Validation of REAGERA-S: a new self-administered instrument to identify elder abuse and lifetime experiences of abuse in hospitalized older adults

Abstract

This study aimed to develop and validate REAGERA-S, a selfadministered instrument to identify elder abuse as well as lifetime experiences of abuse in older adults. REAGERA-S consists of nine questions concerning physical, emotional, sexual, financial abuse and neglect. Participants were recruited among patients (≥ 65 years) admitted to acute in-hospital care (n = 179). Exclusion criteria were insufficient physical, cognitive, or language capacity to complete the instrument. A semistructured interview conducted by a physician was used as a gold standard against which to assess the REAGERA-S. The final version was answered by 95 older adults, of whom 71 were interviewed. Sensitivity for lifetime experiences of abuse was 71.9% and specificity 92.3%. For elder abuse, sensitivity was 87.5% and specificity was 92.3%. REAGERA-S performed well in validation and can be recommended for use in hospitals to identify elder abuse as well as lifetime experience of abuse among older adults.

Experiences of elder abuse: a qualitative study among victims in Sweden

“…Semi structured qualitative interviews were conducted and analyzed using content analysis. The sample was 24 participants from the larger REAGERA (Responding to Elder Abuse in GERiAtric care) project, which included developing and validating the screening instrument REAGERA-S for detecting elder abuse in healthcare [ 25 ]. Consecutive older adults ≥ 65 years of age admitted to a hospital clinic for both acute geriatric and acute medical patients were eligible for inclusion.…”

“…Patients at the clinic were mostly admitted from the emergency department, and the mean duration of stay for patients over 65 years was 10 days at the acute geriatric ward and 4 days at the acute medical ward during the study period. The setting is described in greater detail elsewhere [ 25 ]. Between January and June 2018, 306 potential participants were asked to participate by nurses on the ward.…”

“…Before the interview, a nurse on the ward distributed a questionnaire to potential participants including the screening instrument REAGERA-S [ 25 ], as well as information about voluntary participation and informed consent. The screening instrument included nine questions about different kinds of abuse (e.g."…”

“…Has anyone attempted to control you, limit your contact with others, or decide what you may or may not do?”;”Have you been subjected to any form of physical violence, for example being shoved, pinched, held down, hit or kicked?”), and one question about associated suffering. The instrument in total is available elsewhere [ 25 ]. No precise definition of elder abuse was presented for the participants before the interviews.…”

Development and validation of REAGERA-P, a new questionnaire to evaluate health care provider preparedness to identify and manage elder abuse

“…The Responding to Elder Abuse in GERiAtric care (REAGERA) project was started at the department of acute internal medicine and geriatrics at a Swedish university hospital in 2017. A screening instrument to identify life-time experiences of abuse and elder abuse among older patients was developed and tested in the first part of the project, involving patients (REAGERA-S) [ 35 ]. The present study concerns another part of the project; to develop and test a questionnaire to evaluate provider preparedness to identify and manage elder abuse (the REAGERA -P, where P stands for provider).…”