Scientific evidence of the violence against the older adult: an integrative review

Ribeiro, Maria de Nazaré de Souza; Santo, Fátima Helena do Espírito; Diniz, Cleisiane Xavier; Araújo, Karla Brandão de; Lisboa, Maressa Gasparoto Lenglube; Souza, Cássia Rozária da Silva

doi:10.37689/acta-ape/2021AR00403

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Review Article • Acta Paul Enferm. 34 • 2021 • https://doi.org/10.37689/acta-ape/2021AR00403 linkcopy

Scientific evidence of the violence against the older adult: an integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective: To analyze the scientific evidence of violence against the older adult, with emphasis on the prevalence, the profile of the victim, and the risk factors.

Methods: An integrative review of articles available in the PubMed® databases, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Nursing Database (BDENF), Scientific Electronic Library Online (SciELO) and Latin American and Caribbean Research on Health Sciences (LILACS), published between 2015 and 2019, using the descriptors: “idoso” , “older adult”, “older person”, “aged”, “old”, “exposure to violence”, “ exposição à violência ”, “aging”, envelhecimento” , “elder abuse”, “domestic violence”, “violence”, “ violência”, “maus-tratos ao idoso” and “violência doméstica” . As to refine it, the four phases of the PRISMA study selection flow diagram were used.

Results: 17 articles were identified which presented as increased risk factors for violence against the older adult, family dysfunction, lack of access to social rights and chronic conditions of disability.

Conclusion: The study brings direct contributions to professionals and sectors interested in facing violence against the older adult, which has a high prevalence in today's society.

Keywords
Violence; Aged; Domestic violence; Exposure to violence; Frail elderly

Acronym	Descriptors
P – Population: older adult	Idoso , older adult , older person, aged e old
I – Intervention/Exposure: intrafamily violence	Exposure to violence, exposição à violência , aging, envelhecimento
Co – Outcome/Results/Context: mistreatment, occurrence of violence	Elder abuse, domestic violence, violence, violência, maus-tratos ao idoso, violência doméstica

Year	Title of the Study	Journal	Country	Authors	Database
2019	A1: Violência sobre a pessoa idosa: um estudo documental	Revista Rene Online	Brazil	Alarcon et al.⁽¹²⁾	BDENF
2019	A2: A ocorrência da violência em idosos e seus fatores associados	Revista Brasileira de Enfermagem	Brazil	Maia et al.⁽¹³⁾	LILACS
2018	A3: Funcionalidad familiar y autoestima del adulto mayor, en situación de maltrato. Un estudio participativo comunitário	Revista Lasallista de Investigatión	Ecuador	Chiriboga et al.⁽¹⁴⁾	SciELO
2018	A4: Violência familiar contra a pessoa idosa: expressões do fenômeno e perspectivas para o seu enfrentamento	Textos & Contextos	Brazil	Diel et al.⁽¹⁵⁾	SciELO
2018	A5: Violência contra a pessoa idosa	Revista de Enfermagem UFPE Online	Brazil	Lopes et al.⁽¹⁶⁾	BDENF
2018	A6: Prevalência e fatores associados à violência contra idosos cometida por pessoas desconhecidas, Brasil, 2013	Epidemiologia e Serviços de Saúde	Brazil	Alencar Júnior et al.⁽¹⁷⁾	LILACS
2018	A7: Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial	Clinical Interventions in Aging	Iran	Estebsari et al.⁽¹⁸⁾	PubMed®
2018	A8: Feasibility of intervention in elder self-neglecters: Setting the stage for future research	Journal of Elder Abuse & Neglect	The United States of America	Lee et al⁽¹⁹⁾	PubMed®
2018	A9: Frailty and life course violence: The international mobility in aging study	Archives of Gerontology and Geriatrics	Albania, Brazil, Canada and Colombia	Gomes et al.⁽²⁰⁾	PubMed®
2017	A10: Collective violence and the health of the elderly: a cross-sectional analysis of a population-based national survey in Mexico	Revista Panamericana de Salud Pública	Mexico	García-Peña et al.⁽²¹⁾	SciELO
2017	A11: Cross-sectional study on the association between frailty and violence against community-dwelling elderly people in Brazil	São Paulo Medical Journal	Brazil	Belisário et al.⁽²²⁾	PubMed®
2017	A12: Associations between the differential definitions of elder mistreatment and suicidal ideation outcomes in U.S. Chinese older adults: do the definitions matter?	Journals of Gerontology. Series A, Biological Sciences and Medical Sciences	The United States of America	Dong⁽²³⁾	PubMed®
2017	A13: Elder abuse within the family environment in the Azores Islands	Revista Latino-Americana de Enfermagem	Portugal	Carmona-Torres et al.⁽²⁴⁾	LILACS
2016	A14: The prevalence of resident-to-resident elder mistreatment in nursing homes	Annals of Internal Medicine	The United States of America	Lachs et al.⁽²⁵⁾	PubMed®
2016	A15: Prevalência de violência contra idosos e fatores associados, estudo de base populacional em Florianópolis, SC	Revista Brasileira de Geriatria e Gerontologia	Brazil	Bolsoni et al.⁽²⁶⁾	LILACS
2015	A16: Estudo sobre pessoas idosas vítimas de violência em Portugal: sociografia da ocorrência	Cadernos de Saúde Pública	Portugal	Gil et al.⁽²⁷⁾	LILACS
2015	A17: Physical abuse against elderly persons in institutional settings	Journal of Forensic and Legal Medicine	Portugal	Frazão et al.⁽²⁸⁾	PubMed®

Study	Study design/EL	Objective	Results and conclusions/outcome
A1⁽¹²⁾	Cross-sectional, analytical and retrospective (EL4)	To associate the sociodemographic characteristics of older adult victims of violence and aggressors with the types of violence	Association between type of violence and sex, marital status, education, age, place of occurrence and the victim's form of notification; predominance of financial violence in men and psychological/moral violence in women
A2⁽¹³⁾	Cross-sectional, by population survey (EL4)	To analyze the occurrence of violence against the older adult and associated factors	Forms of violence: little access to social rights, verbal, moral/psychological violence, lack of care. Women are the most frequent victims; association with depressive symptoms
A3⁽¹⁴⁾	Quantitative, correlation scope and cross-sectional (EL4)	To determine the correlation between family functioning and self-esteem of adults and the older adult in situations of abuse	A correlation was found between self-esteem, family functionality and situations of abuse
A4⁽¹⁵⁾	Descriptive, quantitative and documentary (EL4)	To analyze expressions of family violence against the older adult and the perspectives of its confrontation	Main victims: older adult women, widows, with relative economic autonomy, dependent on health care by the family
A5⁽¹⁶⁾	Quantitative, epidemiological and cross-sectional (EL4)	To evaluate the occurrence of violence suffered by the older adult	Prevalence of physical violence, by non-self-inflicted injuries, performed by children and spouses
A6⁽¹⁷⁾	Quantitative and cross-sectional (EL4)	To analyze the association between sociodemographic, behavioral and health characteristics; and prevalence of violence committed by strangers	Sociodemographic characteristics were associated with violence against the older adult committed by strangers
A7⁽¹⁸⁾	Controlled and randomized (EL2)	Design and implement an empowerment educational intervention to prevent abuse of the older adult	Social support, self-efficacy and health promoting behaviors are determinants in reducing the risk of abuse of the older adult
A8⁽¹⁹⁾	Randomized controlled trial (EL2)	To carry out clinical interventions to improve critical situations of older adult people who neglect themselves	The clinical intervention made it possible to improve the participation of the older adult in self-neglect prevention programs
A9⁽²⁰⁾	Quantitative and cross-sectional (EL4)	To estimate the prevalence of frailty; investigate associations between domestic violence and frailty throughout life	The prevalence of frailty and risk of abuse varied among the cities studied, being lowest in Canada and highest in Brazil. Physical abuse in childhood and exposure to psychological violence by the partner were associated with depression
A10⁽²¹⁾	Quantitative and cross-sectional (EL4)	To describe the association between collective violence and the health of the older adult in Mexico	Collective violence has an indirect influence on the health of the population, mainly older adult
A11⁽²²⁾	Cross-sectional, analytical and observational (EL4)	To check the association between violence against the older adult and frailty syndrome	Association between income and physical aggression; living with another person and dependence for IADL and physical and verbal aggression; diseases and physical and/or verbal aggression
A12⁽²³⁾	Quantitative and epidemiological (EL4)	To explore the association between abuse and suicidal ideation in older adult Chinese living in Chicago	Maltreatment psychological, financial abuse and neglect were associated suicidal ideation
A13⁽²⁴⁾	Descriptive and cross-sectional (EL4)	To dimension abuse against vulnerable older adult people in the family and community environment	Prevalence of psychological violence; children as main aggressors; being a woman and belonging to a dysfunctional family are more likely to abuse
A14⁽²⁵⁾	Observational and prevalence (EL4)	To estimate the prevalence of physical, verbal, and sexual abuse in nursing home residents	Prevalence of 20.2%; verbal, physical and sexual violence. Associated factors: cognitive impairment and institutionalized older adult
A15⁽²⁶⁾	Cross-sectional and population-based (EL4)	To estimate prevalence of violence against the older adult and association with demographic, socioeconomic and health factors	Prevalence of verbal violence; older adult woman, single/divorced, greater chance of abuse; living with children or grandchildren twice increases the chance of abuse
A16⁽²⁷⁾	Quantitative, descriptive and cross-sectional (EL4)	To characterize the sociodemographic, economic structure and conditions of violence in the older adult family context	Prevalence of physical and psychological violence. The victims were women, aged 70.7 years and their aggressors were family members
A17⁽²⁸⁾	Quantitative and retrospective (EL4)	To provide knowledge about physical abuse against institutionalized older adult and correct detection of the forensic diagnosis	Prevalence in women ≥75 years, with severe disability and communication difficulties; association between neglect and disability

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[TFN3] Source: Polit DF, Beck CT. Fundamentos da pesquisa em enfermagem: avaliação de evidências para a prática de enfermagem. 9ᵃ ed. Porto Alegre: ArtMed; 2018.⁽¹⁰⁾