Fearing Gwendolyn, Sheppard Christine L, McDonald Lynn, Beaulieu Marie, Hitzig Sander L
a Institute for Life Course and Aging, Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada.
b School of Public Health and Health Systems , University of Waterloo , Waterloo , Ontario , Canada.
J Elder Abuse Negl. 2017 Mar;29(2-3):102-133. doi: 10.1080/08946566.2017.1308286.
Elder abuse and neglect is a societal issue that requires prevention and intervention strategies at the practice and policy level. A systematic review on the efficacy of community-based elder abuse interventions was undertaken to advance the state of knowledge in the field. The peer-reviewed literature between 2009 and December 2015 were searched across four databases. Two raters independently reviewed all articles, assessed their methodological quality, and used a modified Sackett Scale to assign levels of evidence. Four thousand nine hundred and five articles were identified; nine were selected for inclusion. Although there was Level-1 evidence for psychological interventions (n = 2), only one study on strategies for relatives (START) led to a reported decrease in elder abuse. There was Level-4 evidence for conservatorship, an elder abuse intervention/prevention program (ECARE), and a multidisciplinary intervention (n = 4), in which one study yielded significant decreases in elder abuse and/or neglect. The remaining three were classified as Level-5 evidence (n = 3) for elder mediation and multidisciplinary interventions. There are limited studies with high levels of evidence for interventions that decrease elder abuse and neglect. The scarcity of community-based interventions for older adults and caregivers highlights the need for further work to elevate the quality of studies.
老年人虐待与忽视是一个社会问题,需要在实践和政策层面制定预防及干预策略。开展了一项关于社区老年人虐待干预措施效果的系统综述,以推动该领域的知识发展。在四个数据库中检索了2009年至2015年12月间经过同行评审的文献。两名评估人员独立审查了所有文章,评估其方法学质量,并使用改良的萨克特量表来确定证据等级。共识别出4905篇文章;9篇被选入。虽然有1级证据支持心理干预(n = 2),但仅有一项关于亲属策略(START)的研究报告称老年人虐待有所减少。有4级证据支持监护、一项老年人虐待干预/预防项目(ECARE)和一项多学科干预(n = 4),其中一项研究使老年人虐待和/或忽视显著减少。其余三项被归类为5级证据(n = 3),涉及老年人调解和多学科干预。关于减少老年人虐待与忽视的干预措施,证据等级较高的研究有限。针对老年人和照顾者的社区干预措施匮乏,凸显了开展进一步工作以提高研究质量的必要性。