Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 7;25(1):1687.
doi: 10.1186/s12889-025-22580-z.

Certified nursing assistants' perceptions of and suggestions to prevent elder abuse in residential aged care facilities: a qualitative study in Hunan Province, China

Chunhong Shi  1 , Xiya Li  1 , Ming Chen  1 , Yu Li  1 , Sirui Fu  1 , Yinhua Zhang  2
Affiliations

Certified nursing assistants' perceptions of and suggestions to prevent elder abuse in residential aged care facilities: a qualitative study in Hunan Province, China

Chunhong Shi et al. BMC Public Health. .

Abstract

Background: Staff-to-resident abuse in institutional settings demands political attention and evidence-based interventions. Certified nursing assistants (CNAs) views and suggestions on preventing elder abuse can offer practical and policy-relevant insights. This study explores CNAs' perceptions and strategies to address elder abuse in institutional care.

Methods: Sixteen CNAs from residential aged care facilities (RACFs) in Hunan Province, China, were purposively sampled. Semi-structured qualitative interviews were conducted, and transcripts were analysed using content analysis.

Results: CNAs demonstrated a surface-level understanding of elder abuse, including its types, causes, and interventions. However, they provided detailed suggestions through an ecological-systems lens. At the microsystem level, strengthening staff professionalism and empathy was noted as critical, while the mesosystem involved enhancing institutional management. At the macrosystem level, suggested strategies included boosting social support, such as developing the senior care sector, increasing senior benefits, and strengthening legal safeguards.

Conclusion: This study highlights CNAs' limited understanding of elder abuse and presents actionable recommendations for policy and practice. The gap between their perceptions and the ability to ensure abuse-free care underlines the need for evidence-based training and standardised reporting systems. Strengthening staffing quality, institutional leadership, and community support within an ecological-systems framework is essential to reduce elder abuse and promote safe, respectful care environments for older adults.

Keywords: Elder abuse; Mistreatment; Nursing home; Nursing staff; Older adults.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Medical Ethics Committee of Xiangnan University (No. 2024YXLL004) and conducted in accordance with the principles of the Declaration of Helsinki. All participants provided written informed consent prior to participation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

References

    1. Yon Y, Ramiro-Gonzalez M, Mikton CR, Huber M, Sethi D. The prevalence of elder abuse in institutional settings: a systematic review and meta-analysis. Eur J Public Health. 2019;29(1):58–67. - PMC - PubMed
    1. World Health Organization. Abuse of older people. Available from: https://www.who.int/news-room/fact-sheets/detail/abuse-of-older-people. Accessed 20 February 2025.
    1. Gholipour F, Khalili Z, Abbasian M. Definitions and Theories of Elder Abuse. Eld Health J. 2020;6(2):140–5.
    1. Gong H. Study on Elderly Abuse in Residential Aged Care Facilities. Master dissertation. Southwest University of Political Science and Law, Chongqing; 2021. 10.27422/d.cnki.gxzfu.2021.001167.
    1. Ding H, Chen YJ, Li WT, Liu YX. Prevalence and associated factors of abuse of ageing demented individuals in elder-care institutions. J Nurs Sci. 2019;34:15–8.

LinkOut - more resources