The effect of participation in support groups on retirement syndrome in older adults.

BACKGROUND: Retirement and aging are phenomena that often occur simultaneously and lead to various physical and psychological changes in older adults. Retirement syndrome consists of symptoms such as feelings of emptiness, loneliness, uselessness, lack of clear understanding of future conditions and dissatisfaction with one's performance after retirement. This phenomenon requires interventions to adapt to these changes. Considering the supportive role of nurses, the formation of support groups as an effective intervention in adapting to transitional stages is emphasized. AIMS: This study aims to investigate the effect of older adults' participation in support groups on retirement syndrome. METHODS: This Quasi-experimental study recruited a total of 80 retired older adults meeting the inclusion criteria from three Retirement Associations (Retirement centers for social security retirees are among the institutions that have been set up by the government and this organization to provide face-to-face and offline services to social security retirees, as well as providing some facilities to this segment of the society). in Iran, Research samples were randomly assigned to two intervention and control groups. The demographic questionnaire and retirement syndrome questionnaire were completed by both groups at the beginning of the study. Then, four support group sessions lasting 60 to 90 min were held twice a week for the support group, and eight weeks after the end of the intervention, the questionnaires were completed for both groups. The data were analyzed using statistical tests in SPSS version 16. The significance level was set at p < 0.05 for all tests. RESULTS: The results of the covariance analysis showed that after the intervention, the feelings of helplessness and failure (p < 0.001), feelings of older and idleness (p = 0.027), and feelings of confusion and conflict (p = 0.002) were significantly less in the support group compared to the control group. In addition, the Feeling of trying and new direction (p < 0.001) was higher after the intervention. The paired t-test results showed that in the support group, the feelings of helplessness and failure (p < 0.001), feelings of older and idleness (p = 0.004), and feelings of confusion and conflict (p < 0.001) significantly decreased after the intervention compared to before it, while the feelings of trying and new direction (p = 0.004) significantly increased. Therefore, the results showed that after the intervention, there was a statistically significant difference between the two groups in all components of the retirement syndrome. CONCLUSION: The results of this study show that participation of retired older adults in support groups can significantly improve all components of retirement syndrome, leading to an improvement in their quality of life and satisfaction.

Patient safety in home health care: a grounded theory study.

BACKGROUND: The home environment is designed for living, not for professional care. For this reason, safe patient care is one of the most important challenges of home health care. Despite abundant research on safe care, there is still little understanding of safety issues in home care. DESIGN: The aim of the present study was to explain the process of safe patient care in home health care. A qualitative, grounded theory study was conducted based on the approach proposed by Corbin & Strauss in 2015. METHOD: In total, 22 interviews were conducted with 16 participants including 9 home care nurses, 2 home care nursing assistants, 1 home care inspector, 1 home care physician and 3 family caregivers in Tehran, Iran. Four observation sessions were conducted in different homes. Purposeful sampling was used followed by theoretical sampling from August 2020-July 2022. Data analysis was carried out based on the approach proposed by Corbin & Strauss in 2015. RESULTS: The results showed that the healthcare members (nurses, family caregivers, patients and home care centers) used the model of safe patient care in home health care based on four assessment methods, i.e. prevention, foresight, establishment of safety and verification. The core variable in this process is foresight-based care. CONCLUSION: The results of this study showed that the key to safe patient care in home health care, which helps to maintain patient safety and prevent threats to safe care, is the foresight of healthcare members, which is essential for identifying threats to safe care considering the many risks of home health care.

Concept analysis of adoption: A hybrid model.

BACKGROUND: Adoption is a multidimensional concept affected by cultural and social factors. On the other hand, the number of adoptees has recently increased indicating the need to pay more attention to this issue. However, no clear definition of this concept has been provided so far. OBJECTIVE: The objective of this study was to analyze the concept of adoption. METHODS: The present study was an analysis using a hybrid model in three phases. During the theoretical phase, using the keyword "adoption," pertinent articles published between 2010 and 2022 were searched. In the field work phase, eight adoptive parents as the participants were interviewed and the data were analyzed using conventional content analysis method. In the final analysis phase, a general analysis of the two previous phases was performed and a final definition was presented. RESULTS: Adoption is one of the ways of having children that helps infertile couples to experience parental pleasure. If adoption is done wisely based on the abilities of parents, it can provide the best care setting for the child's growth leading to the consolidation of the family and a purposeful life. In adoption, all of the rights and responsibilities of the child are transferred from the biological parents to the adoptive parents, which is affected by religious and cultural beliefs. CONCLUSION: The analysis of the concept of adoption provided a good basis for identifying the various dimensions of adoption and its challenges. The parents need to pay attention to all dimensions of adoption before selecting this path. It also provided a good platform for future research in the field of adoption.

Validity and reliability of the persian version of the modified telephone interview for cognitive status among community-dwelling older adults in Iran.

Due to the increase in the population of the elderly, there is a growing trend in some diseases such as cognitive disorders (dementia) which are common in this era, and the diagnosis and treatment of this disease are still facing challenges. Therefore, early identification of cognitive disorders is of particular importance. In this regard, the use of any tool or cognitive tests may not be enough to diagnose dementia in the early stages and a special tool is needed. Objective: The validity and reliability of the Persian version of the Modified Telephone Interview for Cognitive Status (P-TICS-M) in older adults living in the Iranian community for a comprehensive screening of mild cognitive impairment and dementia was investigated. Methods: In the first phase, translation, re-translation, and word-taking were performed by using the face validity and content validity. In the second phase, a stratified convenient sampling with 150 participants aged ≥60 years was conducted based on cognitive status using the global deterioration scale in 2018. The external and internal reliability of the P-TICS-M using the interclass correlation coefficient and Cronbach's alpha coefficient of total items of this tool were estimated. Results: The mean age of the participants was 68.6 (standard deviation±7.4) years. According to global deterioration scale, 87 (58.0%) had normal cognition, 40 (26.7%) had mild cognitive impairment, and 23 (15.3%) had dementia. The Spearman's correlation coefficient between P-TICS-M scores and Mini-Mental State Examination scale was 0.764. In exploratory factor analysis, seven domains were detected, which were compatible with those defined by the tool developer. The Cronbach's alpha of the P-TICS-M was 0.920. The absolute agreement between test-retest score was >0.90. The sensitivity of 92.2, 94.8, and 100%, and also the specificity of 79.4, 88.2, and 89.8% were calculated for detecting subjects with dementia, respectively. Furthermore, a mild cognitive impairment cutoff of >28 was determined. Conclusion: The development and validation of a P-TICS-M tool can be useful in identifying older adult people with cognitive impairment. Demographic characteristics (level of education, age) can also affect the cutoff point of this tool.

Por causa do aumento da população de idosos, há uma tendência crescente de algumas doenças, como os distúrbios cognitivos (demência), que são comuns nessa época, e o diagnóstico e tratamento dessa doença ainda enfrentam desafios. A identificação precoce de distúrbios cognitivos é de particular importância. Nesse sentido, a utilização de qualquer ferramenta ou testes cognitivos pode não ser suficiente para diagnosticar a demência nas fases iniciais e é necessária uma ferramenta especial. Objetivo: A validade e a confiabilidade da versão persa da Entrevista Telefônica para o Estado Cognitivo - Modificada (P-TICS-M) em idosos que vivem na comunidade iraniana para uma triagem abrangente de comprometimento cognitivo leve e demência foram investigadas. Métodos: Primeira fase, tradução, retradução e tomada de palavras utilizando validade de face e validade de conteúdo. Na segunda fase, foi conduzida uma amostragem estratificada por conveniência com 150 participantes com idade ≥60 anos baseada em estado cognitivo por meio da escala de deterioração global em 2018. Estimaram-se a confiabilidade externa e interna do P-TICS-M por meio do coeficiente de correlação interclasses e o coeficiente alfa de Cronbach do total de itens deste instrumento. Resultados: A média de idade dos participantes foi de 68,6 (desvio padrão±7,4) anos. De acordo com a escala de deterioração global, 87 (58,0%) apresentavam cognição normal, 40 (26,7%) apresentavam comprometimento cognitivo leve e 23 (15,3%) apresentavam demência. O coeficiente de correlação de Spearman entre os escores do P-TICS-M e a escala do Mini-Exame do Estado Mental foi de 0,764. Na análise fatorial exploratória, detectaram-se sete domínios, os quais eram compatíveis com aqueles definidos pelo desenvolvedor da ferramenta. O alfa de Cronbach do P-TICS-M foi de 0,920. A concordância absoluta entre o escore teste-reteste foi >0,90. Calculou-se, respectivamente, sensibilidade de 92,2, 94,8 e 100%, e também especificidade de 79,4, 88,2 e 89,8% para a detecção de indivíduos com demência. Além disso, determinou-se um ponto de corte do comprometimento cognitivo leve >28. Conclusão: O desenvolvimento e validação de uma ferramenta P-TICS-M pode ser útil na identificação de idosos com comprometimento cognitivo. As características demográficas (escolaridade, idade) também podem afetar o ponto de corte dessa ferramenta.

Validity and reliability of the persian version of the modified telephone interview for cognitive status among community-dwelling older adults in Iran / Validade e confiabilidade da versão persa da Entrevista Telefônica para o Estado Cognitivo: modificada entre idosos da comunidade no Irã

ABSTRACT. Due to the increase in the population of the elderly, there is a growing trend in some diseases such as cognitive disorders (dementia) which are common in this era, and the diagnosis and treatment of this disease are still facing challenges. Therefore, early identification of cognitive disorders is of particular importance. In this regard, the use of any tool or cognitive tests may not be enough to diagnose dementia in the early stages and a special tool is needed. Objective: The validity and reliability of the Persian version of the Modified Telephone Interview for Cognitive Status (P-TICS-M) in older adults living in the Iranian community for a comprehensive screening of mild cognitive impairment and dementia was investigated. Methods: In the first phase, translation, re-translation, and word-taking were performed by using the face validity and content validity. In the second phase, a stratified convenient sampling with 150 participants aged ≥60 years was conducted based on cognitive status using the global deterioration scale in 2018. The external and internal reliability of the P-TICS-M using the interclass correlation coefficient and Cronbach's alpha coefficient of total items of this tool were estimated. Results: The mean age of the participants was 68.6 (standard deviation±7.4) years. According to global deterioration scale, 87 (58.0%) had normal cognition, 40 (26.7%) had mild cognitive impairment, and 23 (15.3%) had dementia. The Spearman's correlation coefficient between P-TICS-M scores and Mini-Mental State Examination scale was 0.764. In exploratory factor analysis, seven domains were detected, which were compatible with those defined by the tool developer. The Cronbach's alpha of the P-TICS-M was 0.920. The absolute agreement between test-retest score was >0.90. The sensitivity of 92.2, 94.8, and 100%, and also the specificity of 79.4, 88.2, and 89.8% were calculated for detecting subjects with dementia, respectively. Furthermore, a mild cognitive impairment cutoff of >28 was determined. Conclusion: The development and validation of a P-TICS-M tool can be useful in identifying older adult people with cognitive impairment. Demographic characteristics (level of education, age) can also affect the cutoff point of this tool.

RESUMO. Por causa do aumento da população de idosos, há uma tendência crescente de algumas doenças, como os distúrbios cognitivos (demência), que são comuns nessa época, e o diagnóstico e tratamento dessa doença ainda enfrentam desafios. A identificação precoce de distúrbios cognitivos é de particular importância. Nesse sentido, a utilização de qualquer ferramenta ou testes cognitivos pode não ser suficiente para diagnosticar a demência nas fases iniciais e é necessária uma ferramenta especial. Objetivo: A validade e a confiabilidade da versão persa da Entrevista Telefônica para o Estado Cognitivo - Modificada (P-TICS-M) em idosos que vivem na comunidade iraniana para uma triagem abrangente de comprometimento cognitivo leve e demência foram investigadas. Métodos: Primeira fase, tradução, retradução e tomada de palavras utilizando validade de face e validade de conteúdo. Na segunda fase, foi conduzida uma amostragem estratificada por conveniência com 150 participantes com idade ≥60 anos baseada em estado cognitivo por meio da escala de deterioração global em 2018. Estimaram-se a confiabilidade externa e interna do P-TICS-M por meio do coeficiente de correlação interclasses e o coeficiente alfa de Cronbach do total de itens deste instrumento. Resultados: A média de idade dos participantes foi de 68,6 (desvio padrão±7,4) anos. De acordo com a escala de deterioração global, 87 (58,0%) apresentavam cognição normal, 40 (26,7%) apresentavam comprometimento cognitivo leve e 23 (15,3%) apresentavam demência. O coeficiente de correlação de Spearman entre os escores do P-TICS-M e a escala do Mini-Exame do Estado Mental foi de 0,764. Na análise fatorial exploratória, detectaram-se sete domínios, os quais eram compatíveis com aqueles definidos pelo desenvolvedor da ferramenta. O alfa de Cronbach do P-TICS-M foi de 0,920. A concordância absoluta entre o escore teste-reteste foi >0,90. Calculou-se, respectivamente, sensibilidade de 92,2, 94,8 e 100%, e também especificidade de 79,4, 88,2 e 89,8% para a detecção de indivíduos com demência. Além disso, determinou-se um ponto de corte do comprometimento cognitivo leve >28. Conclusão: O desenvolvimento e validação de uma ferramenta P-TICS-M pode ser útil na identificação de idosos com comprometimento cognitivo. As características demográficas (escolaridade, idade) também podem afetar o ponto de corte dessa ferramenta.

Home care nurses' perception of the challenges they faced during the COVID-19 pandemic: a qualitative study.

BACKGROUND: Despite the significant role they play in the whole health care system, home care nurses are not paid the attention they deserve. Besides highlighting their significant role in the health care system, the COVID-19 pandemic also posed several challenges for home care nurses. OBJECTIVE: The purpose of this study is to explain the nurses' perception of the challenges of home care during the Covid-19 pandemic. METHODS: The present study was a qualitative study with a conventional content analysis approach conducted from November 2020 to September 2021. Participants included 16 home care nurses who were purposefully selected based on the eligibility criteria. After obtaining ethical authorization, the data were collected through semi-structured interviews. MAXQDA Version 10 software was used for data mangement. Data analysis was performed using the Granheim and Lundman five-step method. Guba and Lincoln criteria were utilized for trustworthiness. FINDINGS: The seven main categories obtained in this study included "the onset of a new chapter: from avoidance to relapse", "burnout", "vortex of moral distress", "social stigma", "difficulty in breaking the transmission chain", "care inhibitors related to the patient and family" and "support deficiency: the crisis of home care nursing agencies during the crisis". CONCLUSION: The results showed that nurses working in home care during the Covid-19 pandemic experienced several challenges in various fields. This study captured the nurses' perception of the challenges of home care during the Covid-19 pandemic, a period of unprecedented change and difficulty. These challenges included lack of support, psychological problems, and dealing with new experiences. Identifying these challenges can help improve the quality of home care nursing and planning in this area.

Risk factors of developing critical conditions in Iranian patients with COVID-19.

COVID-19 due to novel Coronavirus was first reported in Wuhan, China. Nowadays, the Islamic Republic of Iran stands among countries with high COVID-19 prevalence and high burden of disease. Since the medical resources are limited, we aimed to identify the risk factors for patients developing critical conditions. This can help to improve resource management and treatment outcomes. In this retrospective study, we included 12,677 patients who were from 26 hospitals, supervised by Tehran University of Medical Sciences with signs and symptoms of COVID-19, until April 12. University integrated IT system was adopted to collect the data. We performed Logistic regression to evaluate the association between death in COVID-19 positive patients and other variables. Cough, respiratory distress and fever were the most common symptoms in our patients, respectively. Cancer, chronic lung diseases and chronic neurologic diseases were the strongest risk factors for death in COVID-19 patients.