Ferrah Noha, Murphy Briony J, Ibrahim Joseph E, Bugeja Lyndal C, Winbolt Margaret, LoGiudice Dina, Flicker Leon, Ranson David L
Department of Forensic Medicine, Monash University and Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia.
The Victoria and Tasmania Dementia Training Study Centre, Australian Centre for Evidence Based Aged Care, Australian Institute for Primary Care and Ageing, Faculty of Health Sciences, La Trobe University, Melbourne, Victoria 3086, Australia.
Age Ageing. 2015 May;44(3):356-64. doi: 10.1093/ageing/afv004. Epub 2015 Jan 28.
resident-to-resident aggression (RRA) is an understudied form of elder abuse in nursing homes.
the purpose of this systematic review was to examine the published research on the frequency, nature, contributing factors and outcomes of RRA in nursing homes.
in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, this review examined all original, peer-reviewed research published in English, French, German, Italian or Spanish between 1st January 1949 and 31st December 2013 describing incidents of RRA in nursing homes. The following information was extracted for analysis: study and population characteristics; main findings (including prevalence, predisposing factors, triggers, nature of incidents, outcomes and interventions).
eighteen studies were identified, 12 quantitative and 6 qualitative. The frequency of RRA ranged from 1 to 122 incidents, with insufficient information across the studies to calculate prevalence. RRA commonly occurred between exhibitors with higher levels of cognitive awareness and physical functionality and a history of aggressive behaviours, and female targets who were cognitively impaired with a history of behavioural issues including wandering. RRA most commonly took place in the afternoon in communal settings, was often triggered by communication issues and invasion of space, or was unprovoked. Limited information exists on organisational factors contributing to RRA and the outcomes for targets of aggression.
we must continue to grow our knowledge base on the nature and circumstances of RRA to prevent harm to an increasing vulnerable population of nursing home residents and ensure a safe working environment for staff.
住院患者之间的攻击行为（RRA）是养老院中一种研究较少的虐待老年人形式。
本系统评价的目的是审查已发表的关于养老院中RRA的频率、性质、促成因素和结果的研究。
根据系统评价和Meta分析的首选报告项目声明，本评价审查了1949年1月1日至2013年12月31日期间以英文、法文、德文、意大利文或西班牙文发表的所有原始的、经过同行评审的研究，这些研究描述了养老院中的RRA事件。提取以下信息进行分析：研究和人群特征；主要发现（包括患病率、诱发因素、触发因素、事件性质、结果和干预措施）。
确定了18项研究，其中12项为定量研究，6项为定性研究。RRA的发生频率从1起至122起不等，各研究之间缺乏足够信息来计算患病率。RRA通常发生在认知意识和身体功能水平较高且有攻击行为史的施虐者与认知受损且有包括徘徊在内的行为问题史的女性受害者之间。RRA最常发生在下午的公共场合，通常由沟通问题和空间侵犯引发，或无明显诱因。关于促成RRA的组织因素以及攻击行为受害者的结果，现有信息有限。
我们必须继续增加对RRA的性质和情况的了解，以防止对日益脆弱的养老院居民群体造成伤害，并确保工作人员有一个安全的工作环境。
