Fang Boye, Li Danyu, Yan Elsie, Zhou Yi, Yu Zhuopeng, Hu Jian
School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China.
Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong.
J Clin Nurs. 2023 Mar;32(5-6):688-700. doi: 10.1111/jocn.16283. Epub 2022 Mar 14.
This study focuses on elder abuse against older adults with mild-to-moderate cognitive and physical impairment who were receiving family care in Chinese context. Specifically, the study examined the associated factors of discrepancy between family caregiver and care recipient reports of elder abuse committed by the caregivers.
Many studies identified the discrepancies between caregivers and care recipients reports of elder abuse, but they did not examine factors contributing to such discrepancies. Various cultural factors may contribute to the accuracy of elder abuse reports.
A consecutive sample of 1,002 older adults with mild-to-moderate cognitive and physical impairment and their family caregivers was surveyed.
Quantitative study with cross-sectional design.
Moderate-to-substantial agreement in caregiver and care recipient reports was found for all forms of abuse (Cohen's kappa = 0.39 to 0.76). Care recipient reports consistently generated higher rates than caregiver reports for psychological abuse (51.1% vs. 42.8%), physical abuse (1.2% vs. 1.0%), caregiver neglect (65.0% vs. 50.2%) and financial exploitation (40.8% vs. 34.2%). Similar factors were found for dyadic discrepancy in the reporting of various forms of elder abuse, which included desire to gain face, fear of losing face and sense of familism in the caregivers, as well as older age, cognitive impairment and female gender of the care recipient. This study was presented in adherence to the Strobe Checklist.
The results suggest that family caregivers might not be reliable as the sole informants to report their care recipients' victimization experiences. Information from multiple parties should be gathered and synthesized to obtain more accurate reporting of the frequency and severity of elder abuse. Meanwhile, cultural factors should be taken into account when seeking information related to elder abuse.
There is a need for multiple parties to provide and report information about the elder abuse. It is also need to consider cultural factors when detecting and intervening elder abuse.
本研究聚焦于在中国背景下接受家庭照料的、患有轻至中度认知和身体障碍的老年人所遭受的虐待。具体而言，该研究考察了家庭照料者与受照料者所报告的由照料者实施的老年人虐待情况之间存在差异的相关因素。
许多研究发现了照料者与受照料者所报告的老年人虐待情况之间存在差异，但它们并未考察导致这种差异的因素。各种文化因素可能会影响老年人虐待报告的准确性。
对1002名患有轻至中度认知和身体障碍的老年人及其家庭照料者进行了连续抽样调查。
采用横断面设计的定量研究。
对于所有形式的虐待，照料者与受照料者报告之间存在中度至高度一致性（科恩kappa系数=0.39至0.76）。在心理虐待（51.1%对42.8%）、身体虐待（1.2%对1.0%）、照料者疏忽（65.0%对50.2%）和经济剥削（40.8%对34.2%）方面，受照料者报告的发生率始终高于照料者报告。在各种形式的老年人虐待报告中的二元差异方面发现了类似的因素，其中包括照料者的爱面子、怕丢脸和家族主义观念，以及受照料者的高龄、认知障碍和女性性别。本研究是按照STROBE清单进行呈现的。
结果表明，家庭照料者作为报告其受照料者受害经历的唯一信息提供者可能不可靠。应收集和综合多方信息，以更准确地报告老年人虐待的频率和严重程度。同时，在获取与老年人虐待相关的信息时应考虑文化因素。
需要多方提供和报告有关老年人虐待的信息。在发现和干预老年人虐待时也需要考虑文化因素。
