The definition and understanding of elder abuse and neglect in nursing homes can vary in different jurisdictions as well as among health care staff, researchers, family members and residents themselves. Different understandings of what constitutes abuse and its severity make it difficult to compare findings in the literature on elder abuse in nursing homes and complicate identification, reporting, and managing the problem. Knowledge about nursing home leaders’ perceptions of elder abuse and neglect is of particular interest since their understanding of the phenomenon will affect what they signal to staff as important to report and how they investigate adverse events to ensure residents’ safety. The aim of the study was to explore nursing home leaders’ perceptions of elder abuse and neglect. A qualitative exploratory study with six focus group interviews with 28 nursing home leaders in the role of care managers was conducted. Nursing home leaders’ perceptions of different types of abuse within different situations were explored. The constant comparative method was used to analyse the data. The results of this study indicate that elder abuse and neglect are an overlooked patient safety issue. Three analytical categories emerged from the analyses: 1) Abuse from co-residents: ‘A normal part of nursing home life’; resident-to-resident aggression appeared to be so commonplace that care leaders perceived it as normal and had no strategy for handling it; 2) Abuse from relatives: ‘A private affair’; relatives with abusive behaviour visiting nursing homes residents was described as difficult and something that should be kept between the resident and the relatives; 3) Abuse from direct-care staff: ‘An unthinkable event’; staff-to-resident abuse was considered to be difficult to talk about and viewed as not being in accordance with the leaders’ trust in their employees. Findings in the present study show that care managers lack awareness of elder abuse and neglect, and that elder abuse is an overlooked patient safety issue. The consequence is that nursing home residents are at risk of being harmed and distressed. Care managers lack knowledge and strategies to identify and adequately manage abuse and neglect in nursing homes.

中文翻译：

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虐待和忽视老年人：患者安全问题被忽视。养老院领导者对老年人虐待和忽视观念的焦点小组研究

在不同的辖区以及医护人员，研究人员，家庭成员和居民本人之间，对疗养院中虐待和忽视老年人的定义和理解可能会有所不同。对虐待的构成及其严重性的不同理解使得很难比较文献中关于养老院虐待老人的发现，并使识别，报告和处理问题变得复杂。尤其需要了解养老院领导者对虐待和忽视老年人的看法，因为他们对现象的理解将影响他们向员工传达的重要报告信息，以及他们如何调查不良事件以确保居民安全。该研究的目的是探索养老院领导者对老年人虐待和忽视的看法。进行了定性探索性研究，对28位疗养院负责人在护理经理中的作用进行了六个专题小组访谈。探索了疗养院领导者在不同情况下对不同类型的虐待的看法。常数比较法用于分析数据。这项研究的结果表明，虐待和忽视老年人是一个被忽视的患者安全问题。分析得出三个分析类别：1）共同居住者的虐待：“养老院生活的正常部分”；居民之间的侵略似乎司空见惯，以致护理领导者认为这是正常现象，没有应对策略。2）虐待亲戚：“私事”；有虐待行为的亲戚到疗养院居民那里探访被认为是困难的，应在居民和亲戚之间保留一些东西；3）虐待直接护理人员：“不可想象的事件”；人们认为很难谈论员工对居民的虐待，并且被视为不符合领导者对员工的信任。本研究的发现表明，护理经理缺乏对老年人虐待和忽视的意识，而老年人虐待是一个被忽视的患者安全问题。结果是疗养院居民有受到伤害和困扰的风险。护理经理缺乏识别和适当管理疗养院中虐待和忽视行为的知识和策略。人们认为很难谈论员工对居民的虐待，并且被认为不符合领导者对员工的信任。本研究的发现表明，护理管理人员缺乏对老年人虐待和忽视的意识，而老年人虐待是一个被忽视的患者安全问题。结果是疗养院居民有受到伤害和困扰的风险。护理经理缺乏识别和适当管理疗养院中虐待和忽视行为的知识和策略。人们认为很难谈论员工对居民的虐待，并且被认为不符合领导者对员工的信任。本研究的发现表明，护理管理人员缺乏对老年人虐待和忽视的意识，而老年人虐待是一个被忽视的患者安全问题。结果是疗养院居民有受到伤害和困扰的风险。护理经理缺乏识别和适当管理疗养院中虐待和忽视行为的知识和策略。结果是疗养院居民有遭受伤害和困扰的风险。护理经理缺乏识别和适当管理疗养院中虐待和忽视行为的知识和策略。结果是疗养院居民有受到伤害和困扰的风险。护理经理缺乏识别和适当管理疗养院中虐待和忽视行为的知识和策略。