Iran Journal of Nursing

fa ارتباط احساس پیری با استقلال عملکردی در سالمندان مبتلا به دیابت نوع دو The Association between the Perception of Aging and Functional Independence in the Elderly Patients with Type II Diabetes Mellitus پرستاری nursing پژوهشي Research <div style="text-align: justify;">زمینه و هدف: بیماری دیابت با شیوع حدود 5/4 میلیون نفر در ایران، دارای ماهیت مزمن پیشرونده به همراه عوارض طولانی مدت است که به دنبال به کارگیری نادرست مهارت‌های مقابله‌ای ناشی از تأ‌ثیر عامل روانشناختی احساس پیری باعث افت سلامتی می‌شود. پژوهش حاضر به منظور تعیین ارتباط احساس پیری با استقلال عملکردی در سالمندان مبتلا به دیابت نوع دو در مرکز دیابت شهرستان بروجن انجام گردید. روش بررسی: این مطالعه مقطعی به روش غیراحتمالی در دسترس بر روی 123 سالمند 60 تا 74 سال مبتلا به دیابت در شهرستان بروجن انجام شد. بعد از اخذ رضایت‌نامه کتبی، پرسشنامه  Barthelجهت ارزیابی استقلال عملکردی و Brief Ageing Perceptions Questionnaire B-APQ)) برای بررسی احساس پیری (ادراک از سالمندی) به صورت مصاحبه حضوری در مدت زمان 20 دقیقه تکمیل شد. یافته‌ها: یافته‌ها در پژوهش حاضر نشان داد که میانگین و انحراف معیار نمره کل احساس پیری در سالمندان مورد مطالعه 5/7 ± 21/58 بود که نشان از احساس نامطلوب از پدیده سالمندی داشت که بعد ادراک منفی از پیری 1/16 درصد را شامل می‌شد. میانگین نمره استقلال عملکردی سالمندان مورد پژوهش 8/4 ± 71/95 بود که 8/52 درصد شرکت کنندگان دارای وابستگی جزئی و کمترین تعداد (4/11%) دارای وابستگی متوسط بودند. نتایج مطالعه ارتباط آماری معنی‌دار و معکوس بین نمره کل استقلال عملکردی و نمره کل احساس پیری (001/0P<، 37/0-r=) را نشان داد. نتیجه‌گیری کلی: با توجه به نتایج این مطالعه که ارتباط معنی‌دار و معکوسی را بین ادراک از سالمندی و استقلال عملکردی در گروه مورد مطالعه نشان داد، شناخت و آگاهی از این گونه عوامل روانشناختی و ظرفیت و استقلال عملکردی در گروه‌های سنی متفاوت می‌تواند به سیاست‌گذاری مرتبط با سلامت جامع سالمندان و طراحی برنامه‌های پیشگیرانه به عنوان مراقبت‌های کل نگر و انجام مداخلات آموزشی و مشاوره‌ای بیانجامد. بنابراین پیشنهاد می‌گردد با توانمندسازی سالمندان و افزایش استقلال عملکردی در آنان، ادراک این گروه سنی را از سالمندی بهبود بخشید. برای کاهش احساس منفی از سالمندی می‌توان با راهکارهایی همچون آموزش و مشاوره‌های توانمندسازی، احساس مثبت از سالخوردگی را در آنان تقویت نمود و آنان را در راستای ارتقاء سلامت و استقلال عملکردی پیش برد.</div> <div style="text-align: justify;">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.</div> احساس پیری, استقلال عملکردی, سالمند, دیابت Perception of Ageing, Functional Independence, Elderly, Diabetes 7 22 http://ijn.iums.ac.ir/browse.php?a_code=A-10-328-5&slc_lang=fa&sid=1 F Bastani فریده باستانی 10800319475328460026932 10800319475328460026932 Yes Professor, Department of Public Health Nursing and Geriatrics, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (*Corresponding author) Tel: 02143651800 Email: bastani.f@iums.ac.ir استاد، گروه پرستاری سلامت جامعه و سالمندی، دانشکده پرستاری مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران (*نویسنده مسئول) شماره تماس:02143651800 bastani.f@iums.ac.ir Email: P Beigi Boroujeni پروانه بیگی بروجنی 10800319475328460026933 10800319475328460026933 No MS, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran کارشناس ارشد، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران