在基层医疗机构接受治疗的非住院老年人中疑似虐待行为的发生率。PRESENCIA 研究

Pub Date : 2024-06-04 DOI:10.1016/j.semerg.2024.102263

F.J. Alonso-Moreno , J.L. Llisterri Caro , M.C. Martínez Altarriba , A. Segura-Fragoso , V. Martín-Sánchez , S. Miravet Jiménez , S. Velilla Zancada , F.V. Martínez García , R.M. Micó Pérez , S. Cinza Sanjurjo , B. Sánchez Sánchez , representing the Scientific Committee and the investigators of the PRESENCIA study

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引用次数: 0

摘要

目标确定非住院老年人中疑似虐待行为的发生率及相关变量。患者和方法对在初级保健（PC）中连续挑选的 65 岁或以上非住院患者进行观察性、描述性、横断面、多中心研究。对患者使用了 EASI 问卷（疑似老年人虐待指数）、EAI 问卷（认知障碍患者疑似虐待指数）、Barthel 指数和 EUROQOL-5D 问卷，对护理人员使用了 CASE 问卷和 Zarit 测试。对所有患者的社会人口学、健康和生活质量变量进行了分析。结果共纳入 84 名患者，平均年龄（78.9 ± 7.9）岁，女性占 58.3%。疑似虐待率为 11.3%（95% CI：9.1%-13.9%）。在老年患者中，依赖程度越低，疑似虐待的发生率越低（高度依赖者为 30.0% 对 8.0%）。在老年患者中，依赖程度越低，疑似虐待发生率越低（高度依赖者为 30.0% 对非依赖者为 8.7%：P-趋势 = 0.006）；健康状况越好，疑似虐待发生率越低（健康状况差者为 29.6% 对健康状况最佳者为 6.9%；P-趋势 = <0.001）。在护理人员中，疑似虐待发生率为 20.4% (95% CI = 12.8%-28.0%) 。在 CASE 问卷中得分越高，疑似虐待发生率越高（56.3% 为高风险，9.6% 无虐待风险；P-趋势 = 0.007）。结论 PRESENCIA 研究结果显示，每 10 名年龄≥65 岁的患者中约有 1 人符合疑似虐待的标准。女性患者、依赖性较强的患者和健康状况较差的患者发生虐待的几率增加。负担更重、风险更大的护理人员更容易被怀疑虐待老人。

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Prevalence of suspected abuse of non-institutionalized older people treated in primary care. PRESENCIA study

Objectives

To determine the prevalence of suspected abuse of non-institutionalised elderly people and the associated variables.

Patients and method

Observational, descriptive, cross-sectional, multicentre study in patients aged 65 years or older, non-institutionalised, consecutively selected in primary care (PC). The EASI questionnaires (Suspected Elderly Abuse Index), the EAI questionnaire (Suspected Abuse Index in patients with cognitive impairment), the Barthel index, and the EUROQOL-5D questionnaire were used with patients, and the CASE questionnaire and the Zarit test were used with caregivers. Socio-demographic, health, and quality of life variables were analysed in all patients.

Results

Eight hundred four patients were included, mean age 78.9 ± 7.9 years, 58.3% women. The prevalence of suspected abuse was 11.3% (95% CI: 9.1%–13.9%). Suspected abuse was more frequent in women than in men (14.4% vs. 7.1%; odds ratio (OR) = 1.97; 95% CI = 1.1–3.4; p = 0.016) and in those who lived with two or more people compared to those who lived alone (18.4% vs. 7.3%; OR = 2.42; 95% CI = 1.1–5.0; p = 0.017).

Among older patients, the lower their dependency, the lower the prevalence of suspected abuse (30.0% in highly dependent vs. 8.7% in non-dependent: p-trend = 0.006); and the better the perceived health status, the lower the prevalence of suspected abuse (29.6% in poor health status vs. 6.9% in optimal health status; p-trend = <0.001).

Among caregivers, the prevalence of suspected abuse was 20.4% (95% CI = 12.8%–28.0%). A trend of higher prevalence of suspected abuse could be observed with higher scores on the CASE questionnaire (56.3% at high risk and 9.6% with no risk of abuse; p-trend = 0.007). In the case of the ZARIT questionnaire with scores below 47, the prevalence of suspected abuse was 9.1%, and for scores above 55, it was 52.6% (p-trend < 0.001).

Conclusions

The results of the PRESENCIA study show that approximately 1 in 10 patients aged ≥65 meet the criteria for suspected abuse. The probability of abuse increases in women, in patients with greater dependency and in patients with poorer perceived health status. Caregivers with greater overload and greater risk presented a greater suspicion of elder abuse.

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