Mental Health Status and its Related Factors in Elderly People Residing in Nursing Homes of Mashhad, Iran

Background: Iranian society is facing the phenomenon of aging and attention to this vulnerable group is necessary. The aim of this study was to assess mental health status and its related factors among elderly people living in nursing homes in Mashhad. Methods: This cross- sectional study was conducted in 2015 on 203 over 60 years old elderly people living in Mashhad nursing homes. Data were collected through a demographic information questionnaire and general health questionnaire (GHQ-28). Data analysis was performed through SPSS19 and using Chi-square, Independent t- test, Mann-Whitney and Logistic Regression. Results: The mean of the GHQ-28 score was 27.24±9.94. Based on the GHQ-28 cut off-point, 130 (%64) of the participants had mental health problems. Mental health had a significant relationship with having chronic diseases (P=0.005), the number of their visitings (P=0.03) and somehow with the number of returnings to home (P=0.05). But, there was no significant relation between mental health score and age, gender, marital status, education, number of children, having an independent income or salary and length of stay in nursing homes (P<0.05). Conclusion: The elderly people living in nursing homes of Mashhad do not have a good mental health status. Since having chronic diseases, the number of their visitings and returnings to home are the most important determinants of their mental health, their families and health policy makers should pay more attention to these items

Assessment of Physical Activity Status and its Effective Factors in Elderly People of Khorramabad City

Background: Population aging is one of the most fundamental challenges of today’s world. Due to the increasing growth of the elderly population and the importance of identifying effective factors on their physical activity, this study was done to determine physical activity and its effective factors among the elderly population of Khorramabad city. Methods: This descriptive-analytical cross-sectional study was conducted in 2017 on 450 elderly people in Khorramabad city. Data were collected using 4 questionnaires about demographic characteristics, Community Healthy Activities Program for Seniors (CHAMPS), Knowledge towards physical activity, and Attitude scale Toward Physical Activities (ATPA). Data were analyzed using independent t-test, Pearson correlation coefficient, ANOVA and stepwise regression in SPSS 22. Results: The mean age of participants was 64.20±5.51 years. The mean of physical activity was 251.02±184.81 MET-min/wk. Mean physical activity was significantly correlated with educational level (P=0.001), employment status (P=0.006) and perceived economic status (P = 0.003). There was also a direct significant correlation between physical activity with weight (r=0.102, P=0.031) and life satisfaction (r=0.120,P=0.011). Also, knowledge (P=0.001) and attitude (P = 0.001) significantly predicted the level of physical activity. Conclusion: The results of this study showed that the physical activity of most of the elderly under study was low and moderate. Illiterate, worker, and low-income elderly people had little physical activity. Considering appropriate programs in this field is necessary. Keywords: Physical Activity, Elderly, Knowledge, Attitud

The Informal Caregivers’ Viewpoint About Care Inhibitors for Community-Dwelling Elderly in an Iranian Context: A Qualitative Study

Objectives: Following the rise in the elderly population worldwide and the increase in chronic diseases among this demographic with their consequent need for care, the subject of elderly care is becoming increasingly important. Considering the traditional standing of the elderly in Iranian society and the importance of in-community care for them, it seems of crucial importance to study the obstacles hindering the care for community-dwelling elderly for a better understanding of the status. This can also facilitate the conditions for the care-givers and care-receivers on the part of policy makers and managers. Methods: In this study, using purposive sampling, 19 semi-structured in-depth interviews were conducted with informal care-givers and were then transcribed verbatim. The content analysis of the transcribed interviews was carried out by determining conceptual units, precise coding, and constant comparative method. Then, the sub-categories and main categories were gradually formed. Results: Data analysis was carried out in constant mode simultaneous with the data collection. From the whole set of interviews, 311 preliminary codes were extracted. The codes were obtained throughout the process of analysis in three main categories of personal, family, and social factors. All categories had their own subcategories that were integrated into certain categories based on their own specific characteristics. The subcategories included the characteristics of the caregiver and the elderly, the lack of knowledge and awareness about caregiving, the lack of support and cooperation on the part of the family members, financial problems, unsuitable homes, the lack of government support, and obstacles hindering the presence of the elderly in the society. Discussion: The inhibitors affect a proper caregiving and based on their own nature, cause discomfort to the caregiver and care receiver. Many of these cases are deemed as rectifiable hindrances that can lead us to optimal care for community-dwelling elderly if the cases are taken into consideration and proper strategies are designed and implemented in small and large scale planning

Bitter experiences of elderly parents of children with intellectual disabilities: A phenomenological study

Background: It is predicted that over the next 30 years, there will be a significant increase in the number of elderly parents who care for their children with intellectual disability. This paper is part of a larger qualitative study which investigated the unpleasant experiences of these parents. Materials and Methods: A phenomenological approach was adopted and data were collected through unstructured in-depth interviews with elderly parents of children with intellectual disability. The data were analyzed using Colaizzi's seven-step method. Results: “Bitterness” is one of the four emergent themes extracted in this study which has five theme clusters: inappropriate behavior toward the child in the society, the society's failure to support the child with intellectual disability, sorrows experienced by parents, the child's problems, and barriers in the care of the child with intellectual disability. One significant barrier in the last theme cluster is limitations due to aging. Conclusions: The findings of this study suggest that the elderly parents of children with intellectual disability experience many sorrows and unpleasant feelings, but they mostly consider the social factors as the cause of problems and not the presence of the child. The results also indicate that older parents cannot look after the child as before in their old age; so, future well-designed studies are required for identification of the process of supporting them

بررسي شيوع سوء رفتار و غفلت از سالمندان در جامعه منتخب از سالمندان در ايران

Background and Objectives: There is no accurate data on the burden of elder abuse in Iran, and few studies have been done in this area. The purpose of this study was to determine the prevalence of elder abuse and negligence in a selected population of Iranian elderlies and also to go beyond and assess its relationship with socioeconomic factors. &nbsp; Methods and Materials: A cross-sectional study focused on the 300 elderlies aged 65 years which were referred to the Emergency Departments of Imam Hossein, Loghman Hakim, and Tajrish Hospitals in Tehran. A special questionnaire focused on elderly abuse with eight subsets of care-giving neglect, psychological abuse, physical abuse, financial abuse, disqualification, rejection, financial neglect, and emotional neglect was completed by the participants. &nbsp; Results: Overall, 300 questionnaires were completed. Among the participants, 54% were women. The mean age of the participants was 74.1 years with a standard deviation of 9.69. Overall, 27.7% were unable to meet their daily needs. Also, 51.7% lived with their spouses, 20.3% lived with their children, and 18% lived alone. Also, 40.3% owned their homes, and 85% had health insurance. The highest scores in this questionnaire were related to the subscales of emotional neglect (25.5%) followed by psychological (17.7%) and financial abuse (12.4%). &nbsp; Conclusion: Maltreatment of the elderly, especially in the areas of emotional neglect, psychological abuse and financial abuse is one of the most important issues in today's Iranian society that may be caused by changing emotional, economic and social values, as well as fading religious beliefs and morals. Therefore, it is necessary to take measures to alleviate these problems to resolve elder’s emotional and mental problems. How to cite this article: Oveissi S, Fadayevatan R, Ghanbari-Boroujeni M, Hatamabadi HR. Prevalence of Abuse and Neglect in Iranian Elderly Population. J Saf Promot Inj Prev. 2021; 8(4):260-5.سابقه و هدف: در كشورهاي جهان سوم آمار صحيحي در مورد سوء رفتار با سالمندان وجود ندارد و در ايران نيز ميزان شيوع سوء رفتار با سالمندان مشخص نمی‌باشد و مطالعات اندکی در این زمینه انجام شده است. هدف از مطالعه حاضر، بررسی شیوع سوء رفتار و غفلت از سالمندان در نمونه‌ای منتخب از سالمندان ایرانی بود. روش بررسی: پژوهش حاضر یک بررسی مقطعی بود که بر روی 300 سالمند بالای 65 سال مراجعه کننده به اورژانس بیمارستان‌های امام حسین (ع) و لقمان حکیم و شهدای تجریش شهر تهران انجام گرفت. پرسشنامه “سوء رفتار با سالمند” با هدف شناسايي و ارزيابي اشـكال مختلـف سـوءرفتار نـسبت بـه سـالمندان در خانواده و شامل هشت زير مقياس غفلت مراقبتـي، سـوء رفتار روان شـناختي، سوء رفتار جسمي، سوء رفتار مالي، سلب اختيار، طردشدگي، غفلت مـالي و عـاطفي برای شرکت کنندگان تکمیل گردید. یافته‌ها: در این مطالعه تعداد 300 پرسشنامه تکمیل شد. در میان این شرکت کنندگان، 54 درصد زن بودند. میانگین سنی شرکت کنندگان 74/1 سال با انحراف معیار 9/69 سال بود. در کل، 27/7 درصد قادر به انجام نیازهای روزمره شخصی نبودند. 57/7 درصد با همسر زندگی می‌کردند 20/3 درصد با فرزندان و 18 درصد تنها زندگی می‌کردند. در 37 درصد، اداره اموال در دست خود سالمند بود، 29 درصد در دست فرزندان و 13/7 درصد در دست همسر بود. همچنین، 40/30 درصد مالکیت منزل خود را داشتند و 85 درصد بیمه درمانی داشتند. سه زیرمقیاس “غفلت عاطفی”، “سوء رفتار روانشناختی” و “سوء رفتار مالی” به ترتیب با شیوع 25/5 درصد، 17/7 درصد و 12/4 درصد بالاترین شیوع را داشتند. نتيجه‌گيري: سوء رفتار با سالمندان بالاخص در حوزه‌های غفلت عاطفی و سوء رفتار روانشناختی و سوء رفتار مالی یکی از مسائل مهم در جامعه امروز ایران است که می‌تواند ناشی از تغيير ارزش‌ها در عرصه‌های عاطفي، اقتصادي و اجتماعي، كمرنگ شدن اعتقادات مذهبي و اخلاقيات و غیره باشد. لذا لازم است اقدامات لازم جهت رفع این مشکلات انجام گیرد تا از مشکلات عاطفی، روانی و بیماری‌های سالمندان بکاهد. How to cite this article: Oveissi S, Fadayevatan R, Ghanbari-Boroujeni M, Hatamabadi HR. Prevalence of Abuse and Neglect in Iranian Elderly Population. J Saf Promot Inj Prev. 2021; 8(4):260-5

What is a key step in the falling process in older people? A qualitative study in an Iranian context

Falls in elderly people occur commonly and may result in significant morbidity and mortality. Prevention of falls is quite possible. The important point is to know and use interventions appropriate to each context. The aim of this study was to explore the facilitators and barriers of the process of falling in elderly people in an Iranian context. A grounded theory data analysis method (constant comparative analysis) was applied using semistructured interviews with15 older persons and seven formal and informal caregivers. According to the experiences of the participants of the current study, the main situation was “response to ageing,” and eight major concepts related to this situation have been explored. In reaction to ageing, older persons show three main responses including maladaptive, corrective adaptation, and unsuccessful or disruptive adaptation. Other related concepts include physical and mental condition, learning on aging, fall consequences, fatalism in falls, lifestyle, social factors related to falling, environmental factors, and restrictive care. Responses to ageing had the most important role in shaping the process of falls. Therefore, the type of interventions that lead people to respond appropriately to aging may be an effective factor in preventing falls in elderly people. It is also necessary to explore the process of fall in each context

Diagnostic accuracy of the Tilburg Frailty Indicator (TFI) for early frailty detection in elderly people in Iran

Abstract Aim Screening is one of the most important ways for early frailty detection that contributes to its prevention and timely treatment. The aim of this study was to determine the diagnostic value of the Persian version of the Tilburg Frailty Indicator (P-TFI) in the frailty screening. Method This is a diagnostic test accuracy study that uses known group method. It was designed based on a STARD statement and performed on 175 elderly people in the City of Kashan, Iran. The subjects were selected among older people available in health centers affiliated to Kashan University of Medical Sciences using purposive sampling. Data analysis was carried out using SPSS v16. Descriptive statistics were used to describe the characteristics of the research subjects. Independent t-test was used to determine the ability of the P-TFI to discriminate frail and non-frail individuals, and to evaluate the cut-off point and instrument accuracy, the receiver operating characteristic (ROC) curve was used. The best cut-off point was determined among the proposed points using Youden index. At the determined cut-off point, the diagnostic value parameters of the P-TFI (sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, accuracy, and diagnostic odds ratio) were calculated and their range was estimated with 95 % confidence interval. Findings A total of 74.3 % of the sample was male and their mean age was 68.6 ± 54.44 years. The area under the ROC curve was calculated 0.922, indicating high accuracy of the instrument. The sensitivity and specificity of this instrument at the cut-off point of 4.5 were 0.95 and 0.86, respectively. Positive and negative predictive values were calculated 0.68 and 0.98, respectively, and the accuracy of the instrument was reported to be 0.88. Conclusion The P-TFI can be used as a sensitive and accurate instrument, which is highly applicable to screen frailty in older people

Determining the status of activity of daily living (ADL) and instrumental activity of daily living (IADL) in healthy and cognitive impaired elderlies

Background & Objective: Dementia is associated with serious effects on memory, cognition and ability to carry out daily activities. There is evidence that impairment in activity of daily living (ADL) is even reported among elder patients who suffer from mild cognitive disorders. Therefore, we aimed to determine the status of ADL and instrumental activity of daily living (IADL) in healthy and cognitive impaired elderlies (MCI, Mild, and Moderate dementia). Methods: In this cross-sectional study which was conducted in 2016, 300 elderlies (60 years and above) were selected using a classified cluster sampling in four groups (each group of 75 individuals). These groups comprised of healthy old people and elderlies with mild cognitive impairment (MCI) and mild to moderate dementia that were residing in rural areas of Isfahan and Tehran and were classified between stages of 1 to 5 according to the Global Deterioration Scale (GDS). All individuals in four groups were assessed by ADL and IADL evaluation tools. The geriatric depression scale (GDS-15) and DSM-IV scale were performed on healthy elderlies by a physician to confirm the lack of mild dementia or depression. Data were analyzed by SPSS 20 software and using descriptive statistics, analysis of variance and independent samples T-test. Results: According to the cognitive impairment screening results by GDS, 76 elderlies were healthy, 75 were in MCI group, 72 individuals were diagnosed with mild dementia and 77 were suffering from moderate dementia. The mean scores of ADL tool on the basis of different cognitive stages of elderlies were statistically significant (p<0.001). The ADL scores among elderlies were lowered by increasing the severity of cognitive impairment. Moreover, the average scores of IADL among elderlies with different cognitive status were significantly different (p<0.001). The IADL scores in cases with moderate dementia were markedly declined in comparison to healthy subjects and elderlies with MCI and mild dementia. Conclusion: Although applying the ADL and IADL tools are not considered as gold standards in rapid assessment of cognitive impairments among elderlies, they could be considered as useful and user friendly tools to detect performance alterations in elderlies with dementia to provide healthcare by geriatric teams

Reasons for Nursing Home Placement of Older Women in Tabriz, Iran: A Content Analysis

Objectives In consistent with the growing rate of elderly population, the burden of chronic diseases has dramatically increased, and subsequently, the need for long-term care has increased, too. The population rate of elderly women is higher than men, and their admission rate to nursing homes is more than men. The present study explained different reasons for the admission of the elderly women to nursing homes. Methods & Materials In total, 13 participants were recruited through purposive sampling method. Semi-structured face-to-face interviews were applied in this qualitative research. Content analysis was used for data analysis. Results Two key factors were the causes of elderly women living in nursing homes. These factors included ‘underlying reasons’ and ‘situational reasons’. The obtained results indicate that the situational reasons played a dominant role in choosing nursing home care. Older women noted several barriers for the lack of participation in the community and at home. Such factors included financial problems, unwanted marriage, abuse, and neglect. Moreover, falls, accidents, loneliness, and emotional problems were classified as major situational reasons. Conclusion In consistent with the growing rate of elderly women, their burden of care continues to rise. Moreover, elderly abuse will increase in this population due to declining financial resources. This could lead to the sending the elderly people to nursing homes. To prevent these factors and facilitate conditions for families and elderly people to live in their desired place, providing community-based services can be useful