ABSTRACT

The Geriatric Emergency Care Applied Research (GEAR) Network (1) conducted a scoping review of the current literature on the identification of and interventions to address elder abuse among patients receiving care in emergency departments and (2) used this review to prioritize research questions for knowledge development. Two questions guided the scoping review: What is the effect of universal emergency department screening compared to targeted screening or usual practice on cases of elder abuse identified, safety outcomes, and health care utilization?; and What is the safety, health, legal, and psychosocial impact of emergency department-based interventions vs. usual care for patients experiencing elder abuse? We searched five article databases. Additional material was located through reference lists of identified publications, PsychInfo, and Google Scholar. The results were discussed in a consensus conference; and stakeholders voted to prioritize research questions. No studies were identified that directly addressed the first question regarding assessment strategies, but four instruments used for elder abuse screening in the emergency department were identified. For the second question, we located six articles on interventions for elder abuse in the emergency department; however, none directly addressed the question of comparative effectiveness. Based on these findings, GEAR participants identified five questions as priorities for future research – two related to screening, two related to intervention, and one encompassed both. In sum, research to identify best practices for elder abuse assessment and intervention in emergency departments is still needed. Although there are practical and ethical challenges, rigorous experimental studies are needed.

摘要

老年急救护理应用研究 (GEAR) 网络 (1) 对当前关于在急诊科接受护理的患者中虐待老人的识别和干预措施的文献进行了范围界定审查，并且 (2) 使用该审查来确定研究问题的优先顺序知识发展。两个问题指导了范围界定审查：与针对性筛查或常规做法相比，普遍的急诊科筛查对确定的虐待老人案例、安全结果和医疗保健利用有何影响？以急诊科为基础的干预与常规护理对遭受虐待的患者的安全、健康、法律和心理社会影响是什么？我们搜索了五个文章数据库。其他材料通过已识别出版物的参考列表找到，PsychInfo，和谷歌学术。结果在共识会议上进行了讨论；利益相关者投票决定优先研究问题。没有发现直接解决关于评估策略的第一个问题的研究，但确定了四种用于急诊科虐待老人筛查的工具。对于第二个问题，我们找到了六篇关于急诊科虐待老人干预的文章；然而，没有一个直接涉及比较有效性的问题。基于这些发现，GEAR 参与者确定了五个问题作为未来研究的重点——两个与筛查相关，两个与干预相关，一个包含两者。总而言之，仍然需要研究以确定急诊部门虐待老人评估和干预的最佳实践。