title: Screening tools for identification of elder abuse: a systematic review.
abstract: OBJECTIVE
  To review the efficacy and accuracy of tools administered to older people, intended to detect and measure elder abuse.
  
  
  BACKGROUND
  The mistreatment of older people represents a widespread problem, with exponential growth risk, especially considering the progressive ageing of the world population. It could have serious consequences for the victim's health if not recognised early, denounced and stopped. Abuse is often undetected by service providers because there is a lack of awareness surrounding the magnitude of the problem. Education and formal training in the signs of abuse are also generally poorly developed, as are reporting procedures which would lead to further investigation.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Comprehensive database searches of MEDLINE, Cochrane, EMBASE and Scopus were undertaken. Screening of 695 articles resulted in 11 included. Appraisal and analysis using PRISMA Statement and STROBE checklist were undertaken.
  
  
  RESULTS
  Eleven screening tools have been presented: H-S/EAST, VASS, EASI, CASE, BASE, E-IOA, EAI, EPAS, CPEABS, OAPAM and OAFEM, all aimed at healthcare professional or, in some cases, expected to be specifically used by nurses.
  
  
  CONCLUSIONS
  The fundamental function of any assessment instrument is to guide through a standardised screening process and to ensure that signs of abuse are not missed. Several tools have been tested; some have demonstrated a moderate to good internal consistency and some have been validated to allow an early identification. None have been evaluated against measurable violence or health outcomes.
  
  
  CONCLUSIONS
  Nurses and all healthcare providers should screen patients routinely. However, we are not able to recommend a single tool as the selection and implementation has to be appropriate to the setting. Furthermore, the study population and the possibility of using multiple tools in combination should be taken into consideration, to assess all the aspects of violence.
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont, Novara/"Maggiore della Carità" University Hospital, Novara, Italy.
authors.forename: Chiara
authors.identifier: http://orcid.org/0000-0003-1334-4374
authors.initials: C
authors.lastname: Gallione
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont - Coordinator of Nursing School, Biella Hospital, Biella, Italy.
authors.forename: Alberto
authors.identifier: http://orcid.org/0000-0003-2263-1340
authors.initials: A
authors.lastname: Dal Molin
authors.forename: Fabio V B
authors.initials: FVB
authors.lastname: Cristina
authors.forename: Hilary
authors.initials: H
authors.lastname: Ferns
authors.forename: Mark
authors.initials: M
authors.lastname: Mattioli
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont, Novara/"Maggiore della Carità" University Hospital, Novara, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Suardi
mesh_terms: D000368:Aged; D004552:Elder Abuse / Q000517:prevention & control* / Q000523:psychology; D006299:Health Services for the Aged; D006801:Humans; D009733:Nursing Diagnosis; D009735:Nursing Homes; D011594:Psychometrics
keywords: assessment tools; diagnosis; elder abuse; mass screening; outcome; process assessment; screening tools