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Introduction: It has been estimated that 335 million elderly, about 13 percent of general population, live in developing countries. It has been predicted that in 2040, this percentage will rise to 20 percent. Psychophysical complains are common in elderly and investigation of quality of life (QOL) in these samples of population is very important.

Materials and Methods: This research is a descriptive analytical study carried out to investigate the QOL of elderly residents of Zahedan city. In this study a short form questionnaire (SE 36) of QOL was used. Estimated required number of the samples was 200 that were selected with random cluster sampling.

Results: Average age of studied population was 72.3 years and their mean number of children was 6.7. Mean scores of the general health perception, physical activity, physical role function, bodily pain, social function, emotional role function, vitality and mental health were 38.6, 42.7, 36.8, 37.8, 43.9, 45,46.7 and 42.7, respectively.

Conclusion: Since currently there are no sound data for elderly QOL in Iran, considering mean QOL score of 50 and standard deviation of 10, all observed QOL scores (in eight dimensions) were low. These findings show importance of attention to QOL in elderly clients.

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Background & Aim: Urinary tract infection is one of the most prevalent complains among elderly in primary care centers. The purpose of this study was to assess urinary tract disorders and prevalence of urinary tract infection in residents of Kahrizak elderly House.

Methods & Materials: In this cross-sectional study, 142 men and 114 women (mean age: 76.03±8.32 years) were randomly selected for the study. Data were gathered using a questionnaire. Weight and height of the participants was measured and urine cultures were ordered. Data were analyzed using c² and Fisher‘s exact test. The P<0.05 denoted statistical significance.

Results: Findings showed that 34% of elderly had urinary tract infection. Of those, 55% (46 cases) were women and 45% (41 cases) were men. Prostate hypertrophy (32.5%) and gyneacologic disorders (16.9%) were the most diagnosed disorders (P<0.05).

Conclusion: The prevalence of urine tract infection in elderly with urinary system disorders is high. Recognizing at risk elderly and referring them to the health care centers can prevent urinary tract infection and its complications.

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  Background & Aim: Falling is common among elderly due to changes in sensory–motor function. Falling causes physical, emotional and financial problems and decreases the quality of life in elderly. Since the causes of falling are multifactorial, multi-dimensional approaches should be considered to prevent it. This study aimed to investigate the effect of a multidimensional fall prevention program on the incidence of falling and quality of life among old people living in nursing homes.

  Methods & Materials: This before-after quasi-experimental study was conducted on 60 old people living in nursing homes who met the inclusion criteria. Multidimensional fall prevention program was focused on: 1- exercise (stretching, balance, and strength) 2-training classes for caregivers and elderly and 3-environmental modification. Data were collected before and six months after the intervention using demographic and illness form, fall frequency form and the LEIPAD questionnaire. Collected data were analyzed using the paired t-test, one-way ANOVA, Mann-Whitney and Wilcoxon tests in the SPSS-16 . 

  Results: Before and six months after the intervention, the mean frequencies of falling were 2.00 (±0.70) and 0.20 (±0.55), respectively. The mean scores of quality of life before and six months after the intervention w ere 56.48 (±10.45) and 77.43 (±10.45), respectively. Results indicated that there were statistically significant difference between the study participants before and six months after the intervention regarding falling frequency (P<0.001) and quality of life score (P<0.001).

  Conclusion: The multi-dimensional fall prevention program decreased the fall frequency and increased quality of life of participants. Health care providers, particularly nurses can use the prevention program to diminish falling incidence among elderly and improve their quality of life.

  

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  Background & Aim: Demographic transition and aging are global conditions result in increased risk of disability and chronic diseases such as diabetes. Considering stress as having mutual interaction with different aspects of health is vital in treatment of common disorders among older adults with diabetes. This study aimed to assess the relationship between the perceived stress with spiritual health among older adults with diabetes registered to the Association of Diabetes Prevention and Control in Babol .

  Methods & Materials: In this cross-sectional (descriptive- analytical) study, 194 older adults aged 60-75 years old were selected using convenience sampling from the Association of Diabetes Prevention and Control in Babol. Data were collected using the demographic form as well as the Perceived Stress Scale (PSS) and the Spiritual Well-being Questionnaire (SWB). The validity and reliability of the scales were confirmed previously. Data were analyzed using descriptive and inferential statistics including ANOVA, Chi-Squared tests, t-test and Pearson correlation coefficient in the SPSS-21 . 

  Results: The study findings showed that perceived stress was low in a substantial percentage of the elderly (74.2%) with the mean ± SD of 22.52±8.06. Also, the levels of spiritual health were medium to high among most participants (97.72 ± 11.51). Interestingly, there was a significant negative relationship between the perceived stress and spiritual health (r=-0.48, P<0.001) .

  Conclusion: This study elaborated the relationship between the perceived stress with spiritual health of elderly patients with diabetes. Considering the results, enhancing spiritual health as one of the health dimensions seems necessary .

  

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Background & Aim: Quality of life indicates the level of individual’s satisfaction or dissatisfaction with the different aspects of life and has specific characteristics at each stage of life. The quality of life in the elderly may be influenced by death anxiety and depression. The aim of this study was to evaluate the relationship of depression and death anxiety to the quality of life among the elderly population.

Methods & Materials: This study was a cross-sectional research conducted on 294 elderly living in Saghez in 2016. Samples were selected through convenience sampling. The 12-Item Short Form Health Survey (SF-12), Geriatric Depression Scale (GDS) and Death Anxiety Scale were used to gather the data. Data were analyzed using descriptive statistics, the Kolmogorov-Smirnov test, Pearson correlation coefficient and linear regression by Enter method. The level of significance was considered P<0.05.

Results: The mean (and standard deviation) scores for the quality of life, depression and death anxiety among the studied elderly were respectively 33.22±7.81, 4.92±3.82 and 33.63±7.40. There was a significant relationship between depression and the quality of life (P<0.0001) but there was no significant relationship between the quality of life and death anxiety.

Conclusion: Depression is a common problem among the elderly and related to their quality of life. When assessing the quality of life in the elderly, paying attention to their depression is necessary. Appropriate diagnosis and management of depression can improve the quality of life in the elderly.

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Background & Aim: Falling is a serious problem in the elderly population, with many physical, psychological, social and economic consequences. The fear of falling has been considered an activity limiting condition, which can lead to a reduction in the quality of life of the elderly people. The study aimed to determine effect of fall care behaviors training on fear of falling among the elderly people referred to health centers.
Methods & Materials: This double-blind randomized clinical trial was carried out on 110 elderly people referred to health centers in Ardabil in 2017. Participants were selected by the multi-stage random sampling and divided into intervention and control groups by random allocation. The data collection tools were consisted of demographic questionnaire, Mini-Mental State Examination: MMSE, Abbreviated Mental Test Score: AMTS and Fall efficacy scale international: FES-I. Data were analyzed using statistical tests on the SPSS software version 22.
Results: The mean and standard deviation of fear of falling in the intervention and control groups before the intervention were 33.91±12.03 and 31.22±14.76, respectively (P=0.29). Three months after the intervention, the mean and standard deviation of fear of falling were 22.32±4.45 and 30.85±15.03 (P<0.001). Also, ANCOVA was used for controlling pre-test scores and level of education compared to the post-test scores in the two groups (P<0.001).
Conclusion: The results showed that education on fall care behaviors reduces the fear of falling in the elderly people. Therefore, this education is suggested to be considered in the self-care program for elderly people.
Clinical trial registry: IRCT20180205038618N1
 

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Background & Aim: Maintaining and improving the health of the elderly through effective interventions requires the recognition of their lifestyle, including exercise using a valid and appropriate culture-specific tool. The aim of this study was to design and evaluate the psychometric properties of a tool for measuring exercise self-efficacy in the elderly.
Methods & Materials: A sequential exploratory mixed method study was performed in the form of a questionnaire with two qualitative and quantitative sections in 2019. The qualitative section consisted of item generation including three stages: theoretical stage (targeted search of existing literature), field work (semi-structured interviews with the elderly) and final analysis (integration of the results from the two previous stages). In the quantitative section, the psychometric properties of the questionnaire was evaluated using face, content and construct validity as well as the reliability through internal consistency and stability.
Results: Out of 37 initial items, four items were removed after calculating the item impact score.  Seven items were removed after assessing the content validity ratio and content validity index. Also, five items were omitted due to having a load factor less than 0.03. The result of exploratory factor analysis consisted of three factors “recognition”, “situational compatibility” and “self-control” which all together could explain 90.180% of the variance. The Cronbach’s alpha and the Intraclass correlation coefficient were found to be 0.957 and 0.949 respectively.
Conclusion: The data analysis approved that the designed tool can be used for measuring exercise self-efficacy among the elderly due to having acceptable reliability and validity, simplicity and a short completion time.
 

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Background & Aim: The experience of approaching death is one of the undeniable facts of aging that can cause fear and anxiety in the elderly. Given that spirituality as a solid base can be a powerful factor in controlling tense situations, this study was conducted to examine the effect of spiritual group therapy on death anxiety in the elderly.
Methods & Materials: This quasi-experimental study was conducted on 50 elderly people attending the elderly daily center in Aliabad Katoul (Golestan Province) in 2018. Sampling was done using the convenience method and participants were randomly assigned into either experimental- or control group. The experimental group received spiritual group therapy in 8 sessions within eight weeks. The data were collected using a demographic characteristics questionnaire and the Templer death anxiety scale. Using the SPSS software version 16, data were analyzed through independent t-test, paired t-test and covariance test at a significance level of less than 0.05.
Results: The rate of death anxiety before the intervention in the experimental- and control group were 7.36±3.67 and 7.32±1.65 respectively, which did not show a statistically significant difference (P=0.961). After the intervention, the average score of death anxiety for the experimental group was 5.24±3.28 and for the control group was 7.84±1.92 which showed a statistically significant difference (P<0.001).
Conclusion: According to the results, it is recommended to provide the necessary conditions to the elderly to participate in spiritual activities, which can be effective in improving the psychological state of the elderly.
Clinical trial registry: IRCT20181207041877N1
 

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Background & Aim: With age, some physiological changes cause a negative effect on gait patterns. The aim of this study was to evaluate the effectiveness of a 6-week rotary exercises program on spatial and temporal gait parameters in elderly men.
Methods & Materials: This was a quasi-experimental study. A total of 38 employees and retirees over 60 years of age from Isfahan University of Technology in 2019, were selected by the convenience and purposeful sampling and were randomly divided into experimental and control groups (19 people). The gait parameters were assessed through marking the subjects’ trunk and lower extremities, along with simultaneously filming from three directions (anterior, posterior, and lateral) with a Canon 700D camera, and loading the videos into KINOVEA software. The exercise program were performed in three 60-minute sessions per week for six weeks. To analyze the data, descriptive statistics and the analysis of variance with repeated measures were used.
Results: The results showed a significant difference in the number of steps per minute (Cadence) (P<0.001), step speed (P=0.019), stride time (P<0.001), step time (P<0.001), time of stretching or deployment (P=0.002), oscillation time (P<0.001) and dual protection time (P=0.014), but other parameters such as stride length (P=0.102), step length (P=0.137) and step width (P=0.089) were not significantly different.
Conclusion: Implementation of the 6-week combined rotary exercises program in the elderly can improve the gait parameters, reduce the risk of falls and thus reduce the number of referrals to treatment centers in this age group.
 

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Background & Aim: With the increasing phenomenon of elder abuse in today's societies, understanding the facilitating and inhibiting factors related to abuse seems necessary. The purpose of this study was to explain the facilitators of elder abuse in Iranian society.
Methods & Materials: This is a qualitative study that used a thematic analysis approach to collect and analyze data in order to explain the elderly’s perceptions of the facilitators of abuse. In this study, 20 elderly people in the community were selected by purposeful sampling. The data were collected by in-depth, semi-structured and face-to-face individual interviews. The Braun and Clark’s thematic analysis was used to analyze the data.
Results: The results of data analysis led to the identification of three themes including role modeling, evacuation of failures, and cultural-familial context of the society. The third theme had three sub-themes intergenerational gap, parenting style and society’s indifference.
Conclusion: Abuse is the result of a combination of causes and factors. The elderly’ experiences suggest that abuse goes beyond a personal matter and is rooted in cultural, social, and economic practices. Today, it is not acceptance of each other and disregard for the expectations of the other party that gives rise many contradictions and abuses at the family and community level.

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Background & Aim: Health promotion nursing activities for the elderly with COPD is different in various health care structures, and research in this area can help to identify the existing knowledge gap. The aim of this study was to determine health promotion nursing activities for the elderly with COPD.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2020. A total of 180 nurses working in teaching hospitals affiliated to Mazandaran University of Medical Sciences were selected using the convenience sampling method. Data collection tools included a demographic questionnaire and a researcher-made questionnaire on health promotion nursing activities for the elderly with COPD. The data was analyzed through the SPSS software version 18 using t-test, ANOVA and multivariate regression.
Results: The mean age of nurses was 34.58±8.05 years, 84.4% were female and 70.6% were married. The mean score of health promotion nursing activities was 197.10±37.90. Among the dimensions related to health promotion activities, “drugs/smoking cessation” (34.4%) and “self-empowerment” (32.8%) had the lowest frequency. There was a significant relationship between health promotion nursing activities with the work place (P=0.034), age (P<0.001), gender (P=0.022) and marital status (P=0.014).
Conclusion: The health promotion nursing activities for the elderly with COPD was above moderate levels. In-service training programs and internal conferences are needed especially in the area of ​​counseling behaviors and smoking cessation in order to improve the professional competency of nurses.
 

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Background & Aim: Today, ageing is a challenge for health and care systems, and one of its main consequences is an increase in the readmission rates. Therefore, in all countries, efforts are being made to reduce the readmission rate. The Readiness for Hospital Discharge Scale was designed to understand patients' readiness levels for discharge. This study was conducted to translate and evaluate the psychometric properties of the Readiness for Hospital Discharge Scale.
Methods & Materials: In this methodological study, a convenience sample of 500 elderly patients admitted to hospitals affiliated with Mashhad University of Medical Sciences was selected in 2020-2021. The instrument was translated using the forward-backwards method. The psychometric properties of the final version of the instrument were assessed by employing exploratory and confirmatory factor analysis (validity) and Cronbach's alpha and the Guttman's split-half coefficient (reliability).
Results: In the factor analysis, all items had a factor loading above 0.3 and, all of them were retained. The goodness of fit indices confirmed the model and a good fit of the model. The Cronbach's alpha coefficient for the whole scale and the Guttman's split-half coefficient were 0.92 and 0.86, respectively.
Conclusion: The results of our study supported the four-dimensional structure of this instrument and indicated that this instrument has adequate validity and reliability. Therefore, nurses and doctors can use this tool as a suitable method to measure the elderly patients' readiness for discharge and to achieve a safe transfer from the hospital to home.

 

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Background & Aim: Feelings of loneliness can affect the mental health of the elderly and lead to cognitive problems. As a potentially effective treatment approach, cognitive-behavioral therapy (CBT) has emerged as an intervention to alleviate loneliness among the elderly. This study aims to determine the effect of CBT on alleviating loneliness among elderly women referred to health centers in Khomeini Shahr.
Methods & Materials: This quasi-experimental study was conducted in 2020 on a sample of 60 elderly women who had been referred to health centers in Khomeini Shahr. The participants were conveniently selected and then randomly assigned to either the intervention or control groups. Data were collected using a demographic information form and the Deshiri et al’s loneliness questionnaire, which were administered before, immediately after, and one month after the intervention. The intervention group received eight counseling sessions of CBT that lasted for 60 minutes each, while the control group did not receive any counseling. Data analysis was carried out using the SPSS software version 23, employing descriptive and inferential statistics.
Results: The results obtained from conducting a two-way repeated measures analysis of variance (ANOVA) showed a significant statistical difference in the mean score of loneliness resulting from communication with family, the score of emotional symptoms of loneliness and the total score of loneliness in the intervention group before and after the intervention (P<0.001). However, no statistically significant difference was observed in the control group (P>0.05). Furthermore, when comparing the mean score of loneliness resulting from communication with friends in the intervention group, no statistically significant difference was observed before and after the intervention (P=0.094). Similarly, no statistically significant difference was observed in the control group (P=0.338).
Conclusion: The results of the current study indicate that CBT is an effective approach to alleviate loneliness in elderly women. Therefore, it is suggested that this method be implemented as a means to reduce feelings of loneliness among elderly women.

 

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Background & Aim: Osteoporosis is a common condition in the elderly, contributing to fracture incidence and associated pain. This study aims to analyze trends in osteoporosis-related fractures within the elderly population from 2017 to 2021.
Methods & Materials: A descriptive cross-sectional study was conducted in 2024 involving 448 elderly people over 60 who experienced pelvic, hip, distal hand, or spinal injuries during 2017-2021 in Kashan. Data were extracted from the National Trauma Registry of Iran, including demographic information, injury severity, and frequency of fractures. The data were analyzed using analysis of variance and chi-square tests, with a significance level set at P<0.05.
Results: Among the 448 participants, 244 were female (54.5%), with an average age exceeding 75 years among those diagnosed with osteoporosis. The most common fracture types included hip and pelvic fractures, affecting 331 individuals (73.9%), followed by distal hand fractures in 71 individuals (15.8%), and spinal fractures in 65 individuals (14.5%). The average injury severity score increased from 8.43±2.80 in 2017 to 8.96±2.77 in 2021. No significant changes were observed in the age distribution of the elderly population during this period; however, the proportion of males increased by approximately 6%.
Conclusion: The study results indicate a rising trend in hip fractures among the elderly in Kashan. To reduce fracture incidence, it is recommended to implement proactive screening for osteoporosis risk factors in this population.