Choo Esther K, Edwards Chelsea, Abuwandi Malik, Carlson Kristina, Bonito Jennifer, Jubanyik Karen, Gill Thomas M, Abujarad Fuad
Center for Policy & Research in Emergency Medicine, Oregon Health & Science University, Portland, OR, USA.
Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.
Gerontechnology. 2021 Jun;20(2). doi: 10.4017/gt.2021.20.2.33-476.11.
Healthcare settings represent a missed opportunity to systematically identify and address mistreatment.
Our objective was to obtain perspectives of older adults, caregivers, and emergency care providers regarding screening and intervention for elder mistreatment in the emergency department (ED) with a focus on utilizing digital health tools to facilitate the process. These findings will inform the development of a Web-based, digital health tool optimized for a tablet device to educate, screen, and facilitate reporting of elder mistreatment among patients presenting to the ED.
We conducted a qualitative study utilizing three in-person focus groups (N=31) with older adults from the community, caregivers for older adults, and clinicians and social workers who worked in the ED. Using a semi-structured interview guide, we identified attitudes about the process of divulging abuse, attitudes towards the ED as the location for screening and information delivery, and perceptions of digital tools for screening and information.
Participants identified numerous challenges to the disclosure of mistreatment, including feelings of vulnerability and concerns about losing their homes, social supports, and connection to caregivers. In contrast, they were uncertain about the benefits of disclosure. Digital tools were seen as helpful in terms of overcoming numerous challenges to screening, but participants suggested maintaining a human element to interactions.
While challenges to elder mistreatment screening were identified, participants had recommendations for optimizing such efforts and responded positively to digital health tools as a means of screening.
医疗机构是系统识别和解决虐待问题的一个被错失的机会。
我们的目标是获取老年人、护理人员和急诊护理提供者对于急诊科（ED）中老年人虐待筛查和干预的看法，重点是利用数字健康工具来推动这一过程。这些研究结果将为开发一款基于网络的、针对平板电脑设备优化的数字健康工具提供信息，该工具用于对前往急诊科就诊的患者进行老年人虐待教育、筛查并促进相关报告。
我们开展了一项定性研究，与来自社区的老年人、老年人护理人员以及在急诊科工作的临床医生和社会工作者进行了三个面对面的焦点小组访谈（N = 31）。使用半结构化访谈指南，我们确定了对揭露虐待过程的态度、对急诊科作为筛查和信息传递场所的态度以及对筛查和信息数字工具的看法。
参与者指出了虐待行为披露方面的诸多挑战，包括感到脆弱以及担心失去住所、社会支持和与护理人员的联系。相比之下，他们对披露的益处并不确定。数字工具在克服筛查的诸多挑战方面被视为有帮助，但参与者建议在互动中保持人文因素。
虽然确定了老年人虐待筛查存在挑战，但参与者对优化此类工作提出了建议，并对数字健康工具作为一种筛查手段给予了积极回应。
