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Process Evaluation of Supporting Family Doctors to Address Elder Abuse Intervention in Malaysia: A Mixed-Method Evaluation

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Abstract

Purpose

This study aims to conduct a process evaluation of Supporting Family Doctors to Address Elder Abuse (SAFE) intervention, a training program, and clinical guidelines developed to assist the family doctor in intervening in elder abuse (EA).

Method

160 family doctors answered pre-and post-training questionnaires on knowledge of EA, attitude, subjective norms, and the perceived behavioral control to intervene in EA, followed by semi-structured interviews post-intervention with a purposive sample of family doctors who participated in the SAFE intervention (N = 39).

Results

There is a significant increase in mean scores of the knowledge, attitude, and subjective norms six months post-intervention (p < 0.001). The mean scores of perceived behavioral control of family doctors to intervene in EA decreased but were statistically insignificant (p > 0.05). Qualitative data explained the observed effect and process underlying the knowledge transfer and implementation of the SAFE intervention. Knowledge improvements due to awareness enhancement led to empowerment and confidence as the training program was effectual and comprehensive. Family doctors’ self-reflection and empathy toward older adults contribute to attitude changes. Family doctors are better coordinated and receive support in intervening in EA. However, various roadblocks affect their perceived ability to intervene in EA and enhancement strategies necessary to assist family doctors to intervene in EA efficiently.

Conclusion

The SAFE intervention was feasible and effective in improving family doctors’ competency to intervene in EA. However, findings showed that doctors’ capacities must go hand in hand with empowering older adults, creating awareness among community members, and pushing for law and policy reforms.

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References

  • Ahmad, Y., Cuthbert, D., Arunachalam, D., & Niner, S. (2015). Suspected child abuse and neglect team (SCAN team): Early establishment, success stories, challenges and the way forward. Journal of Administrative Science, 12(1), 60–72.

    CAS  Google Scholar 

  • Ajzen, I. (1991). The theory of Planned Behavior. Organizational behavior and human decision processes, 50(2), 179–211.

    Article  Google Scholar 

  • Ajzen, I., & Madden, T. J. (1986). Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. Journal of experimental social psychology, 22(5), 453–474. https://doi.org/10.1016/0022-1031(86)90045-4

    Article  Google Scholar 

  • Alt, K. L., Nguyen, A. L., & Meurer, L. N. (2011). The effectiveness of Educational Programs to improve recognition and reporting of elder abuse and neglect: A systematic review of the literature. Journal of Elder Abuse and Neglect, 23(3), 213–233. https://doi.org/10.1080/08946566.2011.584046

    Article  PubMed  Google Scholar 

  • Baker, P. R., Francis, D. P., Mohd Hairi, N. N., Othman, S., & Choo, W. Y. (2017). Interventions for preventing elder abuse: Applying findings of a new Cochrane review. Age And Ageing, 46(3), 346–348. https://doi.org/10.1093/ageing/afw186

    Article  PubMed  Google Scholar 

  • Bidin, A., & Yusoff, J. Z. M. (2015). Abuse of the malaysian elderly: An analysis on the adequacy and suitability of the domestic violence Act 1994 (Act 521) to protect the elderly victim. Journal of Management Research, 7(2), 71. https://doi.org/10.5296/jmr.v7i2.6928

    Article  Google Scholar 

  • Butchart, A., Mikton, C., Dahlberg, L. L., & Krug, E. G. (2015). Global status report on violence prevention 2014. In: BMJ Publishing Group Ltd.

  • Chokkanathan, S., Natarajan, A., & Mohanty, J. (2014). Elder abuse and barriers to help seeking in Chennai, India: A qualitative study. Journal Of Elder Abuse & Neglect, 26(1), 60–79. https://doi.org/10.1080/08946566.2013.782786

    Article  Google Scholar 

  • Colombini, M., Ali, S. H., Watts, C., & Mayhew, S. H. (2011). One stop crisis centres: A policy analysis of the malaysian response to intimate partner violence. Health research policy and systems, 9(1), 1–8.

    Article  Google Scholar 

  • Department of Statistics Malaysia (2019). Population Projection (Revised), Malaysia, 2010–2040. Retrieved 23rd July from https://www.dosm.gov.my/v1/index.php?r=column/cthemeByCat&cat=118&bul_id=Y3kwU2tSNVFDOWp1YmtZYnhUeVBEdz09&menu_id=L0pheU43NWJwRWVSZklWdzQ4TlhUUT09

  • Dong, X. (2012). Culture diversity and elder abuse: Implications for research, education, and policy. Generations, 36(3), 40–42.

    Google Scholar 

  • Greene, J. C. (2008). Is mixed methods social inquiry a distinctive methodology? Journal of mixed methods research, 2(1), 7–22.

    Article  Google Scholar 

  • Hawe, P., Shiell, A., & Riley, T. (2004). Complex interventions: How “out of control” can a randomised controlled trial be? British Medical Journal, 328(7455), 1561–1563.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative health research, 15(9), 1277–1288.

    Article  PubMed  Google Scholar 

  • Jamaluddin, S. Z. B., Chuan, G. C., & Taher, M. A. (2015). Strategies in the prevention or reduction of elder abuse in Bangladesh and Malaysia. Procedia-Social and Behavioral Sciences, 172, 42–48.

    Article  Google Scholar 

  • Leng, O. T. S., Khan, S., Vergara, R. G., & Khan, N. (2016). Policies and protections for ageing society in Malaysia. Journal of Southeast Asian Research, 2016, 71–78.

  • Mazzotti, M. C., Scarcella, E., D’Antone, E., Fersini, F., Salsi, G., Ingravallo, F., Amadasi, A., & Pelotti, S. (2019). Italian healthcare professionals’ attitude and barriers to mandatory reporting of elder abuse: An exploratory study. Journal Of Forensic And Legal Medicine, 63, 26–30. https://doi.org/10.1016/j.jflm.2019.02.007

    Article  PubMed  Google Scholar 

  • Merriam, S. B. (2001). Andragogy and self-directed learning: Pillars of adult learning theory. New directions for adult and continuing education, 2001(89), 3–14.

    Article  Google Scholar 

  • Mohd Mydin, F. H., & Othman, S. (2020). Elder abuse and neglect intervention in the clinical setting: Perceptions and barriers faced by Primary Care Physicians in Malaysia. J Interpers Violence, 35(23–24), 6041–6066. https://doi.org/10.1177/0886260517726411

    Article  PubMed  Google Scholar 

  • Mohd Mydin, F. H., Othman, S., Choo, W. Y., Hairi, N. N. M., Hairi, F. M., Karim, S., Tan, S. N., Ali, M. P., Aziz, Z. A., Mohd, S., Ramli, R., Mohamad, R., Awaludin, R., L. R., & Adnan, Z. (2020). Clinical recognition of elder maltreatment and intention to report among primary care doctors. Journal Of Elder Abuse & Neglect, 32(1), 72–83. https://doi.org/10.1080/08946566.2020.1731640

    Article  Google Scholar 

  • Mohd Mydin, F. H., Choo, Y. W., & Othman, S. (2021a). The effectiveness of educational intervention in improving primary health-care service providers’ knowledge, identification, and management of elder abuse and neglect: A systematic review. Trauma Violence & Abuse, 22(4), 944–960.

    Article  Google Scholar 

  • Mohd Mydin, F. H., Othman, S., Choo, W. Y., Hairi, N. N. M., Hairi, F. M., Karim, S., Tan, S. N., Ali, M. P., Abdul Aziz, Z., Mohd, S., Mohamad, R., Ramli, R., R., & Awaludin, L. R. (2021b). Supporting family doctors to address elder abuse: A quasi-experimental study in Malaysia. Journal Of Elder Abuse & Neglect, 33(2), 151–167. https://doi.org/10.1080/08946566.2021b.1919272

    Article  Google Scholar 

  • Othman, S., & Mohd Mydin, F. H. (2023). Elder abuse and neglect training modules for primary care providers: Facilitator’s guidebook. Universiti Malaya: Department of Primary Care Medicine, Faculty of Medicine.

    Google Scholar 

  • Othman, S., Mohd Mydin, F. H., Abdul Karim, S., Naqiah, S. N., Farizah, M. H. N., M. H., & Choo, W. Y. (2017). Identifying and managing elder abuse and neglect: A guide for primary care doctors. Department of Primary Care Medicine, Faculty of Medicine, University of Malaya.

  • Schmeidel, A. N., Daly, J. M., Rosenbaum, M. E., Schmuch, G. A., & Jogerst, G. J. (2012). Health care professionals’ perspectives on barriers to elder abuse detection and reporting in primary care settings. Journal Of Elder Abuse & Neglect, 24(1), 17–36. https://doi.org/10.1080/08946566.2011.608044

    Article  Google Scholar 

  • Schoonenboom, J., & Johnson, R. B. (2017). How to construct a mixed methods research design. Kolner Zeitschrift fur Soziologie und Sozialpsychologie, 69(Suppl 2), 107.

    Article  PubMed  PubMed Central  Google Scholar 

  • Seers, K. (2007). Evaluating complex interventions. Worldviews On Evidence-Based Nursing / Sigma Theta Tau International, Honor Society Of Nursing, 4(2), 67–68. https://doi.org/10.1111/j.1741-6787.2007.00083.x

    Article  Google Scholar 

  • Sooryanarayana, R., Ganapathy, S. S., Wong, N. I., Rosman, A., Choo, W. Y., & Hairi, N. N. (2020). Elder abuse: Nationwide findings among community-dwelling malaysian older persons. Geriatrics & gerontology international, 20, 85–91.

    Article  Google Scholar 

  • Tan, Y. J., Noew, H. S., & Nainee, S. (2021). The views on filial piety among the malaysian chinese retired parents and children in Malaysia. Malaysian Journal of Chinese Studies, 9, 23–36. https://doi.org/10.6993/MJCS.202011_9(1).0003

    Article  Google Scholar 

  • Tobin, G. A., & Begley, C. M. (2004). Methodological rigour within a qualitative framework. Journal of advanced nursing, 48(4), 388–396.

    Article  PubMed  Google Scholar 

  • World Health Organization (2022). 13/6/2022). Abuse of older people. Retrieved 5/8/2022 from https://www.who.int/news-room/fact-sheets/detail/abuse-of-older-people

  • Yunus, R. M. (2021). The under-reporting of elder abuse and neglect: A malaysian perspective. Journal Of Elder Abuse & Neglect, 33(2), 145–150.

    Article  Google Scholar 

  • Yunus, R. M., Hairi, N. N., & Choo, W. Y. (2019). Consequences of elder abuse and neglect: A systematic review of Observational Studies. Trauma Violence Abuse, 20(2), 197–213. https://doi.org/10.1177/1524838017692798

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to thank all the participants from the Penang State Health Department, the Ministry of Health Malaysia and the expert panels involved in develo** the elder training module.

Funding

This research was supported by, Universiti Malaya Biasiswa Kecil Penyelidikan Grant (Reference no: BK062-2016) and Universiti Malaya Grand Challenge Grant (Reference no: GC001C_14HTM).

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Correspondence to Fadzilah Hanum Mohd Mydin.

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The authors have no conflict of interest in this study.

Ethical Approval

The study design received approval from the University Medical Ethics Committee (MEC Ref No. 201766-5318) and the National Medical Research Register (NMRR-37067).

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Mohd Mydin, F.H., Othman, S., Choo, W.Y. et al. Process Evaluation of Supporting Family Doctors to Address Elder Abuse Intervention in Malaysia: A Mixed-Method Evaluation. J Fam Viol (2023). https://doi.org/10.1007/s10896-023-00594-8

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