Effect of Jacobson's Progressive Muscle Relaxation on Anxiety and Happiness of Older Adults in the Nursing Home.

Background: Older adults encounter serious psychological challenges in addition to physical problems. Reducing stress and anxiety, along with promoting happiness, is critical to maintaining the mental health of the elderly. Jacobson's Progressive Muscle Relaxation (JPMR) will lead to peace of mind by relieving physical stress. The present study aimed to investigate the effect of JPMR on the anxiety and happiness of older adults. Materials and Methods: A single-group pretest-posttest design as a type of quasi-experimental study was conducted on 34 older adults living in a nursing home in Rasht, the north of Iran, in 2021. The intervention was performed one session per week, for 8 weeks. The research instruments included the Geriatric Anxiety Inventory (GAI) and the Oxford Happiness Inventory (OHI). Descriptive statistics and the Wilcoxon test were used for data analysis. Results: After the intervention, the Mean (Standard Deviation [SD](of anxiety was 4.91 (1.96), and the Mean (SD) (of happiness was 37.18 (7.92). The mean score of anxiety among older adults after the intervention was significantly lower compared to the before intervention (Z = -4.73, p < 0.001). In addition, the mean score of happiness of the samples after the intervention was significantly higher compared to the before intervention (Z = -5.09, p < 0.001). Conclusions: JPMR has a positive effect on reducing anxiety and promoting happiness in the elderly. Developing training programs and allocating time to non-pharmacological treatments such as JPMR for the elderly living in nursing homes will help make them happier and healthier.

The effect of teach-back versus pictorial image educational methods on knowledge of renal dietary restrictions in elderly hemodialysis patients with low baseline health literacy.

INTRODUCTION: Adherence to renal dietary restrictions is an important method for minimizing complications in dialysis patients. This study aimed to investigate the effect of teach-back versus pictorial image educational methods on knowledge of renal dietary restrictions among elderly hemodialysis patients in Iran. Selected markers of diet and kidney function were also measured. METHODS: Sixty-nine elderly hemodialysis patients with a low level of health literacy were randomly divided into three groups: pictorial image education, teach-back education, and usual care (controls). The intervention groups received diet education comprising four 20-30 min sessions. Subsequently, nutrition knowledge was assessed in each of the three groups by questionnaire before and 2 months after the intervention. Blood laboratory indices were obtained from the patients' medical records and compared before and 2 months after the educational intervention. FINDINGS: There were significant differences in the mean nutritional knowledge scores between the two intervention groups and the controls (p < 0.001). Nutrition knowledge scores were higher after educational sessions incorporating images compared to those using a teach-back strategy. DISCUSSION: Nutrition educational strategies utilizing either pictorial images or teach-back techniques increased knowledge relating to renal nutrition.

Status of the utilization of preventive care services and its associated socio-demographic factors among Iranian elderly.

Introduction: The growing population of the elderly, the rising costs of medical care and the low use of preventive services are three factors that highlight the importance of using preventive health care services in the Iranian population. This study aimed to determine the status of the use of preventive care services and its associated socio-demographic factors in the elderly referred to health centers. Methods: In this analytical cross-sectional study, a number of 160 elderly people referred to health centers in East Guilan, Iran was selected by multi-stage cluster sampling. Data were obtained from May to September, 2021 using a questionnaire containing utilization of preventive care services (9 items) and socio-demographic characteristics. Results: The highest and the lowest utilization rates of preventive care services among study participants were related to the blood pressure test (96.9%) and colonoscopy (17.5%), respectively. Multivariate analysis showed that only income had a significant association with performing fasting blood sugar test (p = 0.004), blood lipid test (p = 0.004), and blood pressure test (p = 0.013). Also, the associations between having an underlying disease and performing fasting blood sugar test (p = 0.032) and blood pressure test (p = 0.002), the association between gender and performing the bone mineral density test (p < 0.001), and the association between occupation and performing Pap-smear test (p = 0.011), were statistically significant. Conclusions: The utilization rates of screening tests for most cancers, including gastrointestinal cancers, were low. Since, there were a significant association between income, disease, gender and occupation with the utilization of some preventive care services, considering them in health centers' preventive care program design might be useful.

Effects of health belief model in promoting self-care behaviors among hypertensive older adults.

BACKGROUND: Aging has the fastest growth rate in age groups. With age, the prevalence of a variety of chronic diseases also increases. Among chronic diseases, hypertension is one of the most important diseases among older adults and self-care is one of the effective approaches to control it. The aim of the present study was to apply the health belief model (HBM) in promoting self-care in hypertensive older adults to help improve self-care behaviors in this age group. SETTINGS AND DESIGN: This was a quasi-experimental study. This study was conducted at comprehensive health centers in the east of Guilan province, Iran. METHODS AND MATERIAL: This intervention study was conducted on 106 elderly people with hypertension who were selected with a multi-stage random sampling method from those referred to east health centers of Gilan, Iran, in 2019. The data gathering tool was a questionnaire including demographic characteristics, HBM structure, hypertension knowledge, and hypertension self-care questionnaires. The intervention group received an educational program based on the HBM model. The questionnaire was completed by the elderly before and 2 months after the intervention. The data were analyzed by descriptive statistics, Mann-Whitney, Chi-square, Wilcoxon, Fisher, and ANCOVA tests usingSPSS ver.16. RESULTS: There was a significant difference in knowledge and all HBM constructs before and after the intervention in the intervention group (P < 0.001). In the control group, knowledge (P-value = 0.023), self-efficacy (P-value = 0.001), perceived severity (P-value = 0.005), and cues to action (P-value = 0.008) were significantly different (P < 0.05) after the intervention. CONCLUSION: The present study showed that HBM-based education can be considered an effective educational framework for improving self-care of the hypertensive older adults.

Cultural appropriateness in randomized controlled trials (RCTs) aimed at reducing pesticide exposure among farmers and farmworkers: a systematic review.

OBJECTIVE: The widespread use of pesticides poses serious health hazards to farmers and their families. Some evidence shows that culturally sensitive interventions could be associated with improved outcomes; however, little is known about the effectiveness of cultural adaptations in interventions among farmers and farmworkers. Therefore, the purpose of this study was to summarize strategies used in the cultural adaptation interventions addressing the reduction of pesticide exposure in farmers and farmworkers, as well as assessing the effects of these strategies. METHODS: A comprehensive systematic literature search was conducted on PubMed, Embase, Clarivate Web of Science, Scopus, NIOSHTIC, Agricola, Agris, as well as reference lists to identify randomized controlled trials (RCTs) published in English from January 2000 until March 2022. Data were extracted to examine the characteristics of interventions in terms of the cultural adaptation strategies and their effectiveness by two independent reviewers. RESULTS: Eleven articles from ten trials met the inclusion criteria. The majority of studies were conducted in the USA (n = 7) and were ranked as poor quality (n = 5). Four of the ten studies were rated moderate, and six were rated weak. The socio-cultural and constituent-involving strategies were the most commonly reported across the included studies, followed by linguistic strategy. Six studies (seven articles) were tailored for subgroups or individuals. Overall, 8 of 10 studies reported significant changes in whole and some outcomes in the intervention groups over controls. Seven studies received moderate cultural adaptation scores which may reflect the moderate effectiveness of the interventions. CONCLUSION: Our review underscored the paucity and low quality of existing studies investigating the culturally adapted interventions in reducing farmers' and farmworkers' pesticide exposure. Future high-quality culturally sensitive studies could increase our knowledge regarding the culture's role in reducing pesticide exposure in farmers and farmworkers.

Effectiveness of interventions to promote pesticide safety and reduce pesticide exposure in agricultural health studies: A systematic review.

OBJECTIVE: There is a relationship between pesticide exposure and farmworkers' health. Well-conducted evaluations can provide an insight into how to develop and implement more effective interventions to prevent farmers and farmworkers' exposure to pesticides. This review aimed to summarize the literature on the effectiveness of interventions to promote pesticide safety and reduce pesticide exposure among farmers and farmworkers. METHODS: A comprehensive search on PubMed, Embase, ISI Web of Science, Scopus, Science Direct, Agricola, NIOSHTIC, and Agris databases was performed to identify relevant studies published from 2000 to 2019. Randomized controlled trials (RCTs) and quasi-experimental studies assessing the effectiveness of interventions on a variety of outcomes related to pesticide exposure were considered. The searches were restricted to articles written in English. The methodological quality of included reviews was appraised using the Effective Public Health Practice Project quality assessment tool (EPHPP). RESULTS: The initial search led to 47912 records, 31 studies of which including nine RCTs and twenty-two quasi-experimental studies met the criteria. The majority of the included studies focused on the educational/ behavioral approach. The studies that applied this approach were effective in improving the participants' knowledge and attitude; however, these interventions were less effective in terms of making changes in participants' behaviors and their risk of exposure to toxic pesticides. Multifaceted interventions were moderately effective in terms of improving farmers' and farmworkers' behaviors and reduction in exposure to toxic pesticides. We did not find any studies that had evaluated the effectiveness of engineering/technological, and legislation/enforcement interventions. CONCLUSIONS: Although the majority of studies were based on an educational/behavioral approach and did not assess the effect of interventions on objective measures, the results of this review highlight the significant effectiveness of educational programs and some potential key elements of these interventions. These findings may inform policymakers to develop interventions to reduce pesticide exposure among farmers and farmworkers.

Development of a Colorectal Cancer Screening Intervention for Iranian Adults: Appling Intervention Mapping

Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population. The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews (n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral outcome and theoretical methods and their practical applications were identified to guide intervention development and implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems, fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation, group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and control (P<0.001). Conclusions: IM is a useful process in the design of a theory-based intervention addressing CRC screening among Iranian population.