فصلنامه سالمند
پیاپی 67 (پاییز 1401)

Social participation is a determining factor for promoting health and well-being. This study aims to investigate the factors facilitating and inhibiting the social participation of the elderly in Kerman, Iran based on their health-promoting behaviors.

Methods & Materials: 

This cross-sectional study was conducted on 276 elderly people over 60 years old in Kerman city in 2020. They completed a demographic from, the questionnaire of social participation based on the Canadian Community Health Survey, and the questionnaire of health- promoting behaviors. Descriptive statistics and statistical tests including univariate and multivariate regression were used for data analysis. Data were analyzed in SPSS software, version 26, and P<0.05 was considered statistically significant.

The Mean±SD score of social participation was 6.71±4.01. Illness and health problems (50.3%), costs (39.1%), commuting problems (31.1%), low mood (29.3%), and COVID-19 pandemic (28.2%) were the most common barriers to social participation. The elderly who were single (P<0.001), younger (P<0.001), with academic degree (P<0.001), and low number of children (P<0.001) had significantly higher social participation. Multivariable analysis showed that physical activity (P=0.033), disease prevention (P=0.002), and physical and social health (P<0.001) were the factors affecting social participation of the elderly.

The social participation of the elderly in Kerman is affected by multiple factors. Therefore, planning to manage diseases, increase income, and solve the transportation problems of the elderly are recommended to improve their social participation.

The world’s population is rapidly aging; hence, paying attention to the quality of life (QoL) of the elderly is of great importance. Financial satisfaction is one of the important components of QoL. The present study aims to determine the association between financial literacy and QoL among retired older adults mediated by their financial satisfaction.

Methods & Materials: 

This descriptive and cross-sectional study was conducted in 2020 on 270 retired older adults in Qazvin, Iran. The samples were selected through stratified random sampling method from 8 retirement centers in Qazvin, Iran. The data were collected using demographic checklist, the control, autonomy, self-realization, and pleasure (CASP) scale, financial literacy scale, and financial satisfaction scale. Structural equation modeling was used to determine the mediating role of financial satisfaction in the relationship of financial literacy with the QoL.

The mean age of older adults was 65.17±4.57 years. The majority of them were male (n=166, 61.85%) and married (n=245, 90.7%). Their Mean score of financial literacy and financial satisfaction were 51.60 and 35.11 out of 100, respectively. Their quality of life was at a moderate level (Mean= 63.89 out of 100). The results of the regression analysis showed the significant association of financial literacy (P=0.006, β=-0.17) and financial satisfaction (β=0.25, P<0.001) with the quality of life. The results also confirmed the mediating role of financial satisfaction (P=0.014).

Financial literacy of the elderly has a significant and positive association with their quality of life mediated by financial satisfaction. Therefore, policymakers in Iran are recommended to develop pre-retirement financial education programs for improving the financial literacy of the elderly.

Elder abuse is one of the major social health problems in communities which has significant effects on decreasing their health and safety. The present study aims to investigate the prevalence of elder abuse by family members and its related factors in Gonabad, Iran.

Methods & Materials:

 This analytical cross-sectional study was conducted in 2020 on 401 elderly people in Gonabad, Iran. Who were selected using cluster random sampling. Data collection tools were a two-part questionnaire including a demographic form and the questionnaire of elder abuse by family members. The questionnaires were completed in a community health center. Data were analyzed in SPSS software version 23, using descriptive and inferential statistics. The significance level was set at 0.05.

The mean age of participants was 68.53±6.75 years. The prevalence of elder abuse by family members was 44.6%. The highest prevalence of elder abuse was related to care negligence and the lowest prevalence was related to rejection. The educational level (P=0.03), history of hospitalization (P<0.001), sleep quality (P<0.001), income level (P<0.001) and level of dependency (P<0.001) had a statistically significant relationship with the prevalence of elder abuse by family members.

Given the high prevalence of elder abuse in Gonabad city, it seems necessary to have programs to increase the awareness of the elderly, their caregivers, and health personnel to prevent and reduce elder abuse.

 By the rapid growth of the elderly population, the need to pay attention to this group becomes more obvious. General self-efficacy, self-control and self-esteem are the effective individual factors for the empowerment of the elderly. This study aims to examine the relationship between these individual aspects of empowerment and general health in older adults attending neighborhood houses in Tehran, Iran.

Methods & Materials: 

In this descriptive-analytical study with cross-sectional study design, 320 older men and women over 60 years of age participated who were selected by a cluster sampling method. Data were collected using a demographic form, the 28-item general health questionaire, 10-item general self-efficacy scale, Rosenberg self-esteem scale, and Tangney’s brief self-control scale. Data was described using mean and standard deviation, and analyzed using chi-square test, Spearman correlation test, one-way-ANOVA, and linear regression in SPSS sofwtare, version 22.

 The mean age of the elderly was 68.42±8.3 years. Their mean score of general health was 21.95±13.4. A significant negative correlation was found between general health, general self-efficacy, self-esteem and self-control (P<0.001). Their general health had a significant relationship with their educational level (P<0.001), years of employment (P=0.002) and housing status (P<0.001). The multivariate regression results showed that housing status (P=0.156), self-esteem (P<0.001), self-control (P<0.001), and general self-efficacy (P<0.001) were the significant predictors of general health in the elderly.

 There is a relationship between general health, general self-efficacy, self-esteem, and self-control of the elderly in Tehran. Their general health is related to their educational level, years of employment, and housing status. Housing status, self-esteem, self-control and general self-efficacy are predictors of their general health. Attention should be paid to these factors in developing health promotion programs for the elderly.

 Feeling of loneliness and aggression are common problems in the elderly living in nursing homes that can have serious psychological and physical consequences for them. Due to the growing number of the elderly population, it is essential to use practical strategies for reducing their isolation and aggression. This study aims to assess the effect of combining adapted physical and artistic activities on feeling of loneliness and aggression in the elderly living in nursing homes.

Methods & Materials:

 In this quasi-experimental study, 68 older residents of a nursing home in Shiraz, Iran with feeling of loneliness and aggression and without acute psychological and physical problems participated, who were selected using a convenience sampling method and then assigned into two groups of control and intervention by block randomization method. The control group received routine care, while the intervention group participated in 16 sessions of adapted physical and artistic activities. Data were collected using the UCLA Loneliness Scale and Buss-Perry Aggression Questionnaire before and immediately after the intervention. Data were analyzed using descriptive (Mean±SD, and frequency) and inferential statistics (Chi-square test, Mann-Whitney U test, and Wilcoxon test) in SPSS software, version 22.

 The participants’ mean age was 70.93±7.99 years in total, and 69.1% were women. The scores of loneliness and aggression significantly reduced after the intervention in the intervention group (P<0.001). The scores of loneliness (P<0.001) and aggression (P=0.001) in the intervention group were significantly lower than in the control group.

 Feeling of loneliness and the level of aggression in the elderly living in nursing homes can be reduced significantly by combining adapted physical and artistic activities. This practical and cost-effective intervention can be used to reduce feeling of loneliness and aggression in the elderly living in nursing homes.

Aging is one of the important stages of human development. Death anxiety and sleep quality are among the most common mental health issues in the elderly which can be improved by proper intervention. This study aims to assess the effect of self-healing training on sleep quality and death anxiety of older women living in nursing homes.

Methods & Materials: 

This is a quasi-experimental study with a pretest/posttest/follow-up phase. The study population consists of all older women aged 60-70 years living in a nursing home in Isfahan, Iran in 2020. Of these, 40 were selected using a convenience sampling method and based on the inclusion and exclusion criteria, and were randomly assigned into two groups of intervention (n=20) and control (n=20). They were assessed by the Collett-Lester Fear of Death Scale and Pittsburgh Sleep Quality Index before, immediately after, and 45 days after the intervention. The intervention group received a 12-session self-healing intervention while the control group was placed in a waiting list without receiving any intervention. The results were analyzed by multivariate analysis of covariance in SPSS software, version 24.

 The self-healing training significantly improved the components of death anxiety (fear of own death, fear of the process of own dying, fear of the death of others, and fear of the process of others dying) and some of sleep quality components (subjective sleep quality, sleep latency, sleep disturbances, and use of sleeping medication) (P<0.05). These effects significantly remained constant in the follow-up phase in the components of fear of own death, subjective sleep quality, sleep latency, sleep disturbances and use of sleeping medication (P<0.05). No significant difference was found in other variables between the post-test and follow-up phases (P> 0.05).

 The self-healing training can reduce perceived death anxiety and improve sleep quality of older women living in nursing homes. It can be used as an effective educational method for improving the lifestyle and mental health of older women living in nursing homes.

 Due to the importance of place attachment in older adults, it seems necessary to identify their perception of this concept and its dimensions. The present study aims to design and assess the psychometric properties of a place attachment scale for older adults in Iran.

Methods & Materials:

 The is a sequential exploratory mixed method study that was conducted in 2018-2019 in two quantitative and qualitative phases. Participants were 414 community-dwelling older adults with a mean age of 70.43±8.84 years in Aran & Bidgol city, Iran who were selected by cluster sampling according to the inclusion criteria. By literature review and interview, the items were formulated. The face and validity content validity of the initial draft was assessed by a panel of experts and older adults. The construct validity was determined by exploratory and confirmatory factor analyses. The internal consistency and test-retest reliability were also determined. SPSS software, version 24 and AMOS version 24 applications were used for statistical analysis.

 In examining content validity, most of items had content validity ratio >0.7, content validity index >0.79, and kappa coefficient >0.74. In examining construct validity using exploratory factor analysis, three factors of emotional bond, physical bond, and dependence were extracted for the subscale of attachment to home and three factors of emotional bond, social bond, and physical bond were extracted for the subscale of attachment to neighborhood, which explained 61.75% and 50.06% of the total variance, respectively. The measurement models of attachment to home (GFI=0.877, CFI=0.916, RMSEA=0.080) and neighborhood (GFI=0.809, CFI=0.860, RMSEA=0.077) had acceptable fit to the data. Moreover, the scale had acceptable internal consistency (α= 0.9) and test-retest reliability (ICC= 0.8).

 The designed 42-item place attachment scale with two domains of attachment to home and neighborhood for the community-dwelling older adults in Iran has acceptable validity and reliability. This tool can be used in further studies and by policymaking in Iran.

 Today, one of the most important challenges in the world and in Iran is the increase of older population. With the death of a spouse in old age, the social participation of the elderly decreases; living alone is associated with a high risk of death and an impact on all aspects of health (physical, mental, social) in the elderly. This study aims to investigate the barriers to remarriage in older Iranian women.

Methods & Materials: 

The present study was conducted in 2019 with a qualitative approach and using the content analysis method. Using a purposive sampling method, 10 older women living in Babol city with at least one year of being single, widowed or divorced, the ability to communicate effectively, willingness to participate in research were selected. The data collection method was in-depth semi-structured interviews until reaching data saturation. Each interview was transcribed and analyzed based on Kvale’s step-by-step guidance.

 In order to determine the trustworthiness of the data, the criteria of credibility, dependability, confirmability, and transferability were used. From the interviews, 210 primary codes were extracted. Through analysis, three main categories and 12 sub categories were identified. The three categories were: “characteristics, changes and perspectives of the elderly”, “family and mutual roles of members”, “social relations and its effects”. 

 Considering the shame, modesty, and the taboo of remarriage in older women in Iran and the lack of transparency regarding their desires, planning and promoting culture to improve the quality of life of older women, breaking the taboo of remarriage by changing people’s views and common prejudices, and not violating the older women’s rights seem necessary.

Objectives :

Due to the decline in the function of balance system in older adults and the importance of having an active old age, it is very important to maintain independence during daily living activities such as shopping, holding and carrying an external load. This study aims to determine the effect of external load magnitude and holding mode on the postural sway during standing in healthy community-dwelling older adults.

Methods & Materials:

 In this quasi-experimental study, 15 healthy community-dwelling older adults in Tehran, Iran (7 men and 8 women) with a mean age of 71.53±6.18 years who were independent in daily living activities such as shopping and carrying shopping bags were enrolled using a conveneince sampling method. The independent variables were holding manual loads with a magnitude of 0%, 5%, 10%, 15%, and 20 % of body weight in symmetrical (both hands) and asymmetrical (dominant or non-dominant hand) conditions, standing still on the force plate for 30 seconds. Dependent variables included the amount and velocity of the displacement of the center of pressure (COP) in two anteroposterior and mediolateral directions and the area of the COP displacement.

Results:

 The effect of holding manual loads symmetrically and asymmetrically and the manual load magnitude on the amount and velocity of COP displacement in anteroposterior direction was signifcant, while their interaction effect was not significant on any variables. The paired t-test results showed that the amount and velocity of COP displacement in anteroposterior direction at asymmetric condition was significantly different compared to the symmetrical condition, but there was no significant difference between holding with dominant and non-dominant hands. The amount of COP displacement in anteroposterior direction with 5%, 10%, 15% and 20% of body weight were higher and statistically significant compared to the load magnitude of 0% (P<0.05). The effects of load holding mode and load magnitude were not statistically significant on any of the COP variables in the mediolateral direction. 

Conclusion:

 Aging, Postural balance, External load Holding external loads asymmetrically with any magnitudes can increase the amount and velocity of COP displacement in the anteroposterior direction. For preventing falls, it is recommended for the elderly to pay attention to the fact that holding an external load with two hands is less challenging to the balance system than holding with one hand, whether dominant or non-dominant. In terms of the load magnitude, an external load with 5% of body weight can challenge the balance system compared to the situation without external load. With some exceptions, there is no difference between loads of 5%, 10%, 15% and 20% of body weight.

Objectives :

One of the most common problems in old age is mild cognitive impairment (MCI) which, in addition to cognitive problems, reduces important aspects of social cognition ability such as facial emotion recognition (FER). One of the effective methods in this field is social cognition and interaction training (SCIT). The present study aims to investigate the effect of SCIT on FER  in the elderly with MCI.

Methods & Materials :

This is a quasi-experimental study with pretest/post-test/follow-up design. The study population includes all the elderly over 60 years with MCI living in nursing homes in Tehran, Iran in 2021. Of these, 40 were selected by purposive and convenience sampling methods and randomly assigned to intervention (n=20) and control (n=20) groups. The intervention group received group SCIT at 20 sessions of 60 minutes for two months. During this period, the control group had no training. The used test included the Montreal Cognitive Assessment Test and the Face Emotion Recognition Test. The data were analyzed by mixed analysis of variance and Bonferroni post-hoc test in SPSS software, version 23. 

Results :

The results of mixed analysis of variance showed that the group and time factors explained 51% and 71% of variances in FER, respectively. The results of Bonferroni test showed that FER score in the intervention group was increased immediately after and two months after training, indicating that SCIT had a significant effect on FER (P<0.001). However, FER score in the control group did not show a significant change.

Conclusion:

 The SCIT can be used as an effective method to increase FER in the elderly by using techniques such as examining the role of emotions in social environments and developing emotion recognition skills.