1)The investigation proved that in China, different people agree that the "physical abuse", "psychological abuse" "economic exploitation" and "neglect" are "elder abuse ". However, different genders, ages, education levers have different opinion about "sexual abuse", "daily neglect", "Self-neglect" and "abandoned". According to the investigation and foreign and HongKong's experience, we think we can adopt with the 16 situations of "elder abuse" except "self-neglect" as a judge for future research and the definition of "elder abuse". The categories were six:physical abuse, psychological abuse, sexual abuse, economic exploitation, abandonment and neglect. (2) The Chinese version of CASE was demonstrated that it had a good reliability and validity, and the project settings can apply to an initial screening to assess the risk of abuse of the caregivers of the elderly. It can be used as a screening tool in the study of elder abuse. (3)The educational lever of the Caregivers was the protective factor, which meaned the higher of the Caregivers'education level the less score. The marriage situations and bad ADL of the elderly may be the risk factors of elder abuse.
Keywords/Search Tags:Caregiver, Elder abuse, Evaluation, Risk of abuse, Influencing factors
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