Abstract
Background
Elder abuse is a prevalent and growing social problem with significant consequences
on victims' mental and physical health. Unfortunately, many cases of elder abuse go
unreported. Elderly women are at increased risk for abuse and, as such, obstetrician-gynecologists
(OB/GYNs) are in a unique position to screen for and report abuse. This study intended
to determine OB/GYNs' knowledge, attitudes, and practice regarding elder abuse.
Methods
Two hundred Fellows and Junior Fellows of the American College of Obstetricians and
Gynecologists (ACOG) received a survey. Analysis was completed with SPSS 20.0. In
addition to descriptive statistics, χ2 analyses were used to determine differences between groups.
Findings
In total, 122 fellows responded (61%). Abuse screening rates differed by abuse type.
Few “always” screen for abuse, with half assessing only when it is suspected. Most
(81%) had never reported a case of abuse. Younger males reported different clinical
practice patterns than other groups. Generally, OB/GYNs were knowledgeable about risk
factors and facts about elder abuse, but several knowledge gaps were identified. Most
reported that elder abuse screening is within their professional purview. Half of
the respondents cited time constraints as a barrier to screening.
Conclusions
Greater education about elder abuse screening is needed. Specifically, training regarding
available valid and brief screening tools, local abuse reporting laws, and available
community resources. This study identified the potential need to target younger male
OB/GYNs for additional training.
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References
- Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The National Elder Mistreatment Study.American Journal of Public Health. 2010; 100: 292-297
- National Elder Mistreatment Study.National Criminal Justice Reference Service, Rockville, MD2009 (Available from:)
American College of Obstetricians and Gynecologists (ACOG). (2005, February 6). The scope of practice of obstetrics and gynecology. Available from: http://www.acog.org/About%20ACOG/Scope%20of%20Practice.aspx.
- Committee opinion: Elder abuse and women's health. Committee Opinion 568.Author, Washington, DC2013
- Diagnostic and treatment guidelines on elder abuse and neglect.Author, Washington, DC1992
- Elder abuse and neglect: in search of solutions.Author, Washington DC2012 (Available from:)
- Medical error reporting, patient safety, and the physician.Journal of Patient Safety. 2009; 5: 176-179
- Mortality risk associated with physical and verbal abuse in women aged 50 to 79.Journal of the American Geriatrics Society. 2009; 57: 1799-1809
- Screening tools and referral protocol for stopping abuse against older Ohioans: A guide for service providers.Journal of Elder Abuse & Neglect. 2001; 13: 23-38
- Cesarean delivery on maternal request: Obstetrician-gynecologists' knowledge, perception, and practice patterns.Obstetrics & Gynecology. 2007; 109: 57-66
- Use of a single page elder abuse assessment and management tool: A practical clinician's approach to identifying elder mistreatment.Journal of Gerontological Social Work. 2006; 46: 103-122
- Elder abuse and neglect: Definitions, epidemiology, and approaches to emergency department screening.Clinics in Geriatric Medicine. 2013; 29: 257-273
- Factors associated with self-reported elder mistreatment in Iowa's frailest elders.Research on Aging. 2006; 28: 562-581
- Rape, robbery, and burglary: Responses to actual and feared criminal victimization, with special focus on women and the elderly.Victimology. 1985; 10: 325-358
- Intimate partner violence and physical health consequences.Archives of Internal Medicine. 2002; 162: 1157-1163
- Elder abuse: Is every bruise a sign of abuse?.Mount Sinai Journal of Medicine. 2003; 70: 69-74
- Elder abuse, neglect, and exploitation: Risk factors and prevention strategies.Journal of Gerontological Social Work. 2000; 33: 5-25
- Mistreatment and self-reported emotional symptoms: Results from the National Elder Mistreatment Study.Journal of Elder Abuse & Neglect. 2012; 24: 216-230
- Physical and mental health effects of intimate partner violence for men and women.American Journal of Preventive Medicine. 2002; 23: 260-268
- Contemporary clinical issues in outpatient obstetrics and gynecology: Findings of the Collaborative Ambulatory Research Network, 2001-2004: Part II.Obstetrical & Gynecological Survey. 2004; 59: 787-794
- Psychological distress in victims of elder mistreatment: The effects of social support and coping.Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 1999; 54: P240-P245
- Barriers to screening sexually active adolescent women for chlamydia: A survey of primary care physicians.Journal of Adolescent Health. 2001; 28: 204-210
- Abuse of vulnerable people with dementia by their carers: Can we identify those most at risk.International Journal of Geriatric Psychiatry. 2006; 21: 564-571
- Evidence-based practice guideline-elder abuse prevention.Journal of Gerontological Nursing. 2011; 37: 11-17
- Medical implications of elder abuse and neglect.Clinics in Geriatric Medicine. 2005; 21: 293-313
- Elder abuse and mortality: The role of psychological and social wellbeing.Gerontology. 2010; 57: 549-558
- Elder self-neglect and abuse and mortality risk in a community-dwelling population.Journal of the American Medical Association. 2009; 302: 517-526
- Prospective study of the elder self-neglect and ED use in a community population.American Journal of Emergency Medicine. 2012; 30: 553-561
- The high prevalence of depression and dementia in elder abuse or neglect.Journal of the American Geriatrics Society. 2000; 48: 205-208
- Sex differences among obstetrician-gynecologists: A review of survey studies.Obstetrical & Gynecological Survey. 2013; 68: 235-253
- Accuracy of 3 brief screening questions for detecting partner violence in the emergency department.JAMA. 1997; 277: 1357-1361
- HALF—A tool to assess elder abuse within the family.Geriatric Nursing. 1983; 4: 301-304
- The extent and frequency of abuse in the lives of older women and their relationship with health outcomes.Gerontologist. 2006; 46: 200-209
- Methods to reduce social desirability bias in sex surveys in low-development settings: Experience in Zimbabwe.Sexually Transmitted Disease. 2002; 29: 568-575
- Recognizing and reporting elder abuse and neglect.Geriatrics. 2009; 64: 13-18
- American Medical Association white paper on elderly health: Report of the Council on Scientific Affairs.Archives of Internal Medicine. 1990; 150: 2459-2472
- The assessment of spouse abuse: Two quantifiable dimensions.Journal of Marriage and the Family. 1981; 43: 873-885
- Elder abuse and neglect: The experience, knowledge, and attitudes of primary care physicians.Family Medicine. 2005; 37: 481
- The world report on violence and health.Lancet. 2002; 360: 1083-1088
- Under the radar: New York State elder abuse prevalence study.New York State Office of Children and Family Services, Rensselaer, NY2011
- Elder abuse.Lancet. 2004; 364: 1263-1272
- Risk factors for reported elder abuse and neglect: a nine-year observational cohort study.Gerontologist. 1997; 37: 469-474
- The mortality of elder mistreatment.JAMA. 1998; 280: 428-432
- Elder mistreatment in the United States: Prevalence estimates from a nationally representative study.Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2008; 63: S248-S254
- A comparison of self-report and chart audit in studying resident physician assessment of cardiac risk factors.Journal of General Internal Medicine. 1995; 10: 194-198
- Eating disorders and obstetric-gynecologic care.Journal of Women's Health. 2009; 18: 1395-1401
- Gynecologic health consequences to victims of interpersonal violence.Women's Health Issues. 1999; 9: 115-120
- Elder mistreatment in the nursing home: A systematic review.Journal of the American Medical Directors Association. 2007; 8: 610-616
- Why do patients of female physicians have higher rates of breast and cervical cancer screening?.Journal of General Internal Medicine. 1997; 12: 34-43
- Identification of abuse in emergency departments: effectiveness of a two-question screening tool.Journal of Emergency Nursing. 1995; 21: 391-394
- Agreement of self-reported comorbid conditions with medical and physician reports varied by disease among end-stage renal disease patients.Journal of Clinical Epidemiology. 2007; 60: 634-642
- Broken trust: Elders, families and finances, March 2009.MetLife, New York2009 (Retrieved from:)
- Delivery of STD/HIV preventive services to adolescents by primary care physicians.Journal of Adolescent Health. 1996; 19: 249-257
- Problem-oriented diagnosis: Health screening in older women.American Family Physician. 1999; 59: 1835
- Prevalence and 3-year incidence of abuse among postmenopausal women.American Journal of Public Health. 2004; 94: 605-612
- Impact of self-reported familiarity with guidelines for cystic fibrosis carrier screening.Obstetrics & Gynecology. 2005; 105: 1355-1361
- Obstetrician-gynecologists' practices regarding preterm birth at the limit of viability.Journal of Maternal-Fetal and Neonatal Medicine. 2008; 21: 115-121
- Obstetrician-gynecologists' knowledge of preterm birth frequency and risk factors.Journal of Maternal Fetal Neonatal Medicine. 2008; 20: 895-901
- Sexual assault of the elderly victim.Journal of Interpersonal Violence. 1992; 7: 70-76
- The national elder abuse incidence study: Final report.U.S. Department of Health and Human Services, Washington DC1998
- Health, United States, 2012: With special feature on emergency care.Author, Hyattsville, MD2013
National Committee for the Prevention of Elder Abuse. (2005). White House Conference on Aging: Post-event summary report. Available from: http://www.preventelderabuse.org/whcoaging2005.html.
- The 2004 survey of state Adult Protective Services: Abuse of adults 60 years of age and older.National Center on Elder Abuse, Washington, DC2006
- Bonnie R.J. Wallace R.B. Elder mistreatment: Abuse, neglect, and exploitation in an aging America. National Academies Press, Washington, DC2003
- Validation of the Hwalek-Sengstock elder abuse screening test.Journal of Applied Gerontology. 1991; 10: 406-418
- Methods of coping with social desirability bias: A review.European Journal of Social Psychology. 1985; 15: 263-280
- Physician reporting compared with medical-record review to identify adverse medical events.Annals of Internal Medicine. 1998; 119: 870-876
- Gender differences in provider's use of a standardized screening tool for prenatal substance use.Journal of Addiction Medicine. 2011; 5: 36-42
- Elder abuse: Dermatologic clues and critical solutions.Journal of the American Academy of Dermatology. 2013; 68: e37-e42
- Elder abuse in long-term care: Types, patterns, and risk factors.Research on Aging. 2010; 32: 323-348
- Obesity prevention and treatment practices of U.S. obstetrician-gynecologists.Obstetrics & Gynecology. 2006; 108: 961-968
- Validation of the indicators of abuse (IOA) screen.Gerontologist. 1998; 38: 471-480
- Mandatory reporting of elder abuse: Between a rock and a hard place.The Annals of Family Medicine. 2006; 4: 403-409
- Reporting mistreatment of older adults: The role of physicians.Journal of the American Geriatrics Society. 1996; 44: 65
- Health care professionals' perspectives on barriers to elder abuse detection and reporting in primary care settings.Journal of Elder Abuse & Neglect. 2012; 24: 17-36
- Validity of self-report screening scale for elder abuse: Women's Health Australia Study.Gerontologist. 2003; 43: 110-120
- Three year health outcomes among older women at risk of elder abuse: Women's Health Australia.Quality of Life Research. 2004; 13: 1043-1052
- Mortality and disability outcomes of self-reported elder abuse: A 12-year prospective investigation.Journal of the American Geriatrics Society. 2013; 61: 679-685
- Screening for vulnerability to abuse among older women: Women's Health Australia Study.Journal of Applied Gerontology. 2002; 21: 24-39
- Behavioral health services utilization among older adults identified within a state abuse hotline database.Gerontologist. 2006; 46: 193-199
- Identifying older people at risk of abuse during routine screening practices.Journal of the American Geriatrics Society. 2003; 51: 24-31
- Elder abuse: Screening, intervention, and prevention.Nursing. 2012; 42: 24-29
- Sexual assault and physical health: Findings from a population-based study of older adults.Psychosomatic Medicine. 2000; 62: 838-843
- Assessing barriers to the identification of elder abuse and neglect: A communitywide survey of primary care physicians.Journal of the National Medical Association. 2006; 98: 403
- Speaking out on a silent crime-elder sexual abuse: The dynamics of problem and community-based solutions.National Center on Elder Abuse Newsletter. 2004; 6: 2-3
Virginia Department of Social Services. (2002). Adult protective services: Identifying and preventing adult abuse, neglect and exploitation. Available from: http://www.dss.virginia.gov/files/about/reports/adults/adult_services_annual/aps_2002.pdf.
- Elder abuse education in residency programs: How well are we doing?.Academic Medicine. 2009; 84: 611-618
- Development and validation of a tool to improve physician identification of elder abuse: The Elder Abuse Suspicion Index (EASI)©.Journal of Elder Abuse & Neglect. 2008; 20: 276-300
Biography
Meaghan A. Leddy, PhD, is an Assistant Professor in the Department of Psychiatry at Yale University School of Medicine. Her research interests include women's mental health, and she has published articles on obstetrician-gynecologists' knowledge, attitudes, and practice related to psychiatric concerns.
Biography
Victoria A. Farrow, MA, is a Doctoral Candidate in Clinical Psychology at American University. Her research interests include workload, stress, and psychological health among physicians.
Biography
Jay Schulkin, PhD, is the Director of Research at American College of Obstetricians and Gynecologists. His research interests include women's health, mental health, and behavioral endocrinology.
Article info
Publication history
Accepted:
April 21,
2014
Received in revised form:
April 3,
2014
Received:
December 8,
2013
Identification
Copyright
© 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
