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      Testing an educational intervention to improve health care providers’ preparedness to care for victims of elder abuse: a mixed method pilot study

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          Aabstract

          Background

          Elder abuse is prevalent and associated with ill-health. However, health care providers often lack education about elder abuse and older patients’ victimization often remains unknown to them. In this pilot study we performed initial testing of an educational model aiming at improving health care providers’ preparedness to care for older adults subjected to abuse, or more specifically their self-reported propensity to ask older patients questions about abuse and perceived ability to manage the response.

          Methods

          The educational model consisted of a full training day about elder abuse, including theory, group discussions and forum theatre. Forum theatre is an interactive form of drama in which participants are not only observers, but rather spect-actors, urged to participate in the scene. They are thereby given the opportunity to discuss and practise difficult health care encounters. Medical interns (intervention group n = 16, control group n = 14) in Sweden participated in the study and a mixed method convergent parallel design was used. Quantitative data was collected at baseline and 6 months post-intervention using a questionnaire (the REAGERA-P). Qualitative interviews were conducted with four of the participants in the intervention group and data was analysed using qualitative content analysis.

          Results

          The reported frequency of asking older patients questions about abuse increased in the intervention group (p = 0.047), but not the control group (p = 0.38) post-intervention. Potential mediators for the improvement were an increased awareness of elder abuse and higher self-efficacy for asking questions about elder abuse. Participants also reported a higher perceived ability to manage cases of elder abuse, even though uncertainties concerning how to provide the best possible care remained. The qualitative interviews indicated that learning from each other in group discussions and forum theatre likely was an important contributor to the positive results.

          Conclusion

          This pilot test indicated that the educational model may be effective in improving health care providers’ preparedness to care for older adults subjected to abuse. However, uncertainties about how to handle elder abuse cases remained post-intervention. In a future full-scale test of the model more focus needs to be put on how to manage cases of elder abuse.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12909-022-03653-8.

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          Most cited references42

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          Three approaches to qualitative content analysis.

          Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
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            Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

            Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.
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              Qualitative research: standards, challenges, and guidelines.

              K Malterud (2001)
              Qualitative research methods could help us to improve our understanding of medicine. Rather than thinking of qualitative and quantitative strategies as incompatible, they should be seen as complementary. Although procedures for textual interpretation differ from those of statistical analysis, because of the different type of data used and questions to be answered, the underlying principles are much the same. In this article I propose relevance, validity, and reflexivity as overall standards for qualitative inquiry. I will discuss the specific challenges in relation to reflexivity, transferability, and shared assumptions of interpretation, which are met by medical researchers who do this type of research, and I will propose guidelines for qualitative inquiry.
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                Author and article information

                Contributors
                johanna.simmons@liu.se
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                3 August 2022
                3 August 2022
                2022
                : 22
                : 597
                Affiliations
                [1 ]GRID grid.5640.7, ISNI 0000 0001 2162 9922, Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, , Linköping University, ; Linköping, Sweden
                [2 ]GRID grid.5640.7, ISNI 0000 0001 2162 9922, Department of Emergency Medicine in Norrköping, and Department of Health, Medicine and Caring Sciences, , Linköping University, ; Linköping, Sweden
                [3 ]GRID grid.5640.7, ISNI 0000 0001 2162 9922, Department of Psychiatry in Linköping, and Department of Biomedical and Clinical Sciences, , Linköping University, ; Linköping, Sweden
                [4 ]GRID grid.8148.5, ISNI 0000 0001 2174 3522, Department of Health and Caring Sciences, Faculty of Health and Life Sciences, , Linnaeus University, ; Kalmar, Sweden
                Article
                3653
                10.1186/s12909-022-03653-8
                9351204
                35922855
                d87db363-9420-42a8-a885-f8562bc4fba2
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 31 March 2022
                : 22 July 2022
                Funding
                Funded by: Swedish Crime Victim Fund
                Award ID: 03384/2019
                Award ID: 03384/2019
                Award ID: 03384/2019
                Award ID: 03384/2019
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100016670, Region Östergötland;
                Award ID: RÖ-937398
                Award Recipient :
                Funded by: Linköping University
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Education
                forum theatre,forum play,intimate partner violence,medical education
                Education
                forum theatre, forum play, intimate partner violence, medical education

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