A GLOBAL RESPONSE TO ELDER ABUSE AND NEGLECT
surveys, simply because more convergent (or divergent) lines of data are available to in-person interviewers (Acierno et al., 2003).
Compared with other elder abuse screening tools, for example the Hwalek–Sengstock Elder Abuse Screening Test (H-S/EAST)9, with originally 15 items, the EASI has fewer questions and requires less time to administer (on average two minutes). Furthermore, of the 104 doctors who par- ticipated in the Montreal study, 95.8% rated the questions as “very easy” to “somewhat easy”, and 70.5% considered the questions to have either some or a big impact on ap- proaching elder abuse (Yaffe et al., 2005).
In the Montreal study, results of the EASI were compared with a Social Work Evaluation Form (SWEF)10 to validate the tool.11 is form is a standardized social work assessment to evaluate in greater depth older people at risk of being abused.
e form comprises 67 questions and takes
an average of 66 minutes to administer. Question 59 was the “gold standard” ques- tion to compare and validate the results of the EASI. Within three weeks of the appli- cation of EASI by physicians, social workers
who participated in the study administered the evaluation form to seniors. e inter- v i e w t o o k p l a c e e i t h e r a t t h e o l d e r p e r s o n ’ home or in a safe place to talk that was mutually acceptable to the participant and the social worker. e correlation between the EASI and the SWEF reached a sensitiv- ity rate of 0.44 and a specificity rate of 0.77 (Yaffe et al., 2005).12 s
e findings of this study conducted in
Montreal offer excellent groundwork on which to build further research. However, the original EASI project was focused on the reactions from family doctors and older people in the context of a developed urban society. e aim of the WHO-CIG project proposal was to explore the reactions of similar groups in other cultural contexts and to test a set of questions in geographi- cally different settings across the world.
erefore, focus group participants in
eight countries commented on the ques- tions used by the Montreal researchers that ultimately led to the development of EASI.13
is was one step in the process of looking
at the validity of the EASI in different cul- tural and geographical contexts and assess- ing its acceptance and usefulness among medical doctors and older patients in places other than Canada.
See for example http://www.elderabusecenter.org/print_page.cfm?p=riskassessment.cfm
This form was developed by the Institute René Cassin.
The SWEF can be found in Annex 2.
The sensitivity rate indicates the proportion of people with the target disorder who have a positive test result. It is used to assist in assessing and selecting a diagnostic test/sign/symptom. The specificity rate is the equivalent for negative tests and indicates the proportion of people without the target disorder who have a negative test.
In the WHO-CIG focus group study, materials from the Montreal EASI project were used according to a memorandum of collaboration between the researchers and WHO-CIG. Questions used in the WHO-CIG focus groups are based on the original EASI focus group protocol (see Annex 1), but the order of the questions was changed and some of the questions were split.