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Understanding the impact of prevention programs to eliminate abuse in elderly care homes is necessary to develop an overall idea about the utility of such protocols and programs in reducing incidence of abuses. Moreover, their impact on the well-being of elderly residents is essential to ensure that effective strategies are applied by the authority to provide those individuals with a safe environment. Understanding PIO or Population Intervention and Outcome in this context is also necessary to find effective solutions to the problems associated with abuse in such career homes. In this context, focus will be given to criticism into studies which includes a qualitative one to understand the experience of individuals regarding abuse as well as neglect especially in nursing homes in Norway and in this regard, a qualitative study has been considered. Cross- sectional study which is exploratory one has been chosen for understanding the context of abuse of elders in care settings in Norway. Effective frameworks have also been applied for critiquing these two articles and discussions having considered by analysing relevant data from different perspectives. Contribution of nursing practices in the global context have also been discussed.
Choice of subject
The ideas regarding the abuse and the impact of prevention programs and necessary protocols applicable in Norway have been considered as the central focus of this particular study. As per the views of Dalglish et al. (2020), it is crucial for researchers to make sure that they select a subject based on their significance in contemporary society. In this context, developing an overall idea about this particular topic can help in the process of dealing with a major concern that is abuse of elderly individuals in care homes. For instance, 11.5% of the cases have been registered in the UK which revolves around the problems of elder abuse (Fraga Domingues et al. 2022). The impact of abuse among older adults by an individual who holds a position of authority is supposed to be highlighted to understand how it affects those individuals. For instance, many female victims facing difficulty due to financial as well as psychological abuse have reached the helpline. On the other hand, the importance of implementing proper practice and policy is supposed to be taken into account by considering this particular subject area.
RQ
Does the implementation of prevention programs or necessary protocols to deal with increasing incidence of abuse positively have a positive impact on elderly individuals in care homes and ensure their wellbeing?
Population | Individuals belonging to the older age group residing in care homes in Norway have been considered. |
Intervention | Proper internet access and methods like applying protocols or programs regarding abuse prevention are supposed to be taken into account. |
Outcome | A decline in the incidence of abuse and enhancement of services among elderly individuals in care homes can be regarded as an effective outcome. |
Decline in incidence associated with abuse as well as enhancement of services among elderly individuals in care homes can be regarded as an effective outcome.
Table 1: Applying PIO framework
Paper 1
Link to paper: https://doi.org/10.1186/s12913-021-06713-9
Focus | Saga et al. (2021), has focused on a complex problem which is quite widespread in the care sector in Norway. For instance, the emphasis has been given to cognitive issues as well as frailty faced by the residents in NH or Nursing Homes as they are often incapable of sharing their experiences without any impediments. |
Background | 60% of the nursing staff have reported that they have encountered one or more than one incidence related to abuse of elderly once in care homes (Saga et al. 2021). The impact of self-determination and perceptions in the context of abuse is supposed to be understood to develop an overall idea about the impact of multiple levels of potential abuse (Nazir et al. 2021). In this particular study, the focus has been given to various determinants of neglect as well as abuse in 5 levels including chronosystem, societal relational individual and institutional. |
Aim | The major aim of this particular study is to raise voice against the oppression faced by the residents, especially the elderly ones in Nursing Homes in Norway by conducting an in-depth investigation regarding their experiences. |
Methodology/ broad approach | Broad qualitative design has been applied while creating this particular article. In this article, the focus has also been given to conducting a qualitative study to find out the impact of abuse among elderly care seekers in nursing homes. As per the views of Al Sadawi et al. (2021), researchers require focusing on various aspects including grounded theory, phenomenological or ethnographic aspects associated with qualitative approach depending on their requirement in a particular situation. In this study, the researcher has focused on meeting the aim of the study by accumulating necessary qualitative data from various sources. The authenticity as well as credibility of the sources are also supposed to be ensured to make sure that a particular study is capable of reaching the desired outcome (Zhang et al. 2021). In this study, the focus has been given to gathering data from primary sources to ensure credibility. |
Data accumulation tools | Primary sources have been utilised by conducting qualitative interviews of individuals who are relatives of the residence in nursing homes. In this context, 16 relatives of care seekers who have experienced abuse as well as or neglect during their stay in NH have been taken into consideration. Qualitative methods provide researchers with an opportunity to gain knowledge about human practice, expectations, different types of motives, attributes, experience and various thoughts (Lidegran et al. 2021). This can be helpful in developing an overall idea about the healthcare sector effectively. Keeping open-ended questions provide respondents with an opportunity to share information-rich descriptions from their experiences (Ifenthaler and Yau, 2020). In this regard, a narrative approach has been utilised while conducting those one-to-one interviews by considering SS, LEB and AS. Entire interview considered a focus group and improved it as per their comments provided to the open-ended questions. In this context, the directive approach has also been considered and audio records have been considered with their consent. Transcriptions of their verbatim by retaining pauses at relevant places and emotional experience has been considered. However, writing down the manuscript in full sentences has been considered to give those meaningful expressions. |
Method of interpreting data and overall presentation | In this article, content analysis has been applied to analyse the collected data from different points of views. Short keywords have been marked in order to create subsequent codes and imported to divide the data into code, categories and themes. The research analysis tool called Mind Manager 2020 has been utilised. This has helped in the process of saving valuable time. On the other hand, utilising proper technologists to consider upgrading their technical knowledge to ensure successful completion is necessary (Patil et al. 2021). Identifying themes and sub-themes have helped in the process of developing an overall insight about the topic. |
Sample | In this particular study, the sample size has been 16 as participants whose relatives have encountered difficulty due to abuse in NH in Norway have been considered. The sample size was enough to gather relevant information from each of the interviewees and the interview lasted for 50 to 90 minutes for each of them. As per the views of Opara et al. (2023), considering enough sample size is essential to make sure that adequate information about a certain matter has been gathered. On the other hand, dividing the entire interview in different segments based on demographic factors has been quite time consuming. |
Ethical consideration | Ethical approval has been provided by NCR or Norwegian Centre for Research along with proper registration number. As stated by Islam et al. (2024), the consent of all the interviewees are supposed to be taken into account to avoid any issues in the future. In this particular study, considering oral as well as written consent from the participants prior to conducting the interview has helped in the process of maintaining the ethical standard. Furthermore, personal details of the interviewees have been withheld. |
Main findings | The concept of resident abuse has been divided into segments including characteristics of abuse as per the perception of their relatives, the explanation provided by the relatives regarding the abuse faced by elders and the impact of elder abuse have been considered. As opined by Börner et al. (2020), abusive communication and maltreatments on the part of the relatives are also supposed to be highlighted in terms of elderly care in NH. Contrarily, Orru et al. (2022) argues that the paradoxical connection between missed care or neglect and the gap between practice and theory is supposed to be considered effectively. On the other hand, as an adverse impact of such abuse, elders often face difficulty as they develop depression or a kind of feeling which causes them to consider themselves to be objectified. |
Conclusion, as well as recommendations | This study concludes that elders in NH encounter different forms of abuse and they feel to be mistreated. However, this study has not included proper recommendations apart from considering requirements for developing committed partnership between NH and relatives to prevent risk factors associated with such abusive behaviours. |
Strengths and limitations | Negative aspects associated with abuse of elderly ones in NH have been highlighted. The purposive of sampling has been considered a major strength to involve relevant participants to get valid data. Problems associated with NH institutions including low quality care have not been addressed properly. |
Application to practice | The data gathered from this particular study can be affected in taking necessary steps to improve the quality of services provided to the elderly ones by eliminating abusive behaviours. The voiceless relatives and the service users are supposed to be communicated properly in order to undertake collaborative approaches in the future. |
Table 2: Applying framework for critiquing qualitative study
Paper 2
Link to the paper: https://doi.org/10.1186/s12913-019-4861-s
Focus | Botngård et al. (2021) has focused on the concept of elderly abuse in NH as a problem which leads to a global concern as well as HR or Human Rights related issues. The vulnerability of care seekers in elderly homes are supposed to be identified in advance to take necessary measures (Botngård et al. 2020). Different variables like observed employee-to-resident abuse, perpetrated abuse, psychological aspects that are aggregated by the staff can be considered. |
Background | As per CDC or Centers for Disease Control and Prevention Elder abuse is supposed to be regarded as a mis-treatment and it can be intentional as well as failure on the part of the caregiver. For instance, 32.5% have faced psychological abuse whereas 12.0% have undergone physical abuse (Botngård et al. 2021). In Irish settings male staff are often accused of committing neglect more than their female counterparts and this leads to two individual level risks. As stated by Busetto et al. (2020), issues regarding adult abuse in care homes has been a major problem all across the globe and the authority has undertaken necessary measures to overcome this problem. |
Aim | This particular study aims to understand the prevalence of observed as well as perpetrated employee-resident abuse in NH in Norway. |
Methodology/ broad approach | Cross-sectional exploratory study has been considered to make the desired research outcomes. As for the views of Huang et al. (2022), it is necessary for researchers to ensure that they apply proper research methods and undertaker's broad approach to avoid any issues associated with the research in the future. |
Data accumulation tools | A survey has been conducted among 100 nursing staff. SRS or Simple Random Sampling has been considered as an effective tool in this regard to avoid any biases. As per the ideas of Brotosusilo et al. (2020), researchers independent of SSR makes sure that they are capable of accumulating necessary data from the individuals who are available at a particular point in time. This has been helped in the process of reducing wastage of time and collecting a wide range of data from a large number of participants (Sari and Oktaviani, 2021). In this regard, a pen and paper survey has been conducted on the observation of the participants. only on the other hand utilising a Google form or online survey forms could have been more beneficial (Abir et al. 2021). Applying technology ensures that the concerned authority is capable of accumulating a range of data without any unnecessary delay (Basheti et al. 2021). Instead of using a pen and paper survey, an online survey could have provided the authority with a range of opportunities to collect as well as analyse data based on different factors (Popenoe et al. 2021). On the other hand, considering The observation scale of the nursing staff in terms of identifying the perpetrated are associated with abuse in care settings has been quite effective. Neglect has also been a major part and dividing the nursing staff and two different segments based on their educational qualification age and gender have been quite effective. However, considering certain demographic factors while dividing the participants into different segments can be quite effective in analysing their responses (Lacey and Minnis, 2020). The questions revolved round the concept of material abuse financial abuse psychological sexual and physical abuse. 3000 questions and have been prepared for conducting surveys in the NH. |
Method of interpreting data and overall presentation | Statistical analysis has been applied in this particular study to interpret the collected data. Stata 15.2 software has been utilised for interpreting data and dichotomy of variables like no abuse and abuse have also been considered. Adding relevant groups images and tables acquired is beneficial to interpret relevant data (Dou et al. 2021). Descriptive statistics have also been represented by considering percentage and frequency and relevant tables and graphs and charts have been added. |
Sample | A sample consisting of hundred NH indicating 10% of the NHs in Norway have been considered. 27 Institutions rejected to participate in the survey. Considering a wide range of samples leads researchers to face difficulty in accumulating necessary information (Nicolaidis et al. 2020). On the other hand, sample size has not been statistically computed. Considering 3693 nursing staff in this particular study has required researchers to invest a huge amount of time in conducting the survey. |
Ethical consideration | This particular research has been approved by REC or Regional Ethical Committee for Medical Research. REC has approved this particular study. Coding all the questions helped in the process of identifying the NH. Necessary information has been gathered through email and telephone. Written consent has been taken from the directors of all the images. Considering sealed collection boxes and taking consent from the staff has been quite effective. Maintaining anonymity of participants is also essential (Rajaonah and Zio, 2023). Providing participants with necessary details about a particular survey is essential to avoid any issues related to abuse in adult care in the future (Hado and Feinberg, 2021). |
Main findings | In this article, it has been mentioned that 62.4% of the staff have faced occurrences related to psychological abuse done by other staff whereas 43.4% of them have agreed to observe such abuse more than twice or thrice (Botngård et al. 2021). On the other hand, 46.9 percent of the participants have admitted that they have perpetrated at least one when it came to neglecting elderly one’s in a care setting. |
Conclusion, as well as recommendations | The concluding portion highlights that this particular study has been one of the largest ones to understand the abuse encountered by elderly individuals in different institutions worldwide. On the other hand, necessary recommendations to improve quality of life have not been provided. |
Strengths and limitations | As a strength of the study the focus can be given to the fact that this study has focused on comparing results pertaining to national study. On the other hand, considering a wide range of samples can be regarded as a limitation as it leads to complexities, as well as time constraints. |
Application to practice | This particular article has identified issues associated with staff to resident abuse which took place in NH in Norway. The focus has also been given to the fact that several health consequences occur when institutional care settings fail to ensure safety of an elderly person. |
Table 3: Applying framework for critiquing quantitative study
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It can be discussed that the papers have taken into consideration the problems associated with the elderly abuse in NH. It has also been a global concern as difficulty is faced in such institutions and they become a victim of such abusive behaviour of the staff which lead them to face issues psychologically as well as physically. As stated by Mahmudova (2023), it is vital for individuals to generate an overall idea about the issues faced by care seekers belonging to the aged groups in care homes.
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Male employees have reported that they have committed more physical abuse than their female counterparts. The staff who possess high educational qualifications have self-reported to have committed acts of psychological abuse, neglect as well as physical abuse (Botngård et al. 2021).
The concept of passive neglect by the staff which leads to psychological abuse has also been considered. The physical abuse which is also a cause of resident to resident aggression has also been highlighted in the study (Saga et al. 2021). The interviews provided by nurses regarding the concept of yelling are supposed to be clarified. Moreover, while taking control of the vulnerable ones in adult care homes, constant monitoring is necessary (Durán-Romero et al. 2020). It is crucial for the authority to consider the impact of constant monitoring to put an end to such abuses among elderly individuals in care homes (Durán-Romero et al. 2020). Establishing effective communication with family members and NH can be quite effective (López et al. 2021). Proper communication can help in the process of bridging the gap between the existing policies to reduce abuse of elderly individuals in care settings and its application or intervention (Mahmudova, 2023). Investing in hiring professional experts to ensure constant monitoring can lead the authority to face financial issues.
Conclusion
From this study, it can be concluded that both the papers have focused on the adverse impact of abuse faced by the aged individuals in care homes. The first article has focused mainly on a certain area in Norway whereas the other one has considered a global perspective besides considering Nursing Homes in Norway. It can be stated that such abuse is common all across the globe and individuals face huge problems while considering such services. Lack of communication between the relatives of the service users and the NHs have been a major constraint in this regard. Individuals require considering the impact of keeping in touch with the authority of the nursing homes to make sure that their family members especially the elders do not become a victim of such abuses. Reported abuses are supposed to be highlighted in this context to ensure that they are capable of addressing the issues in this context. It is also recommended that proper training to be all the nursing staff is provided so that they deal politely with those in care homes.
References
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