Testing an educational intervention to improve health care providers' preparedness to care for victims of elder abuse: a mixed method pilot study

Abstract

Background: Elder abuse is prevalent and associated with ill-health. However, health care providers often lack education about elder abuse and older patients' victimization often remains unknown to them. In this pilot study we performed initial testing of an educational model aiming at improving health care providers' preparedness to care for older adults subjected to abuse, or more specifically their self-reported propensity to ask older patients questions about abuse and perceived ability to manage the response.

Methods: The educational model consisted of a full training day about elder abuse, including theory, group discussions and forum theatre. Forum theatre is an interactive form of drama in which participants are not only observers, but rather spect-actors, urged to participate in the scene. They are thereby given the opportunity to discuss and practise difficult health care encounters. Medical interns (intervention group n = 16, control group n = 14) in Sweden participated in the study and a mixed method convergent parallel design was used. Quantitative data was collected at baseline and 6 months post-intervention using a questionnaire (the REAGERA-P). Qualitative interviews were conducted with four of the participants in the intervention group and data was analysed using qualitative content analysis.

Results: The reported frequency of asking older patients questions about abuse increased in the intervention group (p = 0.047), but not the control group (p = 0.38) post-intervention. Potential mediators for the improvement were an increased awareness of elder abuse and higher self-efficacy for asking questions about elder abuse. Participants also reported a higher perceived ability to manage cases of elder abuse, even though uncertainties concerning how to provide the best possible care remained. The qualitative interviews indicated that learning from each other in group discussions and forum theatre likely was an important contributor to the positive results.

Conclusion: This pilot test indicated that the educational model may be effective in improving health care providers' preparedness to care for older adults subjected to abuse. However, uncertainties about how to handle elder abuse cases remained post-intervention. In a future full-scale test of the model more focus needs to be put on how to manage cases of elder abuse.

Keywords: Forum play; Forum theatre; Intimate partner violence; Medical education.

Fig. 1

Overview of results. Quantitative data collected at baseline and 6-month follow-up in both the intervention and control groups (blue), and qualitative data collected post-intervention (green). Both the propensity to ask older patients questions about abuse and providers’ perceived ability to manage the response (yellow arrows) were improved in the intervention group at follow-up. The change was possibly mediated by an increased self-efficacy for asking questions and a higher awareness about the issue. Also, the results indicated that the perceived ability to manage the response affected the propensity for asking questions