赋能预防虐待老年人模式的设计与实施：一项随机对照试验。
Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial.
机构信息
Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran.
Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz.
出版信息
Clin Interv Aging. 2018 Apr 17;13:669-679. doi: 10.2147/CIA.S158097. eCollection 2018.
BACKGROUND
Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse.
METHODS
This parallel randomized controlled trial was conducted in 2014-2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using tests, multiple linear and logistic regression, and structural equation modeling (SEM).
RESULTS
The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher (<0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, <0.05), self-efficacy (Sβ=0.76, β=13.32, SE=0.52, <0.05) and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, <0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=-0.406, β=-0.340, SE=0.03, <0.05), and through social support, self-efficacy, and health promoting behaviors.
CONCLUSION
Educational interventions can be effective in preventing elder abuse.
背景
老年人比年轻人更容易受到健康风险的影响，可能会面临各种危险，包括虐待老人。本研究旨在设计并实施一项权力赋予教育干预措施，以预防虐待老人的行为。
方法
本平行随机对照试验于 2014 年至 2016 年在德黑兰 22 个市的卫生所进行，共 18 个月，纳入了 464 名年龄在 60 岁以上的老年人。数据采用标准问卷收集，包括虐待老人知识问卷、促进健康行为问卷、健康促进生活方式量表 II、健康生活方式障碍量表、感知社会支持量表、自我效能感量表、孤独感量表、老年抑郁量表、多维健康控制源量表和 SCARED（压力、应对、争论、资源、事件和依赖）工具。干预措施包括 20 次 45-60 分钟的培训课程，共 6 个月。采用 t 检验、多元线性和逻辑回归以及结构方程模型（SEM）进行数据分析。
结果
干预前，两组老年人对虐待老人知识、自我效能感、社会支持和健康促进生活方式的认知频率相似。然而，干预后，干预组中具有较高虐待老人知识（94.8% vs. 46.6%）、自我效能感（82.8% vs. 7.8%）、社会支持（97.0% vs. 10.3%）和健康促进生活方式（97.0% vs. 10.3%）的频率显著更高（<0.001），虐待老人风险的频率显著更低（28.0% vs. 49.6%）（<0.001）。SEM 标准化β（Sβ）显示，干预对增加社会支持（Sβ=0.80，β=48.64，SE=1.70，<0.05）、自我效能感（Sβ=0.76，β=13.32，SE=0.52，<0.05）和健康促进行为（Sβ=0.48，β=33.08，SE=2.26，<0.05）的影响最大。干预对降低虐待老人风险的影响是间接的且具有统计学意义（Sβ=-0.406，β=-0.340，SE=0.03，<0.05），并且是通过社会支持、自我效能感和健康促进行为产生的。
结论
教育干预措施可有效预防虐待老人行为。
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