@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2018;10(3):127-132

Background
Health needs assessment is a methodology, and systemic look, irrespective of a cross-sectional and attitudinal approach, in which the custodians of a given community understand whether the members of the target community have received the services in a manner appropriate to their own status or not, and What is the best way to improve the level of health?
Previous Studies
In the study of the results of the need assessment of veterans with musculoskeletal and muscular disorders of the wrist and leg of West Azarbaijan, the most common disorder in the veterans was shortened limb (63%). The difference between the lengths of the two limbs refers to the difference in length between the pairs of organs [1]. Due to the fact that the difference in the length of the two limbs leads to several problems, such as walking disorder, lameness, osteoarthritis, knee pain, back pain and spinal problems [1, 2]; shorthess-offs can reduce the complications of this disorder. The most important intervention in limb length difference is shortness recovery using orthosis or shortening the front side or lifting the short limbs [3, 4]. The most common orthoses for lower limb defects include limb shortening using an insole inside the footboard or internal shoes, or adding a heel to the shoe or sandal on the short side [5]. ... [6-9].
Aim(s)
The purpose of this study was to compare the quality of life, life satisfaction, and satisfaction with medical shoes among veterans with length difference between the lower limbs receiving the service (crutches, walkers, wheelchairs, orthotics and prosthetics, medical shoes and physiotherapy services), and without receiving after-care services. 2 years of follow up.
Research type
This cross-sectional study is a descriptive-comparative study.
Research society, place and time
This research was carried out among veterans with a disparity in the length of two lower limbs receiving services and not receiving it in West Azarbaijan province in 2014 and follow up in 2016.
Sampling method and number
Using purposeful sampling, the records of all veterans (152 veterans) with lower limb difference in West Azarbaijan province in 2014 were investigated. 90 veterans who were evaluated by a physiotherapist and an arthritis evaluator with a length difference between the two organs were separated and these people were contacted. With 12 people, it was not possible to communicate, and 2 people did not want to cooperate with the project, and were excluded from the research, and 76 veterans remained in the project. 48 people received prescription services (crutches, walkers, wheelchairs, orthoses and prosthetics, medical shoes and physiotherapy services), and 28 did not receive orthotics and auxiliary supplies.
Used devices&materials
Forms of follow-up of prescribed interventions were used and demographic information of individuals including gender, occupation, marital status, education, time spent on injuries and age were collected through their case. The SF-12 quality of life questionnaire (short form) [10], life satisfaction questionnaire (SWL) [11] and researcher made questionnaire on satisfaction with medical shoes were used as a research tool. Group 1 was considered as a group receiving services and Group 2 was considered as a group without receiving services. Data were collected on forms and questionnaires of quality of life, life satisfaction and medical shoe by telephone. Data were analyzed using SPSS 20 software. First, the distribution of data was normalized by Kolmogorov-Smirnov test. Chi-square and independent t-test were used to examine the homogeneity of demographic variables in two groups, dependent t-test was used for mental health. Wilcoxon test was used for physical health and life satisfaction, and the Mann-Whitney and Wilcoxon tests were used for the physical and mental quality of life subscales and the range of change in both groups.
Findings by Text
Of the 76 participating veterans, 48 (63.2%) had received the prescribed services and 28 (36.8%) had not received. Mean age and mean of time spent on injuries in the recipient group were 52.31 ± 8.98 and 28.45 ± 5.24 years, respectively and in the non-received group, the mean age and mean of time spent on injury were 52.50 ± 7.25 and 27.42 ± 5.7, 27 years respectively. Demographic variables were not significantly different in the two groups (Table 1).The most commonly used treatment was medical shoes, and 50.17%of the equipment were medical shoes. These shoes were prescribed for 72 (94.7%), of which 47 (65.2%) had their shoes. 26 (53.1%) of the veterans received medical shoe twice (Table 2). In group 1, the difference in evaluation between 2014 and 2016 was significant in terms of mental health and physical health. In the group that had not received the services, the subscale of mental health was significant, but the subscale of physical health was not significant. The overall quality of life in the group who had not received the services was significantly reduced (Table 3). In the evaluation of 2014, in the quality of life variable, the subscale of vitality in group 2 was greater than that of group 1. In 2016, general health was higher in group 1 than group 2. There were no significant differences in other subscales of quality of life. In follow-up after two years, physical performance improved in the recipient group compared to the group without receiving services. Vitality in group 2 was significantly lower than group 1 (Table 4).In the evaluation of 2014, the total score of satisfaction in the two groups was 16.82 ±7.60 and it was 18.09 ± 6.70 in the year 2016, which was not significantly different (p = 0.18). In the evaluation of 2014, the mean life satisfaction in groups 1 and 2 was 16.47 ± 7.10 and 17.42 ± 8.50, respectively, and in the year 2016, it was 18.37 ± 7.20 and 17.60 ± 6.00 respectively and there was no significant difference between the two groups (p >0.05). Differences in the evaluation of the years of 2014 and 2016 were not significant in group 1 (p = 0.14) and in group 2 (p = 0.72) (Table 5).76.6% of veterans who received medical shoes were satisfied (Table 6). The satisfaction score of beauty was 15.87 ± 4.30. The total score of satisfaction with weight was 3.72 ± 1.30, and the satisfaction with the performance was 19.44 ± 5.50.
Main comparison to the similar studies
Satisfaction with health services has been the subject of numerous studies [12-14]. Sydney and Freiberg, in their research on the affairs of the combatants, have stated that this group was more satisfied with the health care received than the ordinary people [15]. In the case of services offered to veterans of Shojaee and Nakhai, the satisfaction rate of veterans and free soldiers who referred to the health centers of Kerman veterans' bureau for medical treatment in 2003 have been evaluated. In their results, they stated that the highest percentage of dissatisfaction (41.7%) was the result of physician therapies [16]. Seyyed Hosseini Davarani et al. Also expressed satisfaction with the amount of satisfaction of veterans with aborting both lower extremities (51.8%) of rehabilitation services, low / very low and 19.4%, very high / high [17]. However, in the present study, the satisfaction with the received services of medical shoes was evaluated due to the disorders in this group, but the level of satisfaction of the people was relatively high. Several studies have been conducted on the impact of psychological, physical and disability problems on people's quality of life. Research has pointed out that physical problems have a profound effect on the quality of life [18, 19]. As the age increases and these problems increase, the quality of life decreases further [19-22]. ... [23, 24]. The reason for the lack of improvement in life satisfaction can be reconciled with the results of studies such as Study of Stoebur et al., Which showed that life satisfaction have significant relationship with occupational, educational, social interactions, personality factors, income, social class and religion, chronic diseases, mental health and social status, and therefore, the score for satisfaction with the lives of veterans is considered lower than normal people [25, 26].
Suggestions
It is suggested that the above factors be investigated in a qualitative research.
Limitations
One of the limitations of the present research was the problem of communication with veterans and the lack of access to a fixed telephone number, alteration of it, availability of a mobile phone number or release of it, which made it difficult to access to people. Despite the key role of pursuing health and rehabilitation services in improving the quality of service provision, this activity is also considered to be the missing service loop in many societies. This research, while revealing the positive and valuable aspects of the services provided to the veterans, indicates that there are limited factors that have led to the failure to provide or receive the orthotics provided to this group.
Conclusions
Most veterans who use medical shoes are highly satisfied. Veterans who received services after two years of follow-up have a high level of physical health than those who did not use the services. Also, the decrease in mental health and quality of life is high in the group receiving the services. The two groups of recipients do not differ in terms of life satisfaction without receiving services.
Acknowledgments
We are grateful to all the friends and loved ones who helped us in this research, as well as the great veterans who participated in this research.
Conflict of interest
No case was reported by the authors.
Ethical Permissions
The ethics committee of the Medical Biological Research Institute of the Foundation of the Veterans and Martyrs Affairs has confirmed this research. Ultimately, care was taken to transfer the advice and assessments prescribed in the veteran case to the intervention form. Information about people was kept confidential and in the case that the veteran was reluctant to reply, he was apologized and removed from the study.
Funding Sources
The cost of this project has been provided by the Research and Medical Science Institute for Veterans.

TABLES and CHARTS

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