Iran Journal of Nursing

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Bastani F, Beigi Boroujeni P. The Association between the Perception of Aging and Functional Independence in the Elderly Patients with Type II Diabetes Mellitus. IJN 2019; 32 (117) :7-22
URL: http://ijn.iums.ac.ir/article-1-2879-en.html

Background & Aims: Diabetes is a progressive, chronic disease associated with long-term consequences, which has an extremely high prevalence in Iran. This condition results in a decline in the health of individuals following the use of improper coping skills caused by the effect of the psychological factor of the feeling of aging. In addition to physical problems, complications of diabetes impose costs on governments, which are both direct (medical care) and indirect (related to disability and early mortality). Over the last few decades, the psychological aspects of diabetes have been taken into account by several specialists, which is mainly due to the fact that diabetes is recognized as one of the most troubling chronic diseases in terms of emotional, cognitive, and behavioral aspects. Given the significant importance of the mental aspect of health in the elderly, evaluation of the health status of this group of people should not just be limited to the physical aspects. Evidence shows that mental factors, including psychological variables, not only affect the quality of life of people but also, they affect the result of coping with a chronic disease, especially in the area of diabetes care, which largely depends on social-mental factors for self-management, self-care and proper control of the disease. By affecting the perceptions of humans, psychological factors can affect the belief in the health and activities of individuals. Therefore, this study aimed to determine the relationship between the feeling of aging and functional independence in the elderly with type 2 diabetes at two diabetes centers in Boroujen, Iran.
Materials & Methods: This cross-sectional, correlational, and descriptive study was performed on 123 elderlies aged 60-73 years, selected by convenience sampling. Following receiving a written consent, the Barthel questionnaire and brief aging perceptions questionnaire (B-APQ) were filled by the participants to evaluate their functional independence and feeling of aging (perception of aging), respectively. Data were collected through in-person interviews with the participants lasting for 20 minutes. Afterwards, data analysis was performed in SPSS version 16 using Pearson’s correlation coefficient, independent t-test, and one-way analysis of variance (P<0.05).
Results: In this study, the mean and standard deviation of the total score of the feeling of aging was reported to be 58.21 ± 7.5, which showed an unfavorable feeling about the aging phenomenon. In this regard, the negative perception of aging included 16.1% of the participants. According to the results, there was a significant difference between the total score of perception of aging and other variables. In addition, Scheffe results demonstrated a significant difference between the mean score of perception of aging in the age group of 60-64 years with the age group of 70-74 years (P=0.001). However, there was no significant difference between other age groups in this regard. On the other hand, there was a significant difference between the mean score of perception of aging among those who lived alone with those who lived with their families (P=0.001) and between those who lived with their relatives and those living with their families (P=0.04). There was also a significant difference between the mean score pf perception of aging in the elderlies with unfavorable economic status and those with favorable economic status (P<0.001) and between the mean score of perception of aging of those with moderate economic status and those with favorable economic status (P=0.001). Our findings were indicative of a significant difference between the mean score of perception of aging in the elderlies whose health status was similar to others and those whose health status was better than others (P<0.001) and the elderlies whose health status was better than others with those whose health status was worse than others (P<0.001). The mean score of functional independence of the participants was 95.71 ± 4.8, and 52.8% and 11.4% of the subjects had slight and moderate dependence, respectively. According to the results of independent-test and one-way ANOVA, there was a significant difference between the total score of functional independence and all variables, except for the level of education and other diseases. Moreover, Scheffe’s results demonstrated a significant difference between all age groups in terms of the mean score of functional independence. Furthermore, a significant difference was observed between the mean score of functional independence of the elderly who lived alone with those who lived with their spouses (P=0.04). Nevertheless, no significant difference was found between the mean score of functional independence of other groups. In addition, there was a significant difference between the mean score of functional independence of the elderly with unfavorable economic status and those with favorable economic status (P=0.03). The results were also indicative of a significant difference between the mean score of functional independence in the elderly whose health status was similar to others and those whose health status was better than others (P=0.01) and between the elderly whose health status was better than others and those whose health status was worse than others (P<0.001). The results also demonstrated a significant, reverse association between the total score of functional independence and the total score of the feeling of aging (r=0.37, P<0.001).
Conclusion: According to the results of the present study, there was a significant, reverse relationship between the perception of aging and functional independence in the studied group. Therefore, recognition and understanding of such psychological factors and capacity and functional independence in different age groups can lead to policies related to the comprehensive health of the elderly and the design of preventive programs as a holistic care and educational interventions and counseling. Therefore, the perception of aging can be improved in this age group by empowering the elderly and increasing their functional independence. In order to reduce the negative feeling of aging, strategies such as education and empowerment counseling can strengthen the positive feeling of old age in them and promote them in order to enhance health and functional independence. Therefore, it is recommended that the relationship between two variables of perception of aging and functional independence be assessed in future research in the form of cohort studies. Furthermore, given the irreparable damage caused by chronic problems and diseases in old age, it is necessary to consider the relationship between functional independence of the elderly and other psychological factors in a greater spatial extent. Since a considerable number of our subjects were young elderly, it is suggested that further studies be performed on older elderlies. In addition, given the fact that the majority of the participants in the current research were married, and living with their families and received their support, it is recommended that other studies be performed on those who lived alone.