Hussein Shereen, Stevens Martin, Manthorpe Jill, Rapaport Joan, Martineau Stephen, Harris Jess
King's College London, Strand, London, UK.
Health Soc Care Community. 2009 Sep;17(5):423-33. doi: 10.1111/j.1365-2524.2008.00840.x. Epub 2009 Feb 12.
Since July 2004, employers of social care staff working with vulnerable adults in England and Wales have been legally required to refer workers or volunteers dismissed for misconduct because they have harmed vulnerable adults or placed them at risk of harm to the Protection of Vulnerable Adults (POVA) list. The POVA list is unique to England and Wales, and is a powerful tool of quality assurance for the care sector and for the safeguarding of vulnerable adults. This article reports on part of a multi-method study including quantitative and qualitative elements to produce a rounded picture of the factors involved in decisions to place staff members on the POVA list. Based on secondary data analysis of all records of POVA referrals from August 2004 to November 2006 (5294 records) as well as a detailed sample of 298 referrals, this article focuses on the prevalence of different types of alleged harm and their association with various staff, employer and service-users' characteristics. The most common form of alleged abuse was physical abuse (33%), while the least was sexual abuse (6%). Some of the other key findings are the over-representation of men referred (31% compared to an average of 15% in the workforce) and significantly different types of abuse in care home and domiciliary settings, where financial abuse was less likely in care homes [odds ratio (OR) 0.17; P < 0.001], while physical abuse more likely in the same setting (OR 3.60; P < 0.001).
自2004年7月起，在英格兰和威尔士，雇主若解雇因行为不端而伤害弱势成年人或使其面临伤害风险的社会护理工作人员或志愿者，依法须将其转介至“保护弱势成年人”（POVA）名单。POVA名单是英格兰和威尔士独有的，是护理行业质量保证及保护弱势成年人的有力工具。本文报告了一项多方法研究的部分内容，该研究包括定量和定性要素，以全面了解将工作人员列入POVA名单的决策所涉及的因素。基于对2004年8月至2006年11月所有POVA转介记录（5294条记录）的二次数据分析以及298条转介记录的详细样本，本文重点关注不同类型的指控伤害的发生率及其与各类工作人员、雇主和服务使用者特征的关联。最常见的被指控虐待形式是身体虐待（33%），而最少见的是性虐待（6%）。其他一些主要发现包括被转介男性比例过高（31%，而劳动力平均比例为15%），以及在养老院和上门护理环境中存在显著不同类型的虐待情况，其中养老院发生财务虐待的可能性较小[优势比（OR）0.17；P<0.001]，而在同一环境中身体虐待的可能性较大（OR 3.60；P<0.001）。
