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Another difficulty pointed out by the participants is that some people may find it hard to answer these questions.

e threat of violence and associated intimidation to an older person is an important issue that is not addressed in the bank of 12 questions.

An entirely accurate comparison of the results from the focus groups with older people and PHC professionals – and ad- ditionally across the countries – is difficult to achieve, since the nature of the focus groups conducted and the number of par- ticipants varied significantly. e following conclusions can be drawn, however:

  • In some countries, such as Singapore, older people and PHC professionals both chose an almost identical set of questions to be retained in the question- naire, but in other countries the selec- tion differs widely.

  • In all the relevant focus groups with older people, Questions 4 and 5 were chosen as the most important, followed by Questions 6, 8 and 11 (with lesser consistency across the countries). e choices made by the PHC professionals were more uniform: Preferences were given mostly to Questions 4, 5, 8, 11 and


  • A number of similar points were brought up in both groups (older people and the PHC professionals):

  • A trusting relationship between the physician and the patient is important.

Most older people feel uncomfortable when asking for help.

Although there was a general agree- ment that the questionnaire needs to be shortened and the wording simplified, there was no consensus on the length of the questions. On the one hand, some thought that longer questions were more difficult to understand but allow for fewer questions. On the other hand, shorter questions might be more com- prehensible but would lead to a longer questionnaire; the more extensive the questionnaire – even if the questions are shorter – the higher the chance of losing the attention of older people.

e importance of some questions, such as those pertaining to alcohol problems and economic dependence, depends on the geographical and cultural context.

e question on sexual abuse sparked the biggest controversy. Most older people considered this question too delicate or not relevant enough, whereas PHC professionals thought that it was necessary to include this question.

  • e main goal of this project was to investi-

gate the feasibility of developing an instru- ment applicable in different cultural and geographical contexts that could raise PHC professionals’ awareness about elder abuse and neglect.

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