Assessment Elder abuse and Perceived stress of informal caregivers of the elderly

Assessment Elder abuse and Perceived stress of informal caregivers of the elderly | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment Elder abuse and Perceived stress of informal caregivers of the elderly Mahsa Ehsaninasab, Seyed Vahid Ahmadi Tabatabaei, Ali Karamoozian, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6318253/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aim : Elder abuse is an important health problem associated with ederly care. This study aimed to assessment elder abuse and perceived stress of informal caregivers in ederly. Methods : This descriptive-analytical study was carried out among 253 elderly individuals and their caregivers. Multi-stage sampling was employed across 10 comprehensive urban health service centers. Data collection was facilitated using Cohen's Caregivers' Perceived Stress Questionnaire, the Elder Abuse Questionnaire, and a demographic questionnaire. Results : Average perceived stress among the informal caregivers of the elderly was 28.96 ± 6.981. There was no significant correlation between the perceived stress of informal caregivers and elder abuse (P-value = 0.151, r = 0.15). However, a significant correlation was found between the perceived stress of informal caregivers and demographic variables such as place of residence, age, occupation, mental illness or trauma, income, number of children, insurance, and addiction. Similarly, elder abuse showed a significant correlation with demographic variables like gender, age, education level, occupation, marital status, physical and mental illness or trauma, type of care, income, and addiction. Conclusions : Elder abuse is a complex and occasionally concealed issue that warrants special attention. Based on the study's findings, it is recommended to implement strategies to manage stress among the informal caregivers of the elderly. Perceived stress elder abuse caregivers of the elderly informal caregivers Introduction The elderly population, which is increasing in Iran and the world, has specific needs and problems in developed and developing countries. The elderly are vulnerable in all dimensions of health due to the physical, social, and psychological changes caused by the aging process( 1 ), which renders them vulnerable to abuse. The World Health Organization (2002) defines abuse as a behavior of the caregiver of the elderly that intentionally or unintentionally reduces the quality of life of older adults and increases their physical and psychological harm. This abuse has different types and can be physical, sexual, psychological, or economic or in the form of neglect or inattention( 2 )( 2 ). According to studies, the incidence of domestic elder abuse is estimated to be between 67% and 73.3%( 3 ). Elder abuse has also been confirmed in Iran. However, there are still no accurate statistics on the rate of elder abuse or the characteristics of the abusers and the victims. For example, the results of Nasiri et al.'s study indicated that 63.3% of the studied elderly were abused by their families( 4 ). While in 2002, the World Health Organization estimated the rate of domestic elder abuse at 4–6%( 5 ), in a 2018 report, it was reported that this rate was increasing( 6 ), and this figure is expected to increase to 24% by 2050( 7 ). Elder abuse-related research is a relatively new field of research compared to child abuse and domestic violence. This phenomenon can lead to an increase in mortality and disability of the elderly, more visits to the emergency rooms, depression, an increase in hospitalizations, and an increase in care costs( 8 ). It can negatively affect the health and sense of security of the elderly and ultimately reduce their quality of life( 9 ). Studies in the field of elder abuse in Iran have been minimal and insignificant( 4 ). Accurate studies have shown that the reported rate of elder abuse in all cultures is less than the actual rate( 10 ), which can be caused by the abusive behavior of the informal caregivers of the elderly. Informal care refers to the care provided without charge by family members, friends, and acquaintances of the elderly person. Most elderly receive the services they need from informal caregivers, usually family members, spouses, friends, and neighbors( 11 ). Taking care of the elderly changes caregivers' lives; some examples are lack of time, reduced emotional feelings, disruption of social life, the feeling of losing control over personal life, and the emergence of physical and emotional burdens (anxiety, stress, and depression)( 12 ), which exposes them to stress. Stress is the body’s natural reaction to any recognized demand, alteration, or challenge. The stressor refers to the specific circumstance or occurrence that triggers this reaction. While stress can negatively impact one’s sense of well-being, leading to feelings of threat, its prolonged presence may result in psychological issues. These can include depression, obsessive behaviors, personality disorders, and pervasive feelings of inadequacy, anxiety, resentment, and boredom ( 13 ), and eventually, caring causes various forms of stress for the caregivers and ultimately (directly or indirectly) for the elderly( 14 ); the greater the degree of physical or emotional dependence of the elderly, the more stress the caregiver is subjected to and the higher the possibility of depression and subsequently the possibility of disturbing behaviors( 15 ). Caregiver stress is considered one of the critical risk factors of elder abuse( 15 ). In the research by Navidian et al. ( 16 ) which focused on family caregivers of individuals with mental illness, the results indicated that 26.4% of caregivers experienced mild mental stress, 60.8% encountered moderate mental stress, and 12.8% suffered from severe mental stress. Additionally, investigations have been carried out to explore instances of elder abuse perpetrated by relatives, informal caregivers, and professional caregiving personnel. Given the complex array of contributing factors, the determinants of abuse have often been overlooked. This study aims to explore the impact of informal caregivers’ perceived stress on the incidence of elder abuse in Kerman, Iran. The findings will guide the development of multifaceted interventions, raise awareness among authorities and the elderly’s relatives about the gravity and repercussions of such abuse, and underscore the urgency of extensive support for the victims. Methods and materials The current study was a descriptive-analytical cross-sectional investigation. Utilizing Morgan’s table, the sample comprised 253 elderly individuals and 253 caregivers from ten comprehensive health service centers in Kerman, conducted in 2023. The sampling process involved researchers visiting these centers, detailing the study’s aims, and employing the Sib system—a registry for Iranian electronic health records established in 2014—to randomly select eligible elders. Subsequent contact was made via telephone to the registered number of each elder, where the researchers introduced themselves to either the elders or their family members. The primary caregiver was identified as the person most involved in the elder’s care. Upon ensuring confidentiality and explaining the study’s methodology, willing and eligible participants were either visited at home or invited to the centers to complete questionnaires in a private setting. The questionnaires were completed in a time frame suitable for the response speed of the caregiver or the elderly subject, i.e., it was different for different participants. The inclusion criteria of caregivers in this study were being Iranian, being willing to participate in the study, and being literate. The inclusion criteria of the elderly subjects were an age of 60 years or older, willingness to participate in the study, ability to communicate verbally, not having a speech disorder, and not suffering from mental illnesses or Alzheimer’s disease (based on information provided by the caregiver or the Sib system). The exclusion criteria for this study included the inability of the elderly subject and the caregiver to answer the questions and their unwillingness to participate in the research. Data were collected using three questionnaires: a demographic questionnaire, Cohen's Measure of Perceived Stress elderly caregivers, and the Elder Abuse Questionnaire. In this research, the 14-item version of Cohen's questionnaire was presented. The Cronbach's alpha obtained in three other studies for this scale was 0.84, 0.85, and 0.86 (Cohen et al.) (1983)( 17 ). The validity and reliability of this questionnaire were confirmed in Iran by Asghari et al. (2013), and its obtained Cronbach’s alpha in the Iranian students sample was 0.84( 18 ). This questionnaire, containing fourteen phrases, seven positive and seven negative phrases, measures the general perceived stress in the past month( 17 ). Elder abuse information was collected in person and using the Elder Abuse Questionnaire, whose validity and reliability were confirmed in Iran by Karimi et al( 19 ) )2008) and Mohseni et al( 20 ) (2019). This questionnaire includes five items and each item includes separate questions about physical condition (skin condition, fractures, and burns), psychological condition (verbal and non-verbal), neglect (failure to meet the needs of personal hygiene and essential medical care, basic activities of daily life, and financial management), abandonment (experience of living in a place other than their own home and satisfaction with this issue), and financial condition (misuse of the elderly person’s money or assets by other individuals or organizations without their permission). The demographic questionnaire was a researcher-made questionnaire whose specific questions were adapted to the environmental and cultural conditions of the research community. It collected data on the individual from the personal and social dimensions. After coding and categorizing the questionnaire responses, the data was inputted into SPSS 22 software (Armonk, NY: IBM Corp.). To characterize qualitative variables, frequency and percentage calculations were performed, while quantitative variables were described using mean, median, standard deviation, and interquartile range. The normality of data distribution was assessed using the Shapiro-Wilk test, as well as kurtosis and skewness measures. Given that caregiver-related data followed a normal distribution, and elderly-related data did not, appropriate analytical models were applied: univariate and multiple linear regression for the former, and univariate and multiple regression with inverse Gaussian distribution for the latter. Both sets of models employed backward elimination to pinpoint critical variables and determine the optimal model. Results The study found no significant correlation between the stress perceived by informal caregivers and instances of elder abuse among elders attending comprehensive health service centers in Kerman in 2023 (P-value = 0.151, r = 0.15). However, a significant association was observed between caregivers’ perceived stress and demographic factors such as residence, age, occupation, health conditions, income, number of children, insurance status, and addiction. Additionally, elder abuse showed a significant relationship with demographic aspects including gender, age, education level, occupation, marital status, health conditions, care type, income, and addiction. The prevalence of different types of abuse is presented in Table 2 and other relevant information in Tables 1 , 3 , and 4 . Table 1 Characteristics N (%)/Mean ± SD Caregiver age (years) 46.42 ± 15.4 Caregiver sex Men Women 96 (37.9) 157 (62.1) Caregiver education Illiterate Reading & writing Middle school High school University 4 (1.6) 19 (7.5) 41 (16.2) 72 (28.5) 117 (46.2) Caregiver location Alone With wife With children With wife and children Other 7 (2.8) 56 (22.1) 14 (5.5) 83 (32.8) 93 (36.8) Caregiver occupation Unemployed Self-employed Homemaker Government clerk Retired Other 17 (6.7) 67 (26.5) 73 (28.9) 55 (21.7) 20 (7.9) 21 (8.3) Caregiver marital status Single Married Divorced Widow/widower 74 (29.2) 144 (56.9) 25 (9.9) 10 ( 4 ) Caregiver physical state Sick Healthy 67 (26.5) 186 (73.5) Caregiver mental state Sick Healthy 60 (23.7) 193 (76.3) Caregiver type of care Independent Collaborative 94 (37.2) 159 (62.8) Caregiver income Up to 5 million tomans 5 to 10 million tomans More than 10 million tomans 87 (34.4) 81 ( 32 ) 85 (33.6) Caregiver number of children Without children One child Several children 108 (42.7) 38 ( 15 ) 107 (42.3) Caregiver insurance No Yes 44 (17.4) 209 (82.6) Caregiver addiction No Yes 175 (69.2) 78 (30.8) Caregiver housing type Apartment House 75 (29.6) 178 (70.4) Caregiver home ownership Owner Tenant 140 (55.3) 113 (44.7) Elderly age (years) 72.47 ± 8.54 Elderly sex Men Women 143 (56.5) 110 (43.5) Elderly education Illiterate Reading & writing Middle school High school University 62 (24.5) 46 (18.2) 31 (12.3) 69 (27.3) 45 (17.8) Elderly location Alone With wife With children With wife and children Other 51 (20.2) 66 (26.1) 38 ( 15 ) 68 (26.9) 30 (11.9) Elderly occupation Unemployed Self-employed Homemaker Government clerk Retired Other 57 (22.5) 31 (12.3) 63 (24.9) 14 (5.5) 87 (34.4) 1 (0.4) Elderly marital status Single Married Divorced Widow/widower 19 (7.5) 137 (54.2) 34 (13.4) 63 (24.9) Elderly physical state Sick Healthy 189 (74.7) 64 (25.3) Elderly mental state Sick Healthy 129 (51) 124 (49) Elderly type of care Able to take care of self Partial care Average care Extreme care Special care 60 (23.7) 66 (26.1) 66 (26.1) 28 (11.1) 33 ( 13 ) Elder income Up to 5 million tomans 5 to 10 million tomans More than 10 million tomans 95 (37.5) 94 (37.2) 64 (25.3) Elder number of children Without children One child Several children 39 (15.4) 36 (14.2) 178 (70.4) Elder Insurance No Yes 39 (15.4) 214 (84.6) Elder addiction No Yes 169 (66.8) 84 (33.2) Elder housing type Apartment House 40 (15.8) 213 (84.2) Elder home ownership Owner Tenant 168 (66.4) 85 (33.6) Table 2 Prevalence of elder abuse and its subscales. % Non-verbal abuse 42.68 Financial abuse 41.5 Verbal abuse 35.96 Rejection 20.55 Neglected by others 14.62 Self-neglect 13.43 Physical abuse 7.9 Table 3 Univariate and multiple linear regression models used to investigate the effect of the studied variables. Characteristics Univariate linear regression Multiple linear regression β (%95 Cl) P.value β (%95 Cl) P.value Caregiver age (years) -0.057 (-0.11,-0.003) 0.047 -0.053 (-0.10,<0.001) 0.048 caregiver sex Men caregiver sex Women 0.07 (-1.71,1.85) 0.93 Caregiver education Illiterate Reading & writing Middle school High school University .1540 1.154 .8860 -0.402 0 (-6.87,7.18) (-2.26,4.57) (-1.62,3.39) (-2.47,1.66) .9660 .5070 .4880 .7030 Caregiver Location Alone With children with wife With wife and children Other -6.422 -0.994 -1.172 -2.508 0 (-11.75,-1.09) (-4.89,2.9) (-3.47,1.12) (-4.56,-0.45) .0180 .6160 .3160 .0170 Caregiver Job Unemployed Self-employed housewife Government clerk Retired Other 6.613 2.262 .8020- -2.748 -1.357 0 (2.38,10.84) (-0.98,5.5) (-4.01,2.4) (-6.07,0.57) (-5.4,2.69) 0.002 .1710 0.623 0.105 0.510 Caregiver Marital status Single Married Divorced Widow/widower -0.122 -2.174 -2.660 0 (-4.73,4.48) (-6.64,2.30) (-7.78,2.46) .9590 .3400 .3070 Caregiver Physical state Sick Healthy .5560 0 (-1.4,2.51) .5770 Caregiver Mental state Sick Healthy 3.324 0 (1.33,5.31) 0.001 2.186 (0.23,4.13) .0280 Caregiver Type of care Independent Collaborative .4970 0 (-1.29,2.28) .5850 Caregiver Income Up to 5 million tomans 5 to 10 million tomans More than 10 million tomans 3.353 3.600 0 (1.3,5.39) (1.51,5.68) 0.001 0.001 3.492 3.534 (1.47,5.5) (1.5,5.56) 0.001 0.001 Caregiver Number Of Children Without children One child Several children 2.048 1.721 0 (0.18,3.91) (-0.86,4.3) 0.031 0.190 Caregiver Insurance No Yes 2.547 0 (0.284,4.81) 0.028 Caregiver Addiction No Yes -2.943 0 (-4.78,-1.1) .0020 3.150- (-4.9,-1.3) < 0.001 Caregiver Housing type Apartment House .6950 0 (-1.2,2.59) 0.47 Caregiver Home ownership Owner Tenant -1.680 0 (-3.4,0.05) 0.057 Table 4 Univariate and multiple linear regression models were used to investigate the effect of the studied variables. Characteristics Univariate linear regression Multiple linear regression β (%95 Cl) P.value β (%95 Cl) P.value Elder age (years) 0.17 (0.09,0.24) < 0.001 Elder sex Men Women -2.62 0 (-3.98,-1.27) < 0.001 Elder education Illiterate Reading & writing Middle school High school University 6.420 3.269 1.775 1.283 0 (4.39,8.45) (1.52,5.009) (0.03,3.51) (-0.01,2.58) < 0.001 < 0.001 0.045 .0530 Elder Location With children with wife With wife and children Other Alone .4550 -0.159 -0.319 2.869 0 (-1.72,2.63) (-1.97,1.65) (-2.10,1.46) (-0.01,5.74) .6830 0.864 .7260 0.051 Elder Job Self-employed housewife Government clerk Retired Other Unemployed -5.316 -1.681 -5.387 -4.442 -10.316 0 (-7.44,-3.18) (-3.92,0.56) (-7.87,-2.9) (-6.38,-2.5) (-12.95,-7.67) < 0.001 0.142 < 0.001 < 0.001 < 0.001 Elder Marital status Married Divorced Widow/widower Single -0.754 -0.402 1.056 0 (-3.29,1.79) (-3.35,2.55) (-1.78,3.9) .5610 .7900 .4670 1.185 .5790 2.167 0 (-0.17,2.53) (-1.04,2.2) (0.63,3.69) .0870 .4850 .0050 Elder Physical state Sick Healthy 5.381 0 (4.42,6.33) < 0.001 1.46 0 (0.36,2.57) 0.009 Elder Mental state Sick Healthy 3.892 0 (2.64,5.13) < 0.001 Elder Type of care Partial care Average care extreme care special care Able to take self-care 3.527 5.073 7.360 9.876 0 (2.51,4.54) (3.87,6.26) (5.14,9.57) (7.29,12.45) < 0.001 < 0.001 < 0.001 < 0.001 2.094 3.451 5.460 7.827 0 (0.95,3.23) (2.004,4.89) (3.15,7.76) (5.25,10.4) < 0.001 < 0.001 < 0.001 < 0.001 Elder Income Up to 5 million tomans 5 to 10 million tomans More than 10 million tomans 4.927 2.476 0 (3.43,6.42) (1.24,3.7) < 0.001 < 0.001 1.598 0.664 0 (0.43,2.76) (-0.19,1.52) 0.007 0.130 Elder Number Of Children Without children One child Several children 0.435 1.287 0 (-1.41,2.28) (-0.8,3.38) 0.645 0.229 Elder Insurance No Yes 1.613 0 (-0.45,3.67) .1260 Elder Addiction No Yes -1.517 0 (-2.98,-0.04) .0430 -1.278 0 (-2.2,-0.35) 0.007 Elder Housing type Apartment House -1.104 0 (-2.71,0.5) .1780 Elder Home ownership Owner Tenant -1.377 0 (-2.83,0.07) .0640 Discussion The present study was conducted to investigate the relationship between perceived stress and elder abuse in the elderly who were referred to comprehensive health service centers in Kerman. The findings showed no significant relationship between the two main variables. However, based on the evidence, stress is considered to be a risk factor for wrong behaviors and violence and one of the factors that play a significant role in initiating or intensifying many disorders and the occurrence of malfunctions and incompatibilities ( 21 ). The complexity of abuse phenomena often stems from its multi-causal nature. Frequently, abuse remains undisclosed due to cultural nuances in caregiving, reverence for elders, and societal norms regarding elder interaction. Specifically in Iran, the pervasive influence of cultural and traditional values dictates familial dynamics. This cultural framework often leads caregivers to underreport their stress levels and the elderly to refrain from disclosing instances of abuse, prioritizing family reputation and the virtues of secrecy and modesty. The mean abuse in the present study was (11.3794 ± 4.66734) which was consistent with the study of Koosheshi (11.4 ± 13.2)( 22 ). The mean perceived stress was (28.96 ± 6.981) which was more or less consistent with the study of Zahed (25.4 ± 10.9) ( 23 )and the study of Bastaani (30 ± 5.86)( 24 ). In this study, non-verbal abuse was the most prevalent type of abuse, which was consistent with Mohseni’s study( 20 ); this can be attributed to the strong emotional connection and attachments of people to each other, especially the strong emotional dependencies between parents and children. This type of relationship causes extensive interactions and sometimes excessive expectations of parents and children from each other. Due to the industrialization of societies and the problems caused by the changes in society's conditions, people may not be able to meet each other's needs fully. Therefore, the possibility of abuse increases in such situations( 25 ). Physical abuse had the lowest prevalence, which was consistent with the studies of AVOW, Khalili( 26 ), and Molayi( 27 ); this can be because other types of (non-physical) abuse are invisible and due to the lack of awareness of people, non-physical types of abuse may not be considered as abuse and this issue causes more abuse to be committed ( 25 ). In the present study, perceived stress was higher in younger caregivers, consistent with Andreou's study( 28 ), so perceived stress was more related to younger age. Because younger caregivers are more dynamic and active due to their age and are eager to work, make money, and have fun, if they become responsible for caring for the elderly either by circumstance or by choice, they will endure more stress when fully occupied by caregiving, considering its stressful, tiring, and time-consuming nature( 29 ). Unemployed caregivers had a higher level of perceived stress than others. Like our study, Cohen's study found that unemployed people reported high levels of psychological stress( 30 ). As homemakers and unemployed women stay home to do the housework and spend more time caring for their patients, they are more vulnerable to the stress and pressure of caring than employed female caregivers( 29 ). This can be true about unemployed men as well. Based on the results, caregivers with an income below a hundred million rials had a higher level of perceived stress than people with an income above a hundred million rials, which was consistent with the study of Hosseini( 31 ). According to Wadsworth, economic tension disturbs family relationships and processes, limits adaptation to stress, and leads to psychological problems in family members( 32 ). Caregivers with no children had higher perceived stress levels than caregivers with several children. Contrary to our study, in Mansouri's study, no significant relationship was found between the perceived stress of caregivers of the elderly and the number of children they had ( 29 ). In old age, children are a great source of social support for parents, which positively affects their mental health and reduces their anxiety and depression( 33 ). In this study, we observed that caregivers residing either alone or with their spouse and children reported lower stress levels compared to others. The data revealed a smaller proportion of caregivers living alone when compared to those living with their spouse and children. Furthermore, the latter group was also smaller than those living under different circumstances. Consequently, there appears to be a direct correlation between the caregivers’ perceived stress and their living arrangements, influenced by the number of caregivers in each living condition. In the present study, caregivers who did not have any insurance had higher levels of perceived stress compared to caregivers with insurance because the function of insurance is to contribute to the compensation of damages and to replace uncertainty with certainty; therefore, insurance, as a method of dealing with risk, is a response to uncertain and risky conditions ( 34 )and people who do not have any insurance may have to more money out of their pockets when they face illnesses and accidents. As a result, they experience more perceived stress both before and after the illnesses and accidents. The findings of the present study showed that caregivers who did not have any type of addiction had a lower level of perceived stress compared to caregivers who were addicted because addiction itself often causes and aggravates stress in people and countless factors, including social, economic, and psychological stress play a role in creating and developing addictions. The inability to face stressful factors and the belief that the use of alcohol and drugs will lead to favorable results is the basis for turning to drug use( 35 ). The results also showed that caregivers who had a mental illness had a higher level of perceived stress compared to healthy people. In Luchesi's study, caregivers with weaker cognitive status experienced higher levels of perceived stress( 36 ), which is consistent with our study; it can be stated that people who have a weaker cognitive status and are somehow suffering from psychological trauma are more likely to suffer from other traumas or mental illnesses, especially stress. The elder abuse rate was higher in older age groups than in other groups, which was consistent with Taheri Tanjani’s study. The elderly who are 75 years old or older, who need help in their daily lives, experience more abuse( 37 ). Needing help in daily life initiates and sometimes aggravates all kinds of abuse towards the elderly, especially older elderly, who usually need more help from others in doing various chores daily. In the present study, the abuse rate in male elderly subjects was lower than it was in female elderly subjects, which was consistent with the study results of Li Wu( 38 ); this difference may be due to different sampling methods, i.e., more men than women in the study population or vice versa. Elderly widows and widowers experienced a higher rate of abuse than unmarried elderly. Koga’s study also showed that having lost a spouse can put a person at a higher risk of experiencing abuse( 39 ). In addition to adverse economic, social, and psychological consequences, widowhood renders the elderly vulnerable in terms of access to services that provide physical and mental health, and the greatest need for health, social, and psychological care often occurs at this stage of life, imposing higher costs on the individual, the health and treatment system( 40 ), and even their caregivers; this issue in itself can cause an increase in abuse in such elderly people. The other finding of this study was that, the elder abuse rate decreased with the increase in the level of education. The results of Taheri Tanjani’s study showed that illiterate elderly women are approximately 1.2 times more likely to experience abuse compared to literate women( 41 ). In our study, the number of illiterate elderly subjects was higher than that of literates. Also, some elderly people do not report abuse because they either are not aware of it or are unable to understand that they have been abused. They hope this abuse will stop somehow( 42 ). This level of awareness and understanding can be related to the level of education and literacy of the elderly person. In the present study, the elder abuse rate in retired or self-employed elderly, government clerks, and those with other jobs was lower than that of unemployed subjects. The results of Heravi’s study showed a significant relationship between elder abuse and employment, which was consistent with our study( 43 ). In our study, people with "other" occupations were those with the “other” job status. Only one person was in the "other" group in this study, so abuse in this group was lower than in other groups. Abuse among unemployed elderly was higher than in elderly people with “other” occupations. Unemployed, elderly people often have little to no income and are somehow dependent on their family members, who are also considered caregivers. Moreover, elder abuse is mainly rooted in problems such as financial constraints and dependencies that the caregivers of the elderly are dealing with, so the physical and emotional costs of caregiving are higher than their income, which can be a factor in the occurrence of elder abuse( 25 ). In this study, it was observed that elders earning between zero to fifty million Rials were more susceptible to abuse compared to those with incomes exceeding one hundred million Rials. These findings align with Hosseini Moghadam’s research, which also suggests that lower economic status is linked to increased domestic abuse of the elderly. Often, unemployed seniors or those with minimal income rely on their relatives for support, who also act as their caregivers. Furthermore, elder abuse frequently stems from financial difficulties and the dependency issues faced by caregivers. When the expenses associated with caregiving surpass their own income, it may contribute to the risk of elder abuse( 25 ). The findings of the present study showed that elderly who did not have any type of addiction experienced a lower level of abuse than the addicted elderly. Mohebi’s study( 44 )also showed that there was a significant relationship between elder abuse and addiction because the family of the addicted elderly may exploit them financially. In other words, the family takes all the savings of the elderly with the excuse of buying drugs for them or claiming they are unfit to maintain and manage their properties. In addition, there is also the possibility that the perpetrators, i.e., family members and acquaintances, will turn an addicted elderly person's house into a base for drug selling or drug use by others. These are all instances of elder abuse( 45 ). In the present study, the elderly who had a disease or physical injury experienced a higher rate of abuse than the elderly who were healthy, and the results of Khalili’s study also showed that elder abuse had a significant relationship with suffering from a chronic disease( 26 ). Functional dependency or poor physical health are risk factors for abuse, as caregivers who are responsible for daily support and are in frequent contact with the people they care for are prone to burnout and stress. On the other hand, the physical functions of the elderly continue to decrease, and they need more support( 39 ). The results in this study showed that elderly who had a mental illness experienced a higher level of abuse than healthy people. Koga reported that mild or severe depression is a risk factor for abuse among elderly participants, which is consistent with our study. When abuse occurs in what would usually be considered a high-trust relationship, the relationship could be destroyed. It may lead to fear of future encounters with people who should be trusted. This fear adds to the psychological stress in the elderly. In addition, depression is one of the main risk factors for abuse, and the relationship between depression and abuse can be a two-way relationship. First, people who were already depressed may be abused. On the other hand, abuse may also be the cause of depression( 39 ). In the present study, as the type of elderly care became more specialized, the abuse also increased. In addition, the results of Hosseini Moghadam's study indicated that the degree of dependence on others increases domestic elder abuse. The dependence of the elderly on the caregiver to conduct daily activities can cause fatigue and increase the psychological burden of the caregivers of the elderly over time. In addition, the caregivers of the elderly have less time to meet their physical, emotional, and social needs, which, as a result, increases the loneliness and isolation of caregivers and, over time, the feeling of helplessness, anxiety, and anger towards the elderly increases. This can play a significant role in initiating and increasing elder abuse( 25 ). In Koosheshi’s study, the degree of dependence of the elderly on their family members played a major and decisive role in the psychological abuse of the elderly( 22 ). The current study faced several limitations. Firstly, the absence of similar studies underscores the challenges encountered during this research. However, the uniqueness of this study could potentially inspire future research of a similar nature, but of higher quality. Additional limitations were also present. The study was exclusively conducted on urban elderly individuals who were cared for at home by family members and acquaintances. This may limit the generalizability of the findings to other populations. The use of a self-report questionnaire was another limitation. While this method is convenient, it may not provide the most accurate data due to potential biases or inaccuracies in self-reporting. Furthermore, as a cross-sectional study, it was not designed to establish cause-and-effect relationships, which is another limitation. Lastly, the potential fear of caregivers among the elderly participants might have led to an underreporting of abuse. Similarly, incorrect responses from caregivers could have resulted in an underestimation of the perceived stress levels. These factors should be taken into account when interpreting the results of the study. Conclusion Elder abuse remains a relatively obscure phenomenon when juxtaposed with other forms of violence. Often, there is a tendency to deny or minimize its occurrence, which complicates efforts to understand its underlying causes. This study, perhaps due to these and other factors, did not find a significant correlation between caregiver stress and the incidence of abuse. Nonetheless, articulating the scope of this issue and establishing the prevalence of elder abuse, alongside assessing caregiver stress levels, serves as a crucial juncture for deeper exploration and scholarly inquiry into elder abuse. This encompasses its epidemiology, risk factors, and the development of preventative and interventional strategies. The current research lays the groundwork for future studies. It is important to acknowledge that the instances of abuse discussed herein represent merely a fraction of a much larger, predominantly concealed problem. Consequently, it is imperative to advocate for routine screening of the elderly who may be susceptible to abuse and to educate them about the facets of elder abuse and their rights as victims. Recognizing and implementing methods to prevent elder abuse, educating families and informal caregivers, enacting supportive legislation, and establishing aid organizations are essential steps in addressing this critical issue. Declarations Ethics approval and consent to participate Maintaining the confidentiality of results from expert participants is essential. All participants who entered the study were informed about the research and were assured of the confidentiality of their information. The study was conducted after obtaining the ethical code to conduct the study and obtaining the necessary permissions, in compliance with ethical standards. The Ethics Committee of Kerman University of Medical Sciences approved the present study with the ethical code IR.KMU.REC.1402.343. Informed consent was obtained from the respondents. Consent for publication Not applicable Clinical trial number Not applicable Conflict of interest The authors declare that they had no conflict of interest. Funding No Funding Author’s contribution This research was carried out under the guidance Mahsa Ehsaninasab and with the supervision of Dr Vahidreza Borhaninejad (corresponding author), Dr Seyed Vahid Ahmadi Tabatabaei and Dr Ali Karamoozian . . Mahsa Ehsaninasab did the data collection and initial writing of the article. All authors read and approved the fnal manuscript. Availability of Data and Materials The datasets collected and analyzed during the current study are available from the corresponding author on reasonable request. Acknowledgments This research was part of Mahsa Ehsaninasab’s thesis. The authors hereby appreciate by Kerman University of Medical Sciences and all the respected professors who helped conduct this research. We are also grateful to all the personnel of the Kerman University of Medical Sciences, the elderly participants, and their respected caregivers who helped us conduct this research. References Riahi ME. 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Navidian A, Salar A, Keikhaee A. investigation of family caregiver strain of patient with mental health disorder who attend to Zahedan centre psychology. Urmia Med J. 2002;3(12):206–14. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983:385–96. Asghari F, Sadeghi A, Aslani K, Saadat S, Khodayari H. The survey of relationship between perceived stress coping strategies and suicide ideation among students at University of Guilan, Iran. Int J Educ Res. 2013;1(11):111–8. Karimi M, Elahi N. Elderly abuse in Ahwaz city and its relationship with individual and social characteristics. Iran J Ageing. 2008;3(1):42–7. Mohseni M, Rashedi V, Iranpour A, Naghibzadeh Tahami A, Borhaninejad V. Prevalence of elder abuse and associated factors among community-dwelling older adults in Iran. J Elder Abuse Negl. 2019;31(4–5):363–72. Hashemipour SS, Zaree E, Namazi S, Amirfakhrae A. Relationship of Health-Promoting Behaviors With Stress Coping Styles Mediated By Cognitive Emotion Regulation Strategies During the Covid-19 Pandemic: A Cross-sectional Study. J Prev Med. 2022;9(1):74–89. Koosheshi M, Valadvand L. A Study on the Psychological Abuse against the Elderly, Case of Elderly Visiting Omid Cultural Center, City of Tehran. J Popul Association Iran. 2014;9(18):146–80. Zahed S, Emami M, Eslami AA, Barekatain M, Hassanzadeh A, Zamani-Alavijeh F. Stress as a challenge in promoting mental health among dementia caregivers. J Educ Health Promotion. 2020;9. Bastani F, Ghasemi E, Ramezanzadeh Tabriz E, Janani L, Rahmatnejad L. The investigation of perceived stress and religious coping among female caregivers of the elderly with dementia. J Rafsanjan Univ Med Sci. 2015;13(10):925–36. Hosseini Moghaddam F, Nikkhah Beydokhti E, Noori R, Sajjadi M, Khajavian N, Kameli F, et al. Prevalence of Elder Abuse by Family Members and its Related Factors in Gonabad, Iran. Iran J Ageing. 2022;17(3):338–51. Khalili Z, Ghanbari-Afra L, Gholipour F, Nemati R. The Prevalence of Abuse and risk factors associated with elder abuse. 2022. Molaei M, Etemad K, Taheri Tanjani P. Prevalence of elder abuse in Iran: A systematic review and meta analysis. Iran J Ageing. 2017;12(2):242–53. Andreou E, Alexopoulos EC, Lionis C, Varvogli L, Gnardellis C, Chrousos GP, et al. Perceived stress scale: reliability and validity study in Greece. Int J Environ Res Public Health. 2011;8(8):3287–98. Mansouri T, Dehdari T, Seyedfatemi N, Gohari MR, Barkhordari M. The effect of communication skills training on perceived stress of caregivers of elderly with Alzheimer's disease referral to Iranian Alzheimer Association in 2012. Razi J Med Sci. 2014;21(121):52–62. Cohen S, Janicki-Deverts D. Who's stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006, and 2009 1. J Appl Soc Psychol. 2012;42(6):1320–34. Bastani F, Javanbakhtian Ghahfarokhi J. The effect of group discussion and telephone counselling on perceived stress of women as caregivers of patient with Alzheimer disease. J Clin Nurs Midwifery. 2012;1(1):61–72. Wadsworth ME, Santiago CD, Einhorn L, Etter EM, Rienks S, Markman H. Preliminary efficacy of an intervention to reduce psychosocial stress and improve coping in low-income families. Am J Community Psychol. 2011;48(3–4):257–71. van den Broek T. Is having more children beneficial for mothers’ mental health in later life? Causal evidence from the national health and aging trends study. Aging Ment Health. 2021;25(10):1950–8. Wang Z, Zhang Y, Xiong F, Li H, Ding Y, Gao Y, et al. Association between medical insurance type and survival in patients undergoing peritoneal dialysis. BMC Nephrol. 2015;16(1):1–7. Samoui Rahleh EA, Mousavi Seyedghfoor H, Akbar R, Saeed. Pattern of coping with stress in self-reported addicts: Isfahan Addiction Center. Iran J Psychiatry Clin Psychol (thought behavior). 2019;6:63–9. Luchesi BM, Souza ÉN, Gratão ACM, de Oliveira Gomes GA, Inouye K, da Silva Alexandre T, et al. The evaluation of perceived stress and associated factors in elderly caregivers. Arch Gerontol Geriatr. 2016;67:7–13. Quinn MJ, Tomita SK. Elder abuse and neglect: Causes, diagnosis, and interventional strategies. Springer Publishing Company; 1997. Wu L, Chen H, Hu Y, Xiang H, Yu X, Zhang T, et al. Prevalence and associated factors of elder mistreatment in a rural community in People's Republic of China: a cross-sectional study. PLoS ONE. 2012;7(3):e33857. Koga C, Hanazato M, Tsuji T, Suzuki N, Kondo K. Elder abuse and social capital in older adults: The Japan Gerontological Evaluation Study. Gerontology. 2020;66(2):149–59. Shirazi Khah M, Mousavi M, Sahaf R. Study of Health and social indicators of elderly women in Iran. Iran J Ageing. 2012;6:66–78. Piri N, Tanjani PT, Khodkarim S, Etemad K. Domestic elder abuse and associated factors in elderly women in Tehran. Iran Epidemiol health. 2018;40. Seutodan Hagh H, Rezaeipandari H, Mousavi S, Allahverdipour H. Prevalence and gender differences of elder abuse among community-dwelling older adults in Tabriz, Iran. Iran J Ageing. 2021;15(4):458–71. Heravi Karimoei M, Reje N, Foroughan M, Montazeri A. Elderly abuse rates within family among members of senior social clubs in Tehran. Iran J Ageing. 2012;6(4):37–50. Mohebbi L, Zahednejad S, Javadi Pour S, Saki A. Domestic Elder Abuse in Rural Area of Dezful, Iran and Its Relation With Their Quality of Life. Salmand: Iranian Journal of Ageing. 2016;10(4):50 – 9. Dehnoalian A, Saadati M, Jafariany S, Bakaeian M, Saadati A. Epidemiology of elderly abuse in neyshabur in 2017. Pars J Med Sci. 2022;16(4):65–72. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6318253","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":451659585,"identity":"65880bdd-9c02-41c3-8df1-8c2c66c9313d","order_by":0,"name":"Mahsa Ehsaninasab","email":"","orcid":"","institution":"Kerman University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mahsa","middleName":"","lastName":"Ehsaninasab","suffix":""},{"id":451659587,"identity":"8752c2a1-fff2-49fd-b830-7f9fce8032b1","order_by":1,"name":"Seyed Vahid Ahmadi Tabatabaei","email":"","orcid":"","institution":"Kerman University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Seyed","middleName":"Vahid Ahmadi","lastName":"Tabatabaei","suffix":""},{"id":451659589,"identity":"5561fc1c-f80a-435a-8be1-5bf466bae7ad","order_by":2,"name":"Ali Karamoozian","email":"","orcid":"","institution":"Kerman University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Ali","middleName":"","lastName":"Karamoozian","suffix":""},{"id":451659590,"identity":"af051d21-ae40-4056-93e6-6524282a67b4","order_by":3,"name":"vahidreza Borhaninejad","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYFACHgYGxgYGBjb2BgZmErXwHCBVC4NEApFaDA7wHnxcucMuj0/yjeHnggobBv727gQCWviSDc+eSS5mk84xlp5xJo1B4szZDXi1SDbwmEk2tjEntknnGEjzth1mMJDIJUpLfWKb5Bnj30Rp4WcAazmc2CbBY0acLfzMQL80th1PbONJK7PmOZPGQ9AvbOy9Bx82tlUnzm8/vPk2T4WNHH97L34tSHHBYQAiefArRwXsD0hRPQpGwSgYBSMIAAAojj6BnOERjgAAAABJRU5ErkJggg==","orcid":"","institution":"Kerman University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"vahidreza","middleName":"","lastName":"Borhaninejad","suffix":""}],"badges":[],"createdAt":"2025-03-27 08:08:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6318253/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6318253/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85085058,"identity":"3ffe0831-fee7-4b27-a378-80ab3758cab4","added_by":"auto","created_at":"2025-06-20 19:01:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2195477,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6318253/v1/468c2fde-f60c-44a1-9f77-4216e5752ec4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment Elder abuse and Perceived stress of informal caregivers of the elderly","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe elderly population, which is increasing in Iran and the world, has specific needs and problems in developed and developing countries. The elderly are vulnerable in all dimensions of health due to the physical, social, and psychological changes caused by the aging process(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e), which renders them vulnerable to abuse. The World Health Organization (2002) defines abuse as a behavior of the caregiver of the elderly that intentionally or unintentionally reduces the quality of life of older adults and increases their physical and psychological harm. This abuse has different types and can be physical, sexual, psychological, or economic or in the form of neglect or inattention(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). According to studies, the incidence of domestic elder abuse is estimated to be between 67% and 73.3%(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Elder abuse has also been confirmed in Iran. However, there are still no accurate statistics on the rate of elder abuse or the characteristics of the abusers and the victims. For example, the results of Nasiri et al.'s study indicated that 63.3% of the studied elderly were abused by their families(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). While in 2002, the World Health Organization estimated the rate of domestic elder abuse at 4\u0026ndash;6%(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e), in a 2018 report, it was reported that this rate was increasing(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), and this figure is expected to increase to 24% by 2050(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eElder abuse-related research is a relatively new field of research compared to child abuse and domestic violence. This phenomenon can lead to an increase in mortality and disability of the elderly, more visits to the emergency rooms, depression, an increase in hospitalizations, and an increase in care costs(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). It can negatively affect the health and sense of security of the elderly and ultimately reduce their quality of life(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Studies in the field of elder abuse in Iran have been minimal and insignificant(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Accurate studies have shown that the reported rate of elder abuse in all cultures is less than the actual rate(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), which can be caused by the abusive behavior of the informal caregivers of the elderly. Informal care refers to the care provided without charge by family members, friends, and acquaintances of the elderly person. Most elderly receive the services they need from informal caregivers, usually family members, spouses, friends, and neighbors(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Taking care of the elderly changes caregivers' lives; some examples are lack of time, reduced emotional feelings, disruption of social life, the feeling of losing control over personal life, and the emergence of physical and emotional burdens (anxiety, stress, and depression)(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), which exposes them to stress. Stress is the body\u0026rsquo;s natural reaction to any recognized demand, alteration, or challenge. The stressor refers to the specific circumstance or occurrence that triggers this reaction. While stress can negatively impact one\u0026rsquo;s sense of well-being, leading to feelings of threat, its prolonged presence may result in psychological issues. These can include depression, obsessive behaviors, personality disorders, and pervasive feelings of inadequacy, anxiety, resentment, and boredom (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), and eventually, caring causes various forms of stress for the caregivers and ultimately (directly or indirectly) for the elderly(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e); the greater the degree of physical or emotional dependence of the elderly, the more stress the caregiver is subjected to and the higher the possibility of depression and subsequently the possibility of disturbing behaviors(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Caregiver stress is considered one of the critical risk factors of elder abuse(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). In the research by Navidian et al. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) which focused on family caregivers of individuals with mental illness, the results indicated that 26.4% of caregivers experienced mild mental stress, 60.8% encountered moderate mental stress, and 12.8% suffered from severe mental stress. Additionally, investigations have been carried out to explore instances of elder abuse perpetrated by relatives, informal caregivers, and professional caregiving personnel.\u003c/p\u003e \u003cp\u003eGiven the complex array of contributing factors, the determinants of abuse have often been overlooked. This study aims to explore the impact of informal caregivers\u0026rsquo; perceived stress on the incidence of elder abuse in Kerman, Iran. The findings will guide the development of multifaceted interventions, raise awareness among authorities and the elderly\u0026rsquo;s relatives about the gravity and repercussions of such abuse, and underscore the urgency of extensive support for the victims.\u003c/p\u003e"},{"header":"Methods and materials","content":"\u003cp\u003eThe current study was a descriptive-analytical cross-sectional investigation. Utilizing Morgan\u0026rsquo;s table, the sample comprised 253 elderly individuals and 253 caregivers from ten comprehensive health service centers in Kerman, conducted in 2023. The sampling process involved researchers visiting these centers, detailing the study\u0026rsquo;s aims, and employing the Sib system\u0026mdash;a registry for Iranian electronic health records established in 2014\u0026mdash;to randomly select eligible elders. Subsequent contact was made via telephone to the registered number of each elder, where the researchers introduced themselves to either the elders or their family members. The primary caregiver was identified as the person most involved in the elder\u0026rsquo;s care. Upon ensuring confidentiality and explaining the study\u0026rsquo;s methodology, willing and eligible participants were either visited at home or invited to the centers to complete questionnaires in a private setting.\u003c/p\u003e \u003cp\u003eThe questionnaires were completed in a time frame suitable for the response speed of the caregiver or the elderly subject, i.e., it was different for different participants. The inclusion criteria of caregivers in this study were being Iranian, being willing to participate in the study, and being literate. The inclusion criteria of the elderly subjects were an age of 60 years or older, willingness to participate in the study, ability to communicate verbally, not having a speech disorder, and not suffering from mental illnesses or Alzheimer\u0026rsquo;s disease (based on information provided by the caregiver or the Sib system). The exclusion criteria for this study included the inability of the elderly subject and the caregiver to answer the questions and their unwillingness to participate in the research.\u003c/p\u003e \u003cp\u003eData were collected using three questionnaires: a demographic questionnaire, Cohen's Measure of Perceived Stress elderly caregivers, and the Elder Abuse Questionnaire. In this research, the 14-item version of Cohen's questionnaire was presented. The Cronbach's alpha obtained in three other studies for this scale was 0.84, 0.85, and 0.86 (Cohen et al.) (1983)(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). The validity and reliability of this questionnaire were confirmed in Iran by Asghari et al. (2013), and its obtained Cronbach\u0026rsquo;s alpha in the Iranian students sample was 0.84(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). This questionnaire, containing fourteen phrases, seven positive and seven negative phrases, measures the general perceived stress in the past month(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Elder abuse information was collected in person and using the Elder Abuse Questionnaire, whose validity and reliability were confirmed in Iran by Karimi et al(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) )2008) and Mohseni et al(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) (2019). This questionnaire includes five items and each item includes separate questions about physical condition (skin condition, fractures, and burns), psychological condition (verbal and non-verbal), neglect (failure to meet the needs of personal hygiene and essential medical care, basic activities of daily life, and financial management), abandonment (experience of living in a place other than their own home and satisfaction with this issue), and financial condition (misuse of the elderly person\u0026rsquo;s money or assets by other individuals or organizations without their permission). The demographic questionnaire was a researcher-made questionnaire whose specific questions were adapted to the environmental and cultural conditions of the research community. It collected data on the individual from the personal and social dimensions.\u003c/p\u003e \u003cp\u003eAfter coding and categorizing the questionnaire responses, the data was inputted into SPSS 22 software (Armonk, NY: IBM Corp.). To characterize qualitative variables, frequency and percentage calculations were performed, while quantitative variables were described using mean, median, standard deviation, and interquartile range. The normality of data distribution was assessed using the Shapiro-Wilk test, as well as kurtosis and skewness measures. Given that caregiver-related data followed a normal distribution, and elderly-related data did not, appropriate analytical models were applied: univariate and multiple linear regression for the former, and univariate and multiple regression with inverse Gaussian distribution for the latter. Both sets of models employed backward elimination to pinpoint critical variables and determine the optimal model.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study found no significant correlation between the stress perceived by informal caregivers and instances of elder abuse among elders attending comprehensive health service centers in Kerman in 2023 (P-value\u0026thinsp;=\u0026thinsp;0.151, r\u0026thinsp;=\u0026thinsp;0.15). However, a significant association was observed between caregivers\u0026rsquo; perceived stress and demographic factors such as residence, age, occupation, health conditions, income, number of children, insurance status, and addiction. Additionally, elder abuse showed a significant relationship with demographic aspects including gender, age, education level, occupation, marital status, health conditions, care type, income, and addiction.\u003c/p\u003e \u003cp\u003eThe prevalence of different types of abuse is presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and other relevant information in Tables\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e\u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eN\u003c/em\u003e (%)/Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver age (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.42\u0026thinsp;\u0026plusmn;\u0026thinsp;15.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver sex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96 (37.9)\u003c/p\u003e \u003cp\u003e157 (62.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003cp\u003eReading \u0026amp; writing\u003c/p\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (1.6)\u003c/p\u003e \u003cp\u003e19 (7.5)\u003c/p\u003e \u003cp\u003e41 (16.2)\u003c/p\u003e \u003cp\u003e72 (28.5)\u003c/p\u003e \u003cp\u003e117 (46.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver location\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlone\u003c/p\u003e \u003cp\u003eWith wife\u003c/p\u003e \u003cp\u003eWith children\u003c/p\u003e \u003cp\u003eWith wife and children\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (2.8)\u003c/p\u003e \u003cp\u003e56 (22.1)\u003c/p\u003e \u003cp\u003e14 (5.5)\u003c/p\u003e \u003cp\u003e83 (32.8)\u003c/p\u003e \u003cp\u003e93 (36.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver occupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003cp\u003eHomemaker\u003c/p\u003e \u003cp\u003eGovernment clerk\u003c/p\u003e \u003cp\u003eRetired\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (6.7)\u003c/p\u003e \u003cp\u003e67 (26.5)\u003c/p\u003e \u003cp\u003e73 (28.9)\u003c/p\u003e \u003cp\u003e55 (21.7)\u003c/p\u003e \u003cp\u003e20 (7.9)\u003c/p\u003e \u003cp\u003e21 (8.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver marital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003cp\u003eWidow/widower\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74 (29.2)\u003c/p\u003e \u003cp\u003e144 (56.9)\u003c/p\u003e \u003cp\u003e25 (9.9)\u003c/p\u003e \u003cp\u003e10 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver physical state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSick\u003c/p\u003e \u003cp\u003eHealthy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67 (26.5)\u003c/p\u003e \u003cp\u003e186 (73.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver mental state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSick\u003c/p\u003e \u003cp\u003eHealthy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60 (23.7)\u003c/p\u003e \u003cp\u003e193 (76.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver type of care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndependent\u003c/p\u003e \u003cp\u003eCollaborative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94 (37.2)\u003c/p\u003e \u003cp\u003e159 (62.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUp to 5\u0026nbsp;million tomans\u003c/p\u003e \u003cp\u003e5 to 10\u0026nbsp;million tomans\u003c/p\u003e \u003cp\u003eMore than 10\u0026nbsp;million tomans\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87 (34.4)\u003c/p\u003e \u003cp\u003e81 (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e85 (33.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver number of children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithout children\u003c/p\u003e \u003cp\u003eOne child\u003c/p\u003e \u003cp\u003eSeveral children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108 (42.7)\u003c/p\u003e \u003cp\u003e38 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e107 (42.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (17.4)\u003c/p\u003e \u003cp\u003e209 (82.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver addiction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e175 (69.2)\u003c/p\u003e \u003cp\u003e78 (30.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver housing type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eApartment\u003c/p\u003e \u003cp\u003eHouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75 (29.6)\u003c/p\u003e \u003cp\u003e178 (70.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver home ownership\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOwner\u003c/p\u003e \u003cp\u003eTenant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e140 (55.3)\u003c/p\u003e \u003cp\u003e113 (44.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly age (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.47\u0026thinsp;\u0026plusmn;\u0026thinsp;8.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly sex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003cp\u003eWomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e143 (56.5)\u003c/p\u003e \u003cp\u003e110 (43.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003cp\u003eReading \u0026amp; writing\u003c/p\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62 (24.5)\u003c/p\u003e \u003cp\u003e46 (18.2)\u003c/p\u003e \u003cp\u003e31 (12.3)\u003c/p\u003e \u003cp\u003e69 (27.3)\u003c/p\u003e \u003cp\u003e45 (17.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly location\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlone\u003c/p\u003e \u003cp\u003eWith wife\u003c/p\u003e \u003cp\u003eWith children\u003c/p\u003e \u003cp\u003eWith wife and children\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (20.2)\u003c/p\u003e \u003cp\u003e66 (26.1)\u003c/p\u003e \u003cp\u003e38 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e68 (26.9)\u003c/p\u003e \u003cp\u003e30 (11.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly occupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003cp\u003eHomemaker\u003c/p\u003e \u003cp\u003eGovernment clerk\u003c/p\u003e \u003cp\u003eRetired\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57 (22.5)\u003c/p\u003e \u003cp\u003e31 (12.3)\u003c/p\u003e \u003cp\u003e63 (24.9)\u003c/p\u003e \u003cp\u003e14 (5.5)\u003c/p\u003e \u003cp\u003e87 (34.4)\u003c/p\u003e \u003cp\u003e1 (0.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly marital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003cp\u003eWidow/widower\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (7.5)\u003c/p\u003e \u003cp\u003e137 (54.2)\u003c/p\u003e \u003cp\u003e34 (13.4)\u003c/p\u003e \u003cp\u003e63 (24.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly physical state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSick\u003c/p\u003e \u003cp\u003eHealthy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e189 (74.7)\u003c/p\u003e \u003cp\u003e64 (25.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly mental state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSick\u003c/p\u003e \u003cp\u003eHealthy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e129 (51)\u003c/p\u003e \u003cp\u003e124 (49)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly type of care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAble to take care of self\u003c/p\u003e \u003cp\u003ePartial care\u003c/p\u003e \u003cp\u003eAverage care\u003c/p\u003e \u003cp\u003eExtreme care\u003c/p\u003e \u003cp\u003eSpecial care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60 (23.7)\u003c/p\u003e \u003cp\u003e66 (26.1)\u003c/p\u003e \u003cp\u003e66 (26.1)\u003c/p\u003e \u003cp\u003e28 (11.1)\u003c/p\u003e \u003cp\u003e33 (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElder income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUp to 5\u0026nbsp;million tomans\u003c/p\u003e \u003cp\u003e5 to 10\u0026nbsp;million tomans\u003c/p\u003e \u003cp\u003eMore than 10\u0026nbsp;million tomans\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95 (37.5)\u003c/p\u003e \u003cp\u003e94 (37.2)\u003c/p\u003e \u003cp\u003e64 (25.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElder number of children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithout children\u003c/p\u003e \u003cp\u003eOne child\u003c/p\u003e \u003cp\u003eSeveral children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (15.4)\u003c/p\u003e \u003cp\u003e36 (14.2)\u003c/p\u003e \u003cp\u003e178 (70.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElder Insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (15.4)\u003c/p\u003e \u003cp\u003e214 (84.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElder addiction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e169 (66.8)\u003c/p\u003e \u003cp\u003e84 (33.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElder housing type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eApartment\u003c/p\u003e \u003cp\u003eHouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40 (15.8)\u003c/p\u003e \u003cp\u003e213 (84.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElder home ownership\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOwner\u003c/p\u003e \u003cp\u003eTenant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e168 (66.4)\u003c/p\u003e \u003cp\u003e85 (33.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of elder abuse and its subscales.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-verbal abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinancial abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e41.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVerbal abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35.96\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRejection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20.55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeglected by others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-neglect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate and multiple linear regression models used to investigate the effect of the studied variables.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eUnivariate linear regression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eMultiple linear regression\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eβ\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(%95 Cl)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eP.value\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eβ\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(%95 Cl)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP.value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver age (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-0.057\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-0.11,-0.003)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.047\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e-0.053\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(-0.10,\u0026lt;0.001)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ecaregiver sex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMen caregiver sex\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eWomen\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.07\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-1.71,1.85)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.93\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIlliterate\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eReading \u0026amp; writing\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMiddle school\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHigh school\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eUniversity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.1540\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e1.154\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.8860\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-0.402\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-6.87,7.18)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-2.26,4.57)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-1.62,3.39)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-2.47,1.66)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.9660\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.5070\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.4880\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.7030\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver Location\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAlone\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eWith children\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ewith wife\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eWith wife and children\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eOther\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-6.422\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-0.994\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-1.172\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-2.508\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-11.75,-1.09)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-4.89,2.9)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-3.47,1.12)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-4.56,-0.45)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.0180\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.6160\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.3160\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.0170\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver Job\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eUnemployed\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eSelf-employed housewife\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eGovernment clerk\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eRetired\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eOther\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e6.613\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e2.262\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.8020-\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-2.748\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-1.357\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(2.38,10.84)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-0.98,5.5)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-4.01,2.4)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-6.07,0.57)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-5.4,2.69)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.1710\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.623\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.105\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.510\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSingle\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMarried\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eDivorced\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eWidow/widower\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-0.122\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-2.174\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-2.660\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-4.73,4.48)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-6.64,2.30)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-7.78,2.46)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.9590\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.3400\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.3070\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ePhysical state\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSick\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHealthy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.5560\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-1.4,2.51)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.5770\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMental state\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSick\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHealthy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.324\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(1.33,5.31)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.186\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(0.23,4.13)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.0280\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eType of care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIndependent\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eCollaborative\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.4970\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-1.29,2.28)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.5850\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver Income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eUp to 5\u0026nbsp;million tomans\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e5 to 10\u0026nbsp;million tomans\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMore than 10\u0026nbsp;million tomans\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.353\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e3.600\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(1.3,5.39)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(1.51,5.68)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e3.492\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e3.534\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(1.47,5.5)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(1.5,5.56)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eNumber Of Children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eWithout children\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eOne child\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eSeveral children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.048\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e1.721\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(0.18,3.91)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-0.86,4.3)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.031\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.190\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver Insurance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.547\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(0.284,4.81)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver Addiction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-2.943\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-4.78,-1.1)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.0020\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e3.150-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(-4.9,-1.3)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHousing type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eApartment\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHouse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.6950\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-1.2,2.59)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.47\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHome ownership\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eOwner\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eTenant\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-1.680\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-3.4,0.05)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.057\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate and multiple linear regression models were used to investigate the effect of the studied variables.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eUnivariate linear regression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eMultiple linear regression\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eβ\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(%95 Cl)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eP.value\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eβ\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(%95 Cl)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP.value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder age (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.17\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(0.09,0.24)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder sex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMen\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eWomen\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-2.62\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-3.98,-1.27)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eIlliterate\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eReading \u0026amp; writing\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMiddle school\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHigh school\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eUniversity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e6.420\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e3.269\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e1.775\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e1.283\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(4.39,8.45)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(1.52,5.009)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(0.03,3.51)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-0.01,2.58)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.045\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.0530\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder Location\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eWith children\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ewith wife\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eWith wife and children\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eOther\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eAlone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.4550\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-0.159\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-0.319\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e2.869\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-1.72,2.63)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-1.97,1.65)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-2.10,1.46)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-0.01,5.74)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.6830\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.864\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.7260\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.051\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder Job\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSelf-employed housewife\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eGovernment clerk\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eRetired\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eOther\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eUnemployed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-5.316\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-1.681\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-5.387\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-4.442\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-10.316\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-7.44,-3.18)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-3.92,0.56)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-7.87,-2.9)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-6.38,-2.5)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-12.95,-7.67)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.142\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMarried\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eDivorced\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eWidow/widower\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eSingle\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-0.754\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e-0.402\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e1.056\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-3.29,1.79)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-3.35,2.55)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-1.78,3.9)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.5610\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.7900\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.4670\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.185\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e.5790\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e2.167\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(-0.17,2.53)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-1.04,2.2)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(0.63,3.69)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.0870\u003c/p\u003e \u003cp\u003e.4850\u003c/p\u003e \u003cp\u003e.0050\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ePhysical state\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSick\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHealthy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e5.381\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(4.42,6.33)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.46\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(0.36,2.57)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMental state\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSick\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHealthy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.892\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(2.64,5.13)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eType of care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePartial care\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eAverage care\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eextreme care\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003especial care\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eAble to take self-care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.527\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e5.073\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e7.360\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e9.876\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(2.51,4.54)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(3.87,6.26)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(5.14,9.57)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(7.29,12.45)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.094\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e3.451\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e5.460\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e7.827\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(0.95,3.23)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(2.004,4.89)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(3.15,7.76)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(5.25,10.4)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder Income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eUp to 5\u0026nbsp;million tomans\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e5 to 10\u0026nbsp;million tomans\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMore than 10\u0026nbsp;million tomans\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e4.927\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e2.476\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(3.43,6.42)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(1.24,3.7)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.598\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.664\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(0.43,2.76)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-0.19,1.52)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003cp\u003e0.130\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eNumber Of Children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eWithout children\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eOne child\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eSeveral children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.435\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e1.287\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-1.41,2.28)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(-0.8,3.38)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.645\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.229\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder Insurance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.613\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-0.45,3.67)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.1260\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder Addiction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-1.517\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-2.98,-0.04)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.0430\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e-1.278\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e(-2.2,-0.35)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHousing type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eApartment\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHouse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-1.104\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-2.71,0.5)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.1780\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eElder\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHome ownership\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eOwner\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eTenant\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-1.377\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e(-2.83,0.07)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.0640\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study was conducted to investigate the relationship between perceived stress and elder abuse in the elderly who were referred to comprehensive health service centers in Kerman. The findings showed no significant relationship between the two main variables. However, based on the evidence, stress is considered to be a risk factor for wrong behaviors and violence and one of the factors that play a significant role in initiating or intensifying many disorders and the occurrence of malfunctions and incompatibilities (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The complexity of abuse phenomena often stems from its multi-causal nature. Frequently, abuse remains undisclosed due to cultural nuances in caregiving, reverence for elders, and societal norms regarding elder interaction. Specifically in Iran, the pervasive influence of cultural and traditional values dictates familial dynamics. This cultural framework often leads caregivers to underreport their stress levels and the elderly to refrain from disclosing instances of abuse, prioritizing family reputation and the virtues of secrecy and modesty.\u003c/p\u003e \u003cp\u003eThe mean abuse in the present study was (11.3794\u0026thinsp;\u0026plusmn;\u0026thinsp;4.66734) which was consistent with the study of Koosheshi (11.4\u0026thinsp;\u0026plusmn;\u0026thinsp;13.2)(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The mean perceived stress was (28.96\u0026thinsp;\u0026plusmn;\u0026thinsp;6.981) which was more or less consistent with the study of Zahed (25.4\u0026thinsp;\u0026plusmn;\u0026thinsp;10.9) (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e)and the study of Bastaani (30\u0026thinsp;\u0026plusmn;\u0026thinsp;5.86)(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). In this study, non-verbal abuse was the most prevalent type of abuse, which was consistent with Mohseni\u0026rsquo;s study(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e); this can be attributed to the strong emotional connection and attachments of people to each other, especially the strong emotional dependencies between parents and children. This type of relationship causes extensive interactions and sometimes excessive expectations of parents and children from each other. Due to the industrialization of societies and the problems caused by the changes in society's conditions, people may not be able to meet each other's needs fully. Therefore, the possibility of abuse increases in such situations(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Physical abuse had the lowest prevalence, which was consistent with the studies of AVOW, Khalili(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), and Molayi(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e); this can be because other types of (non-physical) abuse are invisible and due to the lack of awareness of people, non-physical types of abuse may not be considered as abuse and this issue causes more abuse to be committed (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the present study, perceived stress was higher in younger caregivers, consistent with Andreou's study(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), so perceived stress was more related to younger age. Because younger caregivers are more dynamic and active due to their age and are eager to work, make money, and have fun, if they become responsible for caring for the elderly either by circumstance or by choice, they will endure more stress when fully occupied by caregiving, considering its stressful, tiring, and time-consuming nature(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUnemployed caregivers had a higher level of perceived stress than others. Like our study, Cohen's study found that unemployed people reported high levels of psychological stress(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). As homemakers and unemployed women stay home to do the housework and spend more time caring for their patients, they are more vulnerable to the stress and pressure of caring than employed female caregivers(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). This can be true about unemployed men as well.\u003c/p\u003e \u003cp\u003eBased on the results, caregivers with an income below a hundred million rials had a higher level of perceived stress than people with an income above a hundred million rials, which was consistent with the study of Hosseini(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). According to Wadsworth, economic tension disturbs family relationships and processes, limits adaptation to stress, and leads to psychological problems in family members(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCaregivers with no children had higher perceived stress levels than caregivers with several children. Contrary to our study, in Mansouri's study, no significant relationship was found between the perceived stress of caregivers of the elderly and the number of children they had (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). In old age, children are a great source of social support for parents, which positively affects their mental health and reduces their anxiety and depression(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn this study, we observed that caregivers residing either alone or with their spouse and children reported lower stress levels compared to others. The data revealed a smaller proportion of caregivers living alone when compared to those living with their spouse and children. Furthermore, the latter group was also smaller than those living under different circumstances. Consequently, there appears to be a direct correlation between the caregivers\u0026rsquo; perceived stress and their living arrangements, influenced by the number of caregivers in each living condition.\u003c/p\u003e \u003cp\u003eIn the present study, caregivers who did not have any insurance had higher levels of perceived stress compared to caregivers with insurance because the function of insurance is to contribute to the compensation of damages and to replace uncertainty with certainty; therefore, insurance, as a method of dealing with risk, is a response to uncertain and risky conditions (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e)and people who do not have any insurance may have to more money out of their pockets when they face illnesses and accidents. As a result, they experience more perceived stress both before and after the illnesses and accidents.\u003c/p\u003e \u003cp\u003eThe findings of the present study showed that caregivers who did not have any type of addiction had a lower level of perceived stress compared to caregivers who were addicted because addiction itself often causes and aggravates stress in people and countless factors, including social, economic, and psychological stress play a role in creating and developing addictions. The inability to face stressful factors and the belief that the use of alcohol and drugs will lead to favorable results is the basis for turning to drug use(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe results also showed that caregivers who had a mental illness had a higher level of perceived stress compared to healthy people. In Luchesi's study, caregivers with weaker cognitive status experienced higher levels of perceived stress(\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e), which is consistent with our study; it can be stated that people who have a weaker cognitive status and are somehow suffering from psychological trauma are more likely to suffer from other traumas or mental illnesses, especially stress.\u003c/p\u003e \u003cp\u003eThe elder abuse rate was higher in older age groups than in other groups, which was consistent with Taheri Tanjani\u0026rsquo;s study. The elderly who are 75 years old or older, who need help in their daily lives, experience more abuse(\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Needing help in daily life initiates and sometimes aggravates all kinds of abuse towards the elderly, especially older elderly, who usually need more help from others in doing various chores daily.\u003c/p\u003e \u003cp\u003eIn the present study, the abuse rate in male elderly subjects was lower than it was in female elderly subjects, which was consistent with the study results of Li Wu(\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e); this difference may be due to different sampling methods, i.e., more men than women in the study population or vice versa.\u003c/p\u003e \u003cp\u003eElderly widows and widowers experienced a higher rate of abuse than unmarried elderly. Koga\u0026rsquo;s study also showed that having lost a spouse can put a person at a higher risk of experiencing abuse(\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). In addition to adverse economic, social, and psychological consequences, widowhood renders the elderly vulnerable in terms of access to services that provide physical and mental health, and the greatest need for health, social, and psychological care often occurs at this stage of life, imposing higher costs on the individual, the health and treatment system(\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e), and even their caregivers; this issue in itself can cause an increase in abuse in such elderly people.\u003c/p\u003e \u003cp\u003eThe other finding of this study was that, the elder abuse rate decreased with the increase in the level of education. The results of Taheri Tanjani\u0026rsquo;s study showed that illiterate elderly women are approximately 1.2 times more likely to experience abuse compared to literate women(\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). In our study, the number of illiterate elderly subjects was higher than that of literates. Also, some elderly people do not report abuse because they either are not aware of it or are unable to understand that they have been abused. They hope this abuse will stop somehow(\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). This level of awareness and understanding can be related to the level of education and literacy of the elderly person.\u003c/p\u003e \u003cp\u003eIn the present study, the elder abuse rate in retired or self-employed elderly, government clerks, and those with other jobs was lower than that of unemployed subjects. The results of Heravi\u0026rsquo;s study showed a significant relationship between elder abuse and employment, which was consistent with our study(\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). In our study, people with \"other\" occupations were those with the \u0026ldquo;other\u0026rdquo; job status. Only one person was in the \"other\" group in this study, so abuse in this group was lower than in other groups. Abuse among unemployed elderly was higher than in elderly people with \u0026ldquo;other\u0026rdquo; occupations. Unemployed, elderly people often have little to no income and are somehow dependent on their family members, who are also considered caregivers. Moreover, elder abuse is mainly rooted in problems such as financial constraints and dependencies that the caregivers of the elderly are dealing with, so the physical and emotional costs of caregiving are higher than their income, which can be a factor in the occurrence of elder abuse(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn this study, it was observed that elders earning between zero to fifty million Rials were more susceptible to abuse compared to those with incomes exceeding one hundred million Rials. These findings align with Hosseini Moghadam\u0026rsquo;s research, which also suggests that lower economic status is linked to increased domestic abuse of the elderly. Often, unemployed seniors or those with minimal income rely on their relatives for support, who also act as their caregivers. Furthermore, elder abuse frequently stems from financial difficulties and the dependency issues faced by caregivers. When the expenses associated with caregiving surpass their own income, it may contribute to the risk of elder abuse(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe findings of the present study showed that elderly who did not have any type of addiction experienced a lower level of abuse than the addicted elderly. Mohebi\u0026rsquo;s study(\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e)also showed that there was a significant relationship between elder abuse and addiction because the family of the addicted elderly may exploit them financially. In other words, the family takes all the savings of the elderly with the excuse of buying drugs for them or claiming they are unfit to maintain and manage their properties. In addition, there is also the possibility that the perpetrators, i.e., family members and acquaintances, will turn an addicted elderly person's house into a base for drug selling or drug use by others. These are all instances of elder abuse(\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the present study, the elderly who had a disease or physical injury experienced a higher rate of abuse than the elderly who were healthy, and the results of Khalili\u0026rsquo;s study also showed that elder abuse had a significant relationship with suffering from a chronic disease(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Functional dependency or poor physical health are risk factors for abuse, as caregivers who are responsible for daily support and are in frequent contact with the people they care for are prone to burnout and stress. On the other hand, the physical functions of the elderly continue to decrease, and they need more support(\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe results in this study showed that elderly who had a mental illness experienced a higher level of abuse than healthy people. Koga reported that mild or severe depression is a risk factor for abuse among elderly participants, which is consistent with our study. When abuse occurs in what would usually be considered a high-trust relationship, the relationship could be destroyed. It may lead to fear of future encounters with people who should be trusted. This fear adds to the psychological stress in the elderly. In addition, depression is one of the main risk factors for abuse, and the relationship between depression and abuse can be a two-way relationship. First, people who were already depressed may be abused. On the other hand, abuse may also be the cause of depression(\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the present study, as the type of elderly care became more specialized, the abuse also increased. In addition, the results of Hosseini Moghadam's study indicated that the degree of dependence on others increases domestic elder abuse. The dependence of the elderly on the caregiver to conduct daily activities can cause fatigue and increase the psychological burden of the caregivers of the elderly over time. In addition, the caregivers of the elderly have less time to meet their physical, emotional, and social needs, which, as a result, increases the loneliness and isolation of caregivers and, over time, the feeling of helplessness, anxiety, and anger towards the elderly increases. This can play a significant role in initiating and increasing elder abuse(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). In Koosheshi\u0026rsquo;s study, the degree of dependence of the elderly on their family members played a major and decisive role in the psychological abuse of the elderly(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe current study faced several limitations. Firstly, the absence of similar studies underscores the challenges encountered during this research. However, the uniqueness of this study could potentially inspire future research of a similar nature, but of higher quality.\u003c/p\u003e \u003cp\u003eAdditional limitations were also present. The study was exclusively conducted on urban elderly individuals who were cared for at home by family members and acquaintances. This may limit the generalizability of the findings to other populations. The use of a self-report questionnaire was another limitation. While this method is convenient, it may not provide the most accurate data due to potential biases or inaccuracies in self-reporting. Furthermore, as a cross-sectional study, it was not designed to establish cause-and-effect relationships, which is another limitation. Lastly, the potential fear of caregivers among the elderly participants might have led to an underreporting of abuse. Similarly, incorrect responses from caregivers could have resulted in an underestimation of the perceived stress levels. These factors should be taken into account when interpreting the results of the study.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eElder abuse remains a relatively obscure phenomenon when juxtaposed with other forms of violence. Often, there is a tendency to deny or minimize its occurrence, which complicates efforts to understand its underlying causes. This study, perhaps due to these and other factors, did not find a significant correlation between caregiver stress and the incidence of abuse. Nonetheless, articulating the scope of this issue and establishing the prevalence of elder abuse, alongside assessing caregiver stress levels, serves as a crucial juncture for deeper exploration and scholarly inquiry into elder abuse. This encompasses its epidemiology, risk factors, and the development of preventative and interventional strategies. The current research lays the groundwork for future studies. It is important to acknowledge that the instances of abuse discussed herein represent merely a fraction of a much larger, predominantly concealed problem. Consequently, it is imperative to advocate for routine screening of the elderly who may be susceptible to abuse and to educate them about the facets of elder abuse and their rights as victims. Recognizing and implementing methods to prevent elder abuse, educating families and informal caregivers, enacting supportive legislation, and establishing aid organizations are essential steps in addressing this critical issue.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMaintaining the confidentiality of results from expert participants is essential. All participants who entered the study were informed about the research and were assured of the confidentiality of their information. The study was conducted after obtaining the ethical code to conduct the study and obtaining the necessary permissions, in compliance with ethical standards. The Ethics Committee of Kerman University of Medical Sciences approved the present study with the ethical code IR.KMU.REC.1402.343. Informed consent was obtained from the respondents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they had no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo Funding\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor’s contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was carried out under the guidance Mahsa Ehsaninasab and with the supervision of \u0026nbsp;Dr\u0026nbsp;Vahidreza Borhaninejad (corresponding author), \u0026nbsp;Dr Seyed Vahid Ahmadi Tabatabaei and Dr Ali Karamoozian\u003csup\u003e.\u003c/sup\u003e. Mahsa Ehsaninasab did the data collection and initial writing of the article. All authors read and approved the fnal manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets collected and analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was part of Mahsa Ehsaninasab’s \u0026nbsp;thesis. The authors hereby appreciate by Kerman University of Medical Sciences and all the respected professors who helped conduct this research. We are also grateful to all the personnel of the Kerman University of Medical Sciences, the elderly participants, and their respected caregivers who helped us conduct this research.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eRiahi ME. 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Pars J Med Sci. 2022;16(4):65\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Perceived stress, elder abuse, caregivers of the elderly, informal caregivers","lastPublishedDoi":"10.21203/rs.3.rs-6318253/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6318253/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eAim\u003c/strong\u003e: Elder abuse is an important health problem associated with ederly care. This study aimed to assessment elder abuse and perceived stress of informal caregivers in ederly.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: This descriptive-analytical study was carried out among 253 elderly individuals and their caregivers. Multi-stage sampling was employed across 10 comprehensive urban health service centers. Data collection was facilitated using Cohen's Caregivers' Perceived Stress Questionnaire, the Elder Abuse Questionnaire, and a demographic questionnaire.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Average perceived stress among the informal caregivers of the elderly was 28.96 ± 6.981. There was no significant correlation between the perceived stress of informal caregivers and elder abuse (P-value = 0.151, r = 0.15). However, a significant correlation was found between the perceived stress of informal caregivers and demographic variables such as place of residence, age, occupation, mental illness or trauma, income, number of children, insurance, and addiction. Similarly, elder abuse showed a significant correlation with demographic variables like gender, age, education level, occupation, marital status, physical and mental illness or trauma, type of care, income, and addiction.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: Elder abuse is a complex and occasionally concealed issue that warrants special attention. Based on the study's findings, it is recommended to implement strategies to manage stress among the informal caregivers of the elderly.\u003c/p\u003e","manuscriptTitle":"Assessment Elder abuse and Perceived stress of informal caregivers of the elderly","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-05 13:23:38","doi":"10.21203/rs.3.rs-6318253/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"acdea1a6-066f-4d09-8e60-a6125649b3e1","owner":[],"postedDate":"May 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-20T18:53:38+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-05 13:23:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6318253","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6318253","identity":"rs-6318253","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}