The use of the three assessment tools is needed for optimal identification of abuse, whereas assessment for high risk proved an efficient method in the absence of respondent disclosure or professional detection of signs of abuse. Hospitalization provides an excellent opportunity for identifying elderly persons at risk of abuse.
The aim of the study was to assess the prevalence of abuse among the residents of long-term care facilities in Israel, and its associations with risk indicators. Seventyone such residents aged 70 or more years were assessed in the internal and orthopaedic departments of two university medical centres for possible abuse by carers at the long-term facilities from which they were admitted. The study collected socio-demographic and health profiles and a list of maltreatment or abusive acts, and administered the Signs of Abuse Inventory and the Expanded Indicators of Abuse Questionnaire. Among the 71 residents, 31 per cent reported some form of maltreatment, most being instances of disrespectful behaviour. Signs of abuse, mostly of neglect, were detected in 22.5 per cent of the sample. Hierarchical regression analysis revealed that higher scores on risk indicators and higher dependence on others for the activities of daily living significantly associated with reported abuse, while age, gender, risk indicators and lower blood albumin level (being an indicator of worse nutritional and health status) significantly associated with identified signs of abuse. It is concluded that direct questioning mainly discloses instances of disrespectful behaviours and humiliation, while the assessment of signs of abuse is more sensitive to cases of neglect. Risk indicators were found to be reliable indicators of abuse. Routine screening for these indicators is recommended to improve detection and thereby to prevent abuse in long-term care facilities.KEY WORDS -elder abuse, long-term facilities, signs of abuse, risk indicators.
Staff development programs, which focus on imparting and improving intervention skills, are acknowledged as an efficient way to reduce burnout, but few studies have examined this effect. The aim of the present study was to detect any difference in the level of social worker's burnout before and after attending two different skill-development groups, namely group-intervention skills for more experienced social workers and general hospital social-work skills for less experienced. Twenty-five hospital social workers participated in the study. The three dimensions of burnout, namely emotional exhaustion, depersonalization, and personal accomplishment, changed between the pre-training and post-training measures: personal accomplishment rose by 12.39% and depersonalization fell by 29.75%. The difference was significant for the two dimensions in both groups. Emotional exhaustion significantly declined in the hospital social-work skills group only, and revealed a group-time effect. The level of peer support rose in the hospital-skills group and was positively related to a lowering of emotional exhaustion. This was an exploratory study, with a rather small sample, and the results are preliminary, but they show a promising possibility of burnout reduction among professional workers. Further research on the effect of skill development training on reducing burnout is needed.
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