Prevalence and associated factors of insomnia syndrome in the elderly residing in kahrizak nursing home, tehran, iran.

BACKGROUND: As insomnia is common, especially among the elderly in the nursing homes, we aimed to estimate insomnia prevalence among the elderly residing in nursing homes as well as to determine factors associated with insomnia in the elderly. METHODS: This cross-sectional study was carried out in 2009 on 772 elderly residents at Kahrizak Nursing Home, Tehran Iran. The information was gathered through 5-part questionnaires by interviewing either the individuals or the nurses in charge and also reviewing the subjects' medical files. Eventually, the necessary data were analyzed using oneway ANOVA and Chi-square tests. RESULTS: The mean age of the participants was 76.8 ± 8.05 years (range, 65 to 107 years). Based on the results, 303 (39.2%) of the elderly, including 86 (34.7%) men and 217 (41.1%) women, had insomnia syndrome. 433 (56.1%) participants complained of difficulty initiating sleep, 357 (46.2%) of disrupted sleep, 362 (46.9%) of early morning awakening, and 313 (40.5%) of non-restorative sleep. Our findings also showed that age (P = .004), number of diseases (P = .019), motility status (P = .017), sleep environment satisfaction (P < .001), cognitive status (P = .023), and functional autonomy (P = .003) were significantly associated with insomnia. CONCLUSION: Insomnia is a prevalent disorder amongst the nursing home elderly population, especially elderly women, and several pharmaceutical and nonpharmaceutical factors may trigger its occurrence. However, to prevent this problem, further studies are required in Iran and Middle Eastern region to establish a reliable understanding about insomnia patterns, causes, and cures.

Knowledge, attitude and practice towards blood donation in Iranian population.

BACKGROUND: The increase in demand for blood products because of new surgical and medical procedures seeks more research to find new ways to recruit people to donate blood. OBJECTIVE/AIM: To determine the level of people's knowledge about donating blood considering its relation with infectious and chronic diseases, drug abuse, unsafe sexual intercourse, menstruation and anaemia. In addition, their attitude towards blood donation regarding their previous behaviour and factors such as altruism, religion, family, fears and availability of blood donation centres has been evaluated. METHODS: This study was conducted in Tehran, Iran in 2009 on 1000 respondents. Data were collected through questionnaires that comprised 37 questions considering demographic and background characteristics, level of knowledge and positive and negative attitudes towards blood donation. Finally, data were analysed using SPSS software. RESULTS: Of 1000 in this study, 26% were donors, of whom 55% had donated blood more than once. The mean knowledge score of the participants was 8·6, which was associated with the subjects' gender and level of education (P = 0·031 and P < 0·001, respectively). Age, gender and level of education were significantly associated with one's attitude towards blood donation (P = 0·021, P < 0·001 and P = 0·003,respectively). Ninety-five percent of people have stated that their main motivation to donate blood was altruism. CONCLUSION: Altruism and being encouraged by others had the leading roles in peoples' positive attitude towards blood donation; whereas hard access to blood donation centres seemed to be the main inhibitory factor.

Comparing stroke rehabilitation outcomes between acute inpatient and nonintense home settings.

OBJECTIVE: To compare outcomes in stroke survivors who received rehabilitation services in an acute inpatient rehabilitation setting (multidisciplinary rehabilitation team) with outcomes in survivors in a home-based setting (family caregivers, limited team supervision). DESIGN: Randomized clinical trial, with mean follow-up after 60 days. SETTING: Inpatient rehabilitation setting and home-based settings. PATIENTS: Sixty patients (age range, 43-80yr) who had a stroke between 1996 and 1999 and had been referred after medical stabilization, randomly divided into 2 groups: group 1, inpatient rehabilitation; group 2, home-based rehabilitation. INTERVENTIONS: Group 1: therapeutical and neuromuscular exercises with occupational therapy with professional supervision; group 2: conventional exercises with family caregiver and limited professional supervision. MAIN OUTCOME MEASURES: Spasticity was evaluated with the Ashworth Scale, motor status with Brunnstrom's stages, functional status with the FIM instrument, and cognitive status with the Mini-Mental State Examination before and after rehabilitation. RESULTS: Patients rehabilitated in acute inpatient settings had better motor, functional, and cognitive outcomes (p < .05). Spasticity changes did not differ between the groups. CONCLUSION: Intense inpatient rehabilitation services for stroke survivors provide significantly more favorable functional and cognitive outcomes with relatively low complications than did nonintense rehabilitation efforts in home settings.

Cognitive evaluation and functional outcome after stroke.

OBJECTIVE: To investigate the initial overall cognitive ability and its components as a predictor of functional improvement and ambulation during rehabilitation. Initial cognitive status is widely known to be a predictive factor in functional recovery in patients with stroke although some reports have found no such relationship. DESIGN: Baseline cognitive status was scored by Minimental State Examination and its subsections with such headings as "orientation," "registration," "attention and calculation," "recall," and "language" in 43 patients with postacute stroke, aged between 51 and 68 yr. Function was evaluated in terms of motor FIM and functional ambulation as categorized in "Adapted Patient Evaluation and Conference System" functional scale at the time of admission and discharge. RESULTS: Only total baseline Minimental State Examination score showed a significant correlation with discharge motor FIM improvement (r = 0.31, P = 0.04) and baseline orientation score correlated significantly with functional ambulation score improvement (r = 0.31, P = 0.03). In stepwise linear regression model, the same variables had an effect on similar outcome parameters. CONCLUSIONS: Cognitiveion evaluation should be taken as a whole to predict functional outcome in patients with postacute stroke, except for the baseline orientation score that seemed more predictive for ambulation.