Ayres M M, Woodtli A
College of Nursing, University of Arizona, Tucson, Arizona 85721-0203, USA.
J Adv Nurs. 2001 Aug;35(3):326-34. doi: 10.1046/j.1365-2648.2001.01849.x.
The purpose of this article is to clarify the concept of abuse within the context of ageing women who are at risk for or experiencing physical or emotional injury inflicted by elderly family members for whom they provide care.
The study of abuse of ageing individuals in family caregiving situations has traditionally focused on abuse of the dependent care receiver. However, evidence supports the health risks related to abuse of ageing caregivers as well. Women, usually spouses, daughters, or daughters-in-law, most frequently assume the caregiver role.
A modification of the strategies for concept analysis proposed by Walker and Avant (1995) is used to clarify the concept of caregiver abuse. Searches of the professional literature reveal that caregiver abuse is rarely addressed; therefore, the broader concept of elder abuse is reviewed and then placed within the general context of family caregiving. Audiotapes of the first session of a community based intervention research study entitled Intervention for the Abuse of Ageing Caregivers (Phillips et al., NIH Grant No. R01 DA-AG11155-01, 1996), in which ageing women caregivers described abusive caregiving situations, were analysed qualitatively using the principles of concept analysis. The audiotapes serve as a second source of data for the concept analysis process.
Antecedents, defining characteristics, and consequences of abuse of ageing caregivers were identified through the process of concept analysis. Model, contrary, and borderline cases are presented to illustrate the findings.
Findings supported the need for awareness that ageing caregivers can be placed at risk by verbally and physically abusive behaviours of the elders for whom they provide care. Use of the term 'abuse' by health care professionals has potentially negative consequences for identification and intervention in cases of potential or actual caregiver abuse.
本文旨在阐明虐待这一概念，其背景是老年女性面临风险或正在遭受她们所照料的老年家庭成员施加的身体或情感伤害。
在家庭照料情境中对老年人虐待的研究传统上聚焦于受照料的依赖者所遭受的虐待。然而，有证据表明虐待老年照料者也存在健康风险。女性，通常是配偶、女儿或儿媳，最常承担照料者的角色。
采用沃克和阿万特（1995年）提出的概念分析策略的一种变体来阐明照料者虐待这一概念。对专业文献的检索表明，照料者虐待很少被提及；因此，先回顾了更宽泛的虐待老年人概念，然后将其置于家庭照料的总体背景中。对一项名为“干预老年照料者虐待”（菲利普斯等人，美国国立卫生研究院资助号R01 DA - AG11155 - 01，1996年）的社区干预研究的第一阶段录音带进行了定性分析，在该研究中，老年女性照料者描述了虐待性的照料情况，分析运用了概念分析的原则。这些录音带是概念分析过程的第二个数据来源。
通过概念分析过程确定了老年照料者虐待的前因、定义特征和后果。呈现了典型、相反和临界案例以阐释研究结果。
研究结果支持有必要认识到老年照料者可能会因她们所照料的老年人的言语和身体虐待行为而面临风险。医疗保健专业人员使用“虐待”一词可能会对潜在或实际的照料者虐待案例的识别和干预产生负面影响。
