Trends in elder abuse and age discrimination during the COVID-19 pandemic in Hong Kong: Findings from a two-wave representative telephone survey study.

OBJECTIVES: Empirical evidence about the heightened risks of elder abuse and age discrimination during the COVID-19 pandemic is scarce. This study aimed to track the changes in rates of both, and investigated their associated factors in the community-dwelling older population in Hong Kong. METHODS: In this two-wave, cross-sectional telephone survey, we interviewed a population-based sample of individuals (≥55 years), and captured the situation of elder abuse and age discrimination before the COVID-19 outbreak (n = 1209, Wave 1: October-December 2019) and during the pandemic (n = 891, Wave 2: December 2020-January 2021). Participants reported their experiences of different types of abuse and discrimination, financial health, subjective well-being, satisfaction with environment, health and social services, and resilience. RESULTS: Abuse was reported by 20.2% of the sample before the outbreak and 17.8% during the pandemic; while discrimination was reported by 24.6% and 29.8% at the two time points, respectively. A drop in physical abuse was observed, but it was accompanied by a rise in discrimination in the form of harassment or refusal of services. Findings of logistic regression analysis show that abuse during the pandemic was associated with younger age, poorer subjective well-being, and lower resilience; while discrimination was associated with female gender, being married, and poorer subjective well-being. CONCLUSIONS: Elder abuse and discrimination were prevalent across time points. The pandemic has highlighted the marginalization of older persons in our communities. There is an urgent need for development of effective interventions to end abuse and discrimination.

Typology of family caregivers of older persons: A latent profile analysis using elder mistreatment risk and protective factors.

This study sought to identify subpopulations of caregivers of older persons based on their profiles of individual characteristics and caregiving contexts and aimed at examining the associations between caregiver profiles and elder mistreatment. A convenient sample of 600 adult caregivers of community-dwelling older people in Hong Kong participated. Results of latent profile analysis support a typology of 3 distinctive caregiver profiles: (a) non-vulnerable caregivers; (b) isolated, vulnerable caregivers; and (c) traumatized, vulnerable caregivers. Isolated and traumatized caregivers reported greater risk factors related to elder mistreatment: They had higher levels of caregiver stress and burden, lower levels of social support and resilience, greater neurotic personality orientation and problematic gambling behavior, and more severe childhood traumatic experiences. The two groups also display significantly higher level of abusive behaviors than non-vulnerable caregivers.

Staff Turnover Intention at Long-Term Care Facilities: Implications of Resident Aggression, Burnout, and Fatigue.

OBJECTIVES: Staff shortages and the high turnover rate of nursing assistants pose great challenges to long-term care. This study examined the effects of aggression from residents of long-term care facilities, burnout, and fatigue on staff turnover intention. The findings will help managers to devise effective measures to retain their staff. DESIGN: Cross-sectional descriptive study design. SETTING AND PARTICIPANTS: A total of 800 nursing assistants were recruited from 70 long-term care facilities using convenience sampling. METHODS: The participants were individually interviewed and provided information about their turnover intention, resident aggression witnessed and experienced, self-efficacy, neuroticism, burnout, fatigue, and personal and facility characteristics. RESULTS: Hierarchical multiple regression analysis revealed that the size and organizational practices of long-term care facilities were not associated with staff turnover intention. Staff who spent less time in the industry reported witnessing resident-to-resident aggression, experienced resident-to-staff aggression, reported high levels of burnout, had acute or chronic fatigue, and had low levels of inter-shift recovery were more likely than others to report a high turnover intention. CONCLUSIONS AND IMPLICATIONS: Staff turnover poses great challenges to staff, residents, and organizations. This study identified important factors that may help support staff in long-term care facilities. Specific measures, such as person-centered care to diminish resident aggression by addressing residents' unmet needs, work-directed programs to mitigate burnout and improve staff mental health, and flexible schedules to prevent fatigue should also be advocated to prevent staff turnover.

Predictors of COVID-19 actual vaccine uptake in Hong Kong: A longitudinal population-based survey.

Purpose of the research: Identifying predictors of COVID-19 vaccine uptake decisions is central to the development of evidence-based strategies for promoting vaccination. This longitudinal study investigated the link between previous willingness to vaccinate and vaccine uptake decision, and examined potential predictors of vaccine uptake in Hong Kong. Methods: A longitudinal telephone survey study was conducted using a population-based sample of Chinese adult residents (≥18 years) in Hong Kong. Data were collected at two time points: T1 (December 2020-January 2021) and T2 (June-July 2021). Primary outcome was vaccine uptake status; whilst independent variables and covariates included socio-demographic factors, COVID-19 related experiences, health beliefs, and perception, as well as vaccine related perceptions. Results: Among the 1,003 participants, 23.7% had received a COVID-19 vaccine. Previous willingness to vaccinate did not predict vaccine uptake at later stage. Vaccine uptake by known others (aOR = 8.00), trust in authorities (aOR = 1.53), acceptability of non-pharmaceutical preventive measures (aOR = 2.96), and first-hand experience of COVID-19 (aOR = 1.32) were significant predictors of vaccine uptake after adjusting for confounding factors. Conclusions: Future strategies to promote vaccination may focus on building public trust in government and healthcare professional, and encouraging vaccinated individuals to share their vaccine uptake status via social networking.

Physical, psychological and pandemic fatigue in the fourth wave of COVID-19 outbreak in Hong Kong: population-based, cross-sectional study.

OBJECTIVES: To examine the physical, psychological and pandemic fatigue during the COVID-19 pandemic, and to explore the correlates of fatigue using a representative, population-based, community sample of Chinese adults in Hong Kong. DESIGN: Cross-sectional study. SETTING: Telephone surveys in Hong Kong from December 2020 to January 2021 (during the fourth wave of COVID-19 outbreak). PARTICIPANTS: 1255 adults living in Hong Kong aged 18 years or older sampled using a multistage approach (53% women). MAIN OUTCOME MEASURES: Physical and psychological fatigue: The Fatigue Assessment Scale (with a cut-off score of 22). Pandemic fatigue: Adherence to six disease prevention measures (DPM) recommended by the government. RESULTS: About 25.7% of the participants were feeling fatigued physically and psychologically. Physical and psychological fatigue was not directly associated with pandemic fatigue, and their association was fully mediated by self-perceived disruptions of COVID-19-related restrictions in daily life. Results from the hierarchical regression analysis showed that higher levels of fatigue were associated with economically inactive status (B=0.18, SE=0.04, p<0.001), having family or friend infected with COVID-19 before or during the study (B=0.17, SE=0.01, p<0.001), lower acceptability of DPM (B=-0.16, SE=0.03, p<0.001), greater disruptions in daily life (B=0.22, SE=0.02, p<0.001), and greater trust in authorities in ending the pandemic (B=0.11, SE=0.02, p<0.001). CONCLUSIONS: Fatigue affected many individuals during the pandemic. Disruptions of DPM in daily life may serve as a mediator in the association between pandemic fatigue and physical and psychological fatigue, reflecting the need of effective interventions to reduce self-perceived disruptions of COVID-19-related restrictions in the general population. Resources should be allocated to provide sufficient services to individuals vulnerable to fatigue during the prolonged pandemic.

Predicting Public Adherence to COVID-19 Preventive Measures: A Cross-Sectional Study in Hong Kong.

Objectives: To effectively control the spread of COVID-19, the public's adherence to relevant disease preventive measures (DPM) is critical. This study examined individuals' adherence to various DPM and identified facilitators and barriers to adherence in a community sample in Hong Kong. Methods: In this cross-sectional study, telephone surveys were conducted over December 2020 and January 2021. Participants provided responses on their adherence to DPM as well as other psychosocial and cognitive factors via the phone. Results: Of the sample of 1255 Chinese adults (aged >18 years, 53% women), 94.4% wore face masks in public areas; 88.4% avoided touching their eyes, nose, and mouth; 82.1% performed hand hygiene practices; 81.5% used alcohol-based hand rubs; 74.6% abided by social distancing; and 39.7% tested for COVID-19 on a voluntary basis. Perceived benefits, perceived barriers, self-efficacy, cues to action, perceived acceptability, and disruptions to daily life related to COVID-19 were associated with individuals' adherence to DPM. Conclusions: Adherence to DPM was strong in Hong Kong, and the adherence level could be predicted by various factors. It is vital to consider these factors in order to improve the public's adherence.