Consequences of elder abuse and neglect among older adults in rural Malaysia / Raudah Mohd Yunus
Elder Abuse and Neglect (EAN) is a growing public health concern. With the rapid increase of older population worldwide and especially in developing countries, EAN is likely to escalate. Abuse in late life has been shown to cause various adverse health impacts. However, compared to the other two...
Saved in:
| Main Author: | |
|---|---|
| Format: | Thesis |
| Published: |
2018
|
| Subjects: | |
| Online Access: | http://studentsrepo.um.edu.my/10355/4/raudah.pdf http://studentsrepo.um.edu.my/10355/ |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Institution: | Universiti Malaya |
| Summary: | Elder Abuse and Neglect (EAN) is a growing public health concern. With the rapid
increase of older population worldwide and especially in developing countries, EAN is
likely to escalate. Abuse in late life has been shown to cause various adverse health
impacts. However, compared to the other two domains of family violence – child abuse
and intimate partner violence (IPV) – research findings pertaining to EAN health
consequences are relatively scarce. This study is divided into two phases. Phase I is a
systematic review that seeks to gather and critically appraise all the existing evidence on
the health consequences of EAN. Phase II is a two-year prospective cohort study that
aims at investigating the longitudinal relationships between EAN and three outcomes:
mortality, sleep quality and chronic pain. A total of 1927 older adults in Kuala Pilah,
Negeri Sembilan were recruited through a multi-stage cluster sampling strategy and
interviewed face-to-face at baseline. One thousand one hundred and eighty nine (1189)
were followed-up two years later through phone calls. Mortality was tracked using data
from the National Registration Department. Sleep quality was assessed using the
Pittsburgh Sleep Quality Index (PSQI) and chronic pain was ascertained by self-reports
consisting of two validated questions. Findings from Phase I ranked premature
mortality, depression and anxiety as the most credible health outcomes of EAN. In
Phase II, survival analysis and Cox regression showed no statistically significant
difference of mortality risks between EAN victims and those not abused (β: 0.26,
p=0.25), but patterns of hazard and survival plots suggested greater hazard and lower
survival for EAN victims. A short follow-up period was a possible reason for statistical
non-significance. With regards to sleep quality, abuse victims had significant worsening
iv
of sleep over the period of two years compared to their non-abused counterparts (β:
0.49, p=<0.01). Among the EAN subtypes, neglect and psychological abuse were
identified as stronger contributors to poor sleep: neglect (β: 1.13, p=0.03), psychological
abuse (β: 0.64, p=<0.01). On the other hand, EAN did not contribute to higher risks of
developing chronic pain (β: 1.14, p=0.45). In conclusion, abuse in late life adversely
affects health. Preventive and intervention measures to address this problem need to be
carried out at multiple levels: individual, community, healthcare, larger environment
and system. Scientific evidence related to other health impacts of EAN is still scarce,
thus highlighting the need for more research. |
|---|