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This study aimed to review the validity and/or reliability of light-intensity physical activity (LPA) questionnaires and identify the most suitable questionnaires for measurement of LPA in adults. Following the PRISMA-P 2020 guidelines, we searched MEDLINE, PsycINFO, CINAHL, Scopus, Embase, and MedNar. Only studies that targeted adults [greater than or equal to]18 years old and used LPA measured by accelerometer and/or heart rate monitor as an objective criterion were included. The search resulted in 2748 article hits, from which we extracted 16 studies with 14 questionnaires. The 7-Day Sedentary and LPA Log and LPA Questionnaire were specifically designed for LPA measurement, and the Community Health Activities Model Program for Seniors physical activity self-report questionnaire scale has been revised for LPA measurement. These questionnaires had comparatively high reliability and validity in this review. Most studies contained methodological limitations such as test-retest period. In the future, more accurate reliability/validity studies should be conducted for each questionnaire.

Home-school partnership is key to students' success at schools. Japanese schools have attempted to invite families to participate in school educational activities. However, these efforts are embedded into Japanese school cultures and were not studied empirically. This study aimed to explore teachers' attitudes and actions toward home-school partnership and examine their effects on teachers' burnout. Based on a preliminary study, we developed a questionnaire with 30 items for the partnership attitude (PAT) scale, 37 items for the partnership actions (PAC) scale and three other scales. We examined the concurrent validity of the scales with a sample of 254 teachers. Exploratory factor analysis yielded four subscales for the PAT (Appreciation, Positive Attitude, Traditional Attitude, Difficulty) and five subscales for the PAC (Respect Parents, Individual Contact, Classroom Information Sharing, Being Proactive, Facilitating Conversation). Reliability was moderately supported, while the criterion validity coefficients were moderately supported using correlation analysis. The results of the multiple regressions show that some PAT factors had negative effects, while some PAC factors had positive effects on teachers' burnout. Thus, while it is important for teachers to build a good home-school partnership through partnership actions, a systematic support system is necessary for teachers experiencing difficulties in collaborating with parents.

Empathy is assumed to be a universal human motivation to act altruistically toward others. Developmental models of empathy explaining when and how children acquire the capacity to empathize have been proposed. However, the existing knowledge is largely built upon studies conducted in the Western context. To fill this gap, a cross-culturally validated measure of empathy for children is needed. The purpose of this study was to assess the Japanese version of the Empathy Questionnaire (EmQue), a parent-reported measure of empathy in preschool children, including its construct validity, measurement invariance across genders, and reliability. A total of 550 children aged 1-6 years participated in this study (M[subscript age] = 4.17 years, SD = 1.21). Their mothers completed the Japanese EmQue. Confirmatory factor analysis confirmed the hypothesized three-factor structure (emotional contagion, attention to others' feelings, and prosocial actions) in the 13-item Japanese EmQue. The internal consistencies of the three scales were high. Measurement invariance across gender groups was also supported. Overall, the results demonstrate that the Japanese EmQue is a reliable and valid measure of the empathy of Japanese preschool children. It can serve as a tool in future studies to elucidate the role of culture in shaping empathy in early childhood.

The universality of secure base construct, which suggests that one's use of an attachment figure as a secure base from which to explore the environment is an evolutionary outcome, is one of the core ideas of attachment theory. However, this universality idea has been critiqued because exploration is not as valued in Japanese culture as it is in Western cultures. Waters and Waters (2006) hypothesized that one's experiences of secure base behaviors are stored as a script in memory, and developed a narrative assessment called the Attachment Script Assessment (ASA) to evaluate one's secure base script. This study examined the validity of the ASA and the utility of secure base concept in Japanese culture. A sample of Japanese young adults (N = 89; M = 23.46; SD = 3.20; 57% = females) completed both the ASA and self-report questionnaires. The results revealed that the ASA score was associated with two dimensions of self-report questionnaires assessing parent-youth attachment relationships (trust and communication). The ASA score was not related to Japanese cultural values (amae acceptance, interdependent self-construal, and low independent self-construal). However, a low ASA score was related to a psychological dysfunction in the Japanese cultural context; hikikomori symptoms, which are defined as a desire to remain in his or her own room and his or her understanding of this behavior in other people. We concluded that since hikikomori can be interpreted as an extreme inhibition of exploration, the association between low secure base script and hikikomori symptoms suggests the utility of secure base construct in Japan.

Preparation is an effective and necessary activity; however, most students do not prepare for future lessons. The present study addressed this problem and examined how learners' motives, beliefs, and perceptions affected their strategy use during preparation for future lessons. Participants were 219 Japanese junior high school students who responded to a questionnaire about mathematics learning. The result of a path analysis suggested that learners' intrinsic motives, extrinsic motives, and cognitive beliefs about learning positively related to their spontaneously obtaining prior knowledge and solving example problems. In addition, noncognitive beliefs positively affected perceived cost of preparation and decreased obtaining prior knowledge. Implications for educational practice, limitations of the present study, and suggestions for future research are discussed.

This paper examines the results of a questionnaire on reading ability in English by Japanese college students, which was formerly analyzed using raw scores, from the viewpoint of Rasch measured scores. In the Rasch analysis, the basic requirements for measuring are the following: (1) reduction of experience to one dimensional abstraction; (2) comparisons among persons and items; (3) the linear magnitude inherent in positioning objects along a line; and (4) a unit determined by a process that can be repeated without modification over the range of the variable. With these requirements in mind, this article deals with the rating scale data by focusing on the idea of linearity. Results are examined along a continuum. It is concluded that reading for testing has two components: contents and skills. Contents should be authentic materials because students use skills to comprehend or draw conclusions from the contents. The eventual scores given by the tests are the end product of their comprehension. Thus the process of reading is analyzed by examining three factors: students are given authentic materials; they struggle to comprehend the material and try to use it; their scores are calculated. (6 references.) (KFT)

Objective: This study was designed to develop the Aftermath of Dietary Lapses Coping Questionnaire (ADLCQ) for evaluating how people cope with the aftermath of dietary lapses during weight control. Method: Between June-July 2012, dieticians working in public health centres and city offices in Sizuoka, Japan, recruited 466 participants. They were asked to complete a 20-item self-report questionnaire pertaining to coping strategies in the aftermath of dietary lapses. The questionnaire included items regarding the stage (readiness) of weight control, the experience of weight loss and demographic characteristics. We examined the questionnaire's construct validity by conducting confirmatory and exploratory factor analyses and investigated reliability by examining internal consistency and correlations of factors with readiness for weight control and the experience of weight loss. Results: Data from 411 participants were analysed. Five factors (i.e. self-reflective thoughts, compensation by healthy eating, compensation by exercising, self-monitoring and positive thoughts), collectively consisting of 17 items, reached nearly acceptable levels of validity (adjusted goodness-of-fit index [AGFI] = 0.919, goodness-of-fit index [GFI] = 0.943, comparative fit index [CFI] = 0.832, root mean square error of approximation [RMSEA] = 0.045). Cronbach's alpha coefficients ranged from 0.61 to 0.87. Scores for coping differed with the readiness for weight control and the experience of weight loss. Conclusion: We developed the 17-item ADLCQ to evaluate coping with the aftermath of dietary lapses and confirmed the validity and the reliability of the questionnaire.

In recognition of the rating scale as a crucial tool of performance assessment, this study aims to establish a rating scale suitable for a Story Retelling Speaking Test (SRST), which is a semidirect test of speaking ability in English as a foreign language for classroom use. To identify an appropriate scale, three rating scales, all of which have been designed to have diagnostic functions, were developed for the SRST and compared in terms of their reliability, validity, and practicality. The three scales were (a) an empirically derived, binary-choice, boundary-definition (called EBB1) scale, which has four criteria (Communicative Efficiency, Content, Grammar & Vocabulary, and Pronunciation); (b) an EBB2 scale that was modified from the EBB1 scale and has three criteria (Communicative Efficiency, Grammar & Vocabulary, and Pronunciation); and (c) a multiple-trait (MT) scale that was modified from the EBB2 but has a conventional analytic scale format. The results of the comparison revealed that the EBB2 was the most reliable and valid measure for assessing speech performance in the context of story retelling. However, the MT scale was shown to be the most practical, even though the EBB2 permits more careful scoring, which suggests the influence of the rating scale format on test qualities.

Diagnosing Asperger's syndrome (AS) in adults is difficult and efficient indicators for a precise diagnosis are important in the clinical setting. We examined the clinical characteristics of AS in 129 adults (median age, 32.0 years [range, 19-57]; 102 men and 27 women; AS group (n = 64; median age, 32.0 years [range, 19-50]; 50 men and 14 women), control group (n = 65; median age, 32.0 years [range, 19-57]; 52 men and 13 women) through administration of the Japanese version of the Autism-Spectrum Quotient (AQ) and the Japanese version of the Hospital Anxiety and Depression Scale (HADS), the Liebowitz Social Anxiety Scale (L-SAS), and the NEO Five-Factor Inventory (NEO-FFI). AQ, HADS, and L-SAS scores, and the "Neuroticism" scores of the NEO-FFI were significantly higher in adults with AS than in controls. The "Extraversion", "Agreeableness", and "Conscientiousness" scores of the NEO-FFI were significantly lower in adults with AS than in controls. Total score of the AQ correlated with the "Anxiety" subscale score of the HADS and the "Extraversion", "Openness", and "Conscientiousness" subscale scores of the NEO-FFI in adults with AS, but not in controls. The findings demonstrated that the AQ and other scales could be used to elucidate the clinical characteristics of AS in adults. (Contains 2 tables.)

Introduction: The development of cultural sensitivity is essential for health care professionals but there are few tools to measure this quality in Japan. The purpose of this study was to develop a scale of cultural sensitivity for Japanese health care professionals and examine its reliability and validity. Method: A draft scale was created through conceptual analysis and a questionnaire was completed by 515 health care professionals and 1,322 college students. Exploratory and confirmatory factor analyses were used to determine suitable scale items and examine model fitness. Results: The four-factor 18-item scale showed acceptable model fitness. Cronbach's α coefficient exceeded.90 and correlation coefficients for criterion-related validity were over.29. Construct validity was confirmed by the significantly higher score of the cross-culturally experienced groups. The intraclass correlation coefficient was.642 (professionals) and.722 (students). Discussion: This reliable and valid scale for Japanese health professionals and college students may be used to evaluate training programs to increase their cultural sensitivity. [ABSTRACT FROM AUTHOR]

Background: The Wisconsin Stone Quality of Life questionnaire (WISQOL) is a health-related quality of life (HRQOL) measure designed for patients with urinary stones. It has been translated and used in several languages. This study aimed to validate the Japanese version of the WISQOL (J-WISQOL). Materials and Methods: The J-WISQOL was translated and validated using a multistep process proposed by the World Health Organization that involved forward translation, back-translation, and pilot testing with a group of patients. This study enrolled 150 patients with urinary stones who visited three academic hospitals for stone treatment. We assessed convergent validity of correlation patterns and internal consistency of the J-WISQOL and Short-Form 36-item survey version 2 (SF-36v2). Results: Overall, 150 patients were enrolled. The mean total score of the J-WISQOL was 108.18 ± 20.26 (raw score min–max, 28–140), suggesting that the onset and symptoms of urinary stones reduced the HRQOL in the patients. The J-WISQOL showed good internal consistency (Cronbach's α = 0.96) and interdomain associations (Spearman's correlation coefficient r = 0.67–0.94). The J-WISQOL was correlated with the SF-36v2 in all domains: social, emotional, health, and vitality impact (r = 0.47–0.66). Conclusion: The J-WISQOL is a reliable instrument for evaluating HRQOL measures in patients with urinary stones. It could be a useful quality of life questionnaire for urinary stones in Japan. Clinical Trial 60-20-0047. [ABSTRACT FROM AUTHOR]

Aim: We developed and psychometrically tested the Japanese version of the Professional Attitude Scale for Nurses (PASN‐J). Background: Nurses must recognize the importance of their professionalism; therefore, it is critical to quantitatively measure nurses' professional attitudes. Introduction: This instrument validation study was designed to generate an itemized scale and examine its content validity/psychometric testing using a sample of Japanese nurses. Methods: Based on a trait approach focusing on the characteristic traits of the nursing profession, a 59‐item draft scale was generated. During November 2017, 2657 nurses from 29 facilities in Japan were surveyed. The questionnaire included demographics, the 59‐item draft scale, and a self‐report scale of nurses' professional behaviour and nursing practice ability. Using exploratory and confirmatory factor analyses, we evaluated the construct, criterion‐related, concurrent, and known‐groups validity, and reliability of the PASN‐J. Results: Data from 1716 participants were analysed. The analyses yielded a 38‐item, 3‐factor scale that adequately fit the data. PASN‐J scores were positively correlated with nurses' professional behaviour and nursing practice ability. Conclusion: The 38‐item PASN‐J has good reliability and validity, making it useful for measuring the current condition of nursing professionalism and evaluating nursing education. Implications for Nursing and Health Policy: This scale can evaluate nursing education and promote nurses' professionalism. The PASN‐J will help identifying the elements of undergraduate nursing education that require further emphasis. Additionally, the PASN‐J could facilitate the development of nursing policies to promote professional development in nurses. Ultimately, evaluating nursing education with the PASN‐J enhances nurses' professional attitudes and subsequently improves their quality of nursing, nursing efficiency and patient outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess psychometric properties of the Japanese version of the EQ-5D-Y (3 levels) with a focus on feasibility, reliability, and construct validity.Methods: Respondents were recruited from the general populations of three cities in Japan. First, children and adolescents responded to the EQ-5D-Y and PedsQL by self-report. Parents were also asked to evaluate the health states of their children/adolescents using proxy versions of these questionnaires. Next, the EQ-5D-Y was mailed to their residence approximately 2 weeks later, and both children/adolescents and their parents responded to the questionnaire. Reliability was confirmed by self-report test-retest methods and a comparison of self-report responses with proxy responses. Spearman's correlation coefficients were calculated between responses to the EQ-5D-Y and both responses to and scores of the PedsQL in order to assess construct validity.Results: A total of 654 children/adolescents from aged 8 to 15 (median age: 11) responded to the questionnaires at both the first- and second-stage surveys. Test-retest agreement was sufficiently high and was influenced by age. Proxy test-retest results revealed that parents' responses were more reliable compared to the self-report results. Some correlations (|r| > 0.3) between items of the EQ-5D-Y and PedsQL were found. Meanwhile, no correlations were found between proxy responses to the EQ-5D-Y and self-report responses to the PedsQL.Conclusions: The EQ-5D-Y demonstrates reliability and validity among children/adolescents and their parents in Japan. Construct validity of the EQ-5D-Y by self-report was confirmed through comparisons with the PedsQL. Proxy responses to the EQ-5D-Y were more reliable compared to the self-report results, but construct validity was not confirmed in the proxy version. [ABSTRACT FROM AUTHOR]

In this study, we assessed the factor structure and construct validity of the parent-reported Inventory of Callous-Unemotional Traits (ICU) among school-aged children and adolescents, aged 6 to 15 years, in a community setting in Japan (n = 10,936). We investigated 15 models that have been reported in previous studies and used confirmatory factor analyses to determine a model that might actually be the best-fit among these. We then examined the correlations between the score of ICU and the Strengths and Difficulties Questionnaire (SDQ) in the best fit model and the three-factor bifactor (3FBF) model with the original ICU through cross-sectional and longitudinal analysis to determine the concurrent and predictive validity of the ICU. The results showed that the best-fit model was the two-factor bifactor (2FBF) model with a revised version of the ICU with 12 items, excluding all but one item of unemotional factors. The cross-sectional and longitudinal analysis showed that higher general callous-unemotional factor scores, callousness and uncaring specific factor scores were significantly associated with a higher level of conduct problems and a lower level of prosocial behaviors in the SDQ. These tendencies were shown both in the 2FBF model with the revised version of the ICU and the 3FBF model with the original ICU. We conclude that the 2FBF model was useful for school-aged community samples, as it predicts increases in conduct problems and decreases in prosocial behavior with fewer items than the 3FBF model. [ABSTRACT FROM AUTHOR]

Aim and objective To clarify the characteristics of sub-groups of patients with stable chronic obstructive pulmonary disease having similar approaches to daily body condition management. Background Prior literature has shed light on the experience of patients with chronic obstructive pulmonary disease and revealed that these patients engage in many activities and try different things in their daily lives to regulate and manage their body condition. The research so far has all been qualitative, comprising mostly interviews, and no quantitative studies have been performed. In this study, cluster analysis was used to show that subgroups of patients with similar characteristics undertake similar approaches to body condition management. Design Descriptive, correlational study. Methods Invitations to participate in the survey were extended to patients with stable chronic obstructive pulmonary disease. Cluster analysis was performed on the basis of questionnaire scores relating to nine different categories of daily body condition management actions. The characteristics of the body condition management approaches, in each subgroup, were investigated using analysis of variance and multiple comparisons. Results The cluster analysis produced six subgroups, each defined by the effort expended as part of their body condition management. The subgroups also differed depending on patient age and disease severity. Conclusion Body condition management approaches taken by patients with stable chronic obstructive pulmonary disease are overall, comprehensive approaches. Relevance to clinical practice Patients with chronic obstructive pulmonary disease were subgrouped based on their engagement in body conditioning. Relationships between the subgroups and the engagement in body conditioning, age and shortness of breath severity were observed. The care of patient support should be comprehensive and depend on their age and the duration of the disease. In addition, it should be long term and recognise that the patients are living their own respective lives. Such considerations and focused perspectives are what we think will lead to an improvement in patients' quality of life and prevent their condition from worsening. [ABSTRACT FROM AUTHOR]

Aim: We aimed to develop a Recognition Scale for Female Intimate Partner Violence (IPV) Patients (RS‐FIPVP); measure the levels and clarify the structure of IPV recognition among clinical nurses; and confirm the validity and reliability of the scale. Methods: A cross‐sectional, anonymous, self‐administered questionnaire was administered to clinical nurses (n = 2570) at seven clinical settings in Okinawa, Japan. As a result, 1855 valid responses were obtained and used in the analysis. The statistical analysis examined an exploratory and confirmatory factor analysis, internal consistency, and construct validity. Results: Four factors, comprising 20 items, were extracted for IPV recognition among clinical nurses. The confirmatory factor analysis showed that the indices of fitness supported these results. The Cronbach's alpha coefficient was 0.83 for the total score and 0.71, 0.73, 0.74, and 0.71 for Factors 1, 2, 3, and 4, respectively. Four factors were extracted from the oblique factor analysis, with a cumulative variance of 50.0%: “understanding of the victim's situation”, “violence that is difficult to detect”, “patient characteristics”, and “support and coordination”. The four factors had a moderate correlation (0.27–0.47, P < 0.01) with each other, which indicated construct validity. These findings confirmed fit for the RS‐FIPVP. Conclusions: The RS‐FIPVP, a recognition scale to measure and evaluate the recognition of female IPV patients among clinical nurses, was developed. It may be used to improve the recognition of female IPV patients in nursing continuing education and also to measure and evaluate educational interventions. The reliability and validity of the scale were verified; however, further refining, testing, and evaluation are required. [ABSTRACT FROM AUTHOR]

The Systemic Lupus Activity Questionnaire (SLAQ) is a patient-reported outcome for systemic lupus erythematosus (SLE). We aimed to translate it into Japanese and further investigate its validity and reliability. The English version of the SLAQ was translated into Japanese and administered to Japanese SLE patients at our university clinic. Physicians assessed disease activity using the SLE Disease Activity Index 2000 (SLEDAI-2K). The patients were prospectively followed for repeat assessment a year later. Ultimately, 255 patients participated. The patients’ 10-point ratings of disease activity and SLAQ scores were significantly correlated (Spearman’s ρ = 0.53). The SLAQ score was weakly correlated with the SLE Disease Activity Index 2000 (SLEDAI-2K)-nolab (omitting laboratory items; ρ = 0.18) but not with the SLEDAI-2K (ρ = 0.02). These results suggested its convergent and discriminant validity. The SLAQ demonstrated acceptable internal consistency (Cronbach’s α = 0.80), and good test–retest reliability (intraclass correlation coefficient = 0.85). The effect sizes and the standardized response means of the SLAQ were as follows: clinical worsening, 0.26 and 0.31, and improvement, −0.39 and −0.41, respectively, which indicated a small but significant responsiveness. The Japanese version of the SLAQ demonstrated acceptable reliability and validity; its performance was comparable to that of the original version. [ABSTRACT FROM AUTHOR]

Background: Virtual reality surgical simulators are becoming popular as a means of providing trainees with an opportunity to practice laparoscopic skills. The Lap-X (Epona Medical, Rotterdam, the Netherlands) is a novel VR simulator for training basic skills in laparoscopic surgery. The objective of this study was to validate the LAP-X laparoscopic virtual reality simulator by assessing the face and construct validity in order to determine whether the simulator is adequate for basic skills training. Material and methods: The face and content validity were evaluated using a structured questionnaire. To assess the construct validity, the participants, nine expert surgeons (median age: 40 (32-45)) (>100 laparoscopic procedures) and 11 novices performed three basic laparoscopic tasks using the Lap-X. Results: The participants reported a high level of content validity. No significant differences were found between the expert surgeons and the novices (Ps > 0.246). The performance of the expert surgeons on the three tasks was significantly better than that of the novices in all parameters (Ps < 0.05). Conclusions: This study demonstrated the face, content and construct validity of the Lap-X. The Lap-X holds real potential as a home and hospital training device. [ABSTRACT FROM AUTHOR]

The article focuses on a study related to the organizational justice with regard to the promotion of employee health in Japan. The organizational justice scale (OJS) comprising 20 items in four dimensions were translated from English to Japanese language. Employees from manufacturing companies were asked to respond to the Japanese version of OJS questionnaires. The study found that the OJS in the Japanese version had higher reliability and construct validity as an employee health predictor.

The prevalence of avoidant/restrictive food intake disorder (ARFID) in the general child population is still largely unknown and validated screening instruments are lacking. The aims of this study were (1) to investigate the prevalence of children screening positive for ARFID in a Japanese birth cohort using a newly developed parent-reported screening tool, (2) to estimate the prevalence of children with ARFID experiencing physical versus psychosocial consequences of their eating pattern, and (3) to provide preliminary evidence for the validity of the new screening tool. Data were collected from 3728 4-7-year-old children born between 2011 and 2014 in Kochi prefecture, Japan (response rate was 56.5%); a sub-sample of the Japan Environment and Children's Study (JECS). Parents completed a questionnaire including the ARFID screener and several other measures to assess convergent validity. The point prevalence of children screening positive for ARFID was 1.3%; half of them met criteria for ARFID based on psychosocial impairment alone, while the other half met diagnostic criteria relating to physical impairment (and additional psychosocial impairment in many cases). Sensory sensitivity to food characteristics (63%) and/or lack of interest in eating (51%) were the most prevalent drivers of food avoidance. Children screening positive for ARFID were lighter in weight and shorter in height, they showed more problem behaviors related to mealtimes and nutritional intake, and they were more often selective eaters and more responsive to satiety, which together provides preliminary support for the validity of the new screening tool. This is the largest screening study to date of ARFID in children up to 7 years. Future studies should examine the diagnostic validity of the new ARFID screener using clinically ascertained cases. Further research on ARFID prevalence in the general population is needed. [ABSTRACT FROM AUTHOR]

Background: The older adult population is increasing in number, and elder abuse is expected to become a more pressing problem. Developing tools to assess the presence and severity of elder abuse is important to both effectively prevent this abuse and provide increased support for families. Purpose: This study was intended to test the validity of an Assessment Tool for Domestic Elder Abuse (ATDEA). The items that constitute this tool were derived from a literature review. Methods: Two rounds of self-administered questionnaire surveys were conducted with nurses working at home-visit nursing stations. Round 1 was used to evaluate the face validity, and Round 2 was used to test the content using the content validity index (CVI). Results: Two hundred forty nurses participated in the two studies. In Round 1, 56 nurses evaluated 38 items derived from a literature review, resulting in the development of a 36-item ATDEA. In Round 2, 184 nurses evaluated the content validity of the 36-item ATDEA. The Item-CVI (I-CVI) scores ranged from.61 to 1. Twenty-eight of the items met or exceeded the I-CVI threshold of.78, whereas the eight items assessing self-neglect did not. The overall Scale-CVI score for the assessment tool was.90, which met the threshold of.90. Conclusions/Implications for Practice: The results of validity testing established the preliminary validity of this assessment tool. In addition, as self-neglect is known to damage the well-being of older adults, six of the eight items assessing self-neglect were retained in the ATDEA despite their failure to meet the threshold I-CVI of.78. The remaining two self-neglect items were not included in the ATDEA because of excessively low I-CVI scores (<.70). Thus, the final version of the ATDEA includes 34 items. The authors recommend that nursing professionals use the ATDEA as a checklist to assess the presence of elder abuse and to discern the subtypes and severity of this abuse. When evaluating elder abuse, the higher the degree of severity, the greater the urgency to provide support. [ABSTRACT FROM AUTHOR]