Quality-of-life index and its related factors during COVID-19 pandemic: A community-based study in Rashtian women/Iran.

BACKGROUND: The changes in everyday life, caused by the COVID-19 pandemic, were rapid and unprecedented. This pandemic affected not only physical health but also well-being and life satisfaction. This study was designed to assess the status of a quality-of-life index and some related factors during the coronavirus pandemic in the public population of Rashtian women. MATERIALS AND METHODS: This cross-sectional study was performed on 784 Rashtian women who were selected by cluster random sampling between 2020 and 2021. The data collection tool was the Ferrans and Powers Quality of Life questionnaire, which has two parts: satisfaction and importance of life. Each section consists of four subscales: health and performance, social and economic, psychological/spiritual, and family. Data analysis was done using descriptive and analytic statistics. RESULTS: The mean score of the quality-of-life index in this study was 21.39 (of 30), which is higher than the mean level. The scores obtained from the satisfaction section were inferior to the similar questions in the important section. The findings showed that there was no statistically significant difference between the quality-of-life scores of women living in different urban areas (P > 0.05). CONCLUSION: The feeling of satisfaction increases the ability to cope with problems and mental pressures and improves the level of mental and physical health of couples and ultimately of all members of society. So although the overall quality of life was above average, appropriate interventions should be designed to maintain and improve their satisfaction.

Association between Social Mobility and Quality-of-Life Index in Women of Rasht: A Population-Based Study in the Iranian Context.

Background: Life course research has shown that socioeconomic conditions in childhood have a profound impact on adult health. However, little is known about the different health effects of social mobility. This study was conducted to answer whether the intergenerational social mobility of women in Rasht is related to their quality of life index. Methods: This cross-sectional survey conducted in 2020-2021, in which the researcher created a social mobility questionnaire, was used to study the association between social mobility and the quality of life index of women aged 30-65 in Rasht. The current socioeconomic status of 784 married women in this city was compared to the previous socioeconomic status of their parents. Also, Ferrans and Power's quality of life index questionnaire was used. Data analysis was done using t-test and ANOVA. Results: The mean (SD) score for the overall quality of life index was 21.60 (4.23) of 30. The majority of participants had immobility (350 of them or 44.6%). There was no statistically significant correlation between women's intergenerational mobility and their quality-of-life index (P = 0.734). Still, there was a statistically significant difference between the average score of the quality of life in the socioeconomic groups of the participants. Conclusion: Findings show that the women in Rasht did not have opportunities to promote their status or could not take advantage of these possibilities. Although our results did not show evidence for the effects of social mobility on quality of life, some scholars' findings support the idea of the impact (negative or positive) of intergenerational upward mobility on well-being.

Cost-utility analysis of multiple sclerosis rehabilitation in Iran.

BACKGROUND: Rehabilitation of Multiple Sclerosis (MS) is associated with various clinical, social and economic outcomes. We aimed to evaluate the cost-utility of MS multidisciplinary rehabilitation in Iran. RESEARCH DESIGN AND METHODS: An economic evaluation was conducted using a Markov model designed to reflect the natural course of the disease and interventions. Parameters and variables were extracted from available evidence, and costs and outcomes were calculated from the social perspective. The base-case analysis considered a 5-year time horizon. Costs were estimated based on approved national standards for MS rehabilitation. Sensitivity analyses were also performed. RESULTS: The average cost of the rehabilitation strategy was higher compared to the non-rehabilitation strategy, but it resulted in higher quality-adjusted life years (QALYs) values. The incremental cost-effectiveness ratio (ICER) was found to be $2,845.8 per QALY, indicating that the rehabilitation strategy is cost-effective. In the deterministic sensitivity analysis, extending the time horizon to 10 years made the rehabilitation strategy a dominant choice. Probabilistic sensitivity analysis results were consistent with the base-case findings. CONCLUSIONS: The MS multidisciplinary rehabilitation proved to be a cost-effective strategy; however, the results were sensitive to the input values of the model. Increasing the time horizon increased the probability of rehabilitation being cost-effective.

Cost-benefit analysis of stroke rehabilitation in Iran.

BACKGROUND: The economic evaluation of medication interventions for stroke has been the subject of much economic research. This study aimed to examine the cost-benefit of multidisciplinary rehabilitation services for stroke survivors in Iran. METHODS: This economic evaluation was conducted from the payer's perspective with a lifetime horizon in Iran. A Markov model was designed and Quality-adjusted life years (QALYs) were the final outcomes. First, to evaluate the cost-effectiveness, the incremental cost-effectiveness ratio (ICER) was calculated. Then, using the average net monetary benefit (NMB) of rehabilitation, the average Incremental Net Monetary Benefit (INMB) per patient was calculated. The analyses were carried out separately for public and private sector tariffs. RESULTS: While considering public tariffs, the rehabilitation strategy had lower costs (US$5320 vs. US$ 6047) and higher QALYs (2.78 vs. 2.61) compared to non-rehabilitation. Regarding the private tariffs, the rehabilitation strategy had slightly higher costs (US$6,698 vs. US$6,182) but higher QALYs (2.78 vs. 2.61) compared to no rehabilitation. The average INMB of rehabilitation vs non-rehabilitation for each patient was estimated at US$1518 and US$275 based on Public and private tariffs, respectively. CONCLUSION: Providing multidisciplinary rehabilitation services to stroke patients was cost-effective and has positive INMBs in public and private tariffs.

Reconfiguration of relationships during the process of remarriage after divorce. A qualitative study in Iran.

Marriage is highly respected and somehow sacred in eastern societies, including Iran. This qualitative research aimed to explore lived experience of remarried men and women who had experienced divorce in their relationships with their significant others. Seventeen remarried-after-divorce persons whose second marriage lasted over two years participated in the study, conducted using the content analysis method. Under the theme of inter-relationships, four categories were found, including "different spouses, different relations", "reconfiguration of relationships with families", "impacts on child-rearing", and "the importance of unimportant acquaintances". This study showed the complexity of the relationship network when another marriage happens after the first one collapsed. The other finding was that relations after divorce might not disappear completely, and relics of the first ruined shared life may strongly affect the new partnership. The influence of context-oriented issues, particularly in societies where religion and tradition are strong, was the other result. This study showed that remarriage after divorce has positive and negative consequences. Professionals, policymakers and researchers may apply the findings of the research by taking a strengths perspective.

Socioeconomic Determinants of Social Capital Inequality among Older Adults of Tehran: A Population-Based Study (Urban HEART-2).

Background: Social capital (SC) is an essential concept of communities, and there is more SC inequality. In the current study, we studied SC Inequality concerning the explanatory socioeconomic factors. Methods: In a cross-sectional observational study, the household data were retrieved from an Urban Health Equity Assessment and Response Tool survey in 2011. Over 5000 elderlies in Tehran (> 60 years old) consented toparticipate in the study and filled out 2 SC questionnaires (SCQ) and a household properties questionnaire (HPQ). Subsequently, the collected HPQ data were then statistically analyzed and used to measure the economic status of households. Besides, the statistical concentration index of the SC was applied to measure socioeconomic inequality and decomposed into its determinants using both SCQ and HPQ data collections. The concentration index and the decomposition analysis were used to analyze the study data. Results: The overall concentration index of the SC in Tehran senior citizens was 0.059 (95%CI,0.044-0.076). Among the SC dimensions, collective activity, social coherence, voluntary help, and social network were more concentrated in the poor older adults. Simultaneously, reciprocity was more focused onthe wealthy class, and there was no inequality in trust. The decomposition of the concentration index showed that economic status made the most considerable contribution to the SC inequality among citizens (69.11%), followed by the level of education (12.695) and the elderlies'job type (9.58%). Conclusion: Given that the economic status and level of education are the 2 main determinants of SC inequality, a holistic policy approach should be adopted to address the socioeconomic inequalities that are taken root in Tehran's senior communities.