ERASE：一种适用于荷兰急诊部门的老年虐待可行预警工具。

ERASE: a feasible early warning tool for elder abuse, developed for use in the Dutch emergency department.

机构信息

Department of Geriatric Medicine, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.

Research Department of Emergency and Critical Care, School of Health Studies, Knowledge Centre of Sustainable Healthcare, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands.

出版信息

BMC Emerg Med. 2024 Apr 3;24(1):52. doi: 10.1186/s12873-024-00971-6.

DOI:10.1186/s12873-024-00971-6

PMID:38570746

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10988976/

Abstract

BACKGROUND

Elder abuse is a worldwide problem with serious consequences for individuals and society. To effectively deal with elder abuse, a timely identification of signals as well as a systematic approach towards (suspected) elder abuse is necessary. This study aimed to develop and test the acceptability and appropriateness of ERASE (EldeR AbuSE) in the emergency department (ED) setting. ERASE is an early warning tool for elder abuse self-administered by the healthcare professional in patients ≥ 70 years.

METHODS

A systematic literature review was previously conducted to identify potential available instruments on elder abuse for use in the ED. Furthermore, a field consultation in Dutch hospitals was performed to identify practice tools and potential questions on the recognition of elder abuse that were available in clinical practice. Based on this input, in three subsequent rounds the ERASE tool was developed. The ERASE tool was tested in a pilot feasibility study in healthcare professionals (n = 28) working in the ED in three Dutch hospitals. A semi-structured online questionnaire was used to determine acceptability and appropriateness of the ERASE tool.

RESULTS

The systematic literature review revealed seven screening instruments developed for use in the hospital and/or ED setting. In total n = 32 (44%) hospitals responded to the field search. No suitable and validated instruments for the detection of elder abuse in the ED were identified. The ERASE tool was developed, with a gut feeling awareness question, that encompassed all forms of elder abuse as starting question. Subsequently six signalling questions were developed to collect information on observed signs and symptoms of elder abuse and neglect. The pilot study showed that the ERASE tool raised the recognition of healthcare professionals for elder abuse. The tool was evaluated acceptable and appropriate for use in the ED setting.

CONCLUSIONS

ERASE as early warning tool is guided by an initial gut feeling awareness question and six signalling questions. The ERASE tool raised the recognition of healthcare professionals for elder abuse, and was feasible to use in the ED setting. The next step will be to investigate the reliability and validity of the ERASE early warning tool.

摘要

背景

虐待老人是一个全球性的问题，对个人和社会都有严重的后果。为了有效地应对虐待老人的行为，需要及时发现信号，并对（疑似）虐待老人的行为采取系统的方法。本研究旨在开发和测试 ERASE（老年人虐待识别）在急诊科（ED）环境中的可接受性和适宜性。ERASE 是一种由医护人员对≥70 岁患者进行自我评估的虐待老人早期预警工具。

方法

我们之前进行了一项系统的文献回顾，以确定可用于 ED 的潜在虐待老人评估工具。此外，我们还在荷兰的医院进行了实地咨询，以确定临床实践中可用的识别虐待老人的实践工具和潜在问题。基于这些输入，我们在随后的三轮中开发了 ERASE 工具。我们在三家荷兰医院的 ED 工作的医护人员中进行了一项试点可行性研究，以测试 ERASE 工具。我们使用半结构化在线问卷来确定 ERASE 工具的可接受性和适宜性。

结果

系统文献回顾发现了七种为在医院和/或 ED 环境中使用而开发的筛查工具。共有 n=32（44%）家医院对实地调查做出了回应。没有发现适合和验证的、可用于 ED 中识别虐待老人的工具。我们开发了 ERASE 工具，该工具以一种直觉意识问题为起点，涵盖了所有形式的虐待老人行为。随后，我们开发了六个信号问题，以收集观察到的虐待和忽视老人迹象和症状的信息。试点研究表明，ERASE 工具提高了医护人员对虐待老人的识别能力。该工具被评估为在 ED 环境中使用是可接受和适宜的。