Advances in Health Sciences Education

, Volume 14, Issue 3, pp 377–386 | Cite as

Educational support group in changing caregivers’ psychological elder abuse behavior toward caring for institutionalized elders

  • Hsiu-Fang Hsieh
  • Jing-Jy Wang
  • Maiofen Yen
  • Tzu-Ti Liu


Institutionalized elderly who are frail and dependent are vulnerable to be abused by overwhelmed caregivers especially caregiver psychological abusive behavior is a growing but hidden problem with few evidence-based interventions. The purpose of this study was to examine the effectiveness of an educational support group in alleviating caregiver’s psychological abusive behavior, reducing work stress and promoting knowledge of geriatric care-giving among a group of caregivers. A quasi-experimental design using a case control pre–post test approach was conducted. A total of 100 participants completed the study with 50 caregivers in each group. The research instruments included the Caregiver Psychological Elder Abuse Behavior Scale (CPEAB), the Work Stressors Inventory (WSI), and the Knowledge of Gerontology Nursing Scale (KGNS). The results showed that the intervention had significant effects in alleviating caregiver psychological abuse behavior and increasing care-giving knowledge in the experimental group (p = .048; .018). However, the intervention had no measurable effect on work stress (p = .66). Findings have important implications for education and programming for facility administers and long-term care policy makers when planning quality improvement for elderly care.


Caregiver Educational support group Psychological elder abuse Work stress Knowledge 



Financial support from National Science Council of Taiwan contract # NSC 92-2314-B-242-003.


  1. Acton, G. J., & Kang, J. (2001). Interventions to reduce the burden of caregiving for an adult with dementia: A meta-analysis. Research in Nursing & Health, 24, 349–360. doi: 10.1002/nur.1036.CrossRefGoogle Scholar
  2. Anetzberger, G. J., Palmisano, B. R., Sanders, M., Bass, D., Dayton, C., Eckert, S., et al. (2000). Model intervention for elder abuse and dementia. Gerontologist, 40(4), 492–497.Google Scholar
  3. Baker, M. W., & Heitkemper, M. M. (2005). The roles of nurses on inter-professional teams to combat elder mistreatment. Nursing Outlook, 53, 253–259. doi: 10.1016/j.outlook.2005.04.001.CrossRefGoogle Scholar
  4. Chien, W. T., Chan, S., & Thompson, D. R. (2006). Effects of a mutual support group for families of Chinese people with schizophrenia: 18-month follow-up. British Journal of Psychiatry, 189, 41–49. doi: 10.1192/bjp.bp.105.008375.CrossRefGoogle Scholar
  5. Chou, K., Lu, R., Chen, R., & Ku, Z. (2002). The development and evaluation of domestic family caregiver support group. Retrieved May 1, 2007, from DOH91-TD-1052 Science development web site: (in Chinese).
  6. Dellasega, C., & Haagen, B. (2004). A different kind of caregiving support group. Journal of Psychosocial Nursing, 42(8), 47–55.Google Scholar
  7. Draper, B., Bowring, G., Thompson, C., Heyst, J. V., Conroy, P., & Thompson, J. (2007). Stress in caregivers of aphasic stroke patients: A randomized controlled trial. Clinical Rehabilitation, 21, 122–130. doi: 10.1177/0269215506071251.CrossRefGoogle Scholar
  8. Fulmer, T., Guadagno, L., Bitondo Dyer, C., & Connolly, M. T. (2004). Progress in elder abuse screening and assessment instruments. Journal of the American Geriatrics Society, 52, 297–304. doi: 10.1111/j.1532-5415.2004.52074.x.CrossRefGoogle Scholar
  9. Goergen, T. (2001). Stress, conflict, elder abuse and neglect in German Nursing Home: A pilot study among professional caregivers. Journal of Elder Abuse & Neglect, 13(1), 1–26. doi: 10.1300/J084v13n01_01.CrossRefGoogle Scholar
  10. Goodridge, D. M., Johnston, P., & Thomson, M. (1996). Conflict and aggression as stressors in the work environment of nursing assistants: Implications for institutional elder abuse. Journal of Elder Abuse and Neglect, 8(1), 49–67. doi: 10.1300/J084v08n01_03.CrossRefGoogle Scholar
  11. Hebert, R., Levesque, L., Vezina, J., Lavoie, J. P., Ducharme, F., & Gendron, C. (2003). Efficacy of psychoeducative group program for caregivers of demented persons living at home: A randomized controlled trial. Journal of Gerontology: Social Sciences, 58(1), S58–S67.Google Scholar
  12. Holtzen, V. (1993). Baccalaureate curriculum gerontological nurses objectives. Journal of Gerontological Nursing, 19, 35–41.Google Scholar
  13. Hsu, S. (2006). The development and testing of the caregiver psychological elder abuse behavior scale. Dissertation, Foo-Yin University, Taiwan (in Chinese).Google Scholar
  14. Jones, J. S., Holstege, C., & Holstege, H. (1997). Elder abuse and neglect: Understanding the causes and potential risk factors. American Journal of Emergency Medicine, 15(6), 579–583. doi: 10.1016/S0735-6757(97)90162-5.CrossRefGoogle Scholar
  15. Joshi, S., & Flaherty, J. H. (2005). Elder abuse and neglect in long-term care. Clinical Geriatric Medicine, 21, 333–354. doi: 10.1016/j.cger.2004.10.009.CrossRefGoogle Scholar
  16. Lee, L. (1998). Nurses’ knowledge, attitude, and intention toward caring for elderly people in Kaoshiung City hospital. Dissertation, Chung-Shang Medical College, Taiwan (in Chinese).Google Scholar
  17. Lin, S. (2000). Relationship of work stress and job satisfaction among nurse aids. Dissertation, Yang-Ming University, Taiwan (in Chinese).Google Scholar
  18. Liu, Z. (2006). Associated factors of psychological elder abuse behavior among institutional caregivers and the effects of educational-support group intervention. Dissertation, Foo-Yin University, Taiwan (in Chinese).Google Scholar
  19. Mason, A. (2003). Stop elder abuse and mistreatment: A psycho-educational program for abusers of the elderly. Victimization of the Elderly and Disabled, 5(5), 67.Google Scholar
  20. Ogioni, L., Landi, F., & Bernabei, R. (2007). Cross-sectional association between behavioral symptoms and potential elder abuse among subjects in home care in Italy: Results from the Silvernet study. American Journal of Psychiatry, 15(1), 70–78.CrossRefGoogle Scholar
  21. Pillemer, K., & Finkelhor, D. (1989). Causes of elder abuse: Cargiver stress versus problem relatives. American Journal of Orthopsychiatric, 59(2), 179–187.Google Scholar
  22. Reingold, D. A. (2006). An elder abuse shelter program: Build it and they will come, a long term care based program to address elder abuse in the community. Journal of Gerontological Social Work, 46(3/4), 123–135. doi: 10.1300/J083v46n03_07.CrossRefGoogle Scholar
  23. Richardson, B., Kitchen, G., & Livingston, G. (2002). Effect of education on knowledge and management of elder abuse: A randomized controlled trial. Age and Ageing, 31(5), 335–341. doi: 10.1093/ageing/31.5.335.CrossRefGoogle Scholar
  24. Richardson, B., Kitchen, G., & Livingston, G. (2004). What staff know about elder abuse in dementia and the effect of training. Dementia, 3(3), 377–384.Google Scholar
  25. Schaefer, J. A., & Moos, R. H. (1993). Effects of work stressors and work climate on long-term care staff’s job morale and functioning. Research in Nursing & Health, 19, 63–73. doi:10.1002/(SICI)1098-240X(199602)19:1<63::AID-NUR7>3.0.CO;2-J.CrossRefGoogle Scholar
  26. Tam, S., & Neysmith, S. (2006). Disrespect and isolation: Elder abuse in Chinese communities. Canadian Journal on Aging, 25(2), 141–151.CrossRefGoogle Scholar
  27. Toseland, R. (1990). Long-term effectiveness of peer-led and professionally-led support groups for care-givers. Social Service Review, 64, 309–327.Google Scholar
  28. Toseland, R. W., & Rossiter, C. M. (1989). Group interventions to support family caregivers: A review and analysis. The Gerontologist, 29, 438–448.Google Scholar
  29. Wang, J. J. (2006). Psychological abuse and its characteristic correlates among elderly Taiwanese. Archives of Gerontology and Geriatrics, 42, 307–318. doi: 10.1016/j.archger.2005.08.006.CrossRefGoogle Scholar
  30. Wang, Y., Kao, H., Tsi, M., & Kao, S. (2001). The impact of a training program on behavior change of nurse aids. Long Term Care, 5(1), 65–78 (in Chinese).Google Scholar
  31. Wu, S., & Wang, S. (2004). Assessment and preventive interventions in abuse of the elderly. Nursing Journal, 51(6), 64–69. (in Chinese).Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Hsiu-Fang Hsieh
    • 1
  • Jing-Jy Wang
    • 2
  • Maiofen Yen
    • 2
  • Tzu-Ti Liu
    • 3
  1. 1.Department of NursingFooyin UniversityKaohsiung HsienTaiwan, ROC
  2. 2.Department of Nursing & Allied Health ScienceNational Cheng Kung UniversityTainan CityTaiwan, ROC
  3. 3.Department of NursingPing-Dong HospitalPing DongTaiwan, ROC

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