Development and testing of screening indicators for psychological abuse of older people

Abuse of older people is a serious and growing social problem. Although physical abuse is the easiest to identify, covert acts of psychological abuse are of concern to elders' health care providers. The assessment of psychological abuse in elders is an important, but difficult, aspect of concern for these older adults. This article describes the development and testing of a screening instrument for elders' psychological abuse. The Elders' Psychological Abuse Scale (EPAS) was developed from many abuse indicators that have been identified in past research and from inputs from a focus group discussion. The content validity index of .92 was established through expert panel evaluation. Psychometric findings provided support for the efficacy of the 32-indicator EPAS in screening for the presence of psychological abuse in elders. Significant inverse relationships between the EPAS, the Short Portable Mental State Questionnaire (r = -.32, P < .001), and Barthel's Index (r = -.36, P < .001) provided confirmation of criterion-related validity. A high test-retest agreement percentage and the finding that 26 of 32 kappa values exceeded 0.6 confirmed the reliability of the EPAS. We concluded that the EPAS appears to be a promising tool, providing reliable and valid screening data to help determine psychological abuse among elders in long-term care facilities and domestic settings, as well as facilitating researchers' better understanding of the phenomenon of elders' abuse.