Family, Social Support and Health Status of Older People in Tehran

Iran has recently undergone an exceptionally fast fertility transition. The Total Fertility Rate decreased from 7 in 1980 to 1.8 in 2006 along with declines in adult mortality rates. Consequently, Iran is currently experiencing rapid population ageing. As these demographic changes are intertwined with huge social changes, some major challenges may be anticipated in future. One important concern is that the health status of older people, particularly their mental well-being, may be adversely affected if fewer children lead to a reduction in the support available to older people. The aim of the research described in this thesis was to examine direct and stress-buffering associations between social support and mental health in older age groups. Potential differences between men and women in the associations and the role of different sources of support were also examined. A review of the existing literature indicated that this topic is under-researched in Iran or culturally similar countries. A quantitative cross-sectional survey of a random sample of 800 people aged 60+ years resident in Tehran was conducted. In total, 644 people responded. Multilevel mixed-effects models were used to examine the hypotheses. The findings supported the hypothesis of a direct association between functional aspects of social support and mental health but not that of an association between structural aspects of social support and mental health. No strong evidence of a stress-buffering effect of social support in the association between physical functioning and mental health was found, except in the case of receipt of social support with transportation. The only type of support that showed a significant interaction with gender was receipt of support with paperwork. The source of support did not seem to matter. Implications of these findings for older people currently living in Tehran are considered and recommendations for appropriate social support interventions, taking account of the results, are made

Determinants of health-related quality of life in elderly in Tehran, Iran

BACKGROUND: As Iran started to experience population ageing, it is important to consider and address the elderly people's needs and concerns, which might have direct impacts on their well-being and quality of life. There have been only a few researches into different aspects of life of the elderly population in Iran including their health-related quality of life. The purpose of this study was to measure health-related quality of life (HRQoL) of elderly Iranians and to identify its some determinant factors. METHODS: This was a cross-sectional survey of a random sample of community residents of Tehran aged 65 years old and over. HRQoL was measured using the Short From Health Survey (SF-36). The study participants were interviewed at their homes. Uni-variate analysis was performed for group comparison and logistic regression analysis conducted to predict quality of life determinants. RESULTS: In all, 400 elderly Iranian were interviewed. The majority of the participants were men (56.5%) and almost half of the participants were illiterate (n = 199, 49.8%). Eighty-five percent of the elderly were living with their family or relatives and about 70% were married. Only 12% of participants evaluated their economic status as being good and most of people had moderate or poor economic status. The mean scores for the SF-36 subscales ranged from 70.0 (SD = 25.9) for physical functioning to 53.5 (SD = 29.1) for bodily pain and in general, the respondents significantly showed better condition on mental component of the SF-36 than its physical component (mean scores 63.8 versus 55.0). Performing uni-variate analysis we found that women reported significantly poorer HRQoL. Multiple logistic regression analysis showed that for the physical component summary score of the SF-36, age, gender, education and economic status were significant determinants of poorer physical health-related quality of life; while for the mental component summary score only gender and economic status were significant determinants of poorer mental health-related quality of life. The analysis suggested that the elderly people's economic status was the most significant predictor of their HRQoL. CONCLUSION: The study findings, although with a small number of participants, indicate that elderly people living in Tehran, Iran suffer from relatively poor HRQoL; particularly elderly women and those with lower education. Indeed to improve quality of life among elderly Iranians much more attention should be paid to all aspects of their life including their health, and economic status

Self-assessed health among Thai elderly

<p>Abstract</p> <p>Background</p> <p>The ageing of the population is rapidly progressing in Thailand. Self-assessed health status can provide a holistic view of the health of the elderly. This study aims to identify the determinants of self-assessed health among older Thai people.</p> <p>Methods</p> <p>The data for this study were drawn from a national survey of older persons conducted in 2007. Stratified two-stage random sampling was used for data collection. The analysis was restricted to the population aged 60 and above. The study used univariate, bivariate, and multivariate analysis procedures to analyze the data. Bivariate analysis was used to identify the factors associated with self assessment of health status. After controlling for other variables, the variables were further examined using multivariate analysis (binary logistic regression) in order to identify the significant predictors of the likelihood of reporting poor health.</p> <p>Results</p> <p>Overall, 30,427 elderly people were interviewed in this study. More than half of the sampled respondents (53%) were aged 60-69 years and about one out of seven (13%) were aged 80 years or above. About three in five respondents (56%) reported that their health was either fair or very bad/bad. Logistic regression analysis found that age, education, marital status, working status, income, functional status, number of chronic diseases, and number of psychosocial symptoms are significant predictors in determining health status. Respondents who faced more difficulty in daily life were more likely to rate their health as poor compared to those who faced less such difficulty. For instance, respondents who could not perform 3 or more activities of daily living (ADLs) were 3.3 times more likely to assess their health as poor compared to those who could perform all the ADLs. Similarly, respondents who had 1, 2, or 3 or more chronic diseases were 1.8 times, 2.4 times, and 3.7 times, respectively, more likely to report their health as poor compared to those who had no chronic disease at all. Moreover, respondents who had 1-2, 3-4, or 5 or more psychosocial symptoms in the previous months were 1.6 times, 2.2 times, and 2.7 times, respectively, more likely to report poor health compared to those who did not have any psychosocial symptoms during the same period.</p> <p>Conclusion</p> <p>Self-assessed poor health is not uncommon among older people in Thailand. No single factor accounts for the self-assessed poor health. The study has found that chronic disease, functional status, and psychosocial symptoms are the strongest determinants of self-assessed poor health of elderly people living in Thailand. Therefore, health-related programs should focus on all the factors identified in this paper to improve the overall well-being of the ageing population of Thailand.</p

Social and health-related predictors of family function in older spousal caregivers: a cross-sectional study

Given the benefits of adequate family function for the health and well-being of older adults, it is important to understand what factors predict adequate family function in older people who care for their spouses. Objective: Analyse predictors of family function in older spousal caregivers. Methods: A cross-sectional study design was used to investigate a non-probabilistic sample of 298 older spousal caregivers. Home-based face-to-face interviews were used to evaluate sociodemographic variables and care context, family function (Family APGAR), cognitive function, perceived stress, and depressive symptoms. Data were analysed using multiple logistic regression with stepwise forward method for variable section. Results: Older caregivers having some degree of cognitive impairment (OR=-0.160, 95%CI 0.444–0.579), depressive symptoms (OR=-0.848, 95%CI 0.726–0.992) or high levels of stress (OR=-0.955, 95%CI 0.914-0.999) had overall lower levels of family function. Having more children was linked to approximately 1.3 times higher family function (95%CI 1.080–1.057). Conclusion: Stress, depression, cognitive decline, and number of children are predictors of family function and should be considered in social and health care strategies within the family caregiving context

Is Health Related Quality of Life (HRQoL) a valid indicator for health systems evaluation?

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.The purpose of this review is to do a discussion about the use of the HRQoL as a health measure of the populations that enable to analyze its potential use as a measure of development and efficiency of health systems. The principal use of the HRQoL is in health technologies economics evaluation; however this measure can be use in public health when need to know the health state of population. The WHO recognizes its potential use but its necessary to do a discussion about your difficulties for its application and restrictions for its use as a performance indicator for the health systems. The review show the different aspects about the use of HRQoL how a measure of efficiency ot the health system, each aspect identified in the literature is analyzed and discussed, developing the pros and cons of their possible use, especially when it comes as a cardinal measure. The analysis allows recognize that measuring HRQoL in countries could serve as a useful indicator, especially when it seeks to measure the level of health and disease, as do most of the indicators of current use. However, the methodological constraints that do not allow comparability between countries especially when you have large socioeconomic differences have yet to be resolved to allow comparison between different regions.Romero, D.; Vivas Consuelo, DJJ.; Alvis Guzman, NR. (2013). Is Health Related Quality of Life (HRQoL) a valid indicator for health systems evaluation?. 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Selection an Appropriate Leadership Style to Direct Hospital Manpower

This research has tried to find most proper leadership styles based on a approved model to direct hospital manpower appropriately. The main objective of this research was the comparison between manager’s existing leadership styles and suggested styles to them in order to direct existing styles toward suggested ones. In this cross- sectional study all Qom province hospital managers participated. From the hospital the staff, 385 persons were selected by randomized stratifying sampling. Data were collected by two types of validated questionnaires, one for the staff and another for managers, and analyzed by SPSS software. The finding showed that among four types of leadership styles, 75% of manager’s leadership style was “consultative” and rest were “exploitative- authoritative” or “benevolent- authoritative”, but in the view of about 78% of the staff, manager’s leadership style was “benevolent- authoritative” and only 0.8% of them believed that manager’s style was participative .In general, based on the staff point of view, managers behaved less participative. On the other hand, Tannenbaum and Schmidt leadership style continuum model proved that the best leadership style for all the hospital managers was the “consultative” one. It can be concluded that there was 25% gap between existing leadership styles and suggested ones and it should be tried to close this gap as far as posible