Caregiver factors contributing to psychological elder abuse behavior in long-term care facilities: a structural equation model approach.

Background: Identification of caregiver risk factors associated with psychological elder abuse is crucial for preventing and managing such abuse. The aim of this study was to test the most effective model for explaining caregiver factors contributing to caregiver psychological abuse behavior. We hypothesized that caregiver hours worked each day, years of education, age, geriatric care-giving training, gerontological care knowledge, social resources, and self-reported work stress are factors contributing to psychological abuse behavior of caregivers.

Methods: A cross-sectional study design was used. The sample included a total of 183 caregivers recruited from seven long-term care facilities in southern areas of Taiwan. Instruments included the Caregiver Psychological Elder Abuse Behavior (CPEAB) scale, the Work Stressors Inventory Chinese version (WSI-C), the Personal Resources Questionnaire (PRQ-2000), and Knowledge of Gerontological Nursing Scale (KGNS). The structural equation modeling (SEM) procedure was used to analyze the data.

Results: All the model-fit indexes (chi2 = 87.84, df = 70, p = 0.073; CMIN/DF = 1.26; GFI = 0.94, AGFI =0.91, TLI = 0.96, RMSEA = 0.037) of the final model exceeded their respective common acceptance levels except for the normed fit index (NFI) value (0.88). The study results suggest that caregivers who work fewer hours, received fewer years of education, lack social resources, and had more work stress showed higher levels of psychological abuse behavior in caring for the elderly (p = 0.000-0.037).

Conclusions: These findings should be incorporated into practice by intervening to reduce caregiver stress and reduce elder abuse behaviors. To help reduce elder psychological abuse, caregivers would benefit from stress management and social resource interventions provided by employers or government programs.