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.

Cognitive Impairment Among Elderly Patients With Chronic Heart Failure and Related Factors.

BACKGROUND: Patients with heart failure (HF) older than 65 years have a two-fold increased risk of cognitive impairment than elders without HF. Identifying factors affecting cognitive impairment in HF may present targets for intervention. OBJECTIVES: The aim of the present study was to determine cognitive function and related factors among elderly patients with heart failure. PATIENTS AND METHODS: In this cross-sectional study, 184 elderly patients with heart failure were selected from four Mazandaran University of Medical Sciences teaching hospitals using convenience sampling. Data were collected from patients' medical records and by interview, using the abbreviated mental test, geriatric depression scale, and Charlson comorbidity index. RESULTS: There were significant relationships between cognitive status and living arrangement (P < 0.001), education (P < 0.001), hypertension (P = 0.039), anemia (P = 0.046), Charlson comorbidity index (P < 0.001) and geriatric depression scale (P < 0.001). CONCLUSIONS: Screening of cognitive impairment in elderly patients with heart failure seems necessary.

Prevalence of Types of Cancers in the Elderly Covered by Insurance of the Islamic Republic of Iran Broadcasting Company in 2015 - Comparison with Younger Groups.

Presently, the world population of the elderly is growing. By improving health hygiene and welfare indicators, mortality and birth rates decrease and life expectancy increases, making the present century the century of elderly. Aging is one of the main risk factors for development of cancer, which itself is the second cause of death in old people. This study was conducted to assess the prevalence of cancer in the elderly covered by the Islamic Republic of Iran Broadcasting (IRIB) insurance program and to obtain suitable programs for cancer screening and early detection, increase patient survival, improve elderly care and to reclaim the cost of treatment in comparison to the national and international statistics. This is a cross-sectional study conducted on all elderly patients diagnosed with malignancy based on their pathology reports. In this study, of the total 75,500 patients covered by IRIB insurance, 17.2% belonged to the elderly group, males accounting for 53.3%. The most common cancers in old men were prostatic cancer (61.3%), colon cancer (10.3%) cancer of the hematologic system, bladder cancer (9.6%), lung cancer (9.1%), thyroid cancer (3.9%) and brain tumors (1.3%). In the elderly women, the most common cancers were breast cancer (80.1%), colon cancer (5.1%), thyroid cancers (4.4%), bladder and hematologic system malignancies (3.6), lung cancer (2.9%) and brain tumors (0.7%). In addition, the prevalence of cancer was almost the same as national and international statistics. With the exception of non-melanoma skin cancer no difference was shown in prevalence of cancer between IRIB elderly patients and the other groups of cancer patients in Iran.

The effect of low and moderate intensity aerobic exercises on sleep quality in men older adults.

OBJECTIVE: Sleep is an active and complex rhythmic state that may be affected by the aging process. The purpose of present research was to investigate the effect of low and moderate intensity aerobic exercises on sleep quality in older adults. METHODS: The research method is quasi-experimental with pre-test and post-test design. The statistical sample included 45 volunteer elderly men with age range of 60-70 years-old that divided randomly in two experimental groups (aerobic exercise with low and moderate intensity) and one control group. In each group selected 15 older adults based on inclusion and exclusion criteria (such as, without sleep apnea, not smoking, and no taking hypnotic drugs). First, all subjects were evaluated by a doctor to confirm their physical and mental health. Also, the maximum heart rate (MaxHR) of subjects was obtained by subtracting one's age from 220. Furthermore, based on aerobic exercise type (40-50% MaxHR for low intensity group and 60-70% MaxHR for moderate intensity group) the target MaxHR was calculated for each subject. The exercise protocol consisted of 8 weeks aerobic exercises (2 sessions in per-week) based on Rockport one-mile walking/running test and the control group continued their daily activities. All subjects in per-test and post-test stages completed the Petersburg Sleep Quality Index (PSQI). RESULTS: In pre-test stage, results showed that there were no significant differences between control and experimental groups in sleep quality and its components (P>0.05). On the other hand, results in post-test stage showed that there were significant differences between control and experimental groups in these variables (P<0.05). Also, the Tukey Post Hoc showed that the moderate intensity group scores in total sleep quality and its components were better than other groups (P<0.05). Finally, the low intensity group scores in total sleep quality and its components were better than control group (P<0.05). CONCLUSION: Generally, the present research showed that the aerobic exercises with moderate intensity (60-70% MaxHR) have a positive and significant effect on sleep quality and its components. Thus, based on these findings, the aerobic exercises with moderate intensity is a useful to improve the sleep quality and its components among community older adults were recommended.

The Psychometric Characteristics of the Exercise Benefits/Barriers Scale among Iranian Elderly.

BACKGROUND: The objective of this study was to investigate the validity and reliability of the Farsi version of the perceived benefits/barriers scale of physical activity in Iranian elderly. METHODS: Overall, 388 elderly subjects (60 yr and over) completed the demographic characteristics questionnaire, the Exercise Benefits/Barriers Scale (EBBS) and the Yale physical activity scale. Data were analyzed through of exploratory factor analysis, using Varimax rotation, Cronbach's alpha and Pearson correlation. RESULTS: The matrix table of rotated elements of Farsi version of EBBS showed ten components, and 41 items predicted 61.83% of variance. 28 items in 5 components for benefits of, and 13 items in 5 components for barriers to physical activity were identified. Cronbach's alpha for internal consistency in the whole scale and its subscales was 0.83, 0.94 and 0.68. In addition, positive and significant correlation was found between overall benefits and their sub-scales as well as between overall barriers and their subscales. Moreover, there was significant and positive correlation between physical activity and the benefits (r=0.209, P=0.005) and significant negative correlation between physical activity and the barriers (r=-0.231, P=0.001). CONCLUSION: The results showed acceptable reliability and validity of the Farsi version of Exercise Benefits/Barriers Scale among Iranian elderly.