National Ageing Research Institute, Parkville, Victoria, Western Australia.
School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia.
Gerontologist. 2020 Apr 2;60(3):472-482. doi: 10.1093/geront/gny166.
Without an effective screening tool, accompanied by clear guidelines of what to do when elder abuse is suspected, health workers may face challenges when asking questions about elder abuse. This study aimed to find the most effective and acceptable existing elder abuse screening tool and to create guidelines for using the tool.
A rapid review of the literature identified existing validated elder abuse screening tools. Then, 5 tools (Vulnerability to Abuse Screening Scale [VASS], Elder Abuse Suspicion Index [EASI], Elder Assessment Instrument [EAI], Caregiver Abuse Screen [CASE], and Brief Abuse Screen for the Elderly [BASE]), selected based on their internal rigor, were presented to health professionals to assess the tools' relevance to their practice. Three focus groups were held with 23 health professionals in Victoria, Australia, in 2017. Data were thematically analyzed.
None of the tools were deemed suitable by participants for use in their practice. Criticisms of the tools included: using outdated terminology, asking binary questions, asking multiple questions at once, failure to consider the older person's cognitive status, failure to consider how culture mediates elder abuse, and failure to outline a referral pathway to those administering the tool. Participants emphasized that the screening tool must promote trust and rapport between the assessor and the older person to solicit a story on this sensitive subject.
A successful elder abuse screening tool must be concise, easy to use, account for the older person's health and social vulnerabilities, and outline a referral pathway if elder abuse is suspected.
如果没有有效的筛查工具，并且在怀疑存在虐待老人行为时没有明确的指导方针，卫生工作者在询问虐待老人问题时可能会面临挑战。本研究旨在找到最有效和可接受的现有虐待老人筛查工具，并制定使用该工具的指南。
对文献进行快速回顾，确定了现有的经验证的虐待老人筛查工具。然后，根据内部严谨性选择了 5 种工具（脆弱性虐待筛查量表[VASS]、虐待怀疑指数[EASI]、老年人评估工具[EAI]、照顾者虐待筛查[CASE]和老年人简短虐待筛查[BASE]），并将这些工具呈现给卫生专业人员，以评估其与实践的相关性。2017 年，在澳大利亚维多利亚州举行了 3 次焦点小组会议，共有 23 名卫生专业人员参加。对数据进行了主题分析。
参与者认为没有一种工具适合在实践中使用。对这些工具的批评包括：使用过时的术语、询问二元问题、一次询问多个问题、未能考虑老年人的认知状况、未能考虑文化如何调解虐待老人行为，以及未能概述向工具使用者提供的转介途径。参与者强调，筛查工具必须在评估者和老年人之间建立信任和融洽关系，以便在这个敏感话题上征求一个故事。
成功的虐待老人筛查工具必须简洁、易于使用，考虑到老年人的健康和社会脆弱性，并概述如果怀疑存在虐待老人行为的转介途径。
