The effect of education on knowledge and management of elder abuse: a randomized controlled trial

Abstract

Background: Abuse of older adults may occur to a disproportionate extent in institutions. Lack of familiarity with protocols when managing abuse once it occurs is one of the reasons why it persists. Educational interventions are one of the ways to improve knowledge and management in this area.

Objective: To compare the effectiveness of attending an educational course (Group 1) to printed educational material (Group 2) in improving management of abuse of older people. To determine if positive attitude and low burnout scores are related to improvement.

Design: Randomized controlled trial.

Setting: North London, UK.

Subjects: Nurses, care assistants and social workers working with older people.

Methods: Staff answered questionnaires pre- and post-intervention.

Results: The study was completed by 64 (81%) of staff. Baseline scores on knowledge and management abusive scenarios were low. Those randomized to Group 1 improved after intervention and Group 2 deteriorated (Group 1=3.7 [standard deviation=8.1], ANOVA F=23.0; P=0.0001 and Group 2=-2.9 [standard deviation=10.0]). There was a ceiling effect with those who knew more learning less. The significant independent variables in regression analysis to predict learning were being randomized to Group 1 (P=0.003; odds ratio=6.8; 95% confidence interval=1.9-24.5) and low baseline knowledge and management score, (P=0.015, odds ratio=4.8, confidence interval=1.4-16.9). Most staff had a positive attitude towards people with dementia; positive attitude score correlated with baseline knowledge, but did not predict learning.

Conclusion: Identifying, documenting and reporting abuse of older people is not carried out consistently. Whilst an educational course goes some way in improving this, it needs to be targeted to take into account the baseline knowledge.