Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2020 Jun 5;15(6):e0234195. doi: 10.1371/journal.pone.0234195. eCollection 2020.
A framework of social inclusion can promote equity and aid in preventing and addressing the abuse of older adults. Our objective was to build a social inclusion framework for a comprehensive hospital-based elder abuse intervention being developed. Potential components of such a framework, namely, health determinants and guiding principles, were extracted from a systematic scoping review of existing responses (e.g., interventions, protocols) to elder abuse and collated. These were subsequently rated for their importance to the elder abuse intervention by a panel of violence experts and further evaluated by a panel of elder abuse experts. The final social inclusion framework comprised 12 health determinants each representing factors underpinning susceptibility for abuse in aging populations: history of trauma/abuse, communication needs, disability, health status, mental capacity, social support, culture, language, sexuality, religion, gender identity, and socioeconomic status. The framework also comprised 19 guiding principles each encompassing considerations for equitable engagement with older adults (e.g., All older adults have the right to self-determination, All older adults have the right to be safe, All older adults are assumed competent unless determined otherwise). Integrating this social inclusion framework into the design and delivery of an elder abuse intervention could empower older adults, while at the same time ensuring that practices and policies are tailored to meet their unique and varying needs.
社会包容框架可以促进公平,并有助于预防和解决虐待老年人问题。我们的目标是为正在开发的综合性医院老年人虐待干预措施构建一个社会包容框架。从对老年人虐待现有应对措施(如干预措施、协议)的系统范围审查中提取了该框架的潜在组成部分,即健康决定因素和指导原则,并对其进行了整理。随后,一个暴力问题专家小组对这些组成部分对老年人虐待干预的重要性进行了评分,并由一个老年人虐待问题专家小组对其进行了进一步评估。最终的社会包容框架包括 12 个健康决定因素,每个因素都代表着老年人易受虐待的潜在因素:创伤/虐待史、沟通需求、残疾、健康状况、心理能力、社会支持、文化、语言、性取向、宗教、性别认同和社会经济地位。该框架还包括 19 项指导原则,每项原则都包含了与老年人公平接触的考虑因素(例如,所有老年人都有自决权,所有老年人都有安全权,除非另有规定,否则所有老年人都被假定为有能力)。将这种社会包容框架融入老年人虐待干预措施的设计和实施中,可以增强老年人的权能,同时确保实践和政策能够满足他们独特而多样化的需求。