The Incidence of Fall and Past History of Falling in Aged Hospitalized Patients

Background: Identifying elderly people with the risk of fall in hospitalsis particularly important for prevention of falls. Review of literaturesuggested that the association between falls and some characteristicsof geriatric inpatients. The aim of this study was to determine thepredisposing factors of falling among the elderly hospitalized patients.Methods: In this descriptive-analytic cross-sectional study, 1213elderly hospitalized patients, 60 years old and above recruited toparticipate in the study. Of all participant 385 subjects met theinclusion criteria of the study. Data collected from a secondary studyon falls which was conducted from March to December 2016. Ademographic questionnaire and Johns Hopkins fall risk assessmenttool were used to evaluate the falls incident and risk of fall among theelderly people. The scores were analyzed by SPSS software version 16.Chi square test and exact test of Fisher and logistic regression wereemployed for data analysis. Significance level was set at 0.05.Results: The mean of age in the subjects was 71.68 + 8.32 years old.Off all 385 eligible aged hospitalized patients, the rate of fallsestimated to be 1.05 per 1000 bed-day. Approximately 12% of casesexperienced at least one fall during hospitalization period. Accordingto the results of logistic regression analysis, the most predisposingfactors for falls in hospital was the past history of falling with oddsratio of 12.7. Moreover, older age (age ≥ 80 years old), use ofmedication/equipment, low cognitive ability, and polypharmacy withodds ratios of 2.63, 1.49, 2.26, 0.988, and 3.34 were related to thefalling in the past, respectively.Conclusions: The results of the study indicated that the incident of fallsamong geriatric patients were relatively low, due to clinicalinterventions in hospital to prevent falls or to routine underestimationand under report of falls

The Incidence of Fall and Past History of Falling in Aged Hospitalized Patients

Background: Identifying elderly people with the risk of fall in hospitalsis particularly important for prevention of falls. Review of literaturesuggested that the association between falls and some characteristicsof geriatric inpatients. The aim of this study was to determine thepredisposing factors of falling among the elderly hospitalized patients.Methods: In this descriptive-analytic cross-sectional study, 1213elderly hospitalized patients, 60 years old and above recruited toparticipate in the study. Of all participant 385 subjects met theinclusion criteria of the study. Data collected from a secondary studyon falls which was conducted from March to December 2016. Ademographic questionnaire and Johns Hopkins fall risk assessmenttool were used to evaluate the falls incident and risk of fall among theelderly people. The scores were analyzed by SPSS software version 16.Chi square test and exact test of Fisher and logistic regression wereemployed for data analysis. Significance level was set at 0.05.Results: The mean of age in the subjects was 71.68 + 8.32 years old.Off all 385 eligible aged hospitalized patients, the rate of fallsestimated to be 1.05 per 1000 bed-day. Approximately 12% of casesexperienced at least one fall during hospitalization period. Accordingto the results of logistic regression analysis, the most predisposingfactors for falls in hospital was the past history of falling with oddsratio of 12.7. Moreover, older age (age ≥ 80 years old), use ofmedication/equipment, low cognitive ability, and polypharmacy withodds ratios of 2.63, 1.49, 2.26, 0.988, and 3.34 were related to thefalling in the past, respectively.Conclusions: The results of the study indicated that the incident of fallsamong geriatric patients were relatively low, due to clinicalinterventions in hospital to prevent falls or to routine underestimationand under report of falls

Psychometric Properties of the Persian Version of Informant Questionnaire on Cognitive Decline in the Elderly-Short Form (IQCODE-S)

Background: Dementia and cognitive decline mainly affect older people. Several instruments have been developed for screening and detection of cognitive impairments, among them is the short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-S).; however, there was no instrument to assess it in Persian language speakers. The purpose of the present study was to validate the Persian version of the Informant Questionnaire on Cognitive Decline in the Elderly-Short Form (IQCODE-S).  Methods: In this study, WHO's standard 'forward-backward' translation procedure was performed.  The validity and reliability of the questionnaire were evaluated and it was administered in a sample of 373 inpatient Iranian elderlies. The convenient sampling was performed to include participants from family members caregiving older patients with long diagnosed of dementia. Face and content validity were evaluated and the reliability of the instrument was evaluated.  Results: The mean age of the participants was 71.08 ± 9.89 years. Cronbach’s alpha coefficient was .82. Significant correlations were observed between cognitive status and age, marital status, education and hospitalized wards (p < .05). Appropriate CVI and were calculated as .85 and.7 respectively. Conclusion: This study reports on translation and validation of the Persian version of one of the most important screening tools for dementia. It reveals a significant association between the elderlies’ cognitive decline and their age, marital status, education, and hospitalized ward.  Key words: Psychometrics, Ageing, Cognitive Decline, Informant &nbsp

Analysis of the comprehensive nursing final exam in Shahroud Faculty of Medical Sciences

هر آزمونی به عنوان ابزار سنجش و اندازه گیری می باید دارای روایی و پایایی کافی برای سنجش صفت موردنظر باشد. با استفاده از آزمون های ریاضی و آمار می توان آزمون ها را تحلیل نمود و صحت عمل آنها را سنجید. هدف از انجام این تحقیق تحلیل سوالات جامع آزمون نهایی پرستاری به عنوان اصلی ترین روش ارزشیابی تکوینی در دانشکده علوم پزشکی شاهرود می باشد. در این پژوهش هریک از 360 سوال مجموع سوال های آزمون جامع نهایی از نظر ضریب دشواری، ضریب تمیز، روایی، پایایی، وجود گزینه های انحرافی و غیره مورد ارزیابی و تحلیل قرار گرفتند تا نقاط ضعف و قوت هر سوال و کل آزمون تعیین گردد. نتایج کسب شده در خصوص میزان دشواری هر سوال در هریک از خرده آزمون ها نشان داد که دروس بهداشت جامعه و بهداشت مادران و نوزادان بترتیب با 42 و 40 سوال با ضریب دشواری بسیار بالا (71-1) دارای بیشترین سوال آسان در مجموعه آزمون ها بود. درحالی که در درس داخلی جراحی 2 با 18 سوال با ضریب دشواری بسیار بالا، کمترین سوالات آسان را دارا بود. عمده ترین مشکل طراحی سوال در آزمون جامع نهایی پرستاری در دانشکده علوم پزشکی شاهرود طراحی سوالات با ضریب سهولت بالا (دشواری اندک) و دارای گزینه های فاقد کارآیی برای متمایز ساختن دانشجویان قوی از ضعیف می باشد علاوه بر این استفاده از آزمون های مناسب برای تحلیل سوالات آزمون اجتناب ناپذیر است. پژوهشگران استفاده از روش دونیمه کردن را به جای روش کودر-ریچاردسون 20 توصیه می نمایند

Prevalence and Covariates of Metabolic Syndrome among Elderly People Living in Nursing Homes, Semnan, Iran

Backgrounds: The study aimed to determine the prevalence and covariates of metabolic syndrome among the elderly residents in nursing homes in Semnan Province, Iran. Methods: This cross-sectional study was conducted among aged participants institutionalized in nursing home in 2018. The study participants’ characteristics were assessed using a demographic assessment form. Moreover, the Mini Nutritional Assessment (MNA) questionnaire, Mentally Assessing Nutritional Assessment (MANA), Katz's Index of Independence in Activity of Daily Living, Mini-Mental State Examination (MMSE) and well-being were applied to assess the participants’ physical and mental status. In addition, Para-clinical and biochemical tests for diagnosis of metabolic syndrome used based on the Adult Treatment Panel (ATPIII). Results: In this study, of 129 eligible participants, 27.7% were suffering from metabolic syndrome. The prevalence of MS in male and female subjects were 26.6% and 28%, respectively.  The results of the study indicated a significant relationship between metabolic syndrome and nutritional statues (Pvalue=0.004), mental status (Pvalue=0.001) and ADL (Pvalue=0.003). Moreover, the results showed no significant relationship between well-being and metabolic syndrome. Of all variables of the study, significant relationship between smoking habit, lack of daily activity, abdominal obesity, high systolic and blood pressure, high density lipoprotein cholesterol (HDL-C) HDL-cholesterol, Waist Circumference (WC), systole blood pressure (SBP) were found to be statistically significant. Conclusions: The findings of the study indicated the prevalence of metabolic syndrome among institutionalized elderlies is high. It is recommended to implement preventive and therapeutic measures in this vulnerable group of elderly people. Key words: Metabolic Syndrome, Elderly People, Nursing Homes, Prevalenc

Social Support among the Elderly Living in Shahroud, Iran

Background: Social support is one of the key aspects of social health among the elderly, significantly affecting other aspects of health. This study attempted to explore the extent to which the elderly benefit from social support and the contributing factors among the elderly living in Shahroud, northeastern Iran.Methods: During 2015-2016,a total of 496 elderly residents of Shahroud were selected through randomcluster sampling method. Data were collected by a questionnaire for capturing demographic variables (age, sex, marital status, educational level, number of children and grandchildren, economic status, health status, diseases) and Lubben Social Network Scale (LSNS). The data were analyzed through independent t-test, simple and multiple linear regressions, and ANOVA.Results:Of the 496 elderly participants in the study, 273 (55.3%) were female with a mean age of 67.9±7.84 years old. The mean score of social support achieved by the elderly was 9.0, ranging from 8.19-9.81 at the confidence interval of 95%. There was no significant relationship between age and social support (p=0.9). However, there was a significant relationship between social support and marital status. The difference in the average score of social support in married elderly was significantly less than that of single, widow(er), and divorced elderly (p<0.001).Conclusion: The elderly in Shahroud were poorly covered by social support. In order to improve this situation, it is crucial to devise appropriate plans on family to population scale.

Social Support among the Elderly Living in Shahroud, Iran

Background: Social support is one of the key aspects of social health among the elderly, significantly affecting other aspects of health. This study attempted to explore the extent to which the elderly benefit from social support and the contributing factors among the elderly living in Shahroud, northeastern Iran.Methods: During 2015-2016,a total of 496 elderly residents of Shahroud were selected through randomcluster sampling method. Data were collected by a questionnaire for capturing demographic variables (age, sex, marital status, educational level, number of children and grandchildren, economic status, health status, diseases) and Lubben Social Network Scale (LSNS). The data were analyzed through independent t-test, simple and multiple linear regressions, and ANOVA.Results:Of the 496 elderly participants in the study, 273 (55.3%) were female with a mean age of 67.9±7.84 years old. The mean score of social support achieved by the elderly was 9.0, ranging from 8.19-9.81 at the confidence interval of 95%. There was no significant relationship between age and social support (p=0.9). However, there was a significant relationship between social support and marital status. The difference in the average score of social support in married elderly was significantly less than that of single, widow(er), and divorced elderly (p<0.001).Conclusion: The elderly in Shahroud were poorly covered by social support. In order to improve this situation, it is crucial to devise appropriate plans on family to population scale.

Randomized control trials on Otago exercise program (OEP) to reduce falls among elderly community dwellers in Shahroud, Iran

Background: Fall is a worldwide health problem among elderly people and a known leading cause of disabilities. Fall prevention programs have been implemented in various forms. The Otago exercise program (OEP) is one of the most recent home-base exercise training program. Objectives: This study was conducted to examine the effectiveness of OEP to reduce falls among elderly people in Shahroud, IR Iran. Materials and Methods: This randomised control trial was conducted among the elderly community dwellers in Shahroud city of the Semnan province, IR Iran, with experience of falls in the last 12 months. Subjects of the study (n = 317) were recruited from elderly senior citizens at public health centers. Block systematic random sampling was applied to categorize the subjects in experimental and control groups. The experimental group (n = 160) received OEP for six months and was compared with the control group (n = 157) who received general health training. This study was registered with the following ID, IRCT2014012016285N1. Results: The findings of the study showed that OEP improved physical performance (Berg-Balance-Score with P > 0.025, and Timed-Up-Go-Test with P > 0.017) and functional capacity (Arm-Curl-Test with P > 0.00 and Chair-Stand-Test with P > 0.01). In addition, OEP significantly reduced the incidence of falls (P ≤ 0.00) among senior citizens in the experimental group. Discussion: The OEP as a home-based exercise is effective for the reduction of the incidence of falls among senior citizens with a history of falls. The OEP can be recommended for elderly homebound people who do not have access to facilities

Internal Consistency of Persian Version of Falls Efficacy Scale and Activity-Specific Balance Scale

Background: Falls is worldwide health problem among older adults. Different scales have been introduced related to falls, including Falls Efficacy Scale (FES) and Activity-Specific Balance Scale (ABCS). Persian version of these scale needs to be assessed for internal consistency. The aim of this study was to evaluate the internal consistency of Persian version of FES and ABCS.Methods: In this pilot descriptive cross-sectional study, subjects (n=20) were selected by convenient sampling from elderly community dwellers. Prior to assessing the internal consistency, the original scales were first translated and culturally adapted from English into Persian according to a standardized procedure. Moreover the Cronbach’s alpha of the scales was calculated by SPSS software version 21.Results: The Cronbach’s alpha of the FES and ABCS were calculated as 0.895 and 0.894, respectively. The inter-item correlation matrix of FES with 10 item and ABCS with 16 items, were positive and acceptable in both scales. Moreover, Cronbach’s alpha if item deleted for all items in ABCS were lower than 0.894 and in FES were below 0.895. It suggests that if each item deleted in both scales, the consistency of the test would decline. Therefor all items were necessary for the scales.Conclusions: The unity of the scales and internal consistency of the 16-item ABCS and 10-item of FES were good and comparable to what has been reported for previous versions of the scales in other cultures. FES and ABCS are two scales which can be used in Persian language for further studies on falls among older adults

Internal Consistency of Persian Version of Falls Efficacy Scale and Activity-Specific Balance Scale

Background: Falls is worldwide health problem among older adults. Different scales have been introduced related to falls, including Falls Efficacy Scale (FES) and Activity-Specific Balance Scale (ABCS). Persian version of these scale needs to be assessed for internal consistency. The aim of this study was to evaluate the internal consistency of Persian version of FES and ABCS.Methods: In this pilot descriptive cross-sectional study, subjects (n=20) were selected by convenient sampling from elderly community dwellers. Prior to assessing the internal consistency, the original scales were first translated and culturally adapted from English into Persian according to a standardized procedure. Moreover the Cronbach’s alpha of the scales was calculated by SPSS software version 21.Results: The Cronbach’s alpha of the FES and ABCS were calculated as 0.895 and 0.894, respectively. The inter-item correlation matrix of FES with 10 item and ABCS with 16 items, were positive and acceptable in both scales. Moreover, Cronbach’s alpha if item deleted for all items in ABCS were lower than 0.894 and in FES were below 0.895. It suggests that if each item deleted in both scales, the consistency of the test would decline. Therefor all items were necessary for the scales.Conclusions: The unity of the scales and internal consistency of the 16-item ABCS and 10-item of FES were good and comparable to what has been reported for previous versions of the scales in other cultures. FES and ABCS are two scales which can be used in Persian language for further studies on falls among older adults