Irina Kislaya

Elder Abuse in Portugal: Findings From the First National Prevalence Study

In this study, we present findings of the Portuguese national prevalence study, “Aging and Violence,” the purpose of which was to estimate the prevalence of abuse and neglect of older people in family settings over a 12-month period and examine the relationship between abuse and sociodemographic and health characteristics. Through a telephone survey of a representative probability sample (N = 1,123), we evaluated 12 abusive behaviors and demographic data. Overall, 12.3% of older adults experienced elder abuse in family settings. The prevalence rates of specific types were as follows: psychological, 6.3%; financial, 6.3%; physical, 2.3%; neglect, 0.4%; and sexual, 0.2%. Logistic regression was employed to determine the relationship between abuse and covariates. The study suggests that education level, age, and functional status are significantly associated with abuse. Accurate estimates of the prevalence of elder abuse and understanding of victim and perpetrator characteristics are fundamental to designing effective strategies for prevention and intervention.

Development of a culture sensitive prevalence study on older adults violence: qualitative methods contribution

Purpose – The purpose of this paper is to reflect on how qualitative approaches can improve a prevalence study on older adults’ violence. The paper describes how qualitative data can help frame a complex and multidimensional problem, such as older adults’ violence, within the culture where it happens and therefore prevent two risks present in prevalence studies: underestimation and overestimation. Design/methodology/approach – To adequately measure violence and violent behaviours the authors first conducted four focus groups with the target population – older adults aged 60 and over – and 13 in-depth interviews with older adult victims of violence. Through content analysis of focus groups and in-depth interviews the authors sought to understand how violence is perceived, defined and limited by the general population and by victims. Findings – By employing qualitative methods the authors were able to operationalise violence, decide upon and select specific behaviours to measure, rephrase questions and deve...

Estudo sobre pessoas idosas vítimas de violência em Portugal: sociografia da ocorrência

O presente artigo apresenta dados sobre violencia contra pessoas com 60 e mais anos residentes em Portugal ha mais de 12 meses. O estudo transversal e descritivo recolheu dados por meio de um questionario aplicado presencialmente a vitimas que recorreram a tres entidades governamentais e a uma instituicao nao-governamental de apoio a vitimas. A amostra nao probabilistica foi constituida por 510 vitimas de violencia em contexto familiar. A violencia fisica e a psicologica foram os tipos mais reportados, afetando 87,8% e 69,6% das pessoas estudadas, seguindo-se a violencia financeira (47,5%), sexual (7,5%) e a negligencia (6,5%). A maioria (74,1%) dos respondentes indicou mais de um tipo de violencia. As vitimas, na maioria mulheres, tinham uma media de idade de 70,7 anos. A maioria dos agressores pertencia a familia nuclear, nomeadamente, conjuges ou companheiros, filhos/enteados e filhas/enteadas. Contudo, observaram-se diferencas no agressor consoante o genero da vitima. Os resultados indicam que a violencia nao e um fenomeno uniforme, apresentando-se sob diferentes configuracoes.This article presents data on violence against persons aged 60 years or older and living in Portugal for at least 12 months. The cross-sectional descriptive study collected data with a face-to-face questionnaire applied to victims that had sought assistance at three government institutions and one non-governmental support service for victims. The non-probabilistic sample included 510 victims of violence in family settings. Physical and psychological violence were the most common (87.8% and 69.6%, respectively). Financial violence was reported by 47.5% of the victims, followed by sexual assault (7.5%) and neglect (6.5%). The majority of victims (74.1%) reported more than one type of violence. Victims were mostly women, and mean age was 70.7 years. Most of the perpetrators belonged to the nuclear family, namely spouses or partners, sons/sons-in-law, and daughters/daughters-in-law. However, differences were observed according to victims gender. The results indicate that violence is not a uniform phenomenon, presenting different configurations.

Psychological elder abuse: measuring severity levels or potential family conflicts?

Purpose Psychological elder abuse (PEA) assessment is described with different thresholds. The purpose of this paper is to examine how the prevalence of PEA and the phenomenon’s characterisation varied using two different thresholds. Design/methodology/approach Participants from the cross-sectional population-based study, Aging and Violence (n=1,123), answered three questions regarding PEA. The less strict measure considered PEA as a positive response to any of the three evaluated behaviours. The stricter measure comprised the occurrence, for more than ten times, of one or more behaviours. A multinomial regression compared cases from the two measures with non-victims. Findings Results show different prevalence rates and identified perpetrators. The two most prevalent behaviours (ignoring/refusing to speak and verbal aggression) occurred more frequently (>10 times). Prevalence nearly tripled for “threatening” from the stricter measure (>10 times) to the less strict (one to ten times). More similarities, rather than differences, were found between cases of the two measures. The cohabiting variable differentiated the PEA cases from the two measures; victims reporting abuse >10 times were more likely to be living with a spouse or with a spouse and children. Research limitations/implications Development of a valid and reliable measure for PEA that includes different ranges is needed. Originality/value The study exemplifies how operational definitions can impact empirical evidence and the need for researchers to analyse the effect of the definitional criteria on their outcomes, since dichotomization between victim and non-victim affects the phenomenon characterisation.

Exploring the Correlates to Depression in Elder Abuse Victims: Abusive Experience or Individual Characteristics?

Depression and depressive symptoms have been studied both as risk factors and consequences of elder abuse, even though the most common cross-sectional design of the studies does not allow inferring cause or consequence relationships. This study estimates the proportion of older adults who screened positive for depressive symptoms among those self-reporting elder abuse and examines whether individual characteristics and/or abusive experience aspects are associated with self-reported depressive symptoms. Participants were 510 older adults self-reporting experiences of abuse in family setting enrolled in the cross-sectional victims’ survey of the Aging and Violence Study. Depressive symptoms were assessed through the abbreviated version of the Geriatric Depression Scale (GDS-5). Poisson regression was used to determine the prevalence ratio (PR) of screening depressive symptoms according to individual and abusive experience covariates: sex, age group, cohabitation, perceived social support, chronic diseases, functional status, violence type, perpetrator, and number of conducts. Women (PR = 1.18, 95% confidence interval [CI] = [1.04, 1.35]) individuals perceiving low social support level (PR = 1.36, 95% CI = [1.16, 1.60]) and with long-term illness (PR = 1.17, 95% CI = [1.02, 1.33]) were found to be associated with increased risk for screening depressive symptoms. In regard to abusive experience, only the number of abusive conducts increased the PR (PR = 1.07, 95% CI = [1.05, 1.09]). Routine screening for elder abuse should include psychological well-being assessment. Interventions toward risk alleviation for both mental health problems and elder abuse should target women perceiving low social support level and with long-term illness.

A sociography of elderly victims of family violence in Portugal

O presente artigo apresenta dados sobre violencia contra pessoas com 60 e mais anos residentes em Portugal ha mais de 12 meses. O estudo transversal e descritivo recolheu dados por meio de um questionario aplicado presencialmente a vitimas que recorreram a tres entidades governamentais e a uma instituicao nao-governamental de apoio a vitimas. A amostra nao probabilistica foi constituida por 510 vitimas de violencia em contexto familiar. A violencia fisica e a psicologica foram os tipos mais reportados, afetando 87,8% e 69,6% das pessoas estudadas, seguindo-se a violencia financeira (47,5%), sexual (7,5%) e a negligencia (6,5%). A maioria (74,1%) dos respondentes indicou mais de um tipo de violencia. As vitimas, na maioria mulheres, tinham uma media de idade de 70,7 anos. A maioria dos agressores pertencia a familia nuclear, nomeadamente, conjuges ou companheiros, filhos/enteados e filhas/enteadas. Contudo, observaram-se diferencas no agressor consoante o genero da vitima. Os resultados indicam que a violencia nao e um fenomeno uniforme, apresentando-se sob diferentes configuracoes.This article presents data on violence against persons aged 60 years or older and living in Portugal for at least 12 months. The cross-sectional descriptive study collected data with a face-to-face questionnaire applied to victims that had sought assistance at three government institutions and one non-governmental support service for victims. The non-probabilistic sample included 510 victims of violence in family settings. Physical and psychological violence were the most common (87.8% and 69.6%, respectively). Financial violence was reported by 47.5% of the victims, followed by sexual assault (7.5%) and neglect (6.5%). The majority of victims (74.1%) reported more than one type of violence. Victims were mostly women, and mean age was 70.7 years. Most of the perpetrators belonged to the nuclear family, namely spouses or partners, sons/sons-in-law, and daughters/daughters-in-law. However, differences were observed according to victims gender. The results indicate that violence is not a uniform phenomenon, presenting different configurations.

Factors associated to repeated influenza vaccination in the Portuguese adults with chronic conditions

Annual influenza vaccination is recommended to people with chronic conditions. This study aimed to estimate the proportion of chronically ill adults vaccinated against influenza in consecutive seasons and to identify associated factors. We used data from the first National Health Examination Survey (INSEF), a cross-sectional study conducted in 2015 on a probabilistic sample of individuals aged 25-74 years. The population was restricted to individuals who self-reported diabetes, a respiratory, cardiovascular, liver or kidney disease. Self-reported vaccination in 4 consecutive seasons was categorized in 3 levels: unvaccinated, occasionally (vaccinated 1-3 seasons) and repeatedly vaccinated (in all 4 seasons). A multinomial logistic regression was applied to estimate odds-ratio (OR) of influenza vaccination according to sociodemographic factors, chronic condition, health care use and status. In the target population, the 2014/15 influenza vaccine coverage was 33.8% (95% CI: 29.8-38.1). The higher coverage was found in individuals reporting renal disease (66.7%) and diabetes (43.8%). The coverage decreased to 32.6%, 26.0% and 20.8% for individuals with respiratory, cardiovascular and liver diseases, respectively. The probability of being repeatedly vaccinated, compared to unvaccinated, was higher in males (OR = 2.14: 95% CI: 1.31-3.52); aged 65 and 74 (OR = 4.39; 95% CI: 1.99-9.69); whom had an appointment with a general practitioner (OR = 2.77; 95% CI: 1.00-7.66) or other physician (OR = 3.95: 95% CI: 2.53-6.16); with no smoking habits (OR = 1.58; 95% I: 1.02-2.46) and reporting diabetes (OR = 2.13; 95% CI: 1.02-4.45). Finally, having a self-reported cardiovascular condition decreased the likelihood of being occasionally (OR = 0.38; 95% CI = 0.22-0.65) vaccinated against influenza. Younger individuals, females and the ones with a self-reported cardiovascular condition were identified as more likely of non-compliance to the vaccine uptake recommendation. Future vaccination strategies should focus on the previous identified population subgroups. Also, the medical recommendation of the influenza vaccine uptake should continue and be reinforced particularly in individuals with a cardiovascular condition.

Moderate influenza vaccine effectiveness in a B mismatch season: Preliminary results from the 2017/2018 season in Portugal

Vaccination has become one of the main public health measure for influenza control, its role in reducing the risk of developing the disease and post-infection complications is widely recognised. Influenza vaccination is recommended for the elderly, for individuals with chronic conditions, the pregnant and health professionals. Due to the continuous changes of the influenza virus, the seasonal flu vaccine composition is reformulated annually, to match viruses that are expected to circulate in that season. Early in the season influenza vaccine effectiveness (IVE) estimate is an important indicator of the need for further public health measures, it is critical when the IVE is low. This study aimed to provide early 2017/2018 seasonal IVE using data from the Portuguese influenza surveillance system.

Prevalence, awareness, treatment and control of diabetes in Portugal: Results from the first National Health examination Survey (INSEF 2015)

AIMS Diabetes Mellitus is a major public health threat worldwide and continues to increase in numbers and significance. Estimates of diabetes prevalence, awareness, treatment and control are essential to effectively monitor its trends, plan and evaluate interventions. METHODS We conducted a nationwide health examination survey in the population residing in Portugal aged between 25 and 74 years old in 2015. It consisted in a cross sectional prevalence study which included the measurement of HbA1c, a physical examination and a general health interview of a probabilistic sample of 4911 individuals (Authorization n°9348/2010 of the National Committee for Data Protection). RESULTS The overall prevalence of diabetes was 9.9% (95%CI: 8.4; 11.5). It was higher in males than in females (12.1% vs 7.8%). Diabetes was more prevalent among individuals of lower education and without any professional activity. The majority of persons with diabetes was aware of their condition (87.1%) and was taking antidiabetic medication (79.7%). Of these, 63.2% had glycated hemoglobin levels lower than 7.0% (53 mmol/mol), but the majority failed to comply with the LDL and blood pressure recommended clinical targets (71.9% and 59.0%). Similarly, the prevalence of prediabetes was 16%, higher among women than men (17.5% vs 14.4%). CONCLUSION The prevalence of diabetes and prediabetes remains higher than the global and European estimates, although there is increasing awareness of this disorder.

Socioeconomic inequalities in obesity prevalence: Portuguese Health Examination Survey results

The Portuguese National Health Examination Survey is developed as a part of the project “Improvement of epidemiological health information to support public health decision and management in Portugal. Towards reduced inequalities, improved health, and bilateral cooperation”, that benefits from a 1.500.000€ Grant from Iceland, Liechtenstein and Norway through the EEA Grants.