ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Minooiefar   J. (1)
Ghasemi Borumand   M. (2)
Masoumi   M. (1)
Haghani   H. (1)
Sahaf   R. (*3)






(*3) Iranian Research Center on Ageing, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran
(1) Janbazan Medical & Engineering Research Center, Tehran, Iran
(2) Optometry Department, Rehabilitation Sciences Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Correspondence

Article History

Received:  April  24, 2018
Accepted:  February 16, 2019
ePublished:  May 25, 2019

BRIEF TEXT


Aging is an inevitable part of human life, which is associated with reduced ability, increased dependence, and susceptibility to a variety of diseases.

... [1-5]. Among the common problems of monocular veterans is the lack of binocular vision and decreased vision of about 10 to 25%, which are the most complaints by monocular veterans [6]. In fact, monocular veterans are in difficulty to find spatial position, which results from a reduction of convergence and compliance. On the other hand, the loss of one eye in many cases leads to a loss of person's beauty, and this leads to a person's distraction, and also depression in long-term [7, 8]. … [9-18].

The aim of this study was to compare the quality of life and the ability to perform daily activities in elderly and middle-aged monocular veterans.

This research was a descriptive cross-sectional study.

This study was conducted on 4350 monocular veterans in 19 provinces, including East Azarbaijan, West Azarbaijan, Ardebil, Isfahan, Alborz, Bushehr, Tehran, Zanjan, Semnan, Fars, Qom, Kerman, Kermanshah, Gilan, Lorestan, Mazandaran, Markazi, Hormozgan and Hamedan.

2162 subjects participated in the study (accountability rate was 49.7%). 493 subjects were excluded from the study due to the inaccurate responses to the questionnaire. Considering the monocular vision, the age of 40 years and older and as inclusion criteria, 398 subjects were excluded from the study and 1271 subjects were analyzed. The participants were divided into two groups: middle-aged (between 40 and 59 years old) and elderly (60 years and older). In each province, according to the list provided by the Foundation of Martyrs and Veterans Affairs of each province, a telephone call was made with monocular veterans and invited to participate in the study. Demographic information, including age, duration of injury, gender, marital status, educational level, occupation, percentage of injuries and associate injuries were collected.

The quality of life questionnaires (SF36) was used to assess quality of life. Its Persian version has been approved by the Cronbach's alpha of 0.77 in the normal Iranian society [19]. The Barthel Index for Activities of Daily Living (ADL) was used to assess the ability to perform daily activities [20]. This tool measures 10 domains of everyday activities and has been confirmed by Habibi et al. with Cronbach's alpha of 0.91 [21]. The Lawton Instrumental Activities of Daily Living Scale (IADL) was used to determine the level of complex daily activities of life [19]. Its reliability (with Cronbach's alpha coefficient of 0.81) and the validity of the Persian version of this questionnaire have been confirmed in Iranian studies [22]. Data analysis was performed using SPSS 23. The mean of quantitative variables was compared between the elderly and middle aged groups using independent T-test. In some cases, the non-parametric Mann-U-test was used to compare the normal distribution of data.

Of 1271 monocular veterans, 1205 veterans (94.8%) were middle-aged and 66 veteran (2.5%) were elderly. 1261 veterans (99.2%) were male and 1240 veterans (97.6%) were married. The mean age of the total subjects was 47.5±6.7 years (age range: 40-88 years), in the middle age group, 46.3 ± 4.1 years (age range: 40 to 59 years) and in the elderly group was 68.7±7.9 years (age range: 60-88 years). In total, 1083 subjects (85.2%) had other injuries other than monocular vision, and 188 subjects (14.8%) had only monocular vision. The associated injuries included injury to the face, chest, abdomen and trunk, upper limb, chemical, nervous and mental, back and spine and others (Table 1). In the middle age group, the lowest score of quality of life was observed in the limitation in physical role and the highest score obtained in the physical function. In the elderly group, the lowest score was related to limitation in physical role and the highest score obtained in social function, mental health and physical function. Mean scores of quality of life in monocular veterans was significantly lower than that of the middle age veterans, and this difference was significant in three dimensions, including physical function (p<0.001), limitation in physical role (p=0.003) and vitality (p=0.002). Similar results were also obtained by comparing the two physical and psychological dimensions of quality of life, but only the mean score of the physical dimension was significant between the elderly and middle ages (p=0.010; Table 2).Mean score of ADL activity in the middle-aged and elderly monocular veterans was 92.53±11.46 and 80.68±22.5g, respectively. In the middle aged group, the highest levels of independence were related to eating activities, using toilet and stool control, and the least independence observed in using stairs and movement and mobility at uneven surfaces. Elderly veterans were more independent in stool control and they showed the least independency to the movement and mobility at uneven surfaces. Comparing two groups showed that all ADL scores of the elderly were lower than the middle ages, and, with the exception of the stool control (p=0.428), there was a significant difference between the scores of the two groups in all activities (p<0.001; Table 3) In all dimensions IADL, the mean age of middle-aged group was higher than the elderly, and except for the ability to use drugs, the mean scores obtained from other activities were significantly different between the two groups (p<0.05). In the middle-aged group, the highest independency was observed in using telephone, and the least was seen in washing clothes and working at home. In the elderly veteran group, the highest ability was seen in taking drug and the lowest ability were observed in washing clothes (16.7%) (Table 4).

... [23-28]. The results are consistent with the studies on elderly performed in Iran, and the elderly of the normal society also depended on others in their home affairs more than others [14]. The studies also showed that the higher the incidence of chronic diseases in the elderly, the lower its level of independency in daily routine. Another study in the elderly group has shown that the reduction of vision and hearing has a direct effect on the reduction of the performance of daily activities of elderly life [15]. Older blind veterans had the most problems in using phones, drug management and financial affairs [29], which was significantly different from the results of the study. This difference can be due to the vision of other eye in the veterans of this study. [1-5].... [30-34].

Studies on the quality of life and performance level should be performed in all veterin groups.

The lack of participation of all veterans in each province was one of the limitations of this study.

The levels of quality of life, the ability to perform daily activities, and instrumental daily activities are lower in elderly monocular veterans compared to the middle-aged group.

The authors are grateful to the Foundation of Martyrs and Veterans Affairs of the studied provinces and also the Janbazan Medical and Engineering Research Center (JMERC).

None declared.

This study was approved by the JMERC Ethics Committee (Ethics code: 88-E-P-107).

This study was supported by the JMERC.

TABLES and CHARTS

Show attach file


CITIATION LINKS

[1]Levy BS, Sidel VW. War & public health in the twenty-first century. New England J Public Policy. 2003;19(1):167-78.
[2]Murray CJL, King G, Lopez AD, Tomijima N, Krug EG. Armed conflict as a public health problem. Educ Debate. 2002;324(7333):346-9.
[3]Haji Abed MR, Bagheri F, Asgharnejad Ferid AA. Comparison of life regard index between veterans suffering from post traumatic stress disorder with and without history of substance abuse in Shahid Rajaee Hospital in Isfahan. Iran J War Public Health. 2013;5(2):10-17. [Persian]
[4] Kong L, Fry M, Al-Samarraie M, Gilbert C, Steinkuller PG. An update on progress and the changing epidemiology of causes of childhood blindness worldwide. J AAPOS. 2012;16(6):501-7.
[5]Négrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998;5(3):143-69.
[6]Thach AB, Johnson AJ, Carroll RB, Huchun A, Ainbinder DJ, Stutzman RD, et al. Severe eye injuries in the war in Iraq, 2003–2005. Ophthalmology. 2008;115(2):377-82.
[7]Pourseyed SR, Habibollahi S, Faramarzi S. Effectiveness of life skills educational program on blind and low-vision university students compatibility. Educ Strategy Med Sci. 2010;3(1):7-11. [Persian]
[8]Mousavi B, Soroush MR, Montazeri A. Quality of life in chemical warfare survivors with ophthalmologic injuries: the first results form Iran Chemical Warfare Victims Health Assessment Study. Health Qual Life Outcomes. 2009;7(1):2.
[9]Hemmati MA, Shokoohi H, Masoumi M, Khateri S, Soroush M, Modirian E, et al. Mental health disorders in child and adolescent survivors of post-war landmine explosions. Mil Med Res. 2015;2(1):30.
[10]Falahati F, Soroush MR, Haghani H, khateri Sh. The effects of landmine and UXO accidents on survivor's quality of life in 5 western provinces of Iran. Iran J War Public Health. 2009;1(4):1-8. [Persian]
[11] Schwartz CE, Andresen EM, Nosek MA, Krahn GL, et al. Response shift theory: important implications for measuring quality of life in people with disability. Arch Phys Med Rehabil. 2007;88(4):529-36.
[12]WHOQOL Group. Study protocol for the World Health Organization project to develop a quality of life assessment instrument (WHOQOL). Qual Life Res. 1993;2(2):153-9.
[13]Hinchliff S, Norman S, Schober J. Nursing practice and health care 5e: a foundation text. 5th Edition. Boca Raton: CRC Press; 2008.
[14]Amini R, Haghani H, Masoumi M, Nakhaee M. Quality of life in blind war survivors. Iran J War Public Health. 2009;1(2):24-35. [Persian]
[15]Nejati V, Ahmadi Kh. Evaluation of epidemiology of chronic disease in Iranian psychiatric veterans. Iran J War Public Health. 2010;2(4):8-12. [Persian]
[16] Jafari F, Gitinavard F, Soroush MR, Mousavi B. Quality of life in chemical war victims with sever pulmonary damage. Iran J War Public Health. 2012;4(1):46-52. [Persian]
[17]Katsching H. How useful is the concept of quality of life in psychiatry? Curr Opin Psychiatry. 1997;10(5):337-45.
[18] Schnurr PP, Lunney CA, Bovin MJ, Marx BP. Posttraumatic stress disorder and quality of life: extension of findings to veterans of the wars in Iraq and Afghanistan. Clin Psychol Rev. 2009;29(8):727-35.
[19]Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF-36): translation and validation study of the Iranian version. Qual Life Res. 2005;14(3):875-82.
[20]de Haan R, Limburg M, Schuling J, Broeshart J, Jonkers L, van Zuylen P. Clinimetric evaluation of the Barthel Index, a measure of limitations in dailly activities. Ned Tijdschr Geneeskund. 1993;137(18):917-21. [Dutch]
[21] Habibi Sola A, Nikpoor S, Rezaei M, Haghani H. Health promotion behaviours and level of activities of daily living and instrumental activities of daily living among elderly people in west region of Tehran: A cross-sectional survey. Iran J Ageing. 2007;2(3):331-9. [Persian]
[22]Hassani Mehraban A, Soltanmohammadi Y, Akbarfahimi M, Taghizadeh Gh. Validity and reliability of the Persian version of Lawton instrumental activities of daily living scale in patients with dementia. Med J Islam Repub Iran. 2014;28:25.
[23]Masoumi M, Falahati F, Ghasemi Broumand M, Babaei M, Hajizadeh K, Mousavi B. “Instrumental activities of daily living" in veterans with monocular blindness. Iran J War Public Health. 2017;9(1):47-52. [Persian]
[24]Amini R, Haghani H, Masoumi M, Assari Sh. Activity of daily living and its associated factors in war survivors with no visual acuity. J Res Med Sci. 2010;15(4):202-7.
[25]Manaei Z, Abolmaali Alhosseini Kh, Mousavi B. Epidemiology of mental health status of veterans with monocular blindness; case study of Fars province. Iran J War Public Health. 2016;8(4):235-41. [Persian]
[26]Bijari B, Soltani B. Validation of the Persian version of inflammatory bowel disease questionnaire in patients who referred to clinics and hospitals of Birjand university of medical sciences, Iran. Ann Colorectal Res. 2017;5(1-2):e46367.
[27] Habibi Sola A, Nikpoor S, Seiedoshohadaei M, Haghani H. Quality of life and status of physical functioning among elderly people in west region of Tehran: a cross-sectioal survey. Iran J Nurs. 2008;21(53):29-39. [Persian]
[28]Allami M, Yavari A, Karimi A, Masoumi M, Soroush MR, Faraji E. Health-related quality of life and the ability to perform activities of daily living: a cross-sectional study on 1079 war veterans with ankle-foot disorders. Mil Med Res. 2017;4(1):37.
[29]Esmaeili Shahmirzadi S, Shojaeizadeh D, Azam K, Salehi L, Tol A, Moradian Sorkhkolaei M. The impact of chronic diseases on the quality of life among the elderly people in the east of Tehran. J Payavard Salamat. 2012;6(3):225-35. [Persian]
[30] Jafari F, Moien L, Soroush MR, Mosavi B. Quality of life in chemical warfare victims with ophthalmic damage's spouses. Iran J War Public Health. 2011;3(3):8-12. [Persian]
[31]Arabzadeh M. Relationship Between Basic Psychological Needs and Mental Vitality in the Elderly. Iran J Ageing. 2017;12(2):170-9. [Persian]
[32]Taghva A, Allami M, Alizadeh K, Zandi A, Faraji E, Ganjparvar Z. Mental health among Iranian combat veterans with ankle-foot neuromusculoskeletal injuries. Mil Med Res. 2017;4(1):30.
[33]Richard AI. Monocular blindness in Bayelsa state of Nigeria. Pan Afr Med J. 2010;4:6.
[34] Amini R, Kaldi AR, Sahaf R, Haghani H, Hayatbakhsh R, Davatgaran K, Masoumi M. Independency level in elderly blind war survivors: a cross sectional study. Iran J Ageing. 2012;7(1):67-74. [Persian]