The Development of Construct Validation of Perception of Elder Abuse Questionnaire

The Development of Construct Validation of Perception of Elder Abuse Questionnaire

Nnaemeka Ifeoma. J.,  Nwagbo Chikelue A., Okpala Michael., Tochukwu Stephen Onyeyili., Chukwuma Elizabeth., Anyaorah Godson

Nnamdi Azikiwe University, Awka Anambra State

DOI: https://doi.org/10.51244/IJRSI.2025.12040129

Received: 20 March 2025; Accepted: 09 April 2025; Published: 20 May 2025

ABSTRACT

The study was on the development of construct validation of the Perception of Elder Abuse Questionnaire. Three hundred [300] participants [220) women and 80 men with Mean age of 29.09 years and SD age of 9.78 were involved]. The prevalence and nature of this growing problem of abuse of the elderly has not been adequately addressed especially in Nigeria because it is not recognized as a serious matter. This growing problem has generally remained hidden from public view. The victims of abuse and others are reluctant to talk about it. This research aims to find out what people’s perception of elder abuse is and also to identify factors of abuse that are common in the southeastern part of Nigeria and suggest ways in which various sectors of the society might be mobilized in the prevention of elder abuse. The method used in the construct validation of this study includes the use of experts’ opinion in the content validation exercise, and the exploratory factor analysis. The analysis extracted two components from the 35 items which loaded significantly across the components at a coefficient greater than 0.35 with a reliability coefficient of Cronbach alpha. 0.8401 The components were neglect and psychological abuse. The result of the correlations and pilot study showed a reduction of the items to 29 and  showed significant concurrent validity of the elder abuse scale with self-rating depression scale =0.95 at 0. 001. Similarly divergent validation was seen between the elder abuse scale and life satisfaction = -0.30, though not significant at the .005 level of testing. The discussion of the result was done in line with the dominant factors in the study and the need to improve assessments of elderly abuse in Nigeria.

Keywords: elderly abuse, perception, construct validation

INTRODUCTION

The value of aging varies depending on where you are in the process, even though it is a continuous one. While some changes are welcomed with excitement, others, like the appearance of gray hairs, are met with less enthusiasm [Hunt, 2004]. By 2030, there will be more than 1 billion people over 65 living in the world (Rutty, 2008; World Health Organization, 2002). The sharp rise in the world’s population is reflected in this trend. Life expectancy has risen to 80 years even in many third-world countries, and by 2004, 20% of the world’s population will be elderly, with the number of people 80 and older expected to double or triple (Rutty, 2008). The act of elder abuse is one that is planned or ordered. An act designed or ordered to cause direct or indirect harm to an elderly person in order to lower that person’s sense of value and self-esteem is known as elder abuse. Passive neglect, verbal or emotional abuse, and physical assault or abuse are examples of such acts. Age Issues Elder Abuse and Neglect Prevention Services (2004) argued that abandoning, discriminating against, and isolating elderly people constitute abuse. It further stated that disrespect, disapproval, disloyalty, yelling at, and treating an elderly person with contempt are all acts that can cause them to feel afraid and inferior. It went on to say that physical abuse of elderly people, which can include pushing, hitting, or throwing objects at them, is even worse.

Seven types of elder abuse were recognized by the National Center on Elder Abuse in 1995. Elder abuse can take many different forms, but it is commonly categorized as financial exploitation, psychological abuse, physical abuse and neglect, and rights violations. Even though elder abuse is common in our society, it is unclear whether or not the general public views it as abuse. In isolated villages, the majority of the younger generation leaves their elders to fend for themselves and only learns of their health status when a serious illness strikes or they pass away. Emotional abuse is also frequent as supposed caregivers verbally abuse those elders, they are in charge of either being too slow, too clumsy, or too forgetful. Material and financial exploitation occurs when money sent for the upkeep of the elder is spent with reckless abandon by the caregiver for his/her selfish purposes.

Nigeria is the most populous country in Africa and currently has the highest older person’s population in Africa (Kinsella and Velkoff, 2001). With the largest population in Africa and the ninth in the world, it is estimated that by the year 2025, the population of Nigerians aged 60 and above will constitute 6 percent of the entire population. Nigeria, like other African countries, sees this emerging issue as a serious future challenge. The inability of the government to cope with the regular payment of pensions to the retired workforce, the inadequate social services and health facilities to cater to the needs of an aging population, as well as a predominantly rural agrarian population all pose new threats to food security, social security and national security of Nigeria. Older people’s lives are characterized by growing inadequacies in customary family support, social exclusion, and non-existent social security targeted at them, thus being very vulnerable to poverty and diseases Olayinka Ajomale, 2004. In Nigeria, the extended family system provides love, protection, security, respect, honor, means of subsistence and survival, and all forms of support for the elders in the cultural milieu. The extended family is, however presently dwindling as a culture. Consequently, the status and care provided for the elderly are also dwindling. For instance, the disengagement theory postulated by Cummings and Henry (1961) implies that the elderly are forced into painful and involuntary withdrawal from social and financial roles making them economically dependent, socially isolated, disposable, and powerless. Unfortunately, research findings suggest that the processes of modernization and urbanization are beginning to erode the traditional social welfare system of Africa, the extended family (Mba, 2005). The resulting condition is likely to impact negatively on their financial support, health, image, and self-esteem thereby precipitating elderly abuse due to their socio-economic vulnerability. In Nigeria Society, the cultural values and traditional practices emphasize that the elderly members of the family be treated with honor and respect. The families of the aged persons are expected to ensure the needed care and support for the aged. However, recent changes in the size and structure of families have caused the re-arrangement of the roles and functions of the members in the families. Old age is expected to be the golden period of one’s life characterized by tranquility, enjoyment, and satisfaction.

The reality, however, is a disappointing shattered dream. Old age in many African countries is a nightmare and a tale of woes. There is no denying the fact that abuse exists in our communities because observation has it that most of the behavior meted on the elderly who are regarded as disrespectful is one form of abuse or the other. Although there exist legislative instruments that guarantee the rights of all persons including the older population in some parts of Africa, elder abuse is rampant because older persons are poor and voiceless. They lack basic healthcare, shelter, and dignity. The rights of elderly persons are often trampled upon with impunity and they are looked upon with contempt. Older women, for instance, are often branded as witches and are blamed for every calamity that happens in their communities (The Help Age Ghana, Osu; 2004). This highlights the negative attitudes and psychological trauma elderly persons have to contend with in a traditional African setting.

The perception of elder abuse differs across cultures and countries. What can be termed or described, as elder abuse in countries in Europe and America might not be so in Africa or Asia. Within a specific country, perception also cut across many lines. In Nigeria, for example, some cultural practices associated with the people of the Eastern part of Nigeria are not classified as abuse but in other parts they are. Many older persons in Nigeria believe that any action that diminishes the dignity and respect expected to be accorded an elderly person constitutes abuse. To deal adequately with elder abuse and to develop effective interventions, it is important to ascertain the public’s perceptions of the kinds of behaviors and treatment which they believe constitutes abuse and mistreatment of older people. What might be considered abusive in one culture may be very different from what constitutes abusive behavior in another (Tatara, 1999). The extent of elder abuse as perceived by the general public has been reported by several studies. According to the research carried out in the southeastern part of the country [Enugu state]by Asogwa, L.O., Igbokwe, C.C. 2010. This study determined the prevalence of physical, emotional, and economic/financial abuse of the elderly in domestic settings in Enugu State. Major findings included a low prevalence of physical abuse of the elderly and a moderate prevalence of economic/financial exploitation and emotional abuse of the elderly. Gender was a significant factor in the prevalence of abuse of the elderly. More women were often abused than the male.

The researcher in this work is trying to gather information on the knowledge of people on whether abuse exists in our society. The items gathered are validated to help researchers on the elderly to know the consciousness level of the public on elderly abuse in our communities and seek solutions on how to control the incidents of this condition. Aging and the aged is a thing of joy and gift to people, not everyone is privileged to that. Dying young is taboo and very painful in typical African society, everyone is praying for long life.

Purpose of the Study

The purpose of this study is to develop and validate a reliable instrument for assessing perceptions of elder abuse. This validation process will ensure that the questionnaire accurately measures individuals’ understanding and recognition of elder abuse across different contexts. By establishing the construct validity, reliability, and applicability of the instrument, the study aims to create a standardized tool that can effectively identify perceptions of elder abuse, inform targeted interventions, and support policy recommendations for addressing the issue.”

Relevance of the Study

This paper validated an instrument that measures the perception of elderly abuse in our culture. This will help to understand the problem of elderly abuse from wider perspectives while defining it in the context of Nigeria’s situation.  This study also identifies the various forms of elderly abuse, this effort is to create awareness and sensitize individuals, families, society, and government about the problem and the consequences of continued unabated gross abuse of our senior citizens as they live in silence and ignorance of their right. To generate a theory about elderly abuse in our culture that may encourage further research and better method for screening, prevention, and intervention. This research will present the finding and conclusion aimed at identifying the indication for policy, research, and action.

It will also help educate and train those in the criminal justice system, such as the police, prosecutors, and judiciary on elder abuse as well as increased legislation to protect elders will also help to minimize elders’ abuse and will also provide improved assistance to victims of elder abuse In addition, it will help community involvement in responding to elder abuse can contribute to elderly person safety. Communities can develop programs that are structured around meeting the needs of the elderly This work also aims at contributing its quota in academic research since before now, little research has been carried out on elderly abuse awareness of the public.

METHODS

This study employed a mixed-methods approach to ensure a comprehensive validation of the Perception of Elder Abuse Questionnaire. The primary method was a quantitative survey, which provided the core data for assessing the instrument’s validity and reliability. To complement and enhance the survey findings, focus group discussions (FGDs) were conducted as a qualitative adjunct. The FGDs were used to gain deeper insights into participants’ perceptions of elder abuse, refine questionnaire items, and validate the relevance of survey responses. This triangulation of methods strengthened the study’s findings and ensured a robust evaluation of the instrument.

Participant

A sample of 300 people was selected for the quantitative study. The participants used for the exploratory analysis were randomly selected within the Awka South Local Government Area of the state. They included students, teachers, civil servants, and corporate bodies. Their ages range between 16 to 60 years with a mean age of 29.1 and a standard deviation of age is 9.78. They include 80 males and 220 females at the time of study 118 are married while 182 were still singles

Procedure for Instrument Development

Elder abuse has been shown to have a significant negative effect on victims, and is associated with decreased quality of life, morbidity and mortality; the WHO suggests elder abuse is annually responsible for at least 2500 deaths in Europe (World Health Organization 2011). Consequences of elder abuse include depression, anxiety, fear, feelings of unworthiness and other psychological stress (Dong, Chang et al. 2013), substance addiction (Kaye, Kay et al. 2007; Rosen 201 Elder abuse sometimes goes unreported because of a fear of the consequences, particularly if they are dependent upon the abuser. This includes a fear of retaliation or being abandoned, including being placed in a nursing home (Harbison and Morrow 1998).the care giver stress theory posits that abuse of the elderly I precipitated by stress of the caregiver with the elderly being the scape goat[wolf,2000)

Survey Administration & Data Collection:

The study was carried out in Awka South in Anambra State. Anambra State is a typical Igbo setting where the elderly are highly regarded. The researcher went to the pension office of the civil service to know the time of their meetings and solicited their support. The researcher combines those that retire at levels 10-16 as a high socioeconomic class and those that retire at levels 6-9 as a middle socioeconomic class. The researcher also classifies the women group in a likewise manner. For the low socioeconomic group, they were mostly men and women who retire at low levels i.e. from levels 2-5, and also business males and females whose monthly take home after sales is not more than 15,000. A descriptive study design was selected for the instrument development.

The instrument used in the study was a self-constructed questionnaire called the Perception of Elderly Abuse Questionnaire [PEAQ]. Three steps were taken in the construction validation of the questionnaire. They included

[a]       Item pooling and content validation

[b]       Correlation matrix analysis and

[c]       Factor analysis.

Item Pooling and Content Validation–

The item pooling involved collecting items from 150 people, 60 of them were elderly from the southeast ethnic group of Nigeria of 60-72yrs who were asked orally to give at least six major behaviors they felt were an abuse of their age, while the remaining 90 were randomly selected among the various age groups in Anambra, southeast of Nigeria, who were also asked to comment in 10 ways they think elderly are being abused. The items received from the respondent were collated and analyzed. The items that appear more than once were removed. The researcher collated the remaining 50 items for content validation. Content validity was determined by the expressed opinions of experts in the field of psychology. The instrument was later tested by five experts. They were asked to rate each item on how they measured the construct under study (i.e. elderly abuse). Their ratings were guided on either “relevant”, not relevant” or “relevant but poorly structured. The criterions for accepting an item was that it met 4/5 of the judge’s opinion, from the content validation, 35 items were extracted, and the instrument has 2 sections namely: A & B. The ‘A’ section contained items assessing socio-demographic data, while section ‘B’ contained questions on elderly abuse. After the pilot study the thirty-five (35) item questionnaire with 1 – 5 response formats was reduced to 29items. The alpha coefficient was calculated using the data collected from the participants in this study.

Factor Analysis

Two factors were extracted using the principle component analysis and varimax with Kaiser Normalization for rotation. The criteria for extracting factors were based on the consideration of {a} Eigen value>1 {b} the screen plot analysis and {c} the percentage of variance >5.00. Only two of the initial twelve factors met the criteria used above. The following factors were thus extracted, neglect and psychological abuse.

Presentation of data, and analysis

Presentation of the analyzed data shows the findings that related to the elderly and abuse

Table 1[exploratory analysis]

Factor loading from principal component factor analysis, communalities, for an item of the perception of elderly abuse

Item	Factor Loading					Communality
	1	2	3	4	5
	.267	.547				.680
	.397	.485				.647
	-.279	5.753Σ-02	-412	.356		.707
	.352	-431				.562
	.141				391	.595
	.262	.633				.628
	.202	.638				.645
	.306	.501				.663
	9.834E-02					.797
	-1.65E-02			.436		.637
	.149			.401		.725
	.438					.647
	.454					.652
	.481					.681
	.180					.567
	.511					.664
	.510					.678
	.490					.693
	.511					.628
	.391					.720
	.560					.674
	.535					.823
	.585					.730
	.494					.652
	.555					.657
	.293		.510			.721
	.374				.522	.654
	.483					.687
	.468					.660
	.607					.703
	.503					.632
	.456					.653
	.517					.646
	.581					.632
	.536

Construct Validation & Reliability Testing:

The statistical analysis for Cronbach’s alpha reliability for the Elder Abuse Questionnaire was 0.8401. The probability ratio was 0.05. The Bartlet test of Sphericity = 3526.66 as well as the Kaiser meyer-olkin (KMO) measure of sample adequacy = 0.716 were all significant at p< .001, showing that the items were factorable. Five(5) factors were extracted, but most of the items loaded significantly in factors 1 & 2, and so most of the items were discarded because two or three items is not enough to develop a construct. So, some items that did not load significantly in factors 1 & 2 were discarded from the list. Hence reliability coefficient for the initial 35 items is Cronbach alpha. 0.8401 .Since the Cronbach alpha reliability of the 35 items is .0.8401; it shows that the items are consistent in measuring the perception of the elderly abuse questionnaire

Pilot study/Concurrent / divergent validity

A pilot study was carried out with a smaller sample to ascertain the clarity of the scale and also to ascertain the concurrent validity. The item were further reduced to 29 items Also based on the reliability obtained from the two factors that went for further analysis, it shows that those two factors are okay to measure the construct under study [Anastasia and Urbina, 1994]. The items that were later discarded were so because 2 or three items cannot measure a construct, hence they were not considered in the factors. But all the items proved reliable based on the result of the alpha coefficient. Results of the correlations showed significant concurrent validity of the elder abuse scale with the self-rating depression scale, r =0.95 at 0. 001. Similarly divergent validation was seen between the elder abuse scale and life satisfaction, r = -0.30, though not significant at a .005 level of testing

DISCUSSION

Compared to the abundance of systematic data on population aging and statistics, there is little research, or published data on elder abuse in Nigeria. The awareness is gradually deepening, as researchers are now going into this area that was regarded as taboo in the past. This is a problem that largely gets swept under the carpet and is within the four walls of a home. It is grossly underreported and un-discussed as the older people themselves do not want to discuss it and the relatives and neighbors who are aware of this do not want to get involved.

The concept of elder abuse as relevant to the developed world is alien to the Nigerian society. The Nigerian scenario is not individualistic but a traditional family-based society where older persons still seem to be considered and respected a lot. Due to technical advances and migration from rural to urban areas, the roles of older people have become ill-defined and too insignificant for the family.

The results of the survey indicate that the Elder Abuse Questionnaire had a strong to moderate reliability as an instrument based on a two-factor solution. The standard deviation and variance indicate that although there was a variation between the questions on the Elder Abuse Questionnaire both results were within an accepted ratio of below one (Cronbach, 2001). The alpha coefficient was 0.84 and was considered acceptable for a new instrument. The results of the survey indicate that the Elder Abuse Questionnaire had a strong to moderate reliability as an instrument based on a two-factor solution, which includes, emotional/psychological and neglect. One of the factors that loaded significantly in our culture is psychological or emotional abuse and it occurs when a care giver causes emotional pain or stress for an elder. A care giver may be a family member or a person who is responsible for taking care of the elderly. The care giver may insult, threaten, humiliate, or harass him/her through words or actions. He may also ignore the elder or isolate him from family members, friends, or daily activities. His right may be ignored, limited, or taken from him even if he can act or think for himself. It is important to note that psychological abuse poses some risks if it is not checked; elders may develop serious health and emotional problems. He may also become depressed and have suicidal tendencies.

In support of this study a similar study was carried out in Sweden, the patterns of elder abuse reported by district nurses, in Sweden show a typical situation involving family conflicts, financial concerns, alcohol abuse by the abuser, and mental disturbance in the victim. Psychological abuse was the most frequently reported kind of abuse (Saveman, Hallberg, Norberg, &Eriksson, 1993) Elder abuse in institutional settings is a current focus for Swedish elder abuse research. Saveman and coworkers (Saveman, A°stro¨m, Bucht, & Norberg, 1999) found that psychological and physical abuse related to caregiving activities formed the most commonly reported types of abuse in the residential setting. The abuser was typically described as being aggressive, hot-tempered, exhausted, or burnt out. Also In another study of the Prevalence of Abuse of the Elderly in Domestic Setting in Enugu State, Nigeria (Asogwa, L.O. And Igbokwe, C.C. 2010), the result of the study shows denial of freedom of expression and opportunity for interaction was a high prevalence of (84.11%). It was also not surprising that both verbal aggression/castigation, and regarding the elderly as disoriented and confused were of highly prevalent rates (72.96%; and 65.93%)  This might be because these two forms of emotional abuse could easily be meted to an elderly person quietly without attracting the attention of neighbors and outsiders.  However, more research is needed on this scale to improve its validity. More scholars are thus called upon to voyage into the area of elderly abuse in Nigeria. Indept assessment of the abuse of the elderly will help in geriatric management and counseling.

RECOMMENDATIONS FOR PRACTICE

1. Efforts need to be invested in increasing the public’s knowledge and awareness of elder abuse through the use of the media and campaigns, with particular emphasis on recognizing elder abuse, and where to get information and support when elder abuse occurs.
2. It will help the primary health care workers about elder abuse and makes a recommendation about detection as a first step for the management and prevention of elderly abuse

Recommendations for Research

1. There should be increased awareness and sensitization at the grassroots level to ensure that the existence of the law is well publicized and elders made aware that they have right
2. Further research is needed to compare and contrast definitions of elder abuse ascribed by the public and by professionals and to explore the factors that Influence differences in perceptions.
3. Further explore factors affecting help-seeking behaviors and reporting of Elder abuse among different societal groups, so that these factors can be Targeted to promote, encourage and increase reporting of elder abuse.
4. Further research should be conducted on other dimensions of elder abuse especially on elderly perception of elder abuse to proffer solutions to this growing public health scourge

Recommendations for Education

There is a need to develop public education programs through the mass

Media and/or information programs explaining the extent of the problem, To make known what elder abuse is and highlight the harmful consequences.

This information needs to promote informative beliefs rather than Misconceptions and stigmatizing beliefs surrounding elder abuse.  Education can increase awareness of the extent of the problem and promote and empower older people to protect themselves.

These programs should be tailored to meet the needs of:

Older people, as those who are being abused, may not recognize their mistreatment as such. Education can increase awareness of the extent of the problem and promote and empower older people to protect themselves. Younger people, so that they gain a better understanding of elder abuse and become familiar with the different types of elder abuse.

Schools, in particular, should incorporate information relating to elder abuse into their educational programs.

Different ethnic/cultural groups. As the review demonstrated, understanding and recognizing elder abuse varies according to the cultural beliefs and values of different groups, therefore these differences need to be taken into account when developing informational programs.

Limitation of Study

This does not mean the difficulty met in the course of the work. It means what factors that may limit the generalisability of the research findings. E.g. the respondents may not have said/filled their true opinion on the questions. It is like the error level in statistical computation.

This study should have been conducted throughout the whole southeast region of Nigeria but due to time factors, reaching the entire local district in Igbo land: this would not have been possible. The time and resources available has become the determining barrier for this choice of the area covered by e study.

A qualitative method was chosen to enable the exploration of the subjective attached to their experiences. The collection of the questionnaire was worse than the distribution, and the researcher did several repeats to respondents to encourage them to fill out the questionnaire and submit it, which casually affected the sample size. However, much as these challenges were debilitating and discouraging, it was considered a good rooting and touchstone for effective research work.

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