@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2017;9(1):53-60

Background
Given the fact that the decrease of death and increase of life expectancy has increased the number of elderly people in the world [1], providing ideal conditions for reaching healthy and qualified elderly is one of the main concerns of the societies and international communities.
Previous Studies
… [2-5]. Since the world Health Organization defines the “Health” as having physical, mental, psychological and spiritual well-being [6-9], reaching the health in the old age, also, depends on knowledge and providing their basic needs. … [10-17].
Aim(s)
The aim of this study was to determine the prevalence of diseases and health problems of retired armed forces and the potential impact of serving in this organ on the health needs of the elderly.
Research type
This research is descriptive-analytic-cross-sectional.
Research society, place and time
This study was conducted between 2013 and 2015 among the retired armed forces residing in Tehran (referring to offices and retirement centers in Tehran).
Sampling method and number
The sample size of this research using the formula and assuming that 58% of the retired people live in Tehran can participate in this project estimated 260. The primary criteria were being older than 60 years, the desire to participate in the study, benefit from the ability to communicate effectively and have the ability to read and write.
Used devices&materials
The questionnaire consisted of two parts: a cognitive assessment of the samples using 10-item AMTS test and a researcher-made questionnaire containing 82 questions. The validity and reliability of this questionnaire which is a selective compilation of 12 international recognized tools, were assessed in 2009 by Madah et al. in Iran and Swede separately on the 30 elderly that the reported Kappa and Cronbach’ alpha reliability coefficients for different parts of this questionnaire was higher than 0.07 and face and content validity of the questionnaire were confirmed [18]. In this research to validate the test, concurrent validity and construct validity were used and it was found that the cut-point 7 is appropriate to separate people with dementia from those without dementia in the elderly in Tehran [19]. Data were analyzed using SPSS 16 software and descriptive data. To study the relation between the variables one-way Analysis of Variance and independent t-test were used.
Findings by Text
Totally, 299 subjects participated in this study that 288 (96.3%) were male. 241 (80.6%) were younger than 75 years old and other were older than 75 years old. 192 (64.2%) were in the age range of younger elderly (between 60 and 69 years old). The highest number of the retired persons were related to the Land Force (33.4%), Navy (26.1%), and Air Force (24.4%). 4.3% were retired from Armed Force General Staff and 4.1% were retired from the Police Force. 207 (69.2%) had the record of presence in the war among whom only 31(10.4%) were veterans. In terms of annual referring to the doctors (due to the disease), 48 (16%) did not mention to any reference to the doctor. 62 (20.7%) had the maximum 5 times medical visit and 28 (9.4%) mentioned to more than 50 medical visit in a year. In the case of daily medication (for the treatment of underlying diseases), 61(20.4%) did not mention to any history of drug consumption. The highest frequency of 106 (35.5%) belonged to a group who were continuously using more than 5 medications per day. Of 214 responds to the questions related to medication consumption, 84 (28.1%) had the history of consumption of the herbal medication and the other 130 (43.5%) had no consumption of any herbal drugs. On the other hand, 17 (5.7%) of these 214 persons, mentioned to a proven drug allergy that mostly related to a family of antibiotics (co-trimoxazole, and injected penicillin in most cases), but aspirin for children with chronic cough similar to asthma was also reported. Also, 57(19.1%) had the history of smoking and 15 (5.0%) had the history of drug abuse. Among the 237 participants who responded to the questions related to restraint physical impairment, 159 (53.2%) had no serious health problem limiting communication. However, of the remained 78 persons, the highest prevalence of restraint disorder was related to the hearing problem with the frequency of 36 (12.0%) people that none of them were using hearing aids due to the lack of insurance coverage. However 18 people (6.0%) of the retirees were using crutches and walkers due to the limiting mobility problems. Also, at the time of completing the questionnaire, 96(32.1%) were suffering from physical pain. Among the surveyed retirees, 85 (28.4%) did not reply our questions about the presence of active disease at the time of completing the questionnaire; among others, 144(48.2%) had active disease. 47 (15.7%) had mentioned to a history of hospitalization during the past year were the most common causes of hospitalization were gastrointestinal and cardiovascular problems, thyroid disease, cancers and brain stroke that were related to 7 (2.3%) of the participants. One thing to note is that only 10 (3.3%) of the patients had the history of falling, of which 2 patients (0.7%) had been hospitalized with this case (Table 1). In the group of cardiovascular patients, a spectrum of patients with ischemic heart disease, myocardial infarction, arrhythmias and coronary artery stenosis led to open-heart surgery were reported. The most common psychological disorders that were under medical treatment of the psychologists were depression, obsessive-compulsive disorder, anxiety, panic disorder, and Post-Traumatic Stress disorder (PTSD). In patients with gastrointestinal disease a range of ulcer peptic, gall stones, and Irritable Bowel Syndrome (IBS) to fatty liver and inflammatory bowel disease were reported. 3 cases had cancer (colon cancer, esophageal cancer, and tumor basal cell skin on the face) and 3 cases had other issues including brucellosis, severe discopathy under spine that had led to surgery and cerebral infarction which had led to hemiplegie in the left half of the body. Totally 38 (26.4%) of the samples, had only one disease and the largest number of simultaneous diseases with the frequency of 85 persons (59.0%) was related to the two diseases. While 15 persons (10.4%) had three simultaneous diseases and 5 (3.4%) had four simultaneous diseases and one (0.7%) had five simultaneous diseases. In 566 cases, the disorder and physical problems were reported. In other words, some of the cases had more than one problem and only 85 (15.0%) had no physical problems in the time of completing of this questionnaire. Most complaints of samples were from visual impairments that all were using glasses for removing this problem. 7.0% of the samples (more than half of the cases) were simultaneously using two glasses for vision correction (see far and near) and most of them were reluctant to use bifocal glasses. Most retirees complained of inadequacy of the ceiling allowance to buy glasses. On the other hand, disproportionate increase of allowance for purchasing and the price of glasses and eyeglass frames, was another factor for their dissatisfaction. Most retirees said that the expenses of dentistry is expensive in most cases and are limited to certain centers and it does not have a good distribution in Tehran. A total of 53.5% of the samples had two simultaneous problems, 8.6% had three simultaneous problems and 12.9% of the samples were complaining of four simultaneous physical problems.
Main comparison to the similar studies
It can be said that most retired Armed Forces were not satisfied with the status of their general health that this finding is consistent with the results of findings by Yazdani et al. in Tehran [20], Barati et al. in Hamedan [21] and Nejati in Qom [22]. … [23-31].
Suggestions
It is suggested that with regard to implementation of mandatory schemes for health monitoring in all units of the Armed Forces, the implementation of health monitoring is being done in the retirees with a view to a comprehensive review of periodic health status (with the aim of screening, diagnosis, and treatment of most common diseases and health problems).
Limitations
The limitations of this study were: -Achieving essential permission for the presence of the researcher in the retirement centers and offices and presenting SATA services and starting the activity in the mentioned places for obtaining primary data and filling the questionnaires -change methods and the delivery of services to the retirees of Armed forces by SATA -Trying to achieve the satisfaction of the retirees to participate in the study, complete the questionnaire and doing the interview -Pessimisms of the authorities and retirees of the Armed Forces about the research on the health of retirees of the Armed Forces and -inappropriate place of interview.
Conclusions
The most important health problems of retirees from the Armed Forces, are chronic non-communicable diseases including high blood pressure, diabetes and cardiovascular diseases. Only one-third of the samples, are satisfied with their own health status. Despite of having drug insurance coverage ceiling, the prevalence of polypharmacy is less in the retirees from Armed Forces and more than half of the retirees, have no restrictive communicative problems.
Acknowledgments
All the retirees who patiently and sincerely filled the questionnaire, and the respectful staff of SATA especially Fatemi retirement center that accepted us at their place during 4 years of collecting data are appreciated.
Conflict of interest
Non-declared
Ethical Permissions
The informed consent was obtained from all the participants and all the ethical issues were observed during the study.
Funding Sources
The financial support of this study was provided from the personal income of the researcher and the supports form Iran Army University of Medical Sciences.

TABLES and CHARTS

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