Abuse DomesticAPPEALNCT07494422
A Path to Prevention of Elder Abuse in Long-term Care. Prevalence Study Among Staff in Long-term Care.
An observational study of Abuse Domestic and Abuse Neglect, run by Linkoeping University at 1 site in Sweden.
Trial summary
Globally, studies indicated that 16% of community dwelling older adults have been exposed to some form of abuse in the past 12 months. Furthermore, a global meta-analysis about AOP in long-term care facilities used staff as respondents and found that the pooled estimate of overall self-reported perpetration of staff… Read more about this study
- Who is it for?
- Ages 18 to 69 years
- Conditions the study is for
- Abuse Domestic, Abuse Neglect, Abuse Physical
- How many people
- 6,000 participants
- Where
- 1 siteSweden
- Study dates
- 24 Mar 2026to 30 Apr 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 69 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Two samples are used. 1. Population sample. Statistics Sweden combine data from the Swedish Occupational Register with data about industry codes (SNI-codes) to make a national randomized sample of staff working in home care services (n=12000) and nursing homes (n=11000) in Sweden. 2. Workplace sample. The Swedish Association of Local Authorities and Regions (SALAR) have an official categorization of the 290 municipalities in Sweden based on e.g., urban area size, proximity to a larger urban area, and commuting patterns. One municipality in each of the nine categories has been randomly selected for participation. Staff in each selected municipalities will be invited to participate through managers in each organization.
Who may be able to join
- Working in home care services or a long-term care facility in Sweden
- Working in direct contact with older adults (e.g., providing care, nursing, rehabilitation to older adults)
Who cannot join
- None
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Globally, studies indicated that 16% of community dwelling older adults have been exposed to some form of abuse in the past 12 months. Furthermore, a global meta-analysis about AOP in long-term care facilities used staff as respondents and found that the pooled estimate of overall self-reported perpetration of staff to resident abuse during the past 12 months was 64.2% (95% CI 53.3-73.9%). Similar findings was also reported in a study from Norway in which the overall prevalence of observed staff-to-resident abuse was 76% and 60% of respondents report self-perpetration of abusive acts during the past 12 months. Resident-to-resident aggression was even more common, observed by 88% of respondents.
This study is part of the Swedish national research program APPEAL (A Path to Prevention of Elder Abuse in Long-term care) with the long-term goal to co-create an intervention for abuse of older people (AOP) in nursing homes together with stakeholders, i.e., staff, managers, care recipients and relatives.
Read more
Study design and data collection:
A cross-sectional study design will be used with slightly different data collection modes.
- Population sample. Statistics Sweden combine data from the Swedish Occupational Register with data about industry codes (SNI-codes) to make a national randomized sample of staff working in home care services (n=12000) and nursing homes (n=11000) in Sweden. Data will be collected through a digital survey. Data will be combined with available register data from Statistics Sweden, including for example sex, age, civil state and occupational related data.
- Workplace sample. Sweden has 290 Municipalities. The Swedish Association of Local Authorities and Regions (SALAR) have an official categorization of the municipalities based on e.g., urban area size, proximity to a larger urban area, and commuting patterns. One municipality in each of the nine categories has been randomly selected for participation. In the randomization process, geographical location of the municipalities has been considered to assure national representativeness, meaning that in case several municipalities in the same geographical region were selected a new randomization was conducted. Staff in each selected municipalities will be invited to participate through managers in each organization. Data will be collected through a digital questionnaire. Organizations will be encouraged to set a side time at a staff meeting for completing the questionnaire. If this is not possible, a link to the questionnaire will be sent out by e-mail. Data will be collected anonymously.
Material:
The questionnaire used in the previously mentioned Norwegian study about AOP in long-term care facilities has been translated and culturally adapted. In addition, items about background characteristics of respondents as well as risk factors for AOP on both an individual and system level are included, e.g., workload and perceived support at the workplace and ageist attitudes.
Analysis:
Primary outcomes will be proportion of staff reporting different types of abuse (psychological, physical, sexual, financial abuse and neglect) in different relational contexts, i.e., self-perpetrated, staff-to-resident and relative-to resident abuse, and in long-term care facilities resident-to-resident abuse.
Secondary outcome will be staff reported own exposure to different forms of abuse at the workplace, including by residents, co-workers, relatives and managers.
Logistic regression analysis will be used to investigate associations between reporting different forms of abuse and potentially explanatory factors.
- Conditions
- Abuse Domestic, Abuse Neglect, Abuse Physical, Abuse Verbal, Abuse, Sexual, Violence and Victimization
- Keywords
- Abuse of older people, Long-term care facilities, Home care, Home health care
- Medical subject headings
- Coitus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Random sample | Random sample of staff working in home care services or long-term care facilities according to national registers | |
| Workplace sample | Staff working in home care services and long-term care facilities in a selected number of municiaplities who accepted participation in the study |
What is being measured
The primary outcome is the main question the study is designed to answer.
Self-reported perpetration of abuse
Proportion of staff reporting perpetration of abuse of older people during the past 12 monts
Measured: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about abuse. The timeframe used in the questionnaire is experiences of abuse during the past 12 months.
Staff-to-resident abuse
Proportion of staff reporting witnessing abuse of older people by another staff member during the past 12 monts
Measured: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about witnessing acts of abuse during the past 12 months.
Relative-to-resident abuse
Proportion of staff reporting witnessing abuse by a relative during the past 12 months
Measured: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about witnessing acts of abuse during the past 12 months.
Resident-to-resident aggression
Proportion of staff reporting witnessing resident-to-resident abusive behaviours in the past 12 months
Measured: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about witnessing acts of abuse during the past 12 months.
Secondary outcomes (1)
Staff exposure to abuse
Proportion of staff reporting exposure to abuse at the workplace during the past 12 months
Measured: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about expsoure to abuse at the workplace during the past 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Mar 2026
- Study start24 Mar 2026 (estimated)
- Primary completion31 Oct 2026 (estimated)
- Study completion30 Apr 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Abuse DomesticStudies of the same condition, open and under way.
- More trials run by Linkoeping UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Cross-sectional
- Enrolment
- 6,000 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Linkoeping University
- Sponsor type
- Other government
- Collaborators
- Karolinska Institutet, City of Gothenburg, Norwegian University of Science and Technology
- Responsible party
- Principal investigator, Johanna Simmons, Linkoeping University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07494422
- Sponsor's protocol ID
- 2026-01231-02
- Acronym
- APPEAL
- Status last verified
- Mar 2026
- First submitted
- 20 Mar 2026
- Last updated
- 27 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: We plan to share IPD upon reasonable request and as appropriate according to rules and regulations in Sweden.
Study at a glance
From the registry record, last updated by the sponsor on 27 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Path to Prevention of Elder Abuse in Long-term Care. Prevalence Study Among Staff in Long-term Care.
- ClinicalTrials.gov ID
- NCT07494422
- Acronym / sponsor ID
- APPEAL / 2026-01231-02
- Conditions
- Abuse Domestic, Abuse Neglect, Abuse Physical, Abuse Verbal, Abuse, Sexual, Violence and Victimization
- Keywords
- Abuse of older people, Long-term care facilities, Home care, Home health care
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 6,000 participants (estimated)
- Lead sponsor
- Linkoeping UniversityOther government
- Collaborators
- Karolinska Institutet, City of Gothenburg, Norwegian University of Science and Technology
- Study start
- 24 Mar 2026 (estimated)
- Primary completion
- 31 Oct 2026 (estimated)
- Study completion
- 30 Apr 2027 (estimated)
- First posted
- 27 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Globally, studies indicated that 16% of community dwelling older adults have been exposed to some form of abuse in the past 12 months. Furthermore, a global meta-analysis about AOP in long-term care facilities used staff as respondents and found that the pooled estimate of overall self-reported perpetration of staff to resident abuse during the past 12 months was 64.2% (95% CI 53.3-73.9%). Similar findings was also reported in a study from Norway in which the overall prevalence of observed staff-to-resident abuse was 76% and 60% of respondents report self-perpetration of abusive acts during the past 12 months. Resident-to-resident aggression was even more common, observed by 88% of respondents.
This study is part of the Swedish national research program APPEAL (A Path to Prevention of Elder Abuse in Long-term care) with the long-term goal to co-create an intervention for abuse of older people (AOP) in nursing homes together with stakeholders, i.e., staff, managers, care recipients and relatives.
Study design and data collection:
A cross-sectional study design will be used with slightly different data collection modes.
- Population sample. Statistics Sweden combine data from the Swedish Occupational Register with data about industry codes (SNI-codes) to make a national randomized sample of staff working in home care services (n=12000) and nursing homes (n=11000) in Sweden. Data will be collected through a digital survey. Data will be combined with available register data from Statistics Sweden, including for example sex, age, civil state and occupational related data.
- Workplace sample. Sweden has 290 Municipalities. The Swedish Association of Local Authorities and Regions (SALAR) have an official categorization of the municipalities based on e.g., urban area size, proximity to a larger urban area, and commuting patterns. One municipality in each of the nine categories has been randomly selected for participation. In the randomization process, geographical location of the municipalities has been considered to assure national representativeness, meaning that in case several municipalities in the same geographical region were selected a new randomization was conducted. Staff in each selected municipalities will be invited to participate through managers in each organization. Data will be collected through a digital questionnaire. Organizations will be encouraged to set a side time at a staff meeting for completing the questionnaire. If this is not possible, a link to the questionnaire will be sent out by e-mail. Data will be collected anonymously.
Material:
The questionnaire used in the previously mentioned Norwegian study about AOP in long-term care facilities has been translated and culturally adapted. In addition, items about background characteristics of respondents as well as risk factors for AOP on both an individual and system level are included, e.g., workload and perceived support at the workplace and ageist attitudes.
Analysis:
Primary outcomes will be proportion of staff reporting different types of abuse (psychological, physical, sexual, financial abuse and neglect) in different relational contexts, i.e., self-perpetrated, staff-to-resident and relative-to resident abuse, and in long-term care facilities resident-to-resident abuse.
Secondary outcome will be staff reported own exposure to different forms of abuse at the workplace, including by residents, co-workers, relatives and managers.
Logistic regression analysis will be used to investigate associations between reporting different forms of abuse and potentially explanatory factors.
Study design
- Observational model
- Other
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Random sample | – | –Random sample of staff working in home care services or long-term care facilities according to national registers |
| Workplace sample | – | –Staff working in home care services and long-term care facilities in a selected number of municiaplities who accepted participation in the study |
Who may qualify
- Ages
- 18 to 69 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Two samples are used. 1. Population sample. Statistics Sweden combine data from the Swedish Occupational Register with data about industry codes (SNI-codes) to make a national randomized sample of staff working in home care services (n=12000) and nursing homes (n=11000) in Sweden. 2. Workplace sample. The Swedish Association of Local Authorities and Regions (SALAR) have an official categorization of the 290 municipalities in Sweden based on e.g., urban area size, proximity to a larger urban area, and commuting patterns. One municipality in each of the nine categories has been randomly selected for participation. Staff in each selected municipalities will be invited to participate through managers in each organization.
Key inclusion criteria (2 listed)
- Working in home care services or a long-term care facility in Sweden
- Working in direct contact with older adults (e.g., providing care, nursing, rehabilitation to older adults)
Key exclusion criteria (1 listed)
- None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Self-reported perpetration of abuse
Time frame: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about abuse. The timeframe used in the questionnaire is experiences of abuse during the past 12 months.
Proportion of staff reporting perpetration of abuse of older people during the past 12 monts
Staff-to-resident abuse
Time frame: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about witnessing acts of abuse during the past 12 months.
Proportion of staff reporting witnessing abuse of older people by another staff member during the past 12 monts
Relative-to-resident abuse
Time frame: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about witnessing acts of abuse during the past 12 months.
Proportion of staff reporting witnessing abuse by a relative during the past 12 months
Resident-to-resident aggression
Time frame: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about witnessing acts of abuse during the past 12 months.
Proportion of staff reporting witnessing resident-to-resident abusive behaviours in the past 12 months
1 secondary outcome
Staff exposure to abuse
Time frame: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about expsoure to abuse at the workplace during the past 12 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Mar 2026.
- Project websiteLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. We plan to share IPD upon reasonable request and as appropriate according to rules and regulations in Sweden.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Abuse Domestic and Abuse Neglect, run by Linkoeping University at 1 site in Sweden.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 27 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Johanna Simmons (+46 (0) 13 281000, Johanna.simmons@liu.se), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Self-reported perpetration of abuse (time frame: Day1. Cross sectional study using only one point of data collection. Participants are enrolled by returing a questionnaire including items about abuse. The timeframe used in the questionnaire is experiences of abuse during the past 12 months.). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Mar 2026.