Correction: Comparison of perceptions of domestic elder abuse among healthcare workers based on the Knowledge-Attitude-Behavior (KAB) model.

[This corrects the article DOI: 10.1371/journal.pone.0206640.].

Development and Validity Testing of an Assessment Tool for Domestic Elder Abuse.

BACKGROUND: The older adult population is increasing in number, and elder abuse is expected to become a more pressing problem. Developing tools to assess the presence and severity of elder abuse is important to both effectively prevent this abuse and provide increased support for families. PURPOSE: This study was intended to test the validity of an Assessment Tool for Domestic Elder Abuse (ATDEA). The items that constitute this tool were derived from a literature review. METHODS: Two rounds of self-administered questionnaire surveys were conducted with nurses working at home-visit nursing stations. Round 1 was used to evaluate the face validity, and Round 2 was used to test the content using the content validity index (CVI). RESULTS: Two hundred forty nurses participated in the two studies. In Round 1, 56 nurses evaluated 38 items derived from a literature review, resulting in the development of a 36-item ATDEA. In Round 2, 184 nurses evaluated the content validity of the 36-item ATDEA. The Item-CVI (I-CVI) scores ranged from .61 to 1. Twenty-eight of the items met or exceeded the I-CVI threshold of .78, whereas the eight items assessing self-neglect did not. The overall Scale-CVI score for the assessment tool was .90, which met the threshold of .90. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results of validity testing established the preliminary validity of this assessment tool. In addition, as self-neglect is known to damage the well-being of older adults, six of the eight items assessing self-neglect were retained in the ATDEA despite their failure to meet the threshold I-CVI of .78. The remaining two self-neglect items were not included in the ATDEA because of excessively low I-CVI scores (< .70). Thus, the final version of the ATDEA includes 34 items. The authors recommend that nursing professionals use the ATDEA as a checklist to assess the presence of elder abuse and to discern the subtypes and severity of this abuse. When evaluating elder abuse, the higher the degree of severity, the greater the urgency to provide support.

Comparison of perceptions of domestic elder abuse among healthcare workers based on the Knowledge-Attitude-Behavior (KAB) model.

It is generally agreed that healthcare workers are ideally positioned to recognize and diagnose cases of elder abuse. However, little is known about their knowledge and understanding of this issue. The objective of this study was to assess and compare the perceptions of different groups of healthcare workers toward elder abuse in Japan, using the Knowledge-Attitude-Behavior (KAB) model. Home-visit nurses, medical doctors, care managers, care workers, public health nurses, and social workers, with experience of dealing with elder abuse received self-administered questionnaire surveys that inquired regarding demographics, knowledge, attitudes, and behaviors regarding elder abuse. A total of 311 healthcare workers participated in this survey. To compare the differences among the groups, a one-way analysis of variance with a post-hoc Tukey's test, and a Kruskal-Wallis with post-hoc Steel-Dwass tests were used in accordance with data normality. Multiple linear regression analysis was conducted to explore variables that predicted the healthcare workers' perceptions, and covariance structure analysis was used to examine whether the KAB model can accurately predict healthcare workers' perceptions. Multiple comparisons showed significant differences in knowledge, attitudes, and behaviors regarding elder abuse among the abovementioned six groups. Age, sex, and years of work related to the care of elderly were extracted as significant determinants of healthcare workers' perceptions of elder abuse. The examination of the KAB model with covariance structure analysis yielded a model with strong goodness-of-fit. These findings emphasize the need to take effective measures to improve their perceptions as well as review the role of each healthcare worker so that they can be more concerned with and involved in the safeguarding of the elderly. Given the strong goodness-of-fit demonstrated by the KAB model, education of healthcare workers on both the knowledge of, and attitudes toward, elder abuse may help in improving healthcare workers' behavior in dealing with elder abuse.