The Analysis of Supports for Elder-Abuse-Case in Home : Study of Factors Influencing Quality of Support Process and Outcome

Abstract

The purpose of this study is 1) to identify the influences quality of support process gives to outcome and 2) to clarify the other factors influencing to outcome. We performed follow-up study by mailing the questionnaire on cases which were part of 171 cases grasped by the research toward community health nurses working in Saitama, Fukuoka, and Yamagata in 1995 and being supported continuously in 1995. Twenty-eight valid cases were gained(respondent rate were 67.0%). We chose Quality of Care Management-Process Measurement (QCM-P) asked with five steps measurement and 45 questions to a specific user as assessment tool of support process, and degree of accomplishment to the goal and mutation of abused state as assessment tool of outcome. From the analyses of those results, following four types of cases were identified ; 1) the cases improved by institutionalize, 2) the cases improved by supports of good quality, 3) the cases not to improved by supports of good quality, and 4) the cases not to improved because supports of good quality were not performed. Following things became to make clear through the analyses of each courses of supports; 1) In support of elder-abuse-case , the improve of outcome is induced and further serious situation is able to avoided if support process of good quality is kept. 2) The quality of support process is improved and good outcome is able to come by improvement of conditions connecting to care structure such as shortage of services resources or lack of cooperation system. However, effectiveness of supports is low under the conditions there is financial problem or main abuser is isolated in.