NCT07494422: APPEAL

A Path to Prevention of Elder Abuse in Long-term Care. Prevalence Study Among Staff in Long-term Care.

Not yet recruiting Last updated 27 March 2026

What this trial tests

trial in Abuse Domestic in 6,000 participants. Not yet recruiting.

Timeline

24 March 2026

Primary endpoint
31 October 2026

30 April 2027

Quick facts

Lead sponsor	Linkoeping University
Status	Not yet recruiting
Study type	OBSERVATIONAL
Enrollment	6,000
Start date	24 March 2026
Primary completion	31 October 2026
Estimated completion	30 April 2027
Sites	1 location across Sweden

Conditions studied

• Abuse Domestic — all drugs for Abuse Domestic →
• Abuse Neglect — all drugs for Abuse Neglect →
• Abuse Physical — all drugs for Abuse Physical →
• Abuse Verbal — all drugs for Abuse Verbal →

Sponsor

Linkoeping University

Who can join

Adults 18 to 69, any sex, with Abuse Domestic or Abuse Neglect. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Globally, studies indicated that 16% of community dwelling older adults have been exposed to some form of abuse in the past 12 months. Furthermore, a global meta-analysis about AOP in long-term care facilities used staff as respondents and found that the pooled estimate of overall self-reported perpetration of staff to resident abuse during the past 12 months was 64.2% (95% CI 53.3-73.9%). Similar findings was also reported in a study from Norway in which the overall prevalence of observed staff-to-resident abuse was 76% and 60% of respondents report self-perpetration of abusive acts during the past 12 months. Resident-to-resident aggression was even more common, observed by 88% of respondents.

This study is part of the Swedish national research program APPEAL (A Path to Prevention of Elder Abuse in Long-term care) with the long-term goal to co-create an intervention for abuse of older people (AOP) in nursing homes together with stakeholders, i.e., staff, managers, care recipients and relatives.

Study design and data collection:

A cross-sectional study design will be used with slightly different data collection modes.

1. Population sample. Statistics Sweden combine data from the Swedish Occupational Register with data about industry codes (SNI-codes) to make a national randomized sample of staff working in home care services (n=12000) and nursing homes (n=11000) in Sweden. Data will be collected through a digital survey. Data will be combined with available register data from Statistics Sweden, including for example sex, age, civil state and occupational related data.
2. Workplace sample. Sweden has 290 Municipalities. The Swedish Association of Local Authorities and Regions (SALAR) have an official categorization of the municipalities based on e.g., urban area size, proximity to a larger urban area, and commuting patterns. One municipality in each of the nine categories has been randomly selected for participation. In the randomization process, geographical location of the municipalities has been considered to assure national representativeness, meaning that in case several municipalities in the same geographical region were selected a new randomization was conducted. Staff in each selected municipalities will be invited to participate through managers in each organization. Data will be collected through a digital questionnaire. Organizations will be encouraged to set a side time at a staff meeting for completing the questionnaire. If this is not possible, a link to the questionnaire will be sent out by e-mail. Data will be collected anonymously.

Material:

The questionnaire used in the previously mentioned Norwegian study about AOP in long-term care facilities has been translated and culturally adapted. In addition, items about background characteristics of respondents as well as risk factors for AOP on both an individual and system level are included, e.g., workload and perceived support at the workplace and ageist attitudes.

Analysis:

Primary outcomes will be proportion of staff reporting different types of abuse (psychological, physical, sexual, financial abuse and neglect) in different relational contexts, i.e., self-perpetrated, staff-to-resident and relative-to resident abuse, and in long-term care facilities resident-to-resident abuse.

Secondary outcome will be staff reported own exposure to different forms of abuse at the workplace, including by residents, co-workers, relatives and managers.

Logistic regression analysis will be used to investigate associations between reporting different forms of abuse and potentially explanatory factors.

Publications & conference data

No peer-reviewed publications indexed yet for this trial.