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为医疗服务提供者开展联合签名培训以改善对老年人虐待的发现与应对

Codesigning Training for Health Providers to Improve Detection and Response to Elder Abuse.

作者信息

Brijnath Bianca, Cavuoto Marina G, Feldman Peter, Dow Briony, Antoniades Josefine, Ostaszkiewicz Joan, Nakrem Sigrid, Stevens Catriona, Reyes Patricia, Renshaw Gianna, Peters Micah D J, Gilbert Andrew, Manias Elizabeth, Mortimer Duncan, Enticott Joanne, Cooper Claudia, Durston Cheryl, Appleton Brenda, O'Brien Meghan, Eckert Marion, Markusevska Simona

机构信息

Social Gerontology Division, National Ageing Research Institute, Parkville, Victoria, Australia.

School of Humanities and Social Sciences, La Trobe University, Bundoora, Victoria, Australia.

出版信息

Gerontologist. 2025 Mar 25;65(4). doi: 10.1093/geront/gnae153.

Abstract

BACKGROUND AND OBJECTIVES

Screening for elder abuse can improve detection, but many health providers lack the necessary skills and confidence. To address this, training for health providers on elder abuse screening was codesigned as part of a trial aimed at improving elder abuse detection and response.

RESEARCH DESIGN AND METHODS

Between March and April 2023, 7 health providers and 10 older people and family carers participated in 2 national Australian online codesign workshops. Using the World Café method, discussions focused on what knowledge and skills health providers needed for screening; clinical and social issues affecting screening and referral; and support older people needed throughout the process. Data were thematically analyzed.

RESULTS

Participants said health providers should take a trauma-informed, person-centered approach to screening, and explain the limits of confidentiality to older people. Clinical, social, and systemic issues such as dementia, ethnic diversity, and housing availability complicated screening and referrals. To facilitate disclosure, participants said health providers needed to reflect on whether they held ageist views. There were differing opinions on the length of the training and whether all health providers or only social workers should screen for abuse.

DISCUSSION AND IMPLICATIONS

Participants' feedback on trauma-informed care, consent, and cognitive impairment concorded with evidence on best practice responses to elder abuse and were integrated into the training. Given operational constraints in health services, feedback from health providers about the training length and the inclusion of all health providers in screening were prioritized. The training is being evaluated in a national trial.

摘要

背景与目标

对虐待老年人的情况进行筛查有助于提高发现率,但许多医疗服务提供者缺乏必要的技能和信心。为解决这一问题,作为一项旨在改善虐待老年人情况的发现与应对措施的试验的一部分,共同设计了针对医疗服务提供者的虐待老年人筛查培训。

研究设计与方法

2023年3月至4月期间,7名医疗服务提供者以及10名老年人和家庭护理人员参与了两场澳大利亚全国性在线协同设计研讨会。采用世界咖啡馆方法,讨论聚焦于医疗服务提供者进行筛查所需的知识和技能;影响筛查与转诊的临床和社会问题;以及老年人在整个过程中所需的支持。对数据进行了主题分析。

结果

参与者表示,医疗服务提供者应采用考虑创伤因素、以患者为中心的方法进行筛查,并向老年人解释保密的限度。痴呆症、种族多样性和住房供应等临床、社会和系统性问题使筛查和转诊变得复杂。为便于披露信息,参与者称医疗服务提供者需要反思自己是否持有年龄歧视观点。对于培训时长以及是所有医疗服务提供者还是仅社会工作者应进行虐待情况筛查,存在不同意见。

讨论与启示

参与者关于考虑创伤因素的护理、同意和认知障碍的反馈与虐待老年人最佳实践应对措施的证据一致,并被纳入培训内容。鉴于医疗服务中的操作限制,优先考虑了医疗服务提供者关于培训时长以及所有医疗服务提供者参与筛查的反馈。该培训正在一项全国性试验中进行评估。

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本文引用的文献

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The second shadow pandemic: elder abuse.第二种隐性大流行:虐待老年人。
Lancet Healthy Longev. 2021 Jun;2(6):e301. doi: 10.1016/S2666-7568(21)00122-7. Epub 2021 Jun 3.
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Global reach of ageism on older persons' health: A systematic review.全球老龄化对老年人健康的影响:系统综述。
PLoS One. 2020 Jan 15;15(1):e0220857. doi: 10.1371/journal.pone.0220857. eCollection 2020.

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