Department of Mental Health Sciences, University College London, Highgate Hill, London, UK.
Am J Geriatr Psychiatry. 2009 Oct;17(10):826-38. doi: 10.1097/jgp.0b013e3181b0fa2e.
The authors systematically reviewed the 32 articles fitting predetermined criteria that investigated health and social care professionals' knowledge, detection, and reporting of elder abuse. These included 21 surveys (of 5,325 professionals), nine analyses of elder abuse reports to statutory bodies, and two intervention studies. Compatible results were pooled in a meta-analysis. Professionals consistently underestimated the prevalence of elder abuse. Only a quarter of U.S. physicians were aware of American Medical Association elder abuse guidelines. The authors found that 33.7% (95% confidence interval: 27.5-40.1) of health care professionals had detected a case of older adult abuse in the last year. This was slightly higher when only studies judged to be most representative, which all surveyed physicians, were included (39.9% [23.4-57.7]). About half of the detected abuse cases were reported. Professionals who recalled receiving any training on abuse were no more likely to detect abuse than those who stated they had not had training, although they were more likely to report the abuse if they detected it. Interventions that taught professionals about the management of abuse by face-to-face training were effective in increasing knowledge, whereas giving written information was not. No intervention studies have investigated whether detection and reporting of abuse can also be increased through education. Current evidence would support the development and testing of interventions to increase professionals' detection and reporting of abuse. These would encourage them to ask older people about abuse, and address professionals' concerns about the impact of reporting on therapeutic relationships, victims; and legal consequences for the reporter.
作者系统地回顾了符合预定标准的 32 篇文章，这些文章调查了卫生和社会保健专业人员对虐待老年人行为的了解、发现和报告情况。其中包括 21 项调查（涉及 5325 名专业人员）、9 项向法定机构报告虐待老年人行为的分析报告以及 2 项干预研究。可兼容的结果被合并到荟萃分析中。专业人员始终低估了虐待老年人行为的发生率。只有四分之一的美国医生了解美国医学协会关于虐待老年人行为的准则。作者发现，在过去一年中，有 33.7%（95%置信区间：27.5-40.1）的卫生保健专业人员发现了一起老年虐待案件。当仅包括被认为最具代表性的研究（均调查了医生）时，这一比例略高（39.9%[23.4-57.7]）。大约有一半的已发现虐待案件得到了报告。回忆曾接受过虐待行为培训的专业人员与表示未接受过培训的专业人员相比，发现虐待行为的可能性并不高，尽管他们如果发现虐待行为，更有可能报告。通过面对面培训向专业人员传授虐待行为管理知识的干预措施可有效提高知识水平，而提供书面信息则不然。没有干预研究调查过通过教育是否也可以增加对虐待行为的发现和报告。现有证据支持制定和测试干预措施，以提高专业人员对虐待行为的发现和报告能力。这些措施将鼓励他们询问老年人是否遭受虐待，并解决专业人员对报告对治疗关系、受害者以及对报告人的法律后果的担忧。
