Experiences Living with Fatigue in Iranian Veterans Chemically Injured by Sulfur Mustard Gas: A Phenomenological Study

SummaryPurposeFatigue affects the quality of life. Evidence shows that the phenomenon of fatigue is experienced differently depending on the type of disease and its consequences. The aim of the study was to explicate the meanings of the experience of living with fatigue in chemically injured veterans.MethodsThe hermeneutic phenomenology approach was used in this study, with an emphasis on Van Mennen's viewpoint and approach. According to Van Mennen, six overlapping dynamic activities are recommended to conduct a phenomenological study. During unstructured interviews, the participants were asked to describe their daily living experiences with fatigue. The participants were individuals who were chemically injured due to exposure to mustard gas. After examining every statement in the interview text, extractions of the meaning units, clustering, and themes were performed.ResultsThe data explication was based on the third to sixth stages of Van Mennen's approach. The experience living with fatigue was classified into four essential themes: fatigue as a chronic condition, as an unstable and affected situation, as a physical condition of the entire individual, and as a mental condition of the entire individual.ConclusionDue to unique social interactions and pathogenicity, victims of mustard gas experience fatigue differently than patients with other chronic diseases

First days in intensive care units: A tragedy for families

The first days of patients’ hospitalization in intensivecare units are very important for theirfamily members. Therefore, it is necessary to explorethe families’ perceived experiences in order to adoptappropriate nursing care. This qualitative study aimedto explore the perceptions of families in the first days ofhospitalization of their loved ones in intensive care units.This is a conventional qualitative content analysis study.Unstructured interviews were conducted on 26 familymembers of patients hospitalized in the first five days ofhospitalization in intensive care units in two private andtwo public hospitals in the Karaj, Iran. The data analysisled to the formation of three categories: “Overwhelmingturmoil”, “Scary events” and “Acute psychosomatic tensions”.The results indicated that the first days of hospitalizationof patients in the intensive care units encompass apainful tragedy. Findings can be applied as a guide for thenursing assessment of families to help them for a healthytransition of this stressful situation

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

How do Iranian older adults define place attachment? a qualitative study

Background: Place attachment is the emotional bond between individuals and environment, which seems to increase wellbeing in old age. The purpose of this study was to explore the concept of place attachment from older adults’ perspective. Methods: In this qualitative study, a total of 14 older adults were purposively included in Aran and Bidgool city, Isfahan, Iran. The data were collected using a semi-structured interview and analyzed applying a directed content analysis approach. Results: As participants reported, place attachment meant intensive love, pride, dependency, and familiarity with the environment. Socio-economic attachment was identified as the most prevalent dimension of place attachment, followed by affective, physical, autobiographical, and religious-cultural attachment. Conclusion: Our findings provided a new understanding of place attachment in the context of Iran. The concept of place attachment was identified with a multidimensional nature from Iranian older adults’ perspective. Such a multidimensionality of place attachment should be considered while planning for age-friendly cities or the operationalization of the subject of aging in place, particularly in the developing societies, like Iran

Review: Psychological Factors Affecting Rehabilitation of Neurologic Patients

Psychological factors imply their negative effects on neurologic patients in two ways. Directly, through pathogenic processes of central nervous system, and indirectly, through maladaptive reactions toward disability. Depression: is a common finding in many neurologic diseases and may interfere with rehabilitation process. Correcting patient's attitude toward disability, reducing environmental stresses and potentiating social support network along with antidepressant drugs often help these patients remain in rehabilitation program. Chronic fatigue: decreases the activity levels of patients and the possibility for them to achieve set goals of rehabilitation in proper times. Support, reassurance and sometimes antidepressant drugs may help. Conversion reactions: often accompany chronic illnesses and disabilities and make evaluation and diagnosis difficult. Application of behavioral Techniques may lead to better results. Altered self image: is a prominent feature in patients with spinal cord injury. Counseling and Free discussion on altered self image and sexual problems are essential and other forms of sexual expression must be taught to these patients. Chronic pain: is a disabling condition. Usually physical findings are minor and it seems psychological factors play a more important role in causing it. Antidepressant drugs are effective in most cases. Intensive physical and occupational therapy must be avoided. Excessive emotionality: is a consequence of executive dysfunction arising from frontal lobe injury and mostly seen in stroke, brain injured, and demented patients, Impulsivity and disinhibition may lead to aggressive behavior and socially inappropriate forms of sexual expression. Judicious administration of psychotherapy drugs, behavioral techniques and short-term hospitalization may be helpful. Altered cognition: is a common feature of many pathological conditions of brain. Attention deficit, slowed information processing, disturbed communication, and impaired memory all make patients unfit for participation in rehabilitation program. Neuropsychological evaluations help us to find out the type and the extent of existing impairments. These data can be used to educate therapists and give them guidelines for better interactions with the patients

The Quality of Life Among Rural Elderlies A Cross-sectional Study

Objectives: Life expectancy has increased over the world and resulting in increased number of old people. Thus, it is not just the living years which are important now, but the quality of life is itself a goal. This includes the elderly living in the rural areas as well to help recognize what steps tobe taken to promote these older peoples’ health and prevent disability. This study intends to examine the quality of life of the rural elderlies living in Dashti District of Boushehr Province, Iran. Methods & Materials: In a cross-sectional, descriptive and analytic study,we examined quality of life of the rural older people of Dashti District of Boushehr Province in February 2010, using SF-36 quality of life questionnaire. Applying a multistage cluster sampling, 69 rural older people who fulfilled the inclusion criteria were selected as samples. Data gathering was performed through face to face interview and the statistical software SPSS 17 was used for data analysis. One-way analysis of variance and T-Test were used to determine the relationships between demographic variables and quality of life. Results: The quality of life significantly varied in different ages and marital statuses in its two subscales of vitality and mental health (P0.05). The mean score of sub-scale of physical role limitation was significantly higher in the subjects who were able to read Quran (P=0.016) compared to those who could not. The mean scores of quality of life and its dimensions in the older people living in Dashti Districtwere less than median except in the subscale of social function. Conclusion: According to the results, the quality of life of rural older people in Dashti District is lower than the average, so immediate attention and interventions are necessary to improve their quality of life

Perception of Healthy Lifestyle Among Iranian Elders: A Qualitative Research

Objectives: Healthy lifestyle, as a social determinant of health, is an important source of health promotion, especially in older adults. Given the association of lifestyle to social context, interpreting and recognition of the healthy lifestyle concept may greatly impact on making more appropriate the health promotion interventions. This study aimed to describe the healthy lifestyle as older adults perceive it. Methods & Materials: A qualitative content analysis approach was used in this study. A purposeful sample of 16 community dwelling older adults aged 60 years or older were interviewed. Peer check, member check, and prolonged engagement were considered for building trustworthiness. Results: The healthy lifestyle is composed of 2 main personal and social health related behavioral categories and 12 subcategories of doing healthy habits, having social roles, maintaining inter-personal relationships, having good quality sleep, stress control, prevention of health deterioration, doing daily living activities, observance on healthy food , passing good leisure time, having purpose in life, and being mentally active. Conclusion: Behaviors related to healthy lifestyle in Iranian older adults are influenced by Islamic-Iranian culture and can be divided in 2 major groups: Personal and social

The Role of Group Counseling With Logo-Therapeutic Approach on the Mental Health of Older Women

Objectives: Ageing is the end point of a developmental process which begins with the birth. It is not necessarily accompanied by diseases and disorders, although some are more prevalent in this period. Reportedly mental health problems, especially anxiety and depression, are seen frequently among older people which need more consideration, both in diagnosis and management. Considering the complexities of drug treatment in aging people, using psychotherapeutic approaches has been recommended. This research aimed to investigate the effects of a group counseling program based on logo-therapy concepts on the elderly women residing in the Kahrizak Nursing Home. Methods & Materials: A semi- experimental design was used. Eighteen randomly selected elderly women aged more than 60 years old were evaluated by GHQ-28. Matched according to their GHQ scores, they divided in 2 equal groups. Ten weekly therapeutic group sessions implemented. The subjects were evaluated again by the same instrument. The gathered data analyzed using t test. Results: The results showed that logo-therapeutic approach group therapy led to better mental health of the subjects (P=0.005). This effect was more significant in anxiety (P=0.015) and social (P=0.005) aspects of mental health than depression (P=0.86) and somatic (P=0.13) aspects. Conclusion: Group counseling with logo-therapeutic approach may lead to a better mental health of institutionalized elderly women, hence its application is recommended

Prescription pattern of medication in the elderly residing in nursing homes in Tehran

Objective: This study aimed to investigate prescription patterns for older people in nursing homes of Tehran. Methods: In this cross-sectional study, the data of 170 older people, sampled random cluster gathering method, using medical records, questionnaires and interview with nurses and physicians. Results: The mean average age of the sample was 79.75. 64.7% of them were female. 62.4% received more than 5 types of medicines. The mean number of medicines was 7.55 with the ranging of 1-19 drugs. The most medicine forms used by older people were: tablets 98.2%, injection medicines 20.6 %, drops 13.5%, syrup 8.8%, sprays 6.5%, ointments and suppositories 2.9%. There was not a significant relationship between participating in geriatric educational course And the mean numbers of the prescribed medications (P>0.05)., as well as between covering by health insurance specialty in medicine and the mean of the numbers of mediations (P>0.05). There was a significant relationship between having insurance and the mean number of prescribed medicine (P<0.05). Conclusion: Developing educational programs on geriatric pharmacology general practitioners and more supervision on residential care homes practices may have affects on prescription pattern