Aging adults are at risk for multiple types of abuse including emotional, sexual, or physical abuse. Adults in skilled nursing or assisted living facilities might be particularly vulnerable to injury, including fatal injury resulting from incidents of resident-to-resident aggression (RRA). The purpose of this research is to report findings from the multistate National Violent Death Reporting System (NVDRS) related to fatal RRA incidents between years 2003 and 2016. We analyzed structured categorical data and unstructured narrative data on 101 identified fatal RRA incidents among individuals aged 65+. Findings included that victims average 16 years older than exhibitors and dementia diagnoses are present in most cases. Qualitative analysis revealed that events are described as both unexpected and preventable. Training to improve long-term care staff recognition and reporting of RRA events may potentially improve prevention and provide more accurate trend data. NVDRS data provide a useful source to follow trends in fatal RRA going forward.
These results suggest the need for further investigation into healthcare cultures that are perceived as supportive for infection control. Surveillance processes have potential, especially if information is perceived by HCW as timely and relevant.
Background
Deaths by suicide among US adolescents aged 10 to 19 increased by more than 85% between 2007 and 2017. Interpersonal conflicts with peers or family members, in combination with biological, psychological, and cognitive attributes of adolescents, are among risk factors. More insight about contextual factors, including timing of conflicts relative to suicide, would be useful for professionals and programmers.
Method
We used data from the 2017 National Violent Death Reporting System (NVDRS) reflecting most cases in 37 US states to explore contextual circumstances in adolescent death by suicide preceded by interpersonal conflicts. We calculated descriptive statistics and conducted content analysis of narratives to identify attributes of 197 cases.
Results
Most deaths by suicide (n = 155) occurred within 24 hr of the conflict; most conflicts involved the adolescent and family members (n = 138). When subject matter was described, most conflicts (n = 27) focused on concerns with an adolescent’s behavior. Nearly a quarter of cases (n = 49) involved technology, including technology restrictions as punishment, as either a primary or additional aspect of the conflict.
Conclusions
Our findings provide support for prior research suggesting links between technology and mental health concerns, including suicidality, among adolescents. While previous works have identified both positive and negative aspects of the use of technology by adolescents, our findings suggest that restriction of technology as a punishment may be an additional contextual factor of interest in a proportion of youth suicides preceded by an argument. Given ongoing regular use of technology, practitioners should address these potential risk factors regardless of risk status.
Among short-term mental health consequences for adolescents who have proximate or direct experience with mass shootings in school settings are posttraumatic stress and posttraumatic stress disorder. Identifying incidence of enduring mental health impacts is challenging due to difficulty of tracking individuals into adulthood. The purpose of this paper is to use qualitative secondary analysis to explore how seven individuals reflectively describe and interpret their lived experiences as adolescents during the May 4, 1970, Kent State University Vietnam protest that resulted in deaths and injuries to students fired upon by Ohio National Guard. Archived transcripts from interviews conducted up to 48 years after the event were analyzed using a phenomenological qualitative approach. Aspects of common experience included confusion, emotionally charged responses from others directed toward community members following the event, and belief the experience had a profound and lasting impact on their lives, exemplified by vivid memories of minute details and comparative responses to other events. These findings illustrate how others’ reactions and subsequent incidents contribute to retraumatization into adult years. This report demonstrates the value of qualitative secondary analysis in general, while specific findings illustrate long-term impact of an adolescent trauma experience.
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