Title : Elder abuse in nursing homes: A multi-level analysis of determinants and prevention strategies through the Ecological Systems Theory Lens (ESTL)
Abstract:
Introduction: Elder abuse in nursing homes is a pressing global issue with profound implications for patient safety and quality of care. It encompasses various forms, including physical, psychological, and financial mistreatment, often rooted in complex interplays between individual, organizational, and societal factors. Through the Ecological Systems Theory Lens (ESTL), this study aims to provide a multi-level analysis of determinants and prevention strategies for elder abuse in nursing homes.
Objectives: To offer a systematic theoretical reference and practical guidance for the prevention and intervention of elder abuse in nursing homes in China.
Methodology: Relevant literature published within the past five years was retrieved from databases including The Cochrane Library, EMBASE, PubMed, CINAHL, Web of Science, SpringerLink, China National Knowledge Infrastructure (CNKI), VIP database, Wanfang Database, and China Biology Medicine Literature Database (CBM). This study employs the Ecological Systems Theory as the analytical framework to provide a comprehensive review of the factors influencing elder abuse in nursing homes across three systems: microsystem (individual), mesosystem (family and institutional), and macrosystem (societal and policy).
Results: The findings indicate that elder abuse in nursing homes primarily includes physical, psychological, and financial abuse. At the micro level, poor health status, cognitive impairment, and low psychological resilience among the elderly are significant risk factors for abuse. At the meso level, high work stress among caregivers, inadequate training, and poor management of nursing homes are the main causes. At the macro level, societal stereotypes about the elderly, insufficient geriatric care resources, and inadequate legal frameworks exacerbate the occurrence of abuse.
Conclusions: This study provides a systematic theoretical reference and practical guidance for the prevention and intervention of elder abuse in nursing homes, with a focus on patient-centered care.
