Uncertainty, the overbearing lived experience of the elderly people undergoing hemodialysis: a qualitative study

Background: The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis

Methods: This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach

Results: One of the most important findings emerging in the main study was "uncertainty", which can be important and noteworthy, given other aspects of the elderly life [loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems]. Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis

Conclusion: The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications

[Validity and reliability of WHOQOL-DIS questionnaire in Iranian older people with disability]

Objective: The main purpose of the present study was to evaluate psychometric properties of Persian version of WHOQOL-DIS questionnaire in elderly people with disability

Materials and Methods: A classical psychometric method was used to evaluate validity and reliability of WHOQOL-DIS questionnaire in elderly people with disability. Lawshe, and Waltz and Bausell methods were used for assessing content validity. During convenient sampling, 205 elderly, whose score in WHOQOL-DIS questionnaire was more than 4, completed the SF-12 questionnaire in order to assess convergent validity and criterion validity [using known group's comparison]. Reliability was estimated using internal consistency and test-retest reliability was determined by means of Intraclass Correlation Coefficients [ICC]

Results: According to Lawshe, and Waltz and Bausell methods of content validity, acceptable scores were obtained for all items. Correlation between the WHOQOL-DIS questionnaire and the SF-12 scales was satisfactory except for social domain [P=0.13]. The Intraclass Correlation Coefficients for score of questionnaire dimensions and total score was higher than 0.70. Cronbach's alpha for investigating Intraclass Correlation was higher than 0.70 except for social domain. Comparing known groups revealed distinctions in sex and health and disability status between elderly people [P<0.001]

Conclusion: In general, the findings suggested that the WHOQOL-DIS questionnaire is a reliable and valid measure of health related quality of life among elderly people with disabilities. Therefore, the questionnaire can be used in the investigation on the quality of life of elderly people

[Validity and reliability of the Persian version of measurement of the quality of life of people with disabilities]

Improving disabled quality of life is considered as one of the goals of rehabilitation and maintaining and ameliorating quality of life has become an important aim of medical systems. This study aims at investigating psychometric properties of measurement of the quality of life of people with disabilities, which is developed by World Health Organization [WHO]. The questionnaire was translated based on the International Quality of Life Assessment Project [IQOLA]. 160 individuals over 18 years old with disability in Tehran [age average=50] performed in this study. Socio-demographic inventory, SF12 inventory, and finally WHOQOL-D were given to participants respectively. Validity, concurrent validity with quality of life questionnaire [short form 12] by using correlation coefficients pearson, face validity, content validity and discriminant validity with spearman correlation coefficients of internal consistency and stability by calculating Cronbach's alpha and determining the intraclass correlation coefficients [ICC] was assessed. Version 19 SPSS was used to perform statistical tests. Face and content validity of the questionnaire, simplicity, and clarity were approved phrases. Over 90% of scores with a correlation of each question with the scores of related subtest was significant and positive. These results indicate an appropriate discriminative validity of the test items. Estimating Cronbach's alpha [0.90] confirms high internal consistency of the inventory with the exception of social communication area [0.61]. The results of evaluating reliability using within subject correlation coefficient estimation show that there is a high correlation coefficient between different subtests of the inventory. Results indicate reliability and validity of Persian-version of mentioned inventory. Therefore, its utilization in research studies is highly recommended

[Effect of vibration training and creatine supplementation on neuromuscular]

Background: The aim of this study was to evaluate the short-term effects of creatine supplementation in combination with vibration exercise on physical fitness and neuromuscular performance of elderly women.

Materials and Methods: The study population included women aged over 60 years. For this purpose, 22 healthy elderly females were selected and randomly divided into three groups: vibration exercise with creatine supplementation [n=8], vibration exercise with placebo [n=7], and control [n=7] groups. Vibration exercise with creatine supplementation group, performed exercises which included six posture exercises, based on the principle of overload, for 10 days, with a frequency of 30-35 Hz and amplitude of 5 mm; and at the same time, received 20 grams creatine, for the first 5-day, and 5 grams creatine, for the later 5-day, daily. Vibration exercise with placebo group, instead of creatine, received dextrose. Evaluation factors were the static strength of hands and feet [dynamometer], the dynamic power of leg [knee open device], the static balance [standing on one leg], and dynamic balance [lifted and walking], the lower body performance [30 meters walk, tandem gate and get up and sit on a chair], and flexibility [sit and delivery]. ANOVA and analysis of covariance statistical tests were used to examine the main effects; and post hoc Tukey and Sidak tests, were used to compare pairs of groups [P

Results: The results of ANOVA showed that there was no significant difference between the groups in the static power [P=0.89], lower body function in tandem gate test [P=0.25], and flexibility [P=0.59]; but the static power and performance of leg in 30-meter walk test, was better in vibration exercise with creatine supplementation group than the control group [P<0.016 and 0.02, respectively]. In addition, the results of covariance test showed that there was no significant difference between the groups in the static balance variables [P=0.11] and the getting up and sitting on performances [P=0.68]; but both groups of vibration exercise with creatine supplementation, and vibration exercise and placebo, had better performance in the dynamic balance [P=0.001and P=0.009, respectively], and the dynamic power of leg [P=0.001and P=0.001, respectively], than the control group.

Conclusion: Regarding to the results of the present study, it seems that vibration exercise with creatine supplementation in the short term, can lead to a significant improvement in the static and dynamic power of feet, dynamic balance and 30-meter walk performance in elderly women. Furthermore, it appears that creatine supplementation along with whole-body vibration exercise may have further impact on the static power of leg, and 30-meter walk performance.

Environmental barriers to social participation of children with cerebral palsy in Tehran

Cerebral palsy is the most common type of permanent movement and posture disorder in children leading to activity limitations. Children's participation is influenced by their functional ability, skills, interests, and environmental factors. The objective of the study was to describe parent perception of environmental barriers to participation of children with cerebral palsy. Secondary data analysis of the study of psychometric properties of the Persian version of the Craig Hospital Inventory of Environmental Factors for use with children with cerebral palsy. The questionnaire was administered to a sample of convenience of 75 parents of children with cerebral palsy aged between 5 and 12 years. Barriers to participation most commonly reported by parents were in the services and assistance subscale and the policies subscale of the measure. Also, parents reported the greatest barriers encountered by their children were availability of transportation and availability of education and training. Findings from this study indicate the presence of multiple environmental barriers to participation of children with cerebral palsy. Enhancing participation of children with cerebral palsy by altering barriers and increasing facilitators requires further research concerning these factors. This study suggested that people with lower function in gross motor, manual ability, as well as cognition require further support to participate in social activities

Occupational therapy in Iran: historical review

Occupational therapy in Iran is relatively young - established in 1971 - with a fluctuated development due to the Iranian revolution in 1979, and eight years war from 1981 to 1989. Today, there are ten Bachelor programs across the country approved by World Federation of Occupational Therapists [WFOT]. Furthermore, occupational therapists have opportunities for further postgraduate training in both Master and PhD levels. Fast growing of occupational therapy due to social demands necessitated therapists to develop a professional organization. Therefore, Iranian Occupational Therapy Association [IROTA] was formally established in 1994. This paper aims to present an overview about occupational therapy in Iran. Iranian context including population, health status and culture is also reviewed. This follows with explanation about occupational therapy background, education and development. Finally, conception, development, purposes, and achievements of Iranian Occupational Therapy Association; present situation and future perspectives of occupational therapy are discussed

Upper limb hypertonicity in children with cerebral palsyþ:þ a review study on medical and rehabilitative management

Hypertonicity is the most common type of cerebral palsy consists of 85% of the affected children. It has a very complex nature making intervention and management very difficult. This article tries to make reader familiar with various types of intervention and introduce a new intervention process to help clinicians decide better. Literature was reviewed with two criteria including: identifying various interventions and their effects on upper limb hyper tonicity and level of invasiveness of each intervention. This paper suggested a new way of looking at hyper tonicity based on its two components [i.e., neural and biomechanical] and effectiveness of each intervention on these components. In the treatment and management of hypertonicity, clinicians are required to look at all aspects of hypertonicity and then based on the provided decision tree, decide which kind of treatment to be used for the child