Extended Abstract
1. Objectives
Advances in medical science increased life expectancy, and reduced mortality has increased the aging population [1]. According to the 2016 National Population and Housing Census, (6.090%) of the total population of Iran are the elderly [2]. This vulnerable group requires care from families, community, and government based on human and legal principles. Some family conditions may decline the elderly's social status and cause misconducts, including Elder Financial Abuse (EFA) [3-5]. It significantly reduces the biopsychological health status of the elderly [6]. The prevalence of EFA is high in Iran [3, 7-9]. Thus, this study aimed to investigate the association between EFA and the mental health of older people visiting healthcare centers.
2. Methods & Materials
This descriptive correlational study was conducted on 350 older people referring to the healthcare centers in Shahrekord City, Iran. They were selected using a quota sampling technique. First, all healthcare centers in Shahrekord and the number of older adults referring to each center were identified. Then, from each treatment center, the elderly meeting the study inclusion criteria were selected considering each center's share of overall sample size. The data collection tools were a demographic form, Goldberg's General Health Questionnaire (GHQ), and the Older Adult Financial Exploitation Measure (OAFEM). The GHQ has 28 items rated on a 4-point Likert-type scale (0=less than usual, 1=no more than usual, 2=rather more than usual, and 3= much more than usual). The higher the scores, the better the general health status [11]. 
Negahban et al. reported a Cronbach’s alpha coefficient of 0.84 for its Persian version [12]. The OAFEM has 80 items and 6 subscales of theft and scams, the abuse of trust, financial entitlement, coercion, the signs of possible abuse, and associated risk factors. The items are rated on a 3-point Likert-type scale (0= yes, 1= no, 2= suspected, and 3= unknown). The total obtainable score ranges from 0-240 [10]. This questionnaire was translated to Persian, and its face validity and content validity were evaluated by the opinions of a number of faculty members. Its reliability was also measured as 0.87 using Cronbach’s alpha coefficient. The collected data were analyzed using descriptive statistics as well as Independent Samples t-test and one-way Analysis of Variance (ANOVA). The significance level was set at (P<0.05).
3. Results
Of the 350 study participants, 221(63.1%) were male and 129(36.9%) were female. Their Mean±SD age was 73.89±7 years. In total, (20.9%) of them reported no source of income, and (36.6%) had a monthly income of <1 million Tomans. Their Mean±SD overall mental health score was 39.86±19.59. Moreover, (61.4%) and (38.6%) of the study participants reported experiencing moderate and severe EFA, respectively. The mean scores of theft and scams, the abuse of trust, financial entitlement, coercion, the signs of possible abuse, and associated risk factors were 43.38, 32.14, 2.45, 38.12, 57.58, and 12.79, respectively.
Pearson’s correlation test results reported a significant negative relationship between mental health and EFA. To assess the correlation of four dimensions of mental health with the 6 aspects of EFA, multiple regression analysis was conducted. In this method, the beta coefficient indicates the correlation level between the criterion variable and predictor variable [13]. Each dimension of mental health was entered into the regression model as a criterion variable along with the 6 dimensions of EFA as predictors; then, the beta coefficient value was measured. The attained results revealed that “coercion” had the highest correlation with the “somatic symptoms”; “theft and scams” with “anxiety” and “social dysfunction”; and “the abuse of trust” with “depression.” In all forms of EFA, the subjects’ mental health was at risk. Furthermore, there was a significant and negative relationship between the dimensions of mental health and those of EFA.
4. Conclusion
The current study assessed the relationship between EFA and mental health among the elderly. The obtained results reported a significant association between those variables. With the increase of EFA, the risk of depression, and the social dysfunction of the elderly increased. All forms of EFA can decline this group’s mental health. Therefore, it is suggested that interventions be considered in future studies and policies to increase the awareness of the elderly and their families about EFA and to improve the quality of their care by family members. A limitation of this research was the poor physical conditions of the study participants; therefore, the researcher had to complete the questionnaires through interviewing. Additionally, due to the high number of questions, the questionnaires were completed in two sessions.
Ethical Considerations
Compliance with ethical guidelines
All ethical principles were considered in this article. The participants were informed about the purpose of the research and its implementation stages; they were also assured about the confidentiality of their information; Moreover, They were allowed to leave the study whenever they wish, and if desired, the results of the research would be available to them. This study has also been approved by the Faculty of Nursing, Islamic Azad University, Khorasgan Branch (Isfahan).
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors' contributions
All authors contributed in preparing this article.
Conflicts of interest
The authors declared no conflict of interest.