Developmental Research on Elder Mistreatment

描述（由申请人提供）：预计美国老年人数量的快速增长引起了人们的担忧，即虐待老年人的人数将与老年人人口的增长一样多、一样快。虽然虐待老人的问题已经很明显了——最准确的估计是每年有一百万到两百万的美国老人是虐待的受害者——但大多数事件从未被报道过。个人损失是巨大的：受害者不仅遭受伤害和损失，而且他们可能比没有遭受虐待的老年人更早死亡。人们对围绕虐待老人的问题了解甚少，例如风险或预防因素、身体标志、后果和临床过程、保健和其他费用、成功的干预措施以及研究每一个问题的方法。目前为研究目的而检测滥用行为的方法要么无效，要么不可靠，要么繁琐，而且难以广泛应用，使人口研究不可行。迫切需要一种标准化的测量方法，这种方法可以跨群体推广。本申请建议开发和测试一种自我报告、基于调查的措施，这种措施可以广泛应用于产生虐待人口估计数，并推动老年人虐待研究向前发展。这个项目必须面对一些方法上的问题，包括(a)对普遍接受的五类虐待缺乏标准化的概念和操作定义：身体、心理和性虐待、被信任的其他人忽视和经济剥削；(b)认知受损的老年人，他们的经历不可靠；(c)在各族裔群体中推广该工具；(d)与社区虐待老人专业人员的相关性。因此我们的目标是：目标1。制定概念性定义和方法，以便将所有五类虐待老人的定义付诸实施。目标2。设计一种自我报告的、基于调查的措施，用于检测所有类型的虐待老年人的存在和严重程度。目标3。确定基于调查的测量是否有效和可靠地预测墨西哥裔美国人和非西班牙裔白人社区老年人的虐待，包括认知障碍。有了一个有效、可靠的检测虐待老年人的标准，研究人员就可以开始衡量和理解，政策制定者就可以启动所需的资源，充分解决这一重大和令人痛苦的公共卫生问题。

DESCRIPTION (provided by applicant): The projected rapid increase in numbers of older Americans raises the concern that elder mistreatment will grow as much and as fast as the population of elders. Although it is clear that the problem of elder mistreatment is already large - the best estimate is that one to two million older Americans are victims of mistreatment annually - most events are never reported. The personal costs are profound: not only do victims suffer from their injuries and losses, they are likely to die at an earlier age than elders who are not victims of mistreatment. There is very little understanding of the issues that surround elder mistreatment, for example risk or preventive factors, physical markers, consequences and clinical courses, healthcare and other costs, successful interventions and, methods for studying each of these issues. Current approaches to detecting abuse for research purposes are either invalid and unreliable or cumbersome, and difficult to apply on a broad scale, making population studies infeasible. There is a desperate need for a standardized measurement approach that can be generalized across groups. This application recommends development and testing of a self-report, survey-based measure that can be broadly applied to generate population estimates of abuse and move elder mistreatment research forward. This project must confront a number of methodological issues, including (a) lack of standardized conceptual and operational definitions of the five generally-accepted categories of mistreatment: physical, psychological and sexual abuse, neglect by a trusted other and financial exploitation; (b) cognitively-impaired older adults who are unreliable reporters of their experiences; (c) generalization of the instrument across ethnic groups; and (d) relevance to the community of elder mistreatment professionals. Thus we aim to: Aim 1. Develop conceptual definitions and methods for operationalizing the definitions for all five categories of elder mistreatment. Aim 2. Design a self-reported, survey-based measure for detecting presence and severity of all types of elder mistreatment. Aim 3. Determine whether the survey-based measure validly and reliably predicts elder mistreatment in samples of Mexican American and Non-Hispanic white community-dwelling elders, including the cognitively impaired. With a valid, reliable criterion standard for detecting elder mistreatment, researchers can begin to measure and understand and policy makers can activate the resources needed to adequately address this significant and distressing public health problem.