فصلنامه سالمند
پیاپی 62 (تابستان 1400)

 Aging is one of the most critical stages of human development that has its own characteristics and conditions. The most common issues are the mental health of the elderly. Because this period is full of all kinds of feelings of shortcomings and disabilities. Since anxiety is a multidimensional structure, it can be expected to affect many aspects of the elderly. The present study was conducted with the aim of systematic review and meta-analysis of published studies in the field of anxiety in Iranian elderly death.

 This study reviews the studies related to the death anxiety of the Iranian elderly which were published in Persian between 1390 and 1398 (2012 to 2020). Using the keywords, death anxiety, elderly, the aged, searches were conducted in four internal databases, including Jihad Daneshgahi Scientific Database (SID), Iran Scientific Information and Documentation Research Institute (Irandoc), the countrychr('39')s Magazine Database (Magiran), the Iranian Medical Articles Bank (IDML), and CIVILICA, 61 titles were identified. After screening, 33 studies that met the entry and exit criteria were selected for the final review. We used Stata.14 and SPSS.22 software to perform a meta-analysis and descriptive data.

The results showed that 40.35% of the participants were women and the rest were men. The mean and standard deviation of participantschr('39') age was reported to be 67.80±6.44. The results proved that the mean of death anxiety is higher in men than women. And the elderly living in nursing homes had the highest average death anxiety score of 11.8. Studies were categorized into three sections: comparison (three studies), intervention (eleven studies), and factors affecting the Iranian elderly’s death anxiety (eighteen studies). The results of the meta-analysis showed that there is no positive and significant relationship between spiritual therapy and reduction of death anxiety in the elderly (P > 0.05). In studies with spiritual and behavioral therapies, the amount of heterogeneity was significant and thus a positive and significant relationship was observed between the reductions of death anxiety by these treatments.

 The results of the present study show that the average Iranian elderly’s death anxiety is low. The mean and standard deviation of death anxiety in Iranian elderly using the Templer questionnaire was 67.80±6.44 years. Religious beliefs, hopes for the intercession of imams and religious leaders, and hopes for deliverance from the hardships of this life seem to have contributed to the low death anxiety reported by Iranian seniors. Different results have been reported of the average death anxiety score of men and women. The difference in the findings of various studies might have resulted from the role of culture, religion, and dominant traditions of the society, the difference between the roles of men and women, and even the extent of the expression of fear and anxiety by men in the Iranian society. Most of the men show less tendency to express their emotions, including fear. Treatments and behavioral and spiritual interventions lead to a decrease in the elderly’s death anxiety through its influence on finding meaning in the elderly’s lives.

 Social participation among older adult is one of the key factors in active aging. Social participation is influenced by multiple contextual factors. The present study was conducted to explore the facilitators and barriers of social participation in community dwelling older adult.

 This is a qualitative study with a grounded theory approach. The study population consisted of community dwelling older adult that accepted participant in this study and able to communicate effetely. Data were collected through semi structured in-depth interviews. at first, we used purposeful sampling and then continued by theoretical sampling until data saturation achieved. in total fifteen interview were done in this study. each interview lasted forty-five to sixty minutes (each section 20 to 30 minutes). analysis was done using Strauss and Corbin approach (2015)

 Three main categories were emerged from data analysis: participating older adult, participatory family and community capacity in older adult social participation. Each of the main category has subcategories. Participating older adult had five sub categories. Participatory family two category and community capacity in older adult social participation had four categories.  in total eleven subcategories were emerged.

 Facilitating social participation in community dwelling older adult is associated by individual, family and society. It is necessary for older adult planners to planning in these areas. Providing facilitators for the development of social participation in the older adult social participation can facilitate move towards active aging.

Social isolation can lead to depression, decline in life expectancy, and increased death anxiety among older adults. Therefore, the present study was conducted to determine the predictors of social isolation in community-dwelling older adults residing in Qazvin, Iran.

This descriptive and cross sectional study was conducted on 301 older adults in 2020.  Cluster sampling method was used for selecting the eligible older people. Data were collected using the Demographic and chronic diseases checklists, Lubben Social Network Scale, Perceived Social Support Questionnaire, WHODAS, psychological well-Being scale, religious coping questionnaire. Questionnaires were completed by the researcher through face to face interview. The collected data were analyzed using multivariable regression model.  

The mean age of 301 older adults participated in the study was 68.63 ± 7.31 years. Following multivariate analyses, significant predictors of social isolation were identified as being: perceived social support (β:0.333,p<0.001), disability (β:-0.137,p=0.018), and living with spouse (β=0.154,p=0.010). As, the social isolation was decreased by increasing the social support and decreasing the rate of disability. Furthermore, the older adults who lived with their spouse reported lower social isolation compare with their counterparts.

Given the predictive role of perceived social support and the rate of disability in social isolation, establishing or strengthening supportive social networks, particularly in disable older adults seems to be one of the effective factors in reduction of social isolation.

Frailty syndrome is one of the most important aging syndromes that has a high psychological and financial cost for the elderly, families and health system. Therefore, the aim of this study was to determine the factors associated with Frailty in the older adult in Khuzestan province.

This is a cross-sectional study that was performed in 2019 on 540 older adult in Khuzestan province that selected by multistage random sampling. Data include demographic information, accumulated deficits frailty Index, Social Support Scale and the geriatric depression Scale. Data were analyzed by Spearman correlation, chi-square and sequential logistic regression statistical methods.

The mean age of the participating was 72.61 ± 8.72 years. In this study, 56% of the participants were women. Around 14/3% of the sample were frail elderly and 25.7 were pre-frail. Based on the findings in the bivariate analysis of frailty among older women, the elderly, people with lower education, people without social support, people with depression, the elderly alone, single, the elderly with a history of taking more than 5 drugs, with History of hospitalization and malnutrition and lack of social participation are more common (p< /001).Based on ordinal logistic regression, by controlling the simultaneous effect of variables, the level of frailty is significantly lower among male elderly, young elderly, elderly who take less than 5 items of medication, without hospitalization history, no depression and have higher social support had less frailty(p< /05).

The consequences of frailty syndrome can be reduced by early identification of young elderly at risk and appropriate intervention based on risk factors such as polypharmacy and low social support.

Elderly is one of the phenomena in the field of global health and it is very important to pay attention to this age group psychologically and physically.The main purpose of this study was to compare the effectiveness of the effect of mindfulness and aromatherapy massage on the psychological function of elderly women with chronic pain.

The present study was a semi-experimental, pre-post-test and follow-up study with control group. The research population of the elderly women with chronic pain referring to hospitals, pain clinics, rehabilitation, orthopedics, physiotherapy and elderly in the west of Tehran in 2017 is. By using sampling method, 30 persons were selected using entrance and exit criteria and randomly divided into two equal groups. The experimental group participated in 10 sessions of 120 minutes undergoing a group intervention in the treatment of mindfulness-aromatherapy massage and the control group remained on the waiting list. The groups were evaluated for quality of sleep, quality of life and chronic pain in psychological performance in pre and posttest stages. At the end of the treatment period, the questionnaires were repeated in both groups and after 45 days were retried and pre-test, post-test and follow-up data were analyzed using covariance analysis and analyzed using SPSS-19 software.

Data analysis showed that interventions based on the interaction of mindfullness- aromatherapy massage, the pain and its components, as well as quality of life, sleep quality of elderly people in the experimental group compared with the control group Has significantly improved (P <0.05). And these effects remain high in the follow up phase.

The findings of this study suggest that the mindfullness-aromatherapy massages improves the quality of life and quality of sleep and reduces chronic pain in the elderly, and represents new horizons in clinical interventions. It has been used as an effective intervention in improving general health and quality of life for elderly patients with chronic pain.

The purpose of the current study was to examine the effect of concurrent training weeks eight and Gingkobiloba supplement on BDNF in depressed men elderly.

Forty depressed men elderly were randomly divided into four groups (n = 10) in concurrent training, Gingkobiloba supplemental, concurrent training with Gingkobiloba supplemental and control. In the pre-test phase, blood samples were taken from the subjects in Noor laboratory, and then in the concurrent training group, the participants were trained for eight weeks and 3 sessions per week. In the Ginkgobiloba supplement group, the subjects were given 80 mg daily for eight weeks. In the concurrent training group with the Ginkgobiloba supplment, the subjects performed the concurrent training for 8 weeks, 3 times a week, and during the same period, they received 80 mg daily. Blood samples were taken again 24 hours after the last training session. The data analyzed with paired t-test, univariate analysis of covariance, and Bonferroni post hoc test.

The results showed that eight weeks of concurrent training, Ginkgobiloba supplement and combination of concurrent training with Ginkgobiloba supplement significantly increased BDNF in depressed older men (P <0.05). Other results showed an increase in the brain-derived neurotrophic factor of the concurrent training group with Ginkgobiloba supplement (84.78) compared with concurrent training (74.37) and Ginkgobiloba consumption (72.20) alone.

Overall, the results suggest that professionals working with the elderly may be able to use a combination of concurrent training with Ginkgobiloba supplement to improve brain function.

Nurseschr('39') attitudes affect their preference for working with the elderly as well as the quality of care. The aim of this study was to investigate the factors related to nurseschr('39') attitudes toward caring of elders and the predictive role of altruism, moral intelligence, life satisfaction and general health in Sabzevar hospitals in 2019..

This cross-sectional descriptive-analytical study was performed on 265 randomly selected nurses in Sabzevar hospitals in 2019. Data were collected using demographic information questionnaire, Kogan Attitudes Toward Old People Scale , lennick and kiel moral intelligence questionnaire, Carlochr('39')s altruism questionnaire, Dinerchr('39')s Satisfaction With Life Scale , and General Health Questionnaire-28 (GHQ-28). Data were analyzed via descriptive statistics (mean, standard deviation and frequency) and inferential statistics (correlation coefficient, linear regression, and independent t-test) using SPSS software version 16. A significance level of 0.05 was considered.

The mean age of participants was 33.10±7.17. Nurses had a positive attitude toward the care of the elderlies. The mean score of nurseschr('39') attitudes was 155.39 ± 17.74. There was no significant relationship between nurseschr('39') attitudes and variables such as age, sex, marital status, education, work experience, place of work, and general health of nurses (P Value> 0/05). The results of multivariate regression model showed that the factors of moral intelligence (P = 0.01), altruism (P = 0.008) and life satisfaction (P = 0.03) had a significant relationship with nurseschr('39') attitudes toward caring for the elderly.

Since the attitude of nurses to elders care is predictable with moral intelligence, altruism and life satisfaction. It seems that the evaluation of these characteristics in nurses who provide services to the elderly can positively affect to their attitudes and prevent phenomena such as age discrimination.

One of the fundamental responsibilities of nurses is to prevent patients from harming themselves and others in the care process, and many nurses use physical restraint to achieve this goal. Whereas the use of physical restraint in elderly patients is associated with physical-psychological complications and ethical issues; it is important to identifcation of nurses, perceptions about the use of physical restraint in hospitalized elderly. The aim of this study was to evaluate the psychometric properties of the nurseschr('39') Perception of Physical Restraint Use Questionnaire(PRUQ) in hospitalized elderly.

Methods & Materials: 

Methodology of this study was descriptive and validation that was carried out in university hospitals in Kermanshah(western Iran) in 2019. After obtaining permission from the designers of the Perception of Physical Restraint Use Questionnaire(PRUQ), translation was performed  by using WHO standard protocol. Then, the Persian version of the questionnaire was completed by 330 nurses who were selected by available sampling according to the inclusion criteria. Validity of the questionnaire was assessed through face validity(qualitative and quantitative), content validity(qualitative and quantitative) and construct validity(exploratory and confirmatory factor analysis). The reliability of the questionnaire was assessed by test-retest and internal consistency. Statistical analysis was performed by SPSS23 and AMOS5 software.

Content validity indices for the whole questionnaire were CVR = 0.78 and S-CVI = 0.88. Results of exploratory and confirmatory factor analyses extracted three factors including “prevention of falls”, “prevention interference or disruption with treatment” and “providing safe environment”. The fitness of the three factor model of the PRUQ construct was approved based on standard indices (χ2/df=2.27, GFI=0.83, CFI=0.91, NFI=0.92, RMSEA=0.08). The reliability of the questionnaire was confirmed by Cronbachchr('39')s alpha coefficient(0.82) and intra-class correlation (0.86).

The Persian version of the Perception of Physical Restraint Use Questionnaire(PRUQ) has suitable validity and reliability among nurses working in hospital wards. Given the proper psychometric properties, this questionnaire can be used in future studies in this population.

Prescribing medication for the elderly is an important health issue. In this study, the status of prescribing inappropriate drugs for the elderly in general practitioners prescriptions was investigated.

Methods & Materials: 

The sample size consisted of 16842 prescriptions of general practitioners belongs to two insurance systems (Social Insurance and Health Insurance Organizations) in Tabriz city during 2019. Among the sample, 1500 prescriptions were evaluated for adults 65 years and older. The Beers criterion (version 2019) was used to assess inappropriate medications and suggestion of their alternatives if needed.

The mean number of drugs in each prescription was 3.93±1.5 and the average of inappropriate drugs in each prescription was 0.74±0.8. Polypharmacy was 32.6%, and 53.9% of the prescriptions had at least one inappropriate medication. Non-steroidal anti-inflammatory drugs, analgesics and antihistamines were the most inappropriate prescribed drug groups for the elderly (24.2, 21.4 and 10.9%, respectively). The most common inappropriate prescription medications were Adult cold, Diclofenac, Glibenclamide, Ketorolac and Diphenhydramine, respectively.

The results showed that about 54% of the prescriptions by general practitioners for elderly people contained inappropriate medications and polypharmacy was present in about one third of the prescriptions. In order to improve this condition, it is necessary to modify the educational methods of medical students and appropriate training and continuous retraining courses in the elderly medicine field will be provided for the students and general practitioners. Moreover, supervisions by Ministry of Health and Medical Council of Iran can play an important role in improving the current situation.

To determine the effect of applying collaborative care model on the intensity of fear of falling, the frequency of falls of the elderly.

This is a clinical trial study with a sample of 72 elderly people averagely aged at 71.34 ± 7.47 who went to the comprehensive health service centers of Isfahan in 1398, and were selected through easy sampling. Sample units were randomly divided into two test groups and participated in a collaborative care program for 12 weeks. Moreover, the control group attended two sixty-minute training sessions. The data were collected through the completion of questionnaires by the sample units in three phases, namely before, immediately, and after three months. The entry criteria included: the age of 60 and above, no psychological problems, non-participation in previous studies, having experienced fall. On the other hand, exit criteria included decreased consciousness after entering the study, unwillingness to continue, and death. SPSS software 21 was applied to carry out data analysis through χ2 test, Mann–Whitney test, independent t test, and ANOVA with repeated observations.

The results showed that in the test group, the average scores of fear of falling, were significantly different between the three times (P <0.05). The results of LSD post hoc test showed that in the test group, the mean score of fear of falling immediately after entering was significantly less than that of before entering. Furthermore, it showed that three months after entering, the mean score of fear of falling was less than that of immediately after the intervention (P <0.001).

According to the results, the implementation of collaborative care model reduced fear of falling, prevented falls, of the elderly. Therefore, it is recommended to apply this model in order to educate patients and their families.