The sensitivity and specificity of the Modified Conflict Tactics Scale for detecting clinically significant elder abuse

Cooper, Claudia; Maxmin, Kate; Selwood, Amber; Blanchard, Martin; Livingston, Gill

doi:10.1017/s1041610209009387

Cited by 33 publications

(29 citation statements)

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“…(2005)Quality of life instruments used in dementiaZwakhalen, Hamers, and Berger (2007)A behavioural pain scaleAchterberg, Pot, Scherder, and Ribbe (2007)The nottingham health profileGerritsen et al. (2008)The MDS challenging behaviour profileMcCool, Jogerst, Daly, and Xu (2009)Multidisciplinary reportsCooper, Maxmin, Selwood, Blanchard, and Livingston (2009)The Modified Conflict Tactics ScaleBerkhout, Boumans, Mur, and Nijhuis (2009)“7‐S” modelAcierno et al. (2010)The National Elder Mistreatment StudyTriemstra, Winters, Kool, and Wiegers (2010)The consumer quality index long‐term careInspectie voor de Gezondheidszorg, (2010)VrijheidsbeperkingHeidstra‐Wolke (2011)Zelf‐check voor verpleeghuisartsenPillemer et al.…”

Section: Table A1mentioning

confidence: 99%

What is desirable care in the opinion of formal and informal caregivers in nursing‐home care for patients with dementia?

Dijk

Buijck

2018

Nursing Open

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AimTo examine care characteristics related to desirable care as reported by formal and informal caregivers in Dutch Psycho‐geriatric nursing homes for patients with dementia.DesignQualitative exploratory study.MethodsThe sample consisted of four nursing homes. In each home, semi‐structured interviews were conducted with a manager, a quality advisor or head nurse, a daily care supervisor and an informal caregiver. The findings were analysed by labelling and coding the text fragments.ResultsThe 16 semi‐structured interviews contained 60 discussion items. The 16 items that were shared by the four interviewee categories were clustered into the following six major themes: good quality of care; poor quality of care; elements of a vision; extra hands; bureaucracy; and formal caregivers.

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Section: Table A1mentioning

confidence: 99%

What is desirable care in the opinion of formal and informal caregivers in nursing‐home care for patients with dementia?

Dijk

Buijck

2018

Nursing Open

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“…This scale has been validated for use in family carers of people with dementia. 37 l The Health Status Questionnaire (HSQ) 38 mental health domain measures health-related QoL throughout the age range, is sensitive to change and has been validated in older and younger people. It is summarised as a continuous score, ranging from 0 to 100, with higher scores indicating better outcome.…”

Section: Assessmentsmentioning

confidence: 99%

“…At the lower-bound NICE threshold of £20,000, the START intervention has a 93% likelihood of being seen as cost-effective, rising to 98% at the £30,000 threshold. (20) 23 (26) 41 (24) HADS-D 20 (23) 35 (20) 23 (26) 41 (24) HADS-T 20 (23) 35 (20) 23 (26) 41 (24) MCTS total 32 (37) 59 (34) 40 (46) 78 (45) HSQ mental health 26 (30) 52 (30) 32 (37) 60 (35) QoL-AD total 34 (39) 58 (34) 38 (44) 77 (45) RESULTS NIHR Journals Library www.journalslibrary.nihr.ac.uk…”

Section: Sensitivity Analysesmentioning

confidence: 99%

START (STrAtegies for RelaTives) study: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manual-based coping strategy programme in promoting the mental health of carers of people with dementia

Livingston

Barber

Rapaport

et al. 2014

Health Technology Assessment

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163

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BackgroundTwo-thirds of people with dementia live at home, receiving most care from family carers, about 40% of whom have clinically significant depression or anxiety. This impacts on the person with dementia, families and society, predicting care breakdown. There are currently no clinically effective and cost-effective NHS family carer interventions.ObjectivesTo assess the STrAtegies for RelaTives (START) intervention in the short (4 and 8 months) and long term (1 and 2 years) compared with treatment as usual (TAU).DesignRandomised, parallel-group, superiority trial with blinded assessment recruiting participants 2 : 1 (intervention to TAU) to allow for therapist clustering.SettingThree UK mental health services and one neurological service.ParticipantsFamily carers of people with dementia.InterventionEight-session manual-based coping intervention delivered by supervised psychology graduates to individuals.Main outcome measuresAffective symptoms [Hospital Anxiety and Depression Scale-total (HADS-T)] and cost-effectiveness. Secondary measures: anxiety and depression symptoms and caseness, quality of life (QoL), abusive behaviour and long-term care home admission.ResultsTwo hundred and sixty participants were randomised (173 intervention, 87 TAU). We used intention-to-treat analysis in the short term (152 intervention, 77 TAU) and in the long term (140 intervention, 69 TAU).In the short term, the intervention group had lower HADS-T [mean difference –1.80, 95% confidence interval (CI) –3.29 to –0.31;p = 0.02] and higher quality-adjusted life-years (QALYs) (mean difference 0.03, 95% CI –0.01 to 0.08). Costs were no different between groups [mean £252 (95% CI –£28 to £565) for intervention group]. The cost-effectiveness acceptability curve showed a greater than 99% chance of being cost-effectiveness at a £30,000/QALY willingness-to-pay threshold and a high probability of cost-effectiveness based on the HADS-T score. Carers in the intervention group had less case-level depression [odds ratio (OR) 0.24, 95% CI 0.07 to 0.76], a trend towards reduced case-level anxiety (OR 0.30, 95% CI 0.08 to 1.05), lower Hospital Anxiety and Depression Scale-anxiety (HADS-A) (–0.91, 95% CI –1.76 to –0.07;p = 0.03) and Hospital Anxiety and Depression Scale-depression (HADS-D) (–0.91, 95% CI –1.71 to –0.10;p = 0.03) and higher Health Status Questionnaire (HSQ) QoL (mean difference 4.09, 95% CI 0.34 to 7.83). Group differences in abusive behaviour (OR 0.48, 95% CI 0.18 to 1.27) and the person with dementia’s quality of life-Alzheimer’s disease (QoL-AD) (mean increase 0.59, 95% CI –0.72 to 1.89) were not significant.In the long term, the intervention group had lower HADS-T (mean difference –2.58, 95% CI –4.26 to –0.90;p = 0.03) and higher QALYs (mean difference 0.03, 95% CI –0.01 to 0.06). Carers in the intervention group had less case-level depression (OR 0.14, 95% CI 0.04 to 0.53), a trend towards reduced case-level anxiety (OR 0.57, 95% CI 0.26 to 1.24), lower HADS-A (–1.16, 95% CI –2.15 to –0.18) and HADS-D (1.45, 95% CI –2.32 to –0.57), and higher HSQ (mean difference 7.47, 95% CI 2.87 to 12.08). Thirty-two (18.7%) people with dementia in the intervention group and 17 (20.2%) in TAU were admitted to a care home (hazard ratio 0.83, 95% CI 0.44 to 1.56;p = 0.56). There were no significant differences between groups in abusive behaviour (OR 0.83, 95% CI 0.36 to 1.94), the person with dementia’s QoL-AD (0.17, 95% CI –1.37 to 1.70) or costs (£336, 95% CI –£223 to £895) for intervention group. The probability that the intervention would be seen as cost-effective at £30,000/QALY threshold and cost-effectiveness on the HADS-T remained high.ConclusionsThe START intervention was clinically effective and cost-effective in the short and longer term. The results are robust to the sensitivity analyses performed. Future work is needed to consider mechanism of action; the effects on people with dementia in clinical terms (cognition, neuropsychiatric symptoms, longer-term care home admission); and on health and social care costs. In addition, we will explore the effects of carer abusive behaviour on the care recipient’s care home admission and if this then reduces abusive behaviour. We would also like to implement START and evaluate this implementation in clinical practice.Trial registrationCurrent Controlled Trials ISCTRN70017938.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…The Conflict Tactics Scale (Straus, 2012) is the most widely used tool in family violence research. A modified version of this scale is often used to measure elder abuse in research, although it has been found to not be useful in detecting clinically significant elder abuse (Cooper, Maxmin, Selwood, Blanchard, & Livingston, 2009). The Conflict Tactics Scale conceptualizes aggression, and therefore measures aggression, as direct acts that occur during conflicts.…”

Section: Perpetrated Aggressionmentioning

confidence: 99%

Gender, Relationships, and Elder Abuse

Pickering

Pieters

Mentes

et al. 2015

Journal of Forensic Nursing

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The older adult population is growing rapidly, and with it comes a national concern for elder abuse. Elder abuse is an intentional act of harm or failure to provide care by a person in a trusted relationship with the elder. One relationship is often overlooked in both research and clinical practice as having special significance for elder abuse-that of the adult daughter-elderly mother. However, recent studies suggest that there are gender differences in the use of aggression, which challenge standard assessments of abuse and may be important for assessing mother-daughter relationships. In this narrative review article, the authors review the relevant literature on female-to-female aggression, with an emphasis on its application to mother-daughter relationships and elder abuse. Measurement tools are evaluated in light of the state of the science. The authors conclude with specific recommendations for clinical practice.

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The sensitivity and specificity of the Modified Conflict Tactics Scale for detecting clinically significant elder abuse

Abstract: The MCTS could be used routinely in clinical practice with carers of people with dementia to detect clinically concerning cases of abuse, many of which are currently being missed.

Cited by 33 publications

References 10 publications

What is desirable care in the opinion of formal and informal caregivers in nursing‐home care for patients with dementia?

What is desirable care in the opinion of formal and informal caregivers in nursing‐home care for patients with dementia?

START (STrAtegies for RelaTives) study: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manual-based coping strategy programme in promoting the mental health of carers of people with dementia

Gender, Relationships, and Elder Abuse

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