Introdução: Qualidade de Vida Relacionada à Saúde (QVRS) tem sido considerada como importante medida de avaliação do estado de saúde e de predição de mortalidade em idosos. Diversos estudos detectaram fatores associados à QVRS de idosos, mas, poucos deles, até o momento, propuseram-se a analisar as associações entre violência e QVRS dessa população. Objetivos: identificar a prevalência e as características da violência contra idosos não institucionalizados, residentes no Município de São Paulo; comparar idosos expostos e não expostos à violência em relação a dados sociodemográficos, econômicos, de saúde, de funcionalidade familiar, de incapacidade funcional e dos componentes físico e mental da QVRS; verificar se a violência é um fator independente associado aos escores dos componentes físico e mental da QVRS de idosos. Método: esta pesquisa transversal é parte integrante do Estudo SABE (Saúde, Bem-Estar e Envelhecimento). Os dados foram coletados em 2010 e a amostra compôs-se de 1.147 idosos que responderam o Short-Form 12 Health Related Survey (SF-12), instrumento genérico que avalia a QVRS em seus Componentes Físico (CF) e Mental (CM). O CF e o CM do SF-12 foram as variáveis dependentes do estudo. Utilizou-se a regressão linear múltipla, método stepwise backward, para identificação dos fatores associados aos componentes da QVRS. Resultados: a prevalência da violência contra idosos foi de 10,1% (IC 95% 8,4 12), e o tipo mais comum foi a psicológica (9,3%). As variáveis idade e coabitação não diferenciaram significativamente os idosos expostos e não expostos à violência. Sexo feminino, insuficiência de renda, baixa escolaridade, família disfuncional, saúde percebida como ruim, multimorbidade, dor referida, sintomas depressivos, deterioração cognitiva e dificuldades para executar ABVD ou AIVD foram as características presentes em maior proporção no grupo de idosos expostos à violência, quando comparados ao grupo não exposto. Além disso, os idosos expostos à violência, em comparação aos não expostos, alcançaram menores médias nos escores no CF (44,4, DP=10,8 contra 49,1, DP=9,3) e no CM (50,1, DP=12 contra 55,8, DP=7,5) com p<0,001 em ambos os componentes. Na análise múltipla, a violência contra idosos permaneceu significativamente associada ao CM da QVRS (=-2,69; p<0,001), independente de covariáveis demográficas, econômicas, de saúde, de apoio familiar e de incapacidade funcional. Conclusão: a prevalência da violência contra idosos detectada neste estudo foi elevada; os idosos expostos à violência, em comparação aos não expostos, apresentaram diferenças em relação às suas características demográficas, econômicas, de saúde, de funcionalidade familiar e de incapacidade funcional; e a exposição à violência comprometeu o CM da QVRS dos idosos. Medidas de prevenção e controle desse agravo à saúde devem ser tratadas como prioritárias à população idosa / Introduction: Health-related Quality of Life (HRQoL) has been considered as an important measure of health status assessment and a predictor of mortality in elderly. Several studies found factors associated to elderly\'s HRQoL, however, to date, few have proposed to examine the associations between violence and HRQoL of this population. Objectives: to identify the prevalence and characteristics of violence against non-institutionalized elderly who live in the city of São Paulo; to compare elderly who are exposed and not exposed to violence regarding to following variables: sociodemographic, economic and health data, familiar functionality, functional disability and HRQoL\'s physical and mental components; to verify whether violence is a factor independently associated to scores of the HRQoL\'s physical and mental components in elderly. Method: This cross-sectional study is part of the SABE (Health, Wellness, and Aging Study). Data were collected in 2010 and the sample was composed by 1,147 elderly who responded to the 12-Item Short-Form Health Related Survey (SF-12), a generic instrument that assesses the HRQoL in its Physical (CF) and Mental (CM) Components. The CF and CM of the SF-12 were the dependent variables of this study and we used the multiple linear regression, a method of backward stepwise selection to identify the factors associated to HRQOL\'s components. Results: The prevalence of violence against the elderly was 10,1% (IC 95% 8,4 12) and the psychological violence was the most common (9,3%). The cohabitation and age variables did not significantly differentiate the elderly exposed and those non- exposed to violence. Female sex, insufficient income, low education, dysfunctional family, health perceived as poor, multimorbidity, referred pain, depressive symptoms, cognitive impairment and difficulty to perform ABVD ou AIVD were the features presented with higher proportion in the group of elderly exposed to violence, compared to the unexposed ones. Furthermore, elderly exposed to violence achieved lower scores in HRQoL\'s CF(44,4, SD=10,8 vs. 49,1, SD=9,3) and CM(50,1, SD=12 vs. 55,8, SD=7,5) compared to unexposed ones, with p<0,001 in both components. In multiple analysis, the violence against the elderly remained significantly associated to HRQOL\'s CM (=-2,69; p<0,001), independent of demographic, economic, health, family support and functional disability covariables. Conclusion: The prevalence of violence against elderly identified in this investigation was high; the elderly exposed to violence, compared to non-exposed ones, presented differences concerning their demographic, economic, health, family support and functional disability features; and the exposion to violence undermined the HRQOL\'s CM of elderly. Prevention and control actions for this health hazard should be considered as a priority for the elderly

No / The author explains how Dementia Care Mapping can be used as powerful preventative tool for safeguarding people with dementia from abuse. Used as part of the process of developing person-centred care, the Dementia Care Mapping tool can be used to identify the preconditions of abuse within care settings.

No description available.

Syftet med examensarbetet var att undersöka hur enhetschefer inom äldreomsorgen uppfattar möjligheterna för att uppmärksamma och förebygga vanvård och försummelse hos äldre personer som mottar hemtjänstinsatser i ordinärt boende. Metoden involverar en kvalitativ design med semistrukturerade intervjuer utifrån ett bekvämlighetsurval av enhetschefer inom hemtjänsten. Datainsamlingen inkluderade öppna frågor om möjligheter och resurser för att upptäcka vanvård och försummelse. Reflexiv tematisk analys användes för att analysera datamaterialet. Metoden bidrar till en djupare förståelse av enhetschefernas perspektiv på att förebygga vanvård hos äldre personer. Resultatet visade att en ökad kontinuitet mellan personal och den äldre personen i vardagen ökar förutsättningen att upptäcka vanvård och försummelse, kontinuerlig och kompetenshöjande utbildning krävs för att ge personalen rätt förutsättningar i sin yrkesroll att motverka och förebygga vanvård och försummelse och att samverkan mellan olika aktörer är en förutsättning för att identifiera och motverka vanvård och försummelse mot äldre personer. / The purpose of the undergraduate thesis was to explore home care unit managers' possibilities of identifying and preventing elder abuse and neglect. The study employs a qualitative design with semi-structured interviews in a convenience sample of unit managers from different municipalities and with different experiences. Reflexive thematic analysis was used to analyze data contributing to a deeper understanding of unit managers' perspectives on preventing elder abuse. Results found that increased continuity between staff and the older person in everyday life increases the possibilities to detect elder abuse and neglect. Continuous and competence-enhancing training is required to provide staff with tools in their professional role to counteract and prevent elder abuse and neglect. Additionally, collaboration between different stakeholders is essential for identifying and combating abuse and neglect of older adults.

<p>The overall aim of this thesis was to deepen understanding of elder abuse (EA) by exploring and comparing perceptions held by experts, older persons, representatives of potential support organizations, and family members. Experts’ perspectives (I) were examined through risk indicators and screening questions (a) located in EA literature and (b) selected by an international Delphi panel. Risk indicators most commonly found in the literature or selected by the panel were compiled into consensus lists. There were differences between risk indicators and questions in the two lists. In papers II and III participants were interviewed in focus groups about their perceptions of EA. Older persons (II) considered EA to be due to changing society and family systems where children are not brought up to respect older persons. EA was mainly conceptualized as ageism, criminal actions, mistreatment in residential care, and societal abuse. The abuser was perceived as a stranger or a healthcare worker. Fear was discussed as a major consequence of EA; especially fear among women. Abused persons were described as carrying the responsibility to seek help. Witnesses were described as hesitant to get involved. Improvements in society such as educating children and healthcare workers were considered ways to cope with EA. Besides family and friends there were few spontaneous suggestions for where to seek help and support in society. These suggestions included healthcare, police, church, and volunteer organizations. Representatives of these suggested organizations were interviewed in focus groups about their perceptions of EA (III). Perceptions of both causes and conceptions of EA were very similar to perceptions of older persons (II). Four themes emerged in the data; good intentions in abusive situations, older generation’s responsibility for EA, failing to report abuse, and prevention of abuse. Participants (III) also expressed ageist attitudes themselves and findings included victim blaming and tolerance for EA. Participants perceived that anyone could be provoked to abuse, and that abusers can be considered victims in abusive situations. Confidentiality was discussed as a barrier to reporting and the need for educating children to show respect for older persons was identified. Interviews with an adult family member (IV) explored her experiences of witnessing abuse situations between her uncle and his wife. In her desire to protect and remain loyal to her family she felt powerless and tolerated abuse. She longed for support she could trust but was locked into passivity by her feelings of shame. Synthesis of findings (I – IV) revealed issues of isolation, autonomy, vulnerability, victim blaming, perceiving the abuser as a victim of circumstances, ageism, tolerating EA, shame, and power as essential elements in EA. Based on the findings, alternative descriptions of EA are offered as a challenge to existing EA definitions. Findings suggest that a key to unlocking EA is compassion, understood as the ability to see a situation as if we were in it ourselves, experiencing the potential for disrespect, shame and unworthiness inherent in abusive acts.</p>

The overall aim of this thesis was to deepen understanding of elder abuse (EA) by exploring and comparing perceptions held by experts, older persons, representatives of potential support organizations, and family members. Experts’ perspectives (I) were examined through risk indicators and screening questions (a) located in EA literature and (b) selected by an international Delphi panel. Risk indicators most commonly found in the literature or selected by the panel were compiled into consensus lists. There were differences between risk indicators and questions in the two lists. In papers II and III participants were interviewed in focus groups about their perceptions of EA. Older persons (II) considered EA to be due to changing society and family systems where children are not brought up to respect older persons. EA was mainly conceptualized as ageism, criminal actions, mistreatment in residential care, and societal abuse. The abuser was perceived as a stranger or a healthcare worker. Fear was discussed as a major consequence of EA; especially fear among women. Abused persons were described as carrying the responsibility to seek help. Witnesses were described as hesitant to get involved. Improvements in society such as educating children and healthcare workers were considered ways to cope with EA. Besides family and friends there were few spontaneous suggestions for where to seek help and support in society. These suggestions included healthcare, police, church, and volunteer organizations. Representatives of these suggested organizations were interviewed in focus groups about their perceptions of EA (III). Perceptions of both causes and conceptions of EA were very similar to perceptions of older persons (II). Four themes emerged in the data; good intentions in abusive situations, older generation’s responsibility for EA, failing to report abuse, and prevention of abuse. Participants (III) also expressed ageist attitudes themselves and findings included victim blaming and tolerance for EA. Participants perceived that anyone could be provoked to abuse, and that abusers can be considered victims in abusive situations. Confidentiality was discussed as a barrier to reporting and the need for educating children to show respect for older persons was identified. Interviews with an adult family member (IV) explored her experiences of witnessing abuse situations between her uncle and his wife. In her desire to protect and remain loyal to her family she felt powerless and tolerated abuse. She longed for support she could trust but was locked into passivity by her feelings of shame. Synthesis of findings (I – IV) revealed issues of isolation, autonomy, vulnerability, victim blaming, perceiving the abuser as a victim of circumstances, ageism, tolerating EA, shame, and power as essential elements in EA. Based on the findings, alternative descriptions of EA are offered as a challenge to existing EA definitions. Findings suggest that a key to unlocking EA is compassion, understood as the ability to see a situation as if we were in it ourselves, experiencing the potential for disrespect, shame and unworthiness inherent in abusive acts.

Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 209-220). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A violência doméstica não é um fenômeno novo e a que atinge o idoso é parte integrante deste fenômeno. Os dados sobre violência contra o idoso, entretanto, são escassos no Brasil. Contudo, para se realizar um estudo mais sistemático sobre magnitude, fatores de risco e cuidados às vítimas, torna-se necessária uma documentação sistemática e acurada dos eventos relacionados aos fatores de risco, às situações envolvidas e consequências da violência. Esta tese procurou estudar alguns instrumentos específicos de avaliação de violência doméstica contra o idoso existentes e conhecidos e adaptá-los ao contexto sócio cultural brasileiro, especificamente em idosos atendidos por Serviços de Saúde na cidade do Rio de Janeiro. Outro objetivo desta tese foi inserir a avaliação da violência em um ambiente de avaliação funcional do paciente idoso, por motivos que não serão explicitados. O capítulo 1 concerne à apresentação da tese. O capítulo 2 oferece uma introdução a respeito do problema de violência doméstica com um breve histórico do estudo da violência familiar e especificamente no indivíduo idoso. Fornece alguns dados de magnitude e de que forma a violência doméstica e suas consequências podem ser avaliadas no contexto da avaliação funcional do indivíduo idoso. Alguns conceitos e teorias sobre fatores de risco, causas e métodos estruturados de avaliação são discutidos. Em seguida, o tema específico dos métodos estruturados de avaliação é pormenorizado em no capítulo 3, apresenta-se uma justificativa detalha para os estudos desenvolvidos para esta tese. O quarto capítulo apresenta os métodos utilizados para a produção dos três artigos que, no capítulo 5, são apresentados, na íntegra. No primeiro artigo descreve-se a revisão dos 17 instrumentos de risco de violência contra o idoso que foram encontrados a partir das bases de dados vasculhadas. Destes, somente a Conflicts Tactics Scale foi adaptadas para o Brasil, ainda que para o uso em um grupo etário mais jovem. O segundo artigo descreve as etapas de equivalência da validade conceitual, semântica e de itens de um dos instrumentos escolhidos, especificamente, de avaliação do cuidador do sujeito idoso (Caregiver Abuse Screen CASE). Foi possível estabelecer uma versão em português para o Brasil, mas resta a etapa de equivalência de mensuração deste instrumento. O terceiro artigo, por sua vez, se refere à adaptação transcultural envolvendo as etapas citadas no artigo anteriormente descrito acrescidas da avaliação de equivalência de mensuração do segundo instrumento escolhido, mais especificamente, de avaliação do indivíduo idoso (Hwalek & Sengstock Elder Abuse Screening Test H-S/EAST). À análise de fatores encontraram-se três dimensões, grosso modo em acordo com os autores do instrumento. Entretanto, os itens que carregaram em cada uma das dimensões divergiram, fornecendo interpretações distintas da análise original. Do mesmo modo, as análises de confiabilidade identificaram problemas. Ainda restam lacunas a serem preenchidas com estudos futuros para que o H-S/SEAT possa ser utilizado no Brasil sem restrições. O sexto e último capítulo da tese oferece uma discussão geral sobre a importância de instrumento válidos e confiáveis no âmbito da epidemiologia. Identifica, também, questões a serem ainda resolvidas sobre instrumentos de avaliação de violência doméstica no indivíduo idoso e, por fim, apresenta os desdobramentos em termos de estudos e projetos que se seguirão. / Domestic violence is not a recent phenomenon. Violence against the elderly, about which there are scarce data in Brazil, plays an important role in such phenomenon. An accurate and systematic documentation is needed if one aims to set up research programs to explore risk factors, specific threshold situations, consequences, magnitude and care for the victims of violence. This thesis is concerned with the cross-cultural adaptation to the Brazilian culture of known elderly violence screening instruments. The specific target population consisted of elderly people living in the city of Rio de Janeiro. The secondary goal was to included such screening to functional evaluation of the elderly, for seasons that will be exposed presently. Chapter 1 concerns the thesis presentation. Chapter II offers an introduction to the problem of domestic violence and explores the issue of elder abuse from a brief historical perspective, as well as showing some data regarding magnitude, risk factors and evaluation of elder abuse are shown. Chapter 3 offers a detailed justification for the studies that were developed for this thesis. In the Chapter 4 the methods for the conception of the three resulting studies are described. The three articles are shown in detail in Chapter 5. The first article reviews the international literature in search for screening instruments for violence in the elderly. Thirteen instruments were found but only the Conflict Tactics Scales had been adapted to the Brazilian culture, albeit for use in a younger age group. The second article describes the evaluation of concept, semantic and item equivalence of one chosen instrument that screens for violence from caregiver perspective (Caregiver Abuse Screen CASE). It was possible to establish a Brazilian version but there still remains the evaluation of a screening tool for the elderly, including measurement equivalence (Hwalek & Sengstock Elder Abuse Screening Test H-S/EAST). Roughly, three factors were found in accordance with the original description. However, there were discrepancies in the loadings of some items to each factor which led to somewhat different interpretations from the original. In the same way, reliability analysis uncovered some problems that will have to be faced before the HS/EAST can be used in Brazil without restrictions. The sixth and last Chapter of thesis offers a general discussion on the importance of valid and reliable measurements in epidemiology and concludes with an overview of ensuing studies and projects.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A violência doméstica não é um fenômeno novo e a que atinge o idoso é parte integrante deste fenômeno. Os dados sobre violência contra o idoso, entretanto, são escassos no Brasil. Contudo, para se realizar um estudo mais sistemático sobre magnitude, fatores de risco e cuidados às vítimas, torna-se necessária uma documentação sistemática e acurada dos eventos relacionados aos fatores de risco, às situações envolvidas e consequências da violência. Esta tese procurou estudar alguns instrumentos específicos de avaliação de violência doméstica contra o idoso existentes e conhecidos e adaptá-los ao contexto sócio cultural brasileiro, especificamente em idosos atendidos por Serviços de Saúde na cidade do Rio de Janeiro. Outro objetivo desta tese foi inserir a avaliação da violência em um ambiente de avaliação funcional do paciente idoso, por motivos que não serão explicitados. O capítulo 1 concerne à apresentação da tese. O capítulo 2 oferece uma introdução a respeito do problema de violência doméstica com um breve histórico do estudo da violência familiar e especificamente no indivíduo idoso. Fornece alguns dados de magnitude e de que forma a violência doméstica e suas consequências podem ser avaliadas no contexto da avaliação funcional do indivíduo idoso. Alguns conceitos e teorias sobre fatores de risco, causas e métodos estruturados de avaliação são discutidos. Em seguida, o tema específico dos métodos estruturados de avaliação é pormenorizado em no capítulo 3, apresenta-se uma justificativa detalha para os estudos desenvolvidos para esta tese. O quarto capítulo apresenta os métodos utilizados para a produção dos três artigos que, no capítulo 5, são apresentados, na íntegra. No primeiro artigo descreve-se a revisão dos 17 instrumentos de risco de violência contra o idoso que foram encontrados a partir das bases de dados vasculhadas. Destes, somente a Conflicts Tactics Scale foi adaptadas para o Brasil, ainda que para o uso em um grupo etário mais jovem. O segundo artigo descreve as etapas de equivalência da validade conceitual, semântica e de itens de um dos instrumentos escolhidos, especificamente, de avaliação do cuidador do sujeito idoso (Caregiver Abuse Screen CASE). Foi possível estabelecer uma versão em português para o Brasil, mas resta a etapa de equivalência de mensuração deste instrumento. O terceiro artigo, por sua vez, se refere à adaptação transcultural envolvendo as etapas citadas no artigo anteriormente descrito acrescidas da avaliação de equivalência de mensuração do segundo instrumento escolhido, mais especificamente, de avaliação do indivíduo idoso (Hwalek & Sengstock Elder Abuse Screening Test H-S/EAST). À análise de fatores encontraram-se três dimensões, grosso modo em acordo com os autores do instrumento. Entretanto, os itens que carregaram em cada uma das dimensões divergiram, fornecendo interpretações distintas da análise original. Do mesmo modo, as análises de confiabilidade identificaram problemas. Ainda restam lacunas a serem preenchidas com estudos futuros para que o H-S/SEAT possa ser utilizado no Brasil sem restrições. O sexto e último capítulo da tese oferece uma discussão geral sobre a importância de instrumento válidos e confiáveis no âmbito da epidemiologia. Identifica, também, questões a serem ainda resolvidas sobre instrumentos de avaliação de violência doméstica no indivíduo idoso e, por fim, apresenta os desdobramentos em termos de estudos e projetos que se seguirão. / Domestic violence is not a recent phenomenon. Violence against the elderly, about which there are scarce data in Brazil, plays an important role in such phenomenon. An accurate and systematic documentation is needed if one aims to set up research programs to explore risk factors, specific threshold situations, consequences, magnitude and care for the victims of violence. This thesis is concerned with the cross-cultural adaptation to the Brazilian culture of known elderly violence screening instruments. The specific target population consisted of elderly people living in the city of Rio de Janeiro. The secondary goal was to included such screening to functional evaluation of the elderly, for seasons that will be exposed presently. Chapter 1 concerns the thesis presentation. Chapter II offers an introduction to the problem of domestic violence and explores the issue of elder abuse from a brief historical perspective, as well as showing some data regarding magnitude, risk factors and evaluation of elder abuse are shown. Chapter 3 offers a detailed justification for the studies that were developed for this thesis. In the Chapter 4 the methods for the conception of the three resulting studies are described. The three articles are shown in detail in Chapter 5. The first article reviews the international literature in search for screening instruments for violence in the elderly. Thirteen instruments were found but only the Conflict Tactics Scales had been adapted to the Brazilian culture, albeit for use in a younger age group. The second article describes the evaluation of concept, semantic and item equivalence of one chosen instrument that screens for violence from caregiver perspective (Caregiver Abuse Screen CASE). It was possible to establish a Brazilian version but there still remains the evaluation of a screening tool for the elderly, including measurement equivalence (Hwalek & Sengstock Elder Abuse Screening Test H-S/EAST). Roughly, three factors were found in accordance with the original description. However, there were discrepancies in the loadings of some items to each factor which led to somewhat different interpretations from the original. In the same way, reliability analysis uncovered some problems that will have to be faced before the HS/EAST can be used in Brazil without restrictions. The sixth and last Chapter of thesis offers a general discussion on the importance of valid and reliable measurements in epidemiology and concludes with an overview of ensuing studies and projects.

There is no doubt that the human population is growing old worldwide. As a result we more often think about the ageing and the old age. One of the motives which is, however, connected with ageing is the rough handling, which may develop into maltreatment, abuse and neglect (it is known as the EAN syndrome - Elder Abuse and Neglect). In this graduation theses the authoress targets the violence on seniors in their own families. In this case the aggressor is their child, grandchild or another relative. The main aim of this study is to analyse the main cause which leads to EAN. This negative social phenomenon is described from the point of view of the employee of crisis phone line for seniors.