Relationship between perceived social support and disability with the mediating role of perceived stress among older adults.

BACKGROUND: Social support is essential for individuals to cope with difficult circumstances. Older adults with disabilities face significant challenges in engaging with everyday activities. The current study examines the mediating role of perceived stress in the association between perceived social support and disability among Iranian community-dwelling older adults. METHODS: In this descriptive and cross-sectional study, 300 older adults were selected using cluster sampling from January to June 2022. The data were collected using the Multidimensional Scale of Perceived Social Support (MSPSS), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2), and the Cohen Perceived Stress Scale-14 (PSS-14). The collected data was analyzed using structural equation modeling (SEM) in Mplus. RESULTS: The mean age of older adults was 68.71 ± 6.13 years, ranging from 60 to 85 years old. The results of this study revealed a significant relationship between perceived social support and disability (ß=-0.20, SE = 0.06, p < 0.001) and perceived stress and disability (ß = 0.50, SE = 0.05, p < 0.001). The results also confirmed the mediating role of perceived stress in the relationship between perceived social support and disability (ß=-0.17, SE = 0.03, p < 0.001). CONCLUSION: The results indicated that increasing social support could reduce disability by decreasing perceived stress. These results have important implications for policymakers and healthcare professionals in promoting healthy aging.

Effect of Telenursing on the Quality of Life of Caregivers of Older Patients with Stroke.

BACKGROUND: Family caregivers of stroke patients suffer from a high caregiving burden that affects their quality of life. Telenursing can provide caregivers and patients with services at the lowest cost and full access. Therefore, the aim of this study was to investigate the impact of telenursing on the quality of life of caregivers of older stroke patients. METHODS: A total of 79 family caregivers of older stroke patients participated in this randomized clinical trial. The samples were selected from caregivers of older stroke patients admitted to a teaching hospital in Qazvin, Iran. They were randomly divided into two groups. The intervention group participated in an educational intervention for 12 weeks through telephone follow-up and social media. The Barthel Scale and the 36-item Short Form Survey (SF-36) were used for data collection. The chi-square and independent and paired t-tests were used to analyze the data. RESULTS: The mean age of 79 caregivers participating in the study was 46.16 ± 11.32 years. No significant differences were found between the two groups at baseline. However, the independent ttest showed significant differences in the psychological subscale (p <0.001) between the intervention and control groups after the intervention. In addition, the results of the paired t-test showed significant improvements in the intervention group in physical (p <0.001) and psychological (p <0.001) subscales. CONCLUSION: The results of the current study support the effectiveness of telenursing in improving the quality of life of caregivers of older stroke patients.

Predictive factors of Quality of Life in older adults during the COVID-19 pandemic.

BACKGROUND: Given the vulnerability of older people to COVID-19, it is important to consider their physical and mental wellbeing and quality of life (QoL) in the COVID-19 pandemic. Therefore, the present study was aimed to identify the QoL and its predictive factors among a sample of Iranian older adults during the COVID-19 pandemic. METHODS: This descriptive and cross-sectional study was conducted on 500 older people residing in Qazvin, Iran, from May 22th to November 21rd, 2021. Multistage cluster sampling method was used for selecting the eligible older adults. Data were collected using the demographic checklist, fear of COVID-19 scale, and Elderly Quality of Life Questionnaire (LIPAD). The multivariate regression model was used for determining the predictive factors of QoL in older people. RESULTS: The mean age of older participants was 69.17 ± 6.75 years old. The results of multivariate regression model showed that fear of COVID-19, age, marital status, level of education, living arrangement, and economic situation were the significant predictors of QoL in the older adults during the COVID-19 pandemic. CONCLUSIONS: It is recommended to pay close attention to divorced, lonely, and illiterate older people and those with low economic situation during the COVID-19 pandemic.

Predicting role of illness perception in treatment self-regulation among patients with type 2 diabetes.

Background and Objective: Impaired self-regulation negatively impacts self-efficacy, self-management, blood sugar control, and quality of life among patients with diabetes. Hence, identifying the predictors of self-regulation is a necessity for healthcare providers. The current study aimed to determine the predictive role of illness perception in treatment self-regulation in patients with type 2 diabetes. Methods: The current study is a descriptive cross-sectional study. A total of 200 patients with type 2 diabetes, who were referred to the only specialized clinic for endocrinology and diabetes affiliated with Qazvin University of Medical Sciences in 2019-2020, were recruited through a convenience sampling method. For data collection, the brief Illness Perception Questionnaire and the Treatment Self-Regulation Questionnaire were used. Collected data were analyzed by SPSS v21 using a multivariable regression model. Results: Mean and standard deviation scores of self-regulation and illness perception were 69.11 ± 17.61 and 36.21 ± 7.05, respectively. Results of the multivariate regression model revealed the significant correlations of self-regulation with illness perception, age, cardiovascular complications, diabetic retinopathy, and diabetic foot ulcers. Conclusions: In this study, participants presented a moderate level of self-regulation. The results also revealed that illness perception could be a predictor of improving patients' self-regulation. Therefore, providing infrastructure programs such as continuous education and appropriate care programs for diabetic patients to improve their illness perception can effectively improve their self-regulation behaviors.

Validation of the Persian version of Skindex-16 among older patients with skin diseases.

BACKGROUND: Skin conditions often considerably impact the older patients' psycho-social health and quality of life (QoL). The present study was aimed to examine the validity and reliability of the Persian version of Skindex-16 among older people with skin diseases. METHODS: In this validation study, 260 older patients suffering from a range of skin conditions were recruited from a dermatology clinic in Rasht, Iran. Data were collected using a checklist for demographic and clinical characteristics and the Skindex-16 questionnaire. In this study, validity (face, content, and construct) and reliability (Cronbach's alpha) of the Skindex-16 were assessed and reported. RESULTS: The mean age of participants was 64.51 ± 5.04 years. The results of confirmatory factor analysis showed that the model had acceptable fitness into the expected three-factor structure [χ 2 /df = 249.363, P < 0.001; GFI = 0.961; TLI =0.952; RMSEA = 0.078 (90% CI = 0.06, 0.09) and SRMR = 0.06]. The reliability analysis results confirmed that the values of Cronbach's alpha coefficient for Skindex-16 were in the acceptable range (0.923). CONCLUSIONS: Our evaluation of the Skindex-16 indicates that it is reliable and a valid instrument that can be used for measuring QoL for Iranian dermatologic patients.

Caregiver burden and coping strategies in caregivers of older patients with stroke.

BACKGROUND: Coping strategies play a key role in modulating the physical and psychological burden on caregivers of stroke patients. The present study aimed to determine the relationship between the severity of burden of care and coping strategies amongst a sample of Iranian caregivers of older stroke patients. It also aimed to examine the differences of coping strategies used by male and female caregivers. METHODS: A total of 110 caregivers of older patients who previously had a stroke participated in this descriptive and cross-sectional study. The Zarit Burden Interview and Lazarus coping strategies questionnaires were used for data collection. Questionnaires were completed by the caregivers, who were selected using convenience sampling. The collected data were analyzed using Pearson's correlations and independent t-tests. RESULTS: The mean age of participants was 32.09 ± 8.70 years. The majority of the caregivers sampled reported mild to moderate (n = 74, 67.3%) burden. The most commonly used coping strategies reported were positive reappraisal and seeking social support. Results of the independent t-test showed that male caregivers used the positive reappraisal strategy (t(110) = 2.76; p = 0.007) and accepting responsibility (t(110) = 2.26; p = 0.026) significantly more than female caregivers. Pearson's correlations showed a significant positive correlation between caregiver burden and emotional-focused strategies, including escaping (r = 0.245, p = 0.010) and distancing (r = 0.204, p = 0.032). CONCLUSIONS: Caregivers with higher burden of care used more negative coping strategies, such as escape-avoidance and distancing. In order to encourage caregivers to utilize effective coping skills, appropriate programs should be designed and implemented to support caregivers. Use of effective coping skills to reduce the level of personal burden can improve caregiver physical health and psychological well-being.

Effect of Acupressure on Dynamic Balance in Elderly Women: A Randomized Controlled Trial.

BACKGROUND: Balance disorders are common in the elderly and are a major cause of falls. This study aimed to determine the effect of acupressure on dynamic balance in elderly women. METHODS: This randomized controlled clinical trial was conducted on 72 elderly women in Qazvin, Iran. The intervention group received rotary massage using the thumb at the pressure points for 4 weeks, 3 times a week for 20 minutes each session. Dynamic balance in both groups was measured before, 2 and 4 weeks after the intervention using timed up and go test and the step test. Data were analyzed using two way repeated measures ANOVA. RESULTS: The mean age of participants was 67.34 ± 6.30 with a range of 60 to 80 years old. The results showed statistically significant improvement in the dynamic balance quantified by timed up and go test (%Δ = 26.53) and step test for the right (%Δ = 35.22) and left (Δ% = 32.62) legs (p < .001). However, in the control group, no significant change was observed in the dynamic balance after completion of the program. CONCLUSION: The results support that acupressure therapy can be an effective, safe, and inexpensive method to improve the dynamic balance and maintain maximum autonomy of the elderly.

Screening for domestic abuse and its relationship with demographic variables among elderly individuals referred to primary health care centers of Shiraz in 2018.

BACKGROUND: Elder abuse is an important public health problem. The present study was aimed to determine the rate of domestic abuse and its relationship with demographic characteristics among elderly people referred to Primary Health Care (PHC) centers in Shiraz, Iran, 2018. METHODS: This descriptive and cross-sectional study was conducted on 400 older people aged 60 years old and above who referred to 22 PHC centers of Shiraz. The data were collected using demographic characteristics questionnaire, Katz index, the domestic elder abuse questionnaire, and elder neglect checklist through face-to-face interview and observation methods. Backward linear regression model was used for analyzing the data. RESULTS: The results indicated that 52.5% of the participants were female and 51.8% aged 60-69 years old. A total of 159 cases (39.8%) reflected at least one form of elder abuse or neglect. The results indicated that 21% of the participants (n = 84) were abused by their own children. Care neglect was the most reported form (42.8%), followed by psychological abuse (41.3%), emotional neglect (38.8%), and financial abuse (34.3%). The most common types of neglect were motion limitations (25%) followed by the dental problems (23.8%). The results also showed a significant relationship between domestic elder abuse and level of income (p = 0.017), having a house (p = 0.028), type of perpetrator (< 0.001), and insurance status (p = 0.027). CONCLUSIONS: The results revealed a considerable rate of domestic abuse against elderly people, causing a serious risk for their health and security.

Validity and Reliability of the Flourishing Scale in a Sample of Older Adults in Iran.

BACKGROUND: Flourishing is related to positive outcomes for physical and mental health, as well as overall wellbeing. The aim of the present study was to determine the validity and reliability of the Flourishing Scale (FS) among a sample of older participants in Iran. METHODS: In this validation study, 300 older people were selected by cluster sampling method. Data were collected using a checklist for demographic characteristics, the FS, and the Oxford happiness questionnaire. The validity (face, content, convergent, and construct) and reliability (Cronbach's alpha, test-retest) of the FS was evaluated in this cross-sectional study. RESULTS: The exploratory factor analysis demonstrated a one-dimensional structure consisting of 8 items with an eigenvalue of 3.583. The model had a good fit [χ2 = 52.983, p < 0.001, χ2/df = 2.944, GFI = 0.958, CFI = 0.915, IFI = 0.949, TLI = 0.919, AGFI = 0.948, and RMSEA = 0.081, SRMR = 0.086] with all factor loadings greater than 0.5 and statistically significant. A test of concurrent validity showed a direct and significant association between the FS and the Oxford happiness questionnaire (r = 0.647, p < 0.001). The results of the reliability tests confirmed that the values of Cronbach's alpha coefficient (0.819) and test-retest (0.821) were acceptable. CONCLUSION: The Persian version of the FS demonstrated suitable validity and reliability among a sample of older participants.

Predictors of Quality of Life in Patients with Heart Disease.

Individuals with heart disease have been found to have more negative psychological and physical effects that impact their quality of life (QoL) than the general population. Spiritual well-being is considered a protective factor associated with QoL in people with heart disease. Therefore, the current research seeks to evaluate whether sociodemographic factors and spiritual well-being predict QoL among patients with heart disease. A total of 500 patients who were selected through a convenient sampling method from an Iranian hospital participated in this descriptive-correlational study. Data were collected using the McGill QoL Questionnaire, the Spiritual Well-being Scale, and demographic variables. The data analysis included descriptive and inferential statistics powered by SPSS (v. 23). Following multivariate analyses, findings revealed that those participants with their main source of income derived from family or a government pension and with College or intermediate educational levels were more likely to have higher QoL. Those participants with average or poor socioeconomic status reported higher QoL than those who were more affluent. Furthermore, younger patients (- 0.2, 95% CI - 0.3 to - 0.003, p = 0.016) and those with higher social support (0.7, 95% CI 0.2 to 1.3, p = 0.006) and spiritual well-being (0.2, 95% CI 0.1 to 0.3, p < 0.001) had significantly better QoL. In the current study, spiritual well-being and social support led to reduced negative psychological sequelae and improved QoL in cardiac patients.

Can healthy life style predict successful aging among Iranian older adults?

Background: Successful aging is a prominent and worldwide theme in gerontology. However, until recently, only few studies were conducted about successful aging in Iran. This study examined whether a healthy lifestyle could predict successful aging among older Iranians. Methods: This cross sectional and descriptive study included 975 older Iranians who were selected through a multistage cluster-quota method from the health centers of Shiraz, Iran. A 5-part questionnaire, including demographic characteristics, the Seniors' Healthy Lifestyle, Barthel Index, the Diner Life Satisfaction and Quality of Life, was used to collect the data. A logistic regression analysis was used in data analysis; data were analyzed using SPSS 21; and significance level was set at α = 0.05. Results: The prevalence of successful aging among older Iranians was calculated at 24.0%. Results of multiple logistic regression analysis revealed that age (95% CI = 1.129- 1.702 and OR = 1.352), gender (95% CI = 0.412-0.764 and OR = 0.687), education level (95% CI = 1.443 - 1.699 and OR = 1.454), job (95% CI = 1.063-1.413 and OR = 1.185), monthly income (95% CI = 1.355-4.055 and OR = 2.272), insurance (95% CI = 0.344-0.842 and OR = 0.540), source of income (95% CI = 1.014-1.298 and OR = 1.145), and healthy lifestyle (95% CI = 0.772 - 0.858 and OR = 0.814) were predictors for successful aging. Conclusion: Findings indicated that successful agers were mostly younger men, with higher education level and monthly income, who had insurance and a job and a healthy lifestyle. Thus, to age successfully, one must maintain and improve healthy lifestyle to prolong one's health.

Predictors of death anxiety among patients with heart disease.

Objective: This research examines whether or not socio-demographic factors and hope predict death anxiety among patients with heart disease.Materials and Methods: Our sample consisted of 500 respondents who were hospitalized in a medical institution in Iran. Data were collected using the Templer Death Anxiety Scale (TDAS) and the Herth Hope Index (HHI).Results: The results of current study indicated that higher economic status, having one's main source of income from friends, increased age, increased religious belief, and increased hope were associated with lower death anxiety.Conclusion: These results highlight that improving hope, and religiosity among cardiac patients may be an effective means by which to reduce their death anxiety.

Effect of a Physical Activity Program on Serum Biochemical Parameters among the Elderly Women.

BACKGROUND: The present study examined the efficacy of the walking program on biochemical parameters among the elderly women. METHODS: A total of one hundred elderly women participated in this randomized clinical trial study. The intervention group attended a 24-week walking exercise meeting five times per week. The control group continued with their routine activities. The subjects were assessed in Fasting blood glucose (FBS) and lipid profile before and after 12 and 24 weeks of the program. RESULTS: The mean age of the elderly participants in the study was 68.33 ± 4.55 years. The results of repeated measures ANOVA showed a significant difference between the intervention and the control group in FBS, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol after completing the program (for all p < 0.001). CONCLUSION: The low-cost physical activity intervention could be effective for reducing chronic vascular disease risk factors among community-dwelling elderly women.

Reproductive factors influencing bone mineral density in postmenopausal women.

This study examined the relationship between reproductive characteristics and bone mineral density (BMD) in postmenopausal women who had been referred to the menopause clinics of the National Population and Family Development Board and of the Hospital Kuala Lumpur from July 2011 to January 2012. The participants of this study were 201 postmenopausal Malaysian women aged 45-71 years. Some socio-demographic, lifestyle, and reproductive factors were recorded. Calcaneal BMD was measured by quantitative ultra-sonography. Correlations of reproductive factors with BMD were assessed by Pearson's correlation test and multiple regression analysis. Age at menopause was not significantly correlated with BMD, while the years after menopause, age at the first menstrual period, number of pregnancies, and total lactation periods were inversely correlated with it. Among reproductive factors, only the association between lactation duration and BMD remained significant after adjusting for age, body mass index, activity, and calcium intake. The results indicated that except for prolonged total time of lactation, other reproductive factors were not significantly associated with BMD in postmenopausal women.

Effect of low-cost resistance training on lower-limb strength and balance in institutionalized seniors.

Background/Study Context: Given the rapid increase in the aging population worldwide, fall prevention is of utmost importance. It is essential to establish an efficient, simple, safe, and low-cost intervention method for reducing the risk of falls. This study examined the effect of 12 weeks of progressive elastic resistance training on lower-limb muscle strength and balance in seniors living in the Rumah Seri Kenangan, social welfare home in Cheras, Malaysia. METHODS: A total of 51 subjects qualified to take part in this quasi-experimental study. They were assigned to either the resistance exercise group (n = 26) or control group (n = 25). The mean age of the 45 participants who completed the program was 70.7 (SD = 6.6). The exercise group met twice per week and performing one to three sets of 8 to 10 repetitions for each of nine lower-limb elastic resistance exercises. All exercises were conducted at low to moderate intensities in sitting or standing positions. The subjects were tested at baseline and 6 and 12 weeks into the program. RESULTS: The results showed statistically significant improvements in lower-limb muscle strength as measured by five times sit-to-stand test (%Δ = 22.6) and dynamic balance quantified by the timed up-and-go test (%Δ = 18.7), four-square step test (%Δ = 14.67), and step test for the right (%Δ = 18.36) and left (%Δ = 18.80) legs. No significant changes were observed in static balance as measured using the tandem stand test (%Δ = 3.25), and one-leg stand test with eyes opened (%Δ = 9.58) and eyes closed (%Δ = -0.61) after completion of the program. CONCLUSION: The findings support the feasibility and efficacy of a simple and inexpensive resistance training program to improve lower-limb muscle strength and dynamic balance among the institutionalized older adults.

The Effect of Cognitive Remediation Therapy on Social Skills in Institutionalized Elderly Patients with Schizophrenia.

BACKGROUND: There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia. METHODS: The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data. RESULTS: The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, p<0.001), behavioral problems with others (t=5.44, p<0.001), and self-care (t=4.70, p<0.001). No significant differences were observed from pretest to post test in control group. CONCLUSION: The results of the present study may support the efficacy of cognitive remediation therapy on social skills of elderly patients with schizophrenia.

Erratum: Health Blief Model-based intervention to improve nutritional behavior among elderly women.

[This corrects the article on p. 352 in vol. 10, PMID: 27247733.].

Health Blief Model-based intervention to improve nutritional behavior among elderly women.

BACKGROUND/OBJECTIVES: Nutrition is a determinant factor of health in elderly people. Independent living in elderly people can be maintained or enhanced by improvement of nutritional behavior. Hence, the present study was conducted to determine the impact of Health Belief Model (HBM)-based intervention on the nutritional behavior of elderly women. SUBJECTS/METHODS: Cluster-random sampling was used to assess the sample of this clinical trial study. The participants of this study attended a 12-week nutrition education program consisting of two (2) sessions per week. There was also a follow-up for another three (3) months. Smart PLS 3.5 and SPSS 19 were used for structural equation modeling, determination of model fitness, and hypotheses testing. RESULTS: The findings indicate that intervention had a significant effect on knowledge improvement as well as the behavior of elderly women. The model explained 5 to 70% of the variance in nutritional behavior. In addition, nutritional behavior was positively affected by the HBM constructs comprised of perceived susceptibility, self-efficacy, perceived benefits, and barriers after the intervention program. CONCLUSION: The results of this study show that HBM-based educational intervention has a significant effect in improving nutritional knowledge and behavior among elderly women.

Emotional Intelligence and Depressive Symptoms as Predictors of Happiness Among Adolescents.

BACKGROUND: Given that happiness is an important construct to enable adolescents to cope better with difficulties and stress of life, it is necessary to advance our knowledge about the possible etiology of happiness in adolescents. OBJECTIVES: The present study sought to investigate the relationships of emotional intelligence, depressive symptoms, and happiness in a sample of male students in Tehran, Iran. MATERIALS AND METHODS: This cross-sectional study was conducted on a sample of high school students in Tehran in 2012. The participants comprised of 188 male students (aged 16 to 19 years old) selected by multi-stage cluster sampling method. For gathering the data, the students filled out assessing emotions scale, Beck depression inventory-II, and Oxford happiness inventory. Data analysis was carried out using descriptive and analytical statistics in statistical package for social sciences (SPSS) software. RESULTS: The findings showed that a significant positive association existed between high ability of emotional intelligence and happiness (P < 0.01). Conversely, the low ability of emotional intelligence was associated with unhappiness (P < 0.01), there was a positive association between non-depression symptoms and happiness (P < 0.05), and severe depressive symptoms were positively associated with unhappiness (P < 0.01). High ability of emotional intelligence (P < 0.01) and non-depression symptoms (P < 0.05) were the strongest predictors of happiness. CONCLUSIONS: These findings reinforced the importance of emotional intelligence as a facilitating factor for happiness in adolescences. In addition, the findings suggested that depression symptoms may be harmful for happiness in adolescents.

Energy and macronutrient intakes in older urban and rural Iranian adults.

Adequacy of energy and macronutrient intakes is important for disease prevention, health maintenance and nutrition program development in older adults. The present study was designed to evaluate and compare the adequacy of energy and macronutrient intakes of elderly living in rural and urban areas in the north-west of Iran. A total of 432 older adults (332 urban and 100 rural) were selected through stratified, multistage probability cluster sampling. Dietetic information was obtained through three-day 24-hour dietary recall interviews. A small proportion of the subjects (4% rural and 0.6% urban) were underweight while approximately half was either overweight or obese. Aged subjects from the urban had a significantly higher mean body mass index (BMI) (t=3.46, p<0.05) than their rural counterparts. There was also significant greater proportion of elderly subjects who were overweight or obese (X2=14.42, p<0.05). Older adults from the rural had significant more daily energy (t=3.49, p<0.05), carbohydrates (t=2.96, p<0.05) and fat intakes (t=3.15, p<0.05) than their urban counterparts. Generally, average daily intake of energy was lower than the Recommended Dietary Allowance (RDA) in developing countries. High contribution of carbohydrates and low contribution of proteins to total calory intake were observed in the daily diet of the elderly. There is a need to offer health and nutrition awareness programs for the elderly and their families by health care providers.