Ability of Older Adults to Report Elder Abuse: An Emergency Department-Based Cross-Sectional Study.

Autor: Richmond NL; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Zimmerman S; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Reeve BB; Center for Health Measurement Department of Population Health Sciences and Pediatrics, Duke University, Durham, North Carolina., Dayaa JA; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Davis ME; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Bowen SB; Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Iasiello JA; Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Stemerman R; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Shams RB; Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Haukoos JS; Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado., Sloane PD; Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Travers D; University of North Carolina School of Nursing, Chapel Hill, North Carolina., Mosqueda LA; Family Medicine and Geriatrics, Keck School of Medicine, University of South California, Alhambra, California., McLean SA; Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina., Platts-Mills TF; Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Jazyk: angličtina
Zdroj: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2020 Jan; Vol. 68 (1), pp. 170-175.
DOI: 10.1111/jgs.16211
Abstrakt: Objectives: To characterize assessments of a patient's ability to report elder abuse within the context of an emergency department (ED)-based screen for elder abuse.
Design: Cross-sectional study in which participants were screened for elder abuse and neglect.
Setting: Academic ED in the United States.
Participants: Patients, aged 65 years and older, presenting to an ED for acute care were assessed by trained research assistants or nurses.
Measurements: All patients completed the four-item Abbreviated Mental Test 4 (AMT4), then completed a safety interview (using the Emergency Department Senior Abuse Identification tool) designed to detect multiple domains of elder abuse and received a physical examination. Based on the cognitive assessment and safety interview, assessors ranked their confidence in the patient's ability to report abuse as absolutely confident, confident, somewhat confident, or not confident. To assess interrater reliability, two assessors independently rated confidence for a subset of patients.
Results: Assessors suspected elder abuse in 18 of 276 patients (6.5%). Assessors were absolutely confident in the patient's ability to report abuse for 95.7% of patients, confident for 2.5%, somewhat confident for 1.5%, and not confident for 0.3%. Among patients with an AMT4 of 4 (n = 249), assessors were confident or absolutely confident in 100% of patients. Among patients with an AMT4 of less than 4 (n = 27), they were confident or absolutely confident in the patient's ability to report abuse for 81% of patients, including 11 of 12 patients with mild cognitive impairment and 7 of 11 patients with severe cognitive impairment. For patients receiving paired evaluations (n = 131), agreement between assessors regarding patient ability to report abuse was 97% (κ = 0.5).
Conclusions: In this sample of older adults receiving care in an ED, research assistants and nurses felt that the vast majority were able to report elder abuse, including many patients with cognitive impairment. J Am Geriatr Soc 68:170-175, 2019.
(© 2020 The American Geriatrics Society.)
Databáze: MEDLINE
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