Abuse and neglect of older people in health facilities from the perspective of nursing professionals: A cross-sectional study from Croatia

Abstract

Background: Abuse and neglect of older people represent a salient public health issue that remains understudied in the current literature. However, most studies have focused on estimating the prevalence of mistreatment of older people, while litter priority has been put on healthcare professionals and their role in addressing this problem.

Objectives: The aim of this paper was to determine nurses' perceptions of neglect and abuse of older persons within health facilities in Croatia.

Methods: A cross-sectional survey with convenience sampling approach was conducted on 632 nursing professionals between 26 March and 26 April 2020. Participation was voluntary and anonymous. A questionnaire from Drennan et al. (NCPOP, University College Dublin, Dublin, 2012), previously adapted by Neuberg et al. (Arch Ind Hyg Toxicol, 68, 2017, 190), was used as a survey instrument. Descriptive and inferential statistics has been used, as well as multivariable methods (reliability analysis). Significance was set at p < .05 (two-tailed).

Results: Abuse/neglect of older people was observed by 13.8% to 57.4% of nursing professionals, depending on the incident type. The most prevalent incidents observed were ignoring the call of an older person (57.4%), shouting at an older person in anger (41.1%) and force-feeding an older person (34.5%), while the least prevalent incidents observed were denial of food or some privileges as a form of punishment (13.8%). Male nursing professionals reported observing various forms of abuse significantly more often than their female counterparts (p = .038), without statistically significant age-related differences. Furthermore, mistreatment of older people was much more frequently observed in nursing homes (p = .013), with suboptimal the ratio of caregivers and care recipients, as well as by nursing professionals who work in shifts (p = .012). Reliability analysis demonstrated a satisfactory level of internal consistency for the used questionnaire.

Conclusions: This study reinforces neglect and abuse of older people as a growing public health problem and puts the emphasis on its perception; hence, there is a need for systematic and continuous training of nursing professionals on preventing, identifying and responding to such mistreatment, with the aim of enhancing the quality of life in this vulnerable group.

Implications for practice: This study contributes to the growing body of research on the quality of evidence-based nursing care of older people, most notably from providers' perspective - with direct implications for policy, practice, research and training.

Keywords: health facilities; nursing professionals; older people abuse; older people neglect; quality of nursing care.