Independent factors associated with abuse.

BackgroundThe global rise in the elderly population brings attention to the pressing issue of elder abuse, categorized into physical, psychological, neglect, financial and sexual abuse. According to the World Health Organization (2022), one in six individuals aged 60 and older has experienced some form of abuse in community setting necessitating increase in awareness and support for older people. This study aimed to assess abuse and its associated factors among elderly population of Kamalamai Municipality of Sindhuli District, Nepal.MethodologyWe conducted a community-based cross-sectional study utilizing both qualitative and quantitative methods. We collected data from June 15 to September 15, 2023. The study involved 398 elderly participants (≥60 years). Stratified sampling techniques was used to select participants. For the qualitative study we utilized purposive sampling technique which included two key informant interviews, one in-depth interview and two focus group discussions. We analyzed quantitative data using IBM SPSS version 20 applying bivariate and multivariable logistic regression analysis at a 95% confidence interval. For qualitative data, thematic analysis was done.ResultsThe mean ± SD age of the elderly participants was (70.8± 8.08) years. Among the total of 398 study participants, (64.1%) participants reported experiencing different forms of abuse. The study found that neglect (46.0%), psychological abuse (42.5%), and financial abuse (24.4%) were the most common while physical abuse (4.8%) and sexual abuse (2.8%) were less common. Living in a nuclear family (AOR: 2.74, 95% CI: 1.67–4.51) and lower socio-economic status (AOR: 5.42, 95% CI: 2.28–12.92) were significantly associated with increase risk of elder abuse. Qualitative findings revealed mistreatment, vulnerability, negligence, economic factors, family dynamics, loneliness, financial exploitation, food withholding, physical abuse, and emotional attachment as key aspects of elder abuse.ConclusionThis study highlights neglect and psychological abuse were the most common forms of elder abuse. These findings emphasize the urgency of implementing programs at the municipal level such as financial support system for elderly individuals from lower socioeconomic backgrounds and education programs for both elderly individuals and their families and caregivers. These initiatives aim to control and reduce the incidence of elder abuse and ensure comprehensive well-being of elderly population.研究背景 全球老年人口规模持续扩张，使得老年人虐待（elder abuse）这一亟待解决的公共卫生问题受到广泛关注，该虐待可划分为身体虐待、心理虐待、忽视型虐待、财务虐待与性虐待五大类别。据世界卫生组织（World Health Organization）2022年发布的数据，每6名60岁及以上的老年人中就有1人在社区环境中遭受过某种形式的老年人虐待，这亟需提升社会对老年人虐待问题的认知水平，并加大对老年人的帮扶支持力度。本研究旨在评估尼泊尔辛杜利县卡马莱伊市老年人群的老年人虐待发生情况及其相关影响因素。 研究方法 本研究采用定性与定量相结合的社区横断面研究设计，数据采集时段为2023年6月15日至9月15日。本次研究共纳入398名年龄≥60岁的老年参与者，采用分层抽样法选取研究对象。定性研究部分采用目的抽样法，共开展2次关键知情人访谈、1次深度访谈与2次焦点小组讨论。定量数据采用IBM SPSS 20.0统计软件进行分析，以95%置信区间为统计检验水准，运用双变量logistic回归与多变量logistic回归模型开展数据分析；定性数据则采用主题分析法进行编码与解析。 研究结果 老年参与者的平均年龄±标准差（Standard Deviation, SD）为（70.8±8.08）岁。在全部398名研究对象中，64.1%的参与者报告曾遭受过不同形式的老年人虐待。本研究发现，忽视型虐待（46.0%）、心理虐待（42.5%）与财务虐待（24.4%）是最为常见的虐待类型，而身体虐待（4.8%）与性虐待（2.8%）的发生率相对较低。居住于核心家庭（调整后优势比（Adjusted Odds Ratio, AOR）：2.74，95%置信区间（Confidence Interval, CI）：1.67~4.51）与较低的社会经济地位（调整后优势比（Adjusted Odds Ratio, AOR）：5.42，95%置信区间（Confidence Interval, CI）：2.28~12.92）与老年人虐待发生风险的升高呈显著正相关。定性研究结果显示，虐待行为、个体脆弱性、疏忽大意、经济因素、家庭互动模式、孤独感、财务剥削、克扣食物、身体虐待以及情感依附问题是老年人虐待的核心维度。 研究结论 本研究证实忽视型虐待与心理虐待是老年人虐待最为常见的类型。上述研究结果凸显了在市级层面推出针对性帮扶项目的紧迫性，例如为社会经济地位较低的老年群体搭建财务支持体系，同时面向老年人、其家属及照护者开展健康教育与宣传活动。此类举措旨在遏制并降低老年人虐待的发生率，保障老年人群的全面健康福祉。