Elder abuse and neglect intervention in the clinical setting: Perceptions and barriers faced by Primary Care Physicians in Malaysia
Document Type
Article
Publication Date
11-1-2020
Abstract
This qualitative study attempts to explore the definition, perceptions, practice experience, and barriers of primary care physicians (PCPs) in identifying and intervening in cases of elder abuse and neglect at the primary care level. Semistructured in-depth interview was conducted among 10 PCPs. Participants were selected by purposive sampling. The interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis. In general, PCPs showed consistency in defining elder abuse and neglect. PCPs considered that they were optimally positioned to intervene in cases of elder abuse and neglect, but indicated the potential of overlooking such problems. The hurdles faced by PCPs in the identification and intervention of elder abuse were determined to be occurring at three levels: clinical, organizational, and policy. At the clinical level, PCPs recognize that they are lacking both the confidence and knowledge of elder abuse and neglect intervention. PCPs' conflicting personal and professional beliefs create barriers during the clinical practice. Time constraints, patients' other clinical problems, and, in addition, the preservation of a good doctor-patient relationship overshadow the importance of addressing and intervening in elder abuse and neglect issues during the consultation. This is further exacerbated by the barriers perceived by the patients: their nondisclosure and reluctance to accept outside intervention. At the organizational level, the lack of efficient interagency networks or support for the health system poses barriers. At the policy level, the absence of legislation specifically addressing elder abuse also creates considerable difficulties. However, PCPs gave differing responses when asked about a law concerning the elderly and mandatory reporting. Addressing these multilevel barriers is critical for ensuring that opportunities arising at the primary care level for elder maltreatment intervention are correctly utilized.
Keywords
Elder abuse and neglect, Primary care physician, Perceptions, Barriers, Qualitative research, Malaysia
Divisions
primarycare
Funders
Provision of Postgraduate Research (PPP), University of Malaya (P0041/2013 A),Grand Challenge Grant, University of Malaya (GC001C_14HTM)
Publication Title
Journal of Interpersonal Violence
Volume
35
Issue
23-24
Publisher
SAGE Publications
Publisher Location
2455 TELLER RD, THOUSAND OAKS, CA 91320 USA