@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2015;2(2):28-37

Background
Increasing the life span and the population of elderlies is one of the achievements of the 21st century. Aging is a phenomenon with which some countries are already facing and others will face in near future [1].
Previous Studies
... [2-5]. Among the determinant factors of health, health-promoting self-care behaviors have been known to be the most fundamental way for preventing the diseases especially chronic ones. Thus, health promoting self-care behaviors must be considered as a main strategy to maintain and improve health [6]. ... [7-12].
Aim(s)
This study aimed to investigate the effect of educational intervention of self-care program on the life quality of elderlies.
Research type
This interventional study is quasi-experimental with pre-posttest on the control group.
Research society, place and time
This study was conducted in 2014 in Zanjan. The population of the study consisted of all people over 60 years old who are covered by health centers of Zanjan.
Sampling method and number
... [13]. Regarding α=0.05 and test power of 80%, the sample size was estimated 76 people in each group which were considered 80 to improve the accuracy of the study. The samples of the study were selected from among the elderly people who had referred to 8 health centers of Zanjan through cluster method and were randomly assigned to two groups of interventional (80) and control (80). Criteria for entering the study included being over 60 years old, absence of lunacy or dementia, living in Zanjan and the willingness to participate in the study. Exclusion criteria were having heart and pulmonary diseases, metabolic disorders and musculoskeletal diseases.
Used devices&materials
The data collection instruments included the questionnaires of demographic and contextual features and to assess the life quality, 36-item short form questionnaire of life quality was used. 36-item short form questionnaire has been widely employed in patients with chronic diseases and in seniors inside and out of Iran. In reviewing the articles related to life quality, Darvishpoor reported that the 36-item short form questionnaire is the mostly-used tool in the study of life quality [14]. Besides, the results of a study by Montazeri et al. show that the Persian version of this tool has the adequate reliability and validity in measuring the health-related life quality [15-16]. This questionnaire has been translated into several languages, and its validity and reliability have been approved in multiple internal and external studies [17]. The purpose of designing this questionnaire is assessing health status in terms of physical and emotional state which is achieved by combining the scores of eight domains forming the health. This questionnaire has 36 sentences evaluating eight different domains of health. Areas examined in this questionnaire include: Physical performance (10 questions), limitations of role playing due to physical problems (4 questions), pain (2 items), general health (5 questions), mental general health status (5 questions), limitations of role playing due to emotional and psychological issues (3 questions), social functioning (2 questions), liveliness (4 questions), and 1 question that does not exist in any of the subscales and is added to the total score. Scoring was based on the standard measuring criteria for the SF-36 questionnaire. Two-option, three-option, five-option and six-option questions were considered with scores of 0 and 100, 0-50-100, 0-25-50-75-100 and 0-20-40-60-80-100, respectively. Moreover, the questionnaire contains two parts of the total psychological dimensions and total physical dimensions. The standard mean of total physical and mental dimensions is 50 and above and below 50 indicates the average high and low performance, respectively [16]. The subscales of physical performance, limitations of role playing due to physical problems, pain and general health are related to physical aspect while subscales of mental general health status, limitations of role playing due to emotional and psychological problems, social functioning and liveliness are related to the mental aspect of life quality and total life quality can be calculated by computing the mean scores of subscales of physical and mental dimensions. Along with completing the questionnaires, height and weight of elderlies were measured to calculate the body mass index and were interpreted based on integrated health program for the elderly. After collecting data for the experimental group, self-care training courses were held with a focus on healthy food, methods of physical activities such as regular walking, old age`s exercises, preventing incidents, utilizing permanent care behaviors for protecting oneself and how to modify the risky controllable factors, the process of removing harmful habits such as smoking, ways of dealing with stress and recommendations for better sleep, recommendations for preventing backache, taking care of knees and legs and osteoporosis by the master expert of nursing, master of mental health and the researcher using books published by the Ministry of Health during six one-hour sessions. Topics presented in these meetings included two sessions of the correct principles of nutrition, two sessions of physical exercises, one session of mental health and one session about health advice. 10 elderly people participated in each training session. In holding these training sessions, group training methods, questions and answers, brainstorming and lecturing were used. No training program was held during the intervention for the control group. The second phase of data collection was carried out three months after ending the educational intervention and the questionnaire was completed in both groups again. Statistical analysis The collected data was analyzed with the pre-test stage in both experimental and control groups using SPSS version 20. To analyze descriptive data, chi-square and Fisher`s exact tests were used. Besides, difference in the aspects of life quality was examined in both interventional and control groups before and after intervention using independent t and paired t-tests. The significance level was considered less than 0.05 for all tests.
Findings by Text
The total number of subjects in this study was 160 elderly men and women with the mean age of 66.18± 4.70 in the interventional group and 66.30± 4.85 in the control group. In Table 1, the demographic variables are compared with each other in both interventional and control groups. 61.25 percent of the elderlies were in the intervention group while 57.50 percent of them were women in the control group. Also, the majority of people in the interventional and control groups were illiterate or had gone only to primary school. The findings of this study indicate that most of the subjects in both interventional and control groups were 62.5 and 75.78 percent married, respectively. 51.25 percent of the elderlies in the interventional group and 56.25 percent of them in the control group were overweight regarding BMI. In terms of smoking, 81.25 percent in the interventional group and 83.75 percent in the control group were non-smokers. According to the results of Chi-square statistical test and Fisher's exact test, no significant difference was observed between the two groups regarding demographic variables (P>0.05). In Table 2, statistical indices related to the aspects of life quality of people in the interventional and control groups have been compared with each other in the pre-intervention stage using statistical independent t test. The results revealed that there was no significant difference between the two groups in terms of the mean aspects of life quality; in other words the two groups were similar concerning the aspects of life quality (P>0.05). In table 4, statistical indices related to the aspects of life quality of people in the interventional and control groups have been compared before and after the intervention stage using paired t test. According to the results, a significant difference was observed in the mean scores of life quality aspects of the interventional group before and after the intervention (P<0.05). However, in the control group in all aspects of life quality, no significant difference was observed between the mean scores before and after intervention (P>0.05).
Main comparison to the similar studies
... [18-21]. The elderlies` mental health status before and after the intervention had the highest score compared to other aspects of life quality and this is in line with some studies conducted in the country [22-23]. ... [24-27].
Suggestions
Paying particular attention to the elderly, their checkups, the necessary self-care trainings, establishing clinics for elderlies, improving supportive environments, inter-sectoral collaborations and governmental policies are required to promote health status of seniors and improving their quality of life.
Limitations
One of the limitations of this study was that elderly patients with limited mobility were excluded. Collecting data from elderly patients and presenting self-care trainings such as stretching and strengthening exercises all required arrangements with the doctor which was not possible due to budget and time constraints. Other limitations of this study included self-reporting method of collecting data. Also, due to not referring of most of the rich elderlies to governmental health centers, generalizing the research results to the entire population of elderlies is affected.
Conclusions
Results indicated an increase in the mean scores of different aspects of life quality of elderlies in the interventional group after the educational intervention.
Acknowledgments
Many thanks are regarded to the professors, all seniors who participated in this study and the staff of health centers in Zanjan.
Conflict of interest
Non-declared
Ethical Permissions
Research objectives and the way of holding training classes were explained for participants and they were assured that the questionnaires were anonymous and their information will not be used elsewhere. Also there was no compulsion for participation in the study or continuing it.
Funding Sources
This article is taken from a thesis of master degree in the field of health training of Tehran University of Medical Sciences and Health Services.

TABLES and CHARTS

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