Contreras-Yáñez Irazú, Ledón-LLanes Loraine, Guaracha-Basañez Guillermo Arturo, Sánchez-Hernández América, Ortiz-Haro Ana Belén, Pascual-Ramos Virginia
Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Department of Biology of Reproduction, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
PLoS One. 2024 Dec 30;19(12):e0316312. doi: 10.1371/journal.pone.0316312. eCollection 2024.
Mistreatment is a complex problem that impacts people's quality of life, morbidity, and mortality. In aged people, it has been associated with female sex, poor general health, depression, functional and cognitive decline, and increased dependence levels, all of which are well-recognized characteristics of patients with rheumatic diseases (RMDs). The objective was to describe the mistreatment phenomenon in Mexican patients with RMDs. We additionally report the adaptation and validation of the Geriatric Mistreatment Scale (GMS) in the target population.
This cross-sectional study was developed in two phases (June 28, 2023-February 2, 2024), and three convenience samples were used: S-1 (n = 30), S-2 (n = 260), and S-3 (n = 372). Phase 1 consisted of adapting the GMS to RMDs (RMD-MS) (experts' agreement), followed by RMD-MS face validity (pilot testing, S-1), content validity (experts' agreement), concurrent criterion validity (family APGAR score ≤3, S-2), construct validity (exploratory factor analysis and convergent validity, S-2), reliability (internal consistency and temporal stability, S-2) and feasibility (in S-1). Phase 2 consisted of the mistreatment description in S-3.
Patients represented typical RMD outpatients with substantial disease duration. There were 187 (50.3%) patients with overall mistreatment, and psychological was the most frequent in 142 (75.9%) patients, followed by neglect mistreatment in 96 (51.3%), sexual in 30 (16%), physical in 23 (12.3%), and economic mistreatment in 20 (10.7%) patients. Patients' perceived mistreatment was related to the underlying RMD in 13.3% of sexual mistreatment and 53.3% of psychological mistreatment. The number of "I do not want to answer" responses raised to 21.7%-67.7% for abusers' sex and 40%-72.9% for the abusers' relationship with the participant. The RMD-MS was valid, reliable, and feasible.
Half of the Mexican patients with RMDs perceived some mistreatment, most frequently psychological mistreatment, which is also often perceived as related to the underlying RMD.
虐待是一个复杂的问题，会影响人们的生活质量、发病率和死亡率。在老年人中，虐待与女性性别、总体健康状况不佳、抑郁、功能和认知能力下降以及依赖程度增加有关，而所有这些都是风湿病患者（RMD）公认的特征。目的是描述墨西哥RMD患者中的虐待现象。我们还报告了老年虐待量表（GMS）在目标人群中的改编和验证情况。
这项横断面研究分两个阶段进行（2023年6月28日至2024年2月2日），使用了三个便利样本：S-1（n = 30）、S-2（n = 260）和S-3（n = 372）。第一阶段包括将GMS改编为RMD专用量表（RMD-MS）（专家达成共识），随后进行RMD-MS的表面效度评估（预试验，S-1）、内容效度评估（专家达成共识）、同时效度评估（家庭APGAR评分≤3，S-2）、结构效度评估（探索性因子分析和收敛效度，S-2）、信度评估（内部一致性和时间稳定性，S-2）以及可行性评估（在S-1中进行）。第二阶段包括对S-3中的虐待情况进行描述。
患者代表了病程较长的典型RMD门诊患者。共有187名（50.3%）患者遭受了总体虐待，其中心理虐待最为常见，有142名（75.9%）患者，其次是忽视虐待96名（51.3%）、性虐待30名（16%）、身体虐待23名（12.3%）以及经济虐待20名（10.7%）患者。在13.3%的性虐待和53.3%的心理虐待中，患者感知到的虐待与潜在的RMD有关。对于施虐者的性别，“我不想回答”的回答比例升至21.7% - 67.7%，对于施虐者与参与者的关系，这一比例为40% - 72.9%。RMD-MS有效、可靠且可行。
一半的墨西哥RMD患者感知到了某种虐待，最常见的是心理虐待，且这种虐待也常被认为与潜在的RMD有关。
