School of Nursing, Tianjin University of Traditional Chinese Medicine, No. 10 Poyang Lake Road, West Area of Tuanbo New Town, Jinghai District, Tianjin, 301617, China.
School of Nursing, Peking University, 38 College Road, Haidian District, Beijing, 100191, China.
Eur Geriatr Med. 2022 Jun;13(3):585-596. doi: 10.1007/s41999-022-00628-2. Epub 2022 Feb 28.
Many epidemiological studies have reported that elder abuse and neglect were prevalent in rural areas. However, none of them has synthesized the literature in this field. Therefore, we aimed to estimate the overall prevalence of elder abuse and neglect in rural areas through a systematic review and meta-analysis.
PubMed, EMBASE, Web of Science, and Cochrane Library were systematically searched to identify eligible articles, with no language restrictions. Statistical analyses were conducted using Review Manager software (version 5.3). Meta-analyses and sensitivity analysis were performed using a random-effects model. All results were reported as the pooled prevalence of elder and neglect with their 95% confidence intervals (CIs). The quality of the included studies was evaluated by strengthening the reporting of observational studies in epidemiology (STROBE) checklist. Potential publication bias was assessed by the funnel plot.
13 cross-sectional studies involving 10,313 participants were eligible. The prevalence of elder abuse and neglect ranged from 4.5 to 61.7% across the rural areas, and pooled prevalence estimate was 33% (95% CI 23-43). The prevalence of physical abuse was estimated at 7% (95% CI 5-9), financial abuse at 5% (95% CI 4-7), psychological/emotional abuse at 17% (95% CI 11-23), and neglect at 26% (95% CI 17-35). There was significant heterogeneity among the included studies. Stratified analyses revealed that sampling design was part of the heterogeneity source. WHO regions, gender, countries' income classification, and study quality could not explain the potential reasons for heterogeneity.
The pooled prevalence of elder abuse and neglect was relatively high in rural areas. Early and targeted screening and prevention are needed. There is an urgent need for high quality studies using agreed definition of elder abuse and neglect to protect the potential high risk populations.
许多流行病学研究报告称，农村地区普遍存在虐待和忽视老年人的现象。然而，目前尚无研究对这一领域的文献进行综合分析。因此，我们旨在通过系统评价和荟萃分析来评估农村地区老年人虐待和忽视的总体发生率。
系统检索了 PubMed、EMBASE、Web of Science 和 Cochrane Library 以确定合格的文章，无语言限制。使用 Review Manager 软件（版本 5.3）进行统计分析。采用随机效应模型进行荟萃分析和敏感性分析。所有结果均以老年人虐待和忽视的合并发生率及其 95%置信区间（CI）报告。使用加强观察性研究报告的流行病学（STROBE）清单评估纳入研究的质量。通过漏斗图评估潜在的发表偏倚。
纳入了 13 项涉及 10313 名参与者的横断面研究。农村地区老年人虐待和忽视的发生率范围为 4.5%至 61.7%，合并发生率估计为 33%（95%CI 23%至 43%）。躯体虐待的发生率估计为 7%（95%CI 5%至 9%），经济虐待为 5%（95%CI 4%至 7%），心理/情感虐待为 17%（95%CI 11%至 23%），忽视为 26%（95%CI 17%至 35%）。纳入研究之间存在显著异质性。分层分析表明，抽样设计是异质性的来源之一。世界卫生组织区域、性别、国家收入分类和研究质量不能解释潜在的异质性原因。
农村地区老年人虐待和忽视的发生率相对较高。需要进行早期和有针对性的筛查和预防。迫切需要使用老年人虐待和忽视的共识定义进行高质量研究，以保护潜在的高风险人群。
