Browsing by Author "Ribeiro, Oscar"
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- Elder abuse victimization patterns: latent class analysis using perpetrators and abusive behavioursPublication . Santos, Ana João; Nunes, Baltazar; Kislaya, Irina; Gil, Ana Paula; Ribeiro, OscarBackground: Research on elder abuse has defined it as a multidimensional construct that encompasses a set of different abusive behaviours, victims, perpetrators and settings. The array of possible elder abuse configurations is difficult to capture. This study sought to identify victimization patterns that represent distinct elder abuse configurations based on specific abusive behaviours and on the relationship with the perpetrator; it also sought to determine the association between these latent classes with victims' characteristics. Method: Data comes from two elder abuse surveys: a representative sample of community-dwelling adults and a convenience sample of older adults reporting elder abuse to four state and NGOs institutions. Latent Class Analysis (LCA) was used to categorize victimization in the population-based (N = 245) and in the victims' sample (N = 510) using 7 items measuring physical, psychological and financial abuse, and appointed perpetrators. Association tests were conducted to determine differences and similarities of victims' characteristics between the different obtained classes. Results: The LCA procedure identified six different latent classes of victimization experiences in each of the samples, which were statistically and plausibly distinct. In the population-based survey: verbal abuse by others (29%); psychological abuse from children/grandchildren (18%); overlooked by others (18%); stolen by others (15%); verbal Intimate Partner Violence (IPV) (14%) and physical and psychological IPV (6%). In the victims' survey: physical abuse by children/grandchildren (29%); physical IPV (26%); psychological abuse by children/grandchildren (18%); polyvictimization by others (16%); physical abuse by others (6%) and physical and psychological IPV (4%). In the victims survey the 6 groups significantly differ in age, gender, civil status, living arrangements, perceived social support and functional status. Conclusions: The results support the possibility of the multidimensionality of elder abuse not being accounted by the "classical" abuse typologies. Elder abuse victims seeking help may represent a distinct group from that included in population-based prevalence studies. The appointed perpetrators may be the most meaningful and relevant aspect in distinguishing victimization experiences. Further research is needed to develop tailored interventions to specific elder abuse cases and enhance successful outcomes.
- Elder Abuse: Review of Protective Factors in Community-Dwelling Older AdultsPublication . Santos, Ana João; Ribeiro, OscarBackground: Research on older adult’s violence field does not yield the same development on protective as it does on risk factors. Evidence on protective factors is crucial not only because they can reduce the likelihood of violence occurrence, but also act as buffering factors on the risk. This paper’s objective is to undertake a literature review of protective factors for community dwelling older adult’s violence within family context. Method: A search was conducted using PubMed, PsycINFO, Web of Science and Scopus databases for articles published in English from 2009 up to 2014, to identify original studies with statistically significant protective factors. Studies targeting other than 5 most consensual forms of abuse (e.g. self-neglect), setting in care/health/residential facilities or measuring violence in cognitive impairment population were excluded. Results: Thirteen studies were selected. Only two explicitly aimed at identifying protective factors; the remaining studies focused on risk factors and were included considering multivariate statistical analysis results presenting significant variables decreasing the likelihood of older adult’s violence. Data on some potential protective factors was inconsistent between studies, namely gender, marital status and educational level. Older age groups, individuals without financial problems, employed and perceiving higher levels of social support presented decreased odds of reporting violence. Conclusions: Lack of studies addressing protective factors is clear. The results only show potential protective factors and caution in warranted. Older adult’s violence requires more and better designed studies in order to successfully identify consistent protective factors essential to the development of effective intervention strategies.
- Estudo de validação em Portugal de uma versão reduzida da Escala de Depressão GeriátricaPublication . Santos, Ana João; Nunes, Baltazar; Kislaya, Irina; Gil, Ana Paula; Ribeiro, OscarAs propriedades psicométricas da versão reduzida (5 itens) da Escala de Depressão Geriátrica (GDS), instrumento de avaliação da depressão junto de pessoas idosas, foram examinadas em duas amostras de pessoas com 60 e mais anos. A validade concorrente, a especificidade e a sensibilidade foram obtidas contra o Inventário de Depressão do Beck (IDB-II) numa amostra de 66 indivíduos (média das idades de 70 anos), enquanto a validade da estrutura fatorial foi observada numa amostra de base populacional de 1023 indivíduos (média das idades de 71 anos). A versão de 5 itens da Escala de Depressão Geriátrica apresenta valores de consistência interna e de correlação com o IDB-II que sugere a sua fiabilidade e valores de sensibilidade e especificidade adequados ao rastreamento de sintomatologia depressiva na população idosa. Os resultados obtidos pela Análise Fatorial Confirmatória (AFC) sugerem que o modelo unifactorial não apresenta as características desejadas, indicando que um dos itens (item 4) poderá ter um menor poder discriminativo, pelo que se observa um melhor ajustamento no modelo obtido pela AFC para 4 itens.
- Exploring the Correlates to Depression in Elder Abuse Victims: Abusive Experience or Individual Characteristics?Publication . Santos, Ana João; Nunes, Baltazar; Kislaya, Irina; Gil, Ana Paula; Ribeiro, OscarDepression and depressive symptoms have been studied both as risk factors and consequences of elder abuse, even though the most common cross-sectional design of the studies does not allow inferring cause or consequence relationships. This study estimates the proportion of older adults who screened positive for depressive symptoms among those self-reporting elder abuse and examines whether individual characteristics and/or abusive experience aspects are associated with self-reported depressive symptoms. Participants were 510 older adults self-reporting experiences of abuse in family setting enrolled in the cross-sectional victims’ survey of the Aging and Violence Study. Depressive symptoms were assessed through the abbreviated version of the Geriatric Depression Scale (GDS-5). Poisson regression was used to determine the prevalence ratio (PR) of screening depressive symptoms according to individual and abusive experience covariates: sex, age group, cohabitation, perceived social support, chronic diseases, functional status, violence type, perpetrator, and number of conducts. Women (PR = 1.18, 95% confidence interval [CI] = [1.04, 1.35]) individuals perceiving low social support level (PR = 1.36, 95% CI = [1.16, 1.60]) and with long-term illness (PR = 1.17, 95% CI = [1.02, 1.33]) were found to be associated with increased risk for screening depressive symptoms. In regard to abusive experience, only the number of abusive conducts increased the PR (PR = 1.07, 95% CI = [1.05, 1.09]). Routine screening for elder abuse should include psychological well-being assessment. Interventions toward risk alleviation for both mental health problems and elder abuse should target women perceiving low social support level and with long-term illness.
- Exploring victimization patterns with latent class analysis: new Approaches to elder abusePublication . Santos, Ana João; Nunes, Baltazar; Kislaya, Irina; Gil, Ana Paula; Ribeiro, OscarObjectives: Recognized as an important public health issue, elder abuse has been associated with adverse health and social outcomes. However, findings are often complex and contradictory, which can be attributed to elder abuse being a multidimensional construct that encompasses a set of different abusive behaviours, victims, perpetrators and settings. The array of possible elder abuse configurations is difficult to capture. This study sought to identify victimization patterns that represent distinct elder abuse configurations based on specific abusive behaviours and on the relationship with the perpetrator; it also sought to determine the association between these latent classes with victims’ characteristics. Methods: Data comes from two elder abuse surveys: a representative sample of community-dwelling adults and a convenience sample of older adults reporting elder abuse to four state and NGOs institutions. Latent Class Analysis (LCA) was used to categorize victimization in the population-based (N=245) and in the victims’ sample (N=510) using 7 items measuring physical, psychological and financial abuse, and appointed perpetrators. Chi-square tests were used to compare victims’ characteristics between the different obtained classes. Results: The LCA procedure identified six different latent classes of victimization experiences in each of the samples, which were statistically and plausibly distinct. In the population-based survey: verbal abuse by others (29%); psychological abuse from children/grandchildren (18%); overlooked by others (18%); stolen by others (15%); verbal IPV (14%) and physical and psychological IPV (6%). In the victims’ survey: physical abuse by children/grandchildren (29%); physical IPV (26%); psychological abuse by children/grandchildren (18%); polyvictimization by others (16%); physical abuse by others (6%) and physical and psychological IPV (4%). In the victims survey the six groups significantly differ in age, gender, civil status, cohabitation, perceived social support and functional status. Conclusion: The results support the possibility of the multidimensionality of elder abuse not being accounted by the “classical” abuse typologies. Elder abuse victims seeking help may represent a distinct group from that included in population-based prevalence studies. The appointed perpetrators may be the most meaningful and relevant aspect in distinguishing victimization experiences. Further research is needed to develop tailored interventions to specific elder abuse cases and enhance successful outcomes.
- Older adults’ emotional reactions to elder abuse: Individual and victimisation determinantsPublication . Santos, Ana João; Nunes, Baltazar; Kislaya, Irina; Gil, Ana Paula; Ribeiro, OscarElder abuse has been gaining public, state, and scientific attention for the past 40 years, but research focusing on emotional reactions of older adults to victimisation is still scarce. The study describes the emotions and feelings of older adults who experienced abuse in a community setting, and the association between these emotions and individual or abuse characteristics. The cross‐sectional study comprises 510 older adults who were identified and referred by four institutions. Participants answered a questionnaire on elder abuse experiences, including the emotion or feeling brought out by the act of abuse that was perceived to be the most serious. Fear and sadness comprised 67.1% of all provided responses. Emotional reactions were associated with functional status, the presence of depressive symptoms, relationship with the perpetrator and, to a limited degree, to the experience of multiple types of abuse. The most significant and meaningful variable was the relationship with the perpetrator. This study demonstrates that older adults present very similar patterns of emotional reactions, but individual characteristics and the established relationship with the perpetrator might mediate the emotional response. Implications for prevention and intervention of elder abuse are discussed.
- Psychological elder abuse: measuring severity levels or potential family conflicts?Publication . Santos, Ana João; Nunes, Baltazar; Kislaya, Irina; Gil, Ana Paula; Ribeiro, OscarPurpose – Psychological elder abuse (PEA) assessment is described with different thresholds. The purpose of this paper is to examine how the prevalence of PEA and the phenomenon’s characterisation varied using two different thresholds. Design/methodology/approach – Participants from the cross-sectional population-based study, Aging and Violence (n¼1,123), answered three questions regarding PEA. The less strict measure considered PEA as a positive response to any of the three evaluated behaviours. The stricter measure comprised the occurrence, for more than ten times, of one or more behaviours. A multinomial regression compared cases from the two measures with non-victims. Findings – Results show different prevalence rates and identified perpetrators. The two most prevalent behaviours (ignoring/refusing to speak and verbal aggression) occurred more frequently (W10 times). Prevalence nearly tripled for “threatening” from the stricter measure (W10 times) to the less strict (one to ten times). More similarities, rather than differences, were found between cases of the two measures. The cohabiting variable differentiated the PEA cases from the two measures; victims reporting abuse W10 times were more likely to be living with a spouse or with a spouse and children. Research limitations/implications – Development of a valid and reliable measure for PEA that includes different ranges is needed. Originality/value – The study exemplifies how operational definitions can impact empirical evidence and the need for researchers to analyse the effect of the definitional criteria on their outcomes, since dichotomization between victim and non-victim affects the phenomenon characterisation.
- Short Version Of The Geriatric Depression Scale: Exploratory Study Of Its Validity In a Portuguese SamplePublication . Santos, Ana João; Kislaya, Irina; Gil, Ana Paula; Nunes, Baltazar; Ribeiro, OscarBackground: To explore the validity of the short Geriatric Depression Scale (GDS) version – 5 items – in Portuguese community-dwelling older adults. Depression is reported to affect between 1% and 3% community-dwelling older adults, whereas depressive symptoms are two to four times more prevalent. Community surveys targeting older adults should have reliable and valid instruments to assess depressive symptoms. Methods: Two samples were considered: a convenience sample (N=71) to compare GDS5 with the 15-item GDS version and the Beck Depression Inventory (BDI); and a population-based sample (N=1030) to compare GDS5 with self-reported depression diagnosis. Internal consistency (Cronbach's alpha coefficient), criterion validity (sensitivity and specificity), diagnostic capacity (area under the ROC curve) and factorial analysis (tetrachoric) were analyzed. Results: The cut-off point was taken as 2 or more. GDS5 was found to be internally consistent: Cronbach Alpha=0.69. GDS-5 and GDS15: Sensitivity= 85.7%; Specificity=83.3%, AUC=94.3. GDS5 and BDI: Sensitivity=70%; Specificity=85.3%, AUC=84.1. GDS5 and self-reported depression: Sensitivity=79%; Specificity=47.4%, AUC=72.2. Conclusions: Results are similar to other GDS5 studies. The low specificity results for the depression diagnose indicating false positives can be due to self-reporting. GDS5 may be a useful alternative to other longer instruments not adequate for research surveys.
- The ageing process in older adults’ narratives of family violencePublication . Santos, Ana João; Gil, Ana Paula; Ribeiro, OscarPurpose – The purpose of this paper is to examine, through a qualitative lens, how community elder abuse and the ageing process are represented in the older adults’ narratives reporting abuse perpetrated by family members. Design/methodology/approach – A qualitative study of a convenience sample of 22 interviews from 24 older adults (two couples) aged 60 years or older who had experienced one or more types of abuse and had sought help about the victimisation experience. A general inductive approach of thematic content analysis was employed. Findings – The four main emergent themes related to the passage of time or the perception of becoming old within the process of abuse were: abuse grown old, abuse after entering later life, vulnerability to abuse and responses to abuse. Ageing was found to be associated with an increase vulnerability to abuse and an important element in shaping how older adults experience, report and cope with victimization. The social and contextual issues of being older also influenced the decision of ending (or not) the abuse and the victims’ repertoire of responses. Originality/value – Despite the little suitability of chronological age to define and delimit elder abuse, understanding the phenomenon demands the recognition of ageing (both as a process and as a product) in order to more accurately identify aetiology processes and develop interventions.