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Editor's Welcome 2 2 The increasing number of aging people around the world, especially in developing countries, and its economic, social, and health consequences demonstrate the necessity of studies focusing on the elderly. The results of the studies can provide ways for solving the existing and future problems that are associated with the aging population. Although research studies on elderly are conducted in Iran and other developing countries, many remain unpublished or published in the languages that cannot be universally used because there are not many English language journals in the area of healthy aging. The Elderly Health Research Center in the School of Public Health at Shahid Sadoughi University (SSU) of Medical Sciences in Yazd, Iran is the publisher of the Elderly Health Journal (EHJ), an English language and peer-reviewed journal. The EHJ received the approval from Iran's Ministry of Culture and Islamic Guidance and periodical commission of Ministry of Health and Medical Education. The call for papers was through e-mails and announcements on the SSU website. We are pleased to release the first issue of the EHJ, containing eight papers related to aging and health. We hope that the readers will find the papers useful. We will do the best we can to receive international indexing for the journal. So we invite researchers, students, and practitioners in the area of healthy aging to submit their research-based articles to assist us in achieving our final goal, which is aging health promotion around the world especially in developing countries. We welcome constructive suggestions to improve the overall quality of the EHJ. Looking forward to seeing your comments and manuscripts. 1 1 2015/06/1 1394/3/11 2015/06/1 1394/3/11 Mohammad Ali Morowatisharifabad Mohammad Ali Morowatisharifabad Professor of Health Education & Editor-in-Chief Iran ## ##

Elderly Community Dwelling Women's Experiences of Managing Strategies for Urinary Incontinence: A Qualitative Research 2 2 Introduction: Urinary incontinence (UI) is high prevalent in older women. Little is known about how they manage with this chronic condition from their points of view. The aim of this study was to explore older women’s experiences of management strategies in dealing with UI. Methods: Eight community dwelling women aged 60 and over, with long term UI participated in this qualitative study. After conducting semi-structured interviews, we transcribed the participants’ responses, and analyzed them using Van-Mannen hermeneutic phenomenological method. Results: One theme emerged from the data which is labeled as strategies adopted to combat the UI. Conclusion: Results indicated that women needs to inform that there exist various treatment for UI and encourage them to seek treatment for UI. 2 4 2015/06/12015/01/22 1393/11/2 2015/06/12015/03/25 1394/1/5 Minoo Pakgohar Minoo Pakgohar Department of Geriatric Nursing and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Iran mpakgohar@razi.tums.ac.ir Tengku Aizan Hamid Tengku Aizan Hamid Institute of Gerontology, University Putra Malaysia, Selangor, Malaysia Malaysia Rahimah Ibrahim Rahimah Ibrahim Institute of Gerontology, University Putra Malaysia, Selangor, Malaysia Malaysia Marzieh Vahid Dastjerdi Marzieh Vahid Dastjerdi Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Iran Aging Female Management Strategies Qulitative Research Urinary Incontinence Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardization of terminology of lower urinary tract function: Report from the standardization sub-committee of the International Continence Society. Neurourology and Urodynamic. 2002; 21(2): 67-78.## Wong T, Lau BY, Mak HL, Pang MW, Cheon C, Yip SK. Changing prevalence and knowledge of urinary incontinence among Hong Kong Chinese women. International Urogynecology Journal. 2006; 17(6): 593-7.##Dooley Y, Kenton K, Cao G, Luke A, DurazoArvizu R, Kramer H, et al. Urinary incontinence prevalence: results from the national health and nutrition examination survey. The Journal of Urology.2008; 179(2): 656-61.##Botlero R, Davis SR, Urquhart DM, Shortreed S, Bell RJ. Age-specific prevalence of, and factors associated with, different types of urinary incontinence in community-dwelling Australian women assessed with a validated questionnaire. Maturitas. 2009; 62(2): 134-9.## Lasserre A, Pelat C, Guéroult V, Hanslik T, Chartier-Kastler E, Blanchon T, et al. Urinary incontinence in French women: prevalence, risk factors, and impact on quality of life. European Urology. 2009; 56(1): 177-83.##Zhu L, Li L, Lang J, Xu T, Wong F. Epidemiology of mixed urinary incontinence in China. International Journal of Gynecology and Obstetrics. 2010; 109(1): 55-8.## Schumacher S. Epidemiology and etiology of urinary incontinence in the elderly. Journal Der Urologe. 2007; 46(4): 357-62.## Nojomi M, Amin E, Bashiri Rad R. Urinary incontinence: hospital-based prevalence and risk factors. Journal of Research in Medical Sciences. 2008.13 (1): 22-8. [Persian]## Khazali S, Hillard T. The postmenopausal bladder. Obstetrics, Gynaecology and Reproductive medicine. 2009; 19(6): 147-51.## Bartoli S, Aguzzi G, Tarricone R. Impact on quality of life of urinary incontinence and overactive bladder: a systematic literature review. Urology.2010; 75(3): 491-500.## Lincoln Y. S, Guba E. G. Naturalistic inquiry, Sage Publications, Inc.1985## Cohen M. Z, Kahn D. L, Steeves R. Hermeneutic phenomenological research: A practical guide for nurse researchers, Sage Publications, Inc. 2000##Zeznock DE, Gilje FL, Bradway C. Living with urinary incontinence: experiences of women from „the last frontier‟. Urologic Nursing. 2009; 29(3): 157-63.## Bradway C.W, Barg F .Developing a cultural model for long-term female urinary incontinence. Social Science & Medicine. 2006; 63(12): 3150-61.## Horrocks S, Somerset M, Stoddart H, Peters TJ. What prevents older people from seeking treatment for urinary incontinence? A qualitative exploration of barriers to the use of community continence services. Family Practice. 2004; 21(6): 689-9.## ##

Sleep Quality among Older Adults in Mehriz, Yazd Province, Iran 2 2 Introduction: Decrease in sleep quality is an age-related problem which appears in different features such as difficulty in sleeping, over sleeping and unusual behaviors during sleep. Regarding the importance of sleep quality among older adults and also its effects on their quality of life and physical and mental status, the study was conducted to determine the status and quality of sleep in older adults in Mehriz, Yazd province, Iran. Methods: The cross-sectional study used cluster random sample of 126 older adults. Data collection tool was a two-part questionnaire including demographic and sleep-related questions and Pittsburgh Sleep Quality Index. Data were analyzed with SPSS software using one-way ANOVA and chi-square tests. Results: The most reported sleep quality related problems were pain (32.8%), waking up for toilet (28.6%) and nightmare (3.2%); waking up problem for driving was the least reported problem (0.8%). Sleep quality was worse among women than men (p = 0.02). There was a statistically significant relation between sleep quality score and morbidity to thedisease of cardiovascular, diabetes, osteoporosis, breathing problems, visual and hearing problems, obesity and depression (p < 0.05). Conclusion: Regarding the significant relation of sleep quality and some chronic conditions, the importance of educatingthe older adults who suffer from chronic conditions and also their families in this area is displayed. As with planning suitable interventions, we may not only increase the sleep quality among older adults but also treat or reduce the risk of chronic conditions among them. 5 11 2015/06/12015/01/222015/02/2 1393/11/13 2015/06/12015/03/252015/04/15 1394/1/26 Hassan Rezaeipandari Hassan Rezaeipandari Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of medical sciences, Yazd, Iran Iran Mohammad Ali Morowatisharifabad Mohammad Ali Morowatisharifabad Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of medical sciences, Yazd, Iran Iran morowatisharif@yahoo.com Seyed Jamal Hashemi Seyed Jamal Hashemi Department of Health Services, School of Public Health, Shahid Sadoughi University of medical sciences, Yazd, Iran Iran Vali Bahrevar Vali Bahrevar Department of Health Services, School of Public Health, Shahid Sadoughi University of medical sciences, Yazd, Iran Iran Aging Iran Sleep adults Wolkove N, Elkholy O, Baltzan M, Palayew M. Sleep and aging: 1. Sleep disorders commonly found in older people. Canadian Medical Association Journal. 2007; 176(9): 1299–304.## Ferris LT, Williams JS, Shen CL, O'Keefe KA, Hale KB. Resistance training improves sleep quality in older adults. Journal of sports science & medicine. 2005; 4(3): 354-60.##Ohayon MM. Epidemiology of insomnia: What we know and what we still need to learn. Sleep Medicine Reviews. 2002; 6(2): 97–111.## Juergens TM, Barczi SR. Sleep. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007.## Mahowald MW. Disorders of sleep. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.## Neikrug AB, Ancoli-Israel S. Sleep disorders in the older adult - a mini-review. Gerontology. 2010; 56(2): 181-9.##Ford DE, Kamerow DB. Epidemiologic study of sleep disturbance and psychiatric disorders. An opportunity for prevention? Journal of the American Medical Association. 1989; 262(11): 1479–84.## Moosavi F, Golestan B, Matini E, Tabatabaei R. Prevalence of sleep disorders and related factors among medical students Islamic Azad University of Tehran. Medical Science Journal of Islamic Azad University. 2010; 20(4): 278-84. [Persian]##Drake CL, Roehrs T, Roth T. Insomnia, causes, consequences and therapeutics: an overview. Depression and Anxiety. 2003; 18(4): 163-76## Krishnan P, Hawranik P. Diagnosis and management of geriatric insomnia (guide for nurse practitioner). Journal of American Academy of Nurse Practitioners. 2008; 20(12): 590-9##Kryger M, Monjan A, Bliwise D, Ancoli-Israel S. Sleep, health, and aging. Bridging the gap between science and clinical practice. Geriatrics. 2004; 5(1): 17-22.## Neubauer D. Sleep problems in the elderly. American Academy of Family. Physicians. 1999; 59(9): 2551-58.## Garcia AD. The effect of chronic disorders on sleep in the elderly. Clinics in Geriatric Medicine. 2008; 24(1): 27-38## Ito Y, Tamakoshi A, Yamaki K, Wakai K, Kawamura T, Takagi K, et al. Sleep disturbance and its correlates among elderly Japanese. Archives of Gerontology and Geriatrics. 2000; 30(2): 85-100.## Foley D, Ancoli -Israel S.A, Britz P, Walsh J. Sleep disturbances and chronic disease in older adults. Results of the 2003 National Sleep Foundation Sleep in America Survey. Journal of Psychosomatic Research. 2004; 56 (5): 497–502## Nobahar M, Vafaaee A. Elderly sleep disturbances and management. Iranian Journal of Aging. 2007; 2(4): 263-68. [Persian]## Cotroneo A, Gareri P, Lacava R, Cabodi S. Use of zolpidem in over 75-year-old patients with sleep disorders and co morbidities. Archives of Gerontology and Geriatrics. 2004 ;( 9): 93-6.## Adib-Hajbaghery M, Izadi-Avanji F, Akbari H. Quality of sleep and its related risk factors in hospitalized older patients in Kashan's Hospitals, Iran 2009. Iranian Journal of Nursing and Midwifery Research. 2012; 17 (6): 414-20.## Foley DJ, Monjan A, Simonsick EM, Wallace RB, Blazer DG. Incidence and remission of insomnia among elderly adults. An epidemiologic study of 6,800 persons over three years. Sleep. 1999; 1(22): 366-72.## Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research. 1989;28(2): 193– 213.## Monk TH, Buysse DJ, Schlarb Je, Beach Sr. Timing, duration and quality of sleep and level of daytime sleepiness in 1166 retired seniors. Healthy Aging & Clinical Care in the Elderly. 2012: 433–40## Li J, Yao Y.S, Dong Q, Dong Y, Liu J, Yang L.S, et al. Characterization and factors associated with sleep quality among rural elderly in China. Archives of Gerontology and Geriatrics. 2013; 56(1): 237-43.##Hosseinabadi R, Noroozi K, Poorismaili Z, Karimloo M, Maddah S.S. Acupoint massage in improving sleep quality of older adults. Rehabilitation 2008; 9(2): 8-14. [Persian]## Abbasi B, Kimiagar M, Sadeghniiat K, Shirazi MM, Hedayati M, Rashidkhani B. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. Journal of Research in Medical Sciences. 2012; 7(12):1161-9.##Ahmadi Sh, Khankeh H, Mohammadi F, FalahiKhoshknab M, Rezasoltani P. The effectiveness of treatment with limiting on sleep quality in elderly. Iranian Journal of Aging. 2010; 5(2): 7-15. [Persian]##Bazargan M. Self-reported sleep disturbance among African-American elderly: the effects of depression, health status, exercise, and social support. International Journal of Aging & Human Development. 1996; 42(2): 143-60.## Chiu HF, Leung T, Lam LC, Wing YK, Chung DW, Li SW, et al. Sleep problems in Chinese elderly in Hong Kong. Sleep. 1999; 22(6): 717-26.##Lauri S, Lepistö M, Kappeli S. Patients' needs in hospital: nurses' patients' views. Journal of Advanced Nursing. 1997; 25(2): 339-46.## Tribl GG, Schmeiser-Rieder A, Rosenberger A, Saletu B, Bolitschek J, Kapfhammer G, et al. Sleeping habits in the Austrian population. Sleep Medicine. 2002; 3(1): 21- 8.## Ohayon M. Epidemiological study on insomnia in the general population. Sleep. 1996; 19(3): 7-15.## Rodin J, Mcavay G, Timko CH. A longitudinal study of depressed mood and sleep disturbances in elderly adults. Journal of Gerontology. 1988; 43(2): 45-53.## ##

Comparative Study of the Effect of Aerobic and Resistance Exercise on Static and Dynamic Balance in Elderly Males 2 2 Introduction: Stumbling or falling is a major health problem among the elderly which accounts for their majority of physical injuries such as pelvic fractures, disability, loss of independency and even death. The goal of the study was comparison of the effect of aerobic and resistance exercise on static and dynamic balance in old men. Methods: A quasi-experimental study was conducted and thirty elderly males, who were referred to Jahandidegan institute of Borujen, were divided randomly in three empirical groups subdividing aerobic, resistance and control group. 24 hours before the start of and 24 hours after completion of eight weeks -aerobic and resistance exercise, all participants went under static and dynamic balance examination. The results were analysed by SPSS software version 19. Results: Mean and standard deviation of dynamic balance scores before the exercise for the resistance, aerobic and control groups were 1017.6 ± 212.7, 930.5 ± 238.2, 1119.6 ± 287.3 and after eight weeks exercise were 851.7 ± 155.5, 743.4 ± 130.1, 1220.06 ± 226.9 respectively. On the other hand, Mean and standard deviation of static balance scores before the exercise in resistance, aerobic and control groups were 2280.3±2286.2, 3534.9±4455.4, 1284.1 ± 231.4 and after eight weeks exercise were 5563.4 ± 8014.6, 6089 ± 7888.4, 1297.1 ± 214.4 respectively. ANOVA test revealed that the difference in changes of three groups were not statistically significant (p > 0.05). Conclusion: Despite marginal correlation between static and dynamic balance as the outcomes of aerobic and resistant exercise these activities are proposed because such the exercises reduce incidence of falling events and related-injuries; and also risk of independency among older adults. 12 15 2015/06/12015/01/222015/02/22015/01/14 1393/10/24 2015/06/12015/03/252015/04/152015/03/15 1393/12/24 Mojgan Banihashemi Emamghisi Mojgan Banihashemi Emamghisi Department of Sport Sciences, Islamic Azad University, Khorasgan Branch, Isfahan, Iran. Iran Gholamreza Sharifi Gholamreza Sharifi Department of Sport Sciences, Islamic Azad University, Khorasgan Branch, Isfahan, Iran. Iran Iman Zakavi Iman Zakavi Department of Exercise Physiology, Abadan School of Medical Sciences, Khuzestan, Iran. Iran Alireza Babaei Mazreno Alireza Babaei Mazreno Department of Sport Sciences, Islamic Azad University, Khorasgan Branch, Isfahan, Iran. Iran alireza.babaei.m@gmail.com Aerobic Aging Balance Exercise Resistant. Liu-Ambrose T, Khan K, Janice J, Lord SR, McKay HA. Balance confidence improves with resistance or agility training: increase is not correlated with objective changes in fall risk and physical abilities. Gerontology. 2012;50(6): 373– 82.## Rosendahl E. Fall prediction and a high-intensity functional exercise programme to improve physical functions and to prevent falls among older people living in residential care facilities [PhD thesis]. Umeå University; 2006. ## Sadeghi H, Norouzi HR, Karimi Asl A, Montazer MR. Functional training program effect on static and dynamic balance in male able-bodied elderly. Iranian Journal of Ageing. 2009; 3(2): 565-71. [Persian]## Erickson KI1, Miller DL, Roecklein KA. The aging hippocampus: interactions between exercise, depression, and BDNF. The Neuroscientist. 2012; 18(1): 82-97.## Pang TY, Hannan AJ. Enhancement of cognitive function in models of brain disease through environmental enrichment and physical activity. Neuropharmacology. 2013; 64: 515-28.## Bagheri H, Abdolvahab M, Raji P, Jalili M, Faghihzadeh S, Soltani Z. The effects of progressive resistive exercises on activities of daily living of elderly persons. Modern Rehabilitation. 2010; 4(1): 56-60. [Persian]##Barnett A, Smith B, Lord SR, Williams M, Baumand A. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomized controlled trial. Age and Aging. 2003; 32(4): 407-14.##BerchTold N.C, Chinn G. Chou M, Kesslak J.P, Cotman C.W. Exercise primes a molecular memory for brain-derived neurotrophic factor protein induction in the rat Hippocampus. Neuroscience. 2005; 133: 853-61.##Cadore EL1, Pinto RS, Lhullier FL, Correa CS, Alberton CL, Pinto SS, et al. Physiological effects of concurrent training in elderly men. International Journal of Sports Medicine. 2010; 31(10): 689-97.##Bruin ED, Murer K. Effect of additional functional exercises on balance in elderly people. Clinical Rehabilitation. 2007; 21(2): 112-21.## Manini T, Marko M, VanArnam T, Cook S, Fernhall B, Burke J. Efficacy of resistance and task-specific exercise in older adults who modify tasks of everyday life. The Journal of Gerontology. 2007; 62(6): 616-23.## Cromwell RL, Meyers PM, Meyers PE, Newton RA. Tae kwon do: an effective exercise for improving balance and walking ability in older adults. The Journal of Gerontology. 2007; 62(6): 641-46.## Katula JA, Rejeski WJ, Marsh AP. Enhancing quality of life in older adults: A comparison of muscular strength and power training. Health Quality Life Outcomes. 2008; 6: 45.##Ghasemi B, AzamianJazi A, Nouri P. Effect of 12 week performance exercise on dynamic balance of healthy elderly women. Iranian Journal of Ageing. 2009; 5(18): 30-6. [Persian]## Perrin PP, Gauchard G.C, Perrot C, Jeandel C. Effects of physical and sporting activities on balance control in elderly people. British Journal of Sports Medicine. 1999; 33(2): 121-26.## Thompson C.J, Cobb K.M, Blackwell J. Functional training improves club head speed and functional fitness in older golfers. Journal of Strength & Conditioning Research. 2007; 21(1): 131-37.## ##

Nutritional Status and Related Factors in Elderly Nursing Home Residents 2 2 Introduction: A challenge for health care providers is that there will be a distinct rise globally in the number of elderly people aged 80 years and over. Malnutrition is a well-known problem among elderly people. The aim of this study was to determine nutritional status and its associated risk factors in elderly nursing home residents in Tehran, Iran.  Methods: The cross-sectional study was carried out among 385 elderly people aged 60 years or elder in 2014. All subjects who were attending to daily care centers for elderly people entered the study voluntarily. Mini Nutritional Assessment (MNA) tool was used to evaluate nutritional status. Results: Of participants, 13.25% were malnourished according to MNA, 60% were at risk for malnutrition, and 26.75% were well fed. In other words, 73.25% of elderly people were at risk of or suffering from Malnutrition. Nutritional status of the elderly based on MNA, was significantly associated with history of acute illness or stress, recent mobility problems, nervous mental depression, personal views about nutrition and health status. Conclusion: Considering the high percentage of elderly people eat risk or suffering from malnutrition in nursing homes, the need for nutritional interventions seems to be crucial. 16 21 2015/06/12015/01/222015/02/22015/01/142015/02/25 1393/12/6 2015/06/12015/03/252015/04/152015/03/152015/04/29 1394/2/9 Zahra Bostani Khalesi Zahra Bostani Khalesi Faculty Member of Guilan University of Medical Science, Rasht, Iran Iran Mahshid Bokaie Mahshid Bokaie Faculty Member of Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mah_bokaie@yahoo.com Malnutrition Nutritional Status Older Adults WHO. International plan of action on ageing: report on implementation; 115th Session; 2004. Available from: http://apps.who.int/gb/archive/pdf_files /EB115/B115_29-en.pdf. Accessed at 17 Jul 2014.## Ribeiro RSV, Rosa MI, Bozzetti MC. Malnutrition and associated variables in an elderly population of Criciúma, SC. Revista Da Associação Médica Brasileira. 2011; 57(1): 56-61.##Raynaud-Simon A, Revel-Delhom C, Hebuterne X. Clinical practice guidelines from the French health high authority: nutritional support strategy in protein-energy malnutrition in the elderly. Clinical Nutrition. 2011; 30(3): 312-9.## Karmakar PS, Pal J, Maitra S, Ghosh A, Sarkar N, Das T, et al. Prevalence of malnutrition and its correlation with various diseases in elderly patients in a tertiary care centre in eastern India. Journal of the Indian Medical Association. 2010; 108(11): 754-6.## Vellas B, Villars H, Abellan G, Soto ME, Rolland Y, Guigoz Y, et al. Overview of the MNA--Its history and challenges. The Journal of Nutrition, Health & Aging.2006; 10(6): 456-63.## Saikia AM, Mahanta N. A Study of nutritional status of elderly in terms of body mass index in urban Slums of Guwahati city. Journal of the Indian Academy of Geriatrics. 2013; 9: 11-14.## Vedantam A, Subramaniam V, Rao NV, John KR. Malnutrition in free living elderly in rural South India: Prevalence and risk factors. Public Health Nutrition. 2010; 13(9): 1328-32.## Samnieng P, Ueno M, Shinada K, Zaitsu T, Wright F, Kawaguchi Y. Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai. Community Dental Health. 2012; 29(1): 117-23.## Lahiri S, Biswas A, Santra S, Lahiri SK. Assessment of nutritional status among elderly population in a rural area of West Bengal, India. International Journal. 2015; 4(4): 569.##Boulos C, Salameh P, Barberger-Gateau P. The AMEL study, a cross sectional population-based survey on aging and malnutrition in 1200 elderly Lebanese living in rural settings: Protocol and sample characteristics. BMC Public Health. 2013 12; 13: 573##Russell CA, Elia M. Nutrition screening survey in the UK in 2007: Nutrition screening survey and audit of adults on admission to hospitals, care homes and mental health units. British Association for Parenteral and Enteral Nutrition; 2008.## Saletti A, Lindgren EY, Johansson L, Cederholm T. Nutritional status according to mini nutritional assessment in an institutionalized elderly population in Sweden. Gerontology. 2000, 46(3): 139-45.## Aliabadi M, Kimiagar M, Ghayour-Mobarhan M, Shakeri MT, Nematy M, Ilaty AA, et al. Prevalence of malnutrition in free living elderly people in Iran: a cross-sectional study. Asia Pacific Journal of Clinical Nutrition. 2008; 17(2): 285-9.## Afkhami A, Keshavarz S.A, Rahimi A, Jazayeri S.A, Sadrzadeh H. Nutritional status and associated non-dietary factors in the elderly living in nursing homes of Tehran and Shemiranat, 2004. Journal of the Iranian Institute for Health Sciences Research. 2008; 7(3): 211-17. [Persian]## Abbaspour N, Wegmueller R, Kelishadi R, Schulin R, Hurrell RF. Zinc status as compared to zinc intake and iron status: a case study of Iranian populations from Isfahan province. International Journal for Vitamin and Nutrition Research. 2013; 83(6): 335-45.## Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The mini nutritional assessment. Clinics in Geriatric Medicine. 2002; 18(4): 737-57.##Guigoz Y. The mini nutritional assessment (MNA) review of the literature. What does it tell us? The Journal of Nutrition, Health & Aging. 2006; 10(6): 485-87##Gazzotti C, Albert A, Pepinster A, Petermons J. Clinical usefulness of the mini nutritional assessment (MNA) scale in geriatric medicine. Journal of Nutritional Health of Aging. 2000; 4(3): 176-81.## Gariballa S. Nutrition and older people: special considerations relating to nutrition and ageing. Clinical medicine. Journal of the Royal College of Physicians of London. 2004; 4(5): 411-4.## Rolland Y, Perrin A, Gardette V, Filhol N, Vellas B. Screening older people at risk of malnutrition or malnourished using the simplified nutritional appetite questionnaire (SNAQ): a comparison with the mini nutritional assessment (MNA) tool. Journal of the American Medical Directors Association. 2012; 13(1): 31-4.##Ulger Z, Halil M, Kalan I, Yavuj B, Cankurtaran M, Güngör E, et al. Comprehensive assessment of malnutrition risk and related factors in a large group of community-dwelling older adults. Clinical nutrition. Official Journal of the European Society of Parenteral and Enteral. 2010; 29(4): 507-11.## Saha S, Basu A, Ghosh S, Saha AK, Banerjee U. Assessment of nutritional risk and its associated factors among elderly women of old age homes of south Suburban Kolkata, West Bengal, India. Journal of Clinical and Diagnostic Research. 2014; 8(2): 118.## Cuervo M, Garcia A, Ansorena D, SanchezVillegas A, Gonzalez M, Astiasaran I, et al. Nutritional assessment interpretation on 2207 Spanish community-dwelling elders through the Mini Nutritional Assessment test. Public Health Nutrition. 2009; 12(1): 82-90.##Timpini A, Facchi E, Cossi S, Ghisla MK, Romanelli G, Marengoni A. Self-reported socioeconomic status, social, physical and leisure activities and risk for malnutrition in late life: a cross-sectional population-based study. The Journal of Nutrition, Health & Aging. 2011; 15(3): 233-8.##Saka B, Kaya O, Ozturk GB, Erten N, Karan MA. Malnutrition in the elderly and its relationship with other geriatric syndromes. Clinical Nutrition. Official Journal of the European Society of Parenteral and Enteral. 2010; 29(6): 745-8.## ##

Home Visit Services Provided for Elderly Dwellers in Isfahan Province: A Cross-Sectional Study 2 2 Introduction: As the elderly population increases, chronic diseases and disabilities also become more prevalent. Home care programs as hospital services supplement, not only can prevent elderly from get worse in their disabilities but also make it easier for governments to manage elderly people's needs; therefore, we aimed to determine the home visit services provided for elderly residing in Isfahan province, Iran. Methods: The cross-sectional study was conducted on 100 elderly persons aged 60 years and above who were randomly selected from the list of the aged people which took services from seven home visit service centers. Data were analyzed through descriptive statistics. Results: Mean ± standard deviation age of the participants was 76 ± 8.8 years and about 70% were illiterate. Only about 56% of included participants were able to care themselves. A large number (56.3%) of participants' income source was personal and 5.7% were did not have any insurance at all. The costs of 93.5% of services were provided by the welfare organization. The services provided at these centers include general physician visits, nursing cares, physiotherapy and occupational therapy services, psychologist and social worker visits. Conclusion: As the home visit services might be effective for providing health care for the aged people and increasing their quality of life, policymaking to spread these services seems to be crucial especially for Iran.  22 26 2015/06/12015/01/222015/02/22015/01/142015/02/252015/03/1 1393/12/10 2015/06/12015/03/252015/04/152015/03/152015/04/292015/04/30 1394/2/10 Zamane Vafaei Zamane Vafaei Vice Chancellor for Health, Isfahan University of Medical Sciences, Isfahan, Iran Iran Zahra Sadooghi Zahra Sadooghi Vice Chancellor for Health, Isfahan University of Medical Sciences, Isfahan, Iran Iran Hamidreza Mokhtari Hamidreza Mokhtari Department of Material Engineering, Isfahan University of Technology, Isfahan, Iran Iran Nasrin Mokhtari Nasrin Mokhtari Department of Dentistry, Khorasgan University of Dentistry Sciences, Isfahan, Iran Iran Mina Moeini Mina Moeini Vice Chancellor for Health, Isfahan University of Medical Sciences, Isfahan, Iran Iran Drm_Moini@yahoo.com Aging Home Care Services Isfahan Khoshbin S, Eshrati B, Aziz Abadifarahani A, Ghosi A, Motlagh MM. The report reviews the status of the elderly. Tehran: Ministry of Health and Medical Education; 2002.## Koshbin S, Radpoian L, Aziz Abadifarahani A, Alizadeh M. Integrated geriatric care and comprehensive training manual. Tehran: Ministry of Health and Medical Education; 2009.## WHO. Integrating poverty and gender in to health programmes. Module on Ageing; 2006.Available from: www.wpro.who.int. Accessed at 21 Apr 2014.## WHO. Gender, Health and Ageing. 2003. Available from: www.who.int. Accessed at 21 Apr 2014. ## WalJennifer D. Potentially avoidable hospitalization in institutionalized older person [PhD thesis]. University of Calgary, Canada, 2006.## Kehusmaa S, Autti-Rämö I, Valaste M, Hinkka K, Rissanen P. Economic evaluation of a geriatric rehabilitation programme: A randomized controlledtrial. Journal of Rehabilitation Medicine. 2010; 42(10): 949-55.## Kemper P. The use of formal and informal home care by disabled elderly. Health Services Research. 1992; 27(4): 421-51.## Ramos ML, Ferraz MB, Sesso R. Critical appraisal of published economic evaluations of home care for the elderly. Archives of Gerontology and Geriatrics. 2004; 39(3): 255-67.## Livadiotakis G. Impact of continuing care reforms to home support service on former senior clients: A Regional Assessment [MSc thesis]. University of Simon Fraser, United States, 2001.## Kato G, Tamiya N, Kashiwogi M, Sato M, Takahashi H. Relationship between home care service use and changes in the care needs level of Japanese elderly. BMC Geriatrics. 2009; 9: 58.## Carriere G. Seniors use of home care. Health Reports. 2006; 17(4): 43-7.##Johnson-Crockett MA, Barber JB Jr. Quality care issues in home care services for the minority elderly. Journal of National Medical Association. 1990; 82(7): 522-26.## Ackermann RJ, Kemle KA, Vogel RL, Griffin RC. Emergency department use by nursing home residents. Annals of Emergency Medicine. 1998; 31(6): 749-57.##McDermott R, Gillespie SM, Nelson D, Newman C, Shah MN. Characteristics and acute care use patterns of patients in a senior living community medical practice. Journal of the American Medical Directors Association. 2012; 13(3): 260-3.## Branch LG, Wetle TT, Scherr PA, Cook NR, Evans DA, Hebert LE, et al. A prospective study of incident comprehensive medical home care use among the elderly. The American Journal of Public Health. 1988; 78(3): 255-9.## Ada C, Denise B. Long-term care service use by frail elders: in ethnicity a factor? The Gerontologist. 1994; 34(2): 190-8.## Martikainen P, Murphy M, Metsa-Simola N, Häkkinen U, Moustgaard H. Seven-year hospital and nursing home care use according to age and proximity to death: variation by cause of death and socio-demographic position. Journal of Epidemiology& Community Health. 2012; 66(12): 1152-8.## Baur C. Improving health literacy for older adults: expert panel report 2009. Department of Health and Human Services; 2009.p. 1-4.## Artaud F, Dugravot A, Sabia S, Singh-Manoux A, Tzourio C, Elbaz A. Unhealthy behaviors and disability in older adults: Three-City Dijon cohort study. British Medical Journal. 2013; 347: 1-15.## WHO. Financing long-term care programmes in health systems with a situation assessment in selected high, middle and low-income countries. 2007. P 6. HSS /HSF Discussion. Available from: www.wpro.who. int. Accessed at 11 Apr 2014.## Sundsli K, Soderhamn U, Espnes GA, Söderhamn O. Ability for self-care in urban living older people in southern Norway. Journal of Multidisciplinary Healthcare. 2012; 5: 85-95.## Marjorie H, Cantor MA. Family and community: Changing roles in an aging society. The Gerontological Society of America 1991; 31(3): 337-46.## ##

Prevalence of Urinary Incontinence among Elderly Women in Yazd, Iran: A Population-Based Study 2 2 Introduction: Urinary incontinence (UI) is a common disorder among aging population especially women. Women are at more risk of UI than men, because of anatomic, social and cultural status and also because of pregnancy, delivery and menopause. Regarding lack of studies in the area in Yazd, the study aimed to find the prevalence and related factors to UI among aging women in Yazd city, Iran. Methods: The cross-sectional study carried out on 127 women aged ≥60 years in Yazd city, in central Iran, who was selected by clustered random sampling. Data were collected with the Persian version of International Consultation on Incontinence Questionnaire-Short Form and were analyzed with descriptive and inferential tests using SPSS software. Results: The mean age of participants was 70.17 ± 6.50. The prevalence of UI was 62.2% while the prevalence of urge UI was 5.5%, stress UI was 39.4% and mixed UI was 3.1%. There was statistically significant relation between UI severity and history of diabetes (p < 0.01), glaucoma (p < 0.01), fecal incontinence (p < 0.01), menopause (p < 0.01) and pain in low abdomen (p = 0.02). Also there was a significant positive correlation between UI severity and women's age and weight. Conclusion: Regarding the high prevalence of UI, especially stress UI and it's relation with some diseases such as diabetes and obesity, any intervention programs aimed to increase the healthy life style among women may be effective in management of UI. 27 31 2015/06/12015/01/222015/02/22015/01/142015/02/252015/03/12015/01/22 1393/11/2 2015/06/12015/03/252015/04/152015/03/152015/04/292015/04/302015/03/28 1394/1/8 Mohammad Ali Morowatisharifabad Mohammad Ali Morowatisharifabad Iran Hassan Rezaeipandari Hassan Rezaeipandari Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran hrezaeipandari@yahoo.com Aghdas Mazyaki Aghdas Mazyaki Department of Health Services, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran Zeinab Bandak Zeinab Bandak Department of Health Services, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran Aging Iran Prevalence Urinary Incontinence Women Clark PG. Quality of life values and team work in geriatrics care: Do we communicate what we mean. Gerontologists Washington. 1995; 35(3): 402-11.## Tashakori M, Moghimi A, Pilevarian A, Moghimian M. Study of severity and prevalence of stress incontinent in menopausal working women in Khorasan. Iranian Journal of Obstetrics Gynecology and Infertility. 2006; 9(2): 47-52. [Persian]## Dehghan Manshadi F, Ghanbari Z, Jabbari Z, Sadat Miri E. Urinary incontinence and its related disorders and risk factors in women. Scientific Journal of School of Public Health and Institute of Public Health Research. 2013; 11(2): 53-64. [Persian]## Landi F, Cesari M, Russo A, Onder G, Lattanzio F, Bernabei R, et al. Potentially reversible risk factors and urinary incontinence in frail older people living in the community. Age and Ageing. 2003; 32(2): 194-9.## Kuchel G, DuBeau C. Urinary incontinence in the elderly. American Society of Nephrology. University of Connecticut Health Center.2009. Available from: https://www.asn online.org /education / distance learning / curricula /geriatrics /Chapter 30.pdf. Accessed at 24 Dec 2014.##Bortolotti A, Bernardini B, Colli E, Benedetto P, GiocoliNacci G, Landoni M, et al. Prevalence and risk factors for urinary incontinence in Italy. European Urology. 2000; 37(1): 481-2##Riazi H, Bashirian S, Ghelichkhani S. Obstetric role in the development of urinary incontinence in women referred to health centers in Hamedan. Journal of Babol University of Medical Sciences. 2006; 8 (5): 40-5. [Persian]## Bakouei F, Bakouei S. Study of the prevalence and some of the risk factors of postpartum urinary incontinence in women admitted to healthtreatment centers in Babol, Iran in 2005. Quarterly Journal of Sabzevar University of Medical Sciences. 2006; 13(3): 152-7. [Persian]## Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourology and Urodynamics. 2004; 23 (4): 322–30.## Hajebrahimi S, Nourizadeh D, Hamedani R, Pezeshki MZ. Validity and reliability of the international consultation on incontinence questionnaire-urinary incontinence short form and its correlation with urodynamic findings. Urology Journal.2012; 9(4): 685-90.## Rafii F, Shareinia H, Seyedalshohahadaee M, Sarraf P, Mahmoodi F. The effect of pelvic floor muscle exercise training on urinary incontinence in patients with multiple sclerosis. Iran Journal of Nursing. 2014; 27(87): 43-54. [Persian]## Hunskaar S, Lose G, Sykes D, Voss S. The prevalence of urinary incontinence in women in four European countries. British Journal of Urology. 2004; 93(3): 324-30## Holtedahl K, Hunskaar S. Prevalence, 1-year incidence and factors associated with urinary incontinence: a population based study of women 50–74 years of age in primary care. European Menopause Journal. 1998; 28 (3) : 205–11## Anger JT, Saigal CS, Litwin MS. The prevalence of urinary incontinence among community dwelling adult women: results from the national health and nutrition examination survey. American urological Association. 2006; 175(2): 601-4.## Hannestad Y.S, Rortveit G, Sandvik H, Hunskaar S. A community-based epidemiological survey of female urinary incontinence: The Norwegian EPINCONT Study. Journal of Clinical Epidemiology. 2000; 53 (11): 1150–57## Pakgohar M, Sabetghadam SH, Vaseg Rahimparvar F, Kazemnejad A. Quality of life in postmenopausal women with urinary incontinence: a cross sectional study. Payesh. 2014; 13(1): 73- 81. [Persian]## Taimoori B, Roudbari M. The prevalence of symptoms of pelvic floor disorders in women that referred to the clinic of gynecology in Ali-ebn Abitaleb Hospital, Zahedan, Iran Tabibehsargh. 2006;8(3): 203-10. [Persian]## Sartore A, Pregazzi R, Bortoli P, Grimaldi E, Ricci G, Guaschino S. Effects of epidural analgesia during labor on pelvic floor function after vaginal delivery. Acta Obstetrician Et Gynecologica Scandinavica. 2003; 82(2): 143 – 6.## Eva UF, Gun W, Preben K. Prevalence of urinary and fecal incontinence and symptoms of genital prolapsed in women. Acta Obstetrician Et Gynecologica Scandinavica. 2003; 82(3): 280–6.##Renfrew MJ, Hannah W, Albers L, Floyd E. Practices that minimize trauma to the genital tract in childbirth: a systematic review of the literature. Birth and the Family Journal. 1998; 25(3): 143–60.## ##

Validity and Reliability of the Functional Assessment of Chronic Illness Treatment Fatigue scale in a Persian-Speaking Aging Population 2 2 Introduction: Now a day, resulting from life style modification and alteration, fatigue, as a consequence, is not uncommon symptom. Diverse tools are available to measure fatigue status. One of which is Functional Assessment of Chronic Illness Treatment (FACIT) fatigue scale. The FACIT is one of the most widely used questionnaires for screening fatigue. The questionnaire has been translated and validated? Into 45 different languages, but there is not Persian version. The aim of the study was to test validity and reliability of Persian version of this scale amongst the elderly population of Yazd, a city in Iran. Methods: The scale was translated into Persian by using standard method of backward-forward. Then a prospective cross-sectional study was defined thereby 150 elderly people, who were selected by a classified cluster random sampling, filled in the Persian FACIT (P-FACIT) Content validity index, test- retest of 20 people and calculating Cronbach’s alpha by SPSS 20 were used to investigate content validity and reliability, respectively. Results: Content validity index of the Persian version was (0.96) and Cronbach’s alpha (0.891) approved its internal consistency. Also, intra-cluster correlation coefficient of questionnaire was upper than 0.7. Conclusion: The P-FACIT fatigue scale achieved acceptable validity and reliability to use as a scale for the elderly in Yazd. In addition, our result made the scale available as a tool for population-based study. 32 35 2015/06/12015/01/222015/02/22015/01/142015/02/252015/03/12015/01/222015/02/15 1393/11/26 2015/06/12015/03/252015/04/152015/03/152015/04/292015/04/302015/03/282015/04/17 1394/1/28 Saeed Ghaneh Ezzabadi Saeed Ghaneh Ezzabadi Department of Ergonomics, School of Public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran saeedghaneh@yahoo.com Zahra Maghsoudi Zahra Maghsoudi Geriatric Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran Alireza Beigomi Alireza Beigomi SABA Healthy Institute, Yazd, Iran. Iran FACIT Fatigue scale Reliability Translation Validity Berrios GE. Feelings of fatigue and psychopathology: A conceptual history. Comprehensive Psychiatry.1990; l31 (2): 140 –51.## Sharpe M. Cognitive behavior therapy for chronic fatigue syndrome: efficacy and implications. The American Journal of Medicine.1998; 105(3): 104- 9.## Williamson A, Lombardi DA, Folkard S, Stutts J, Courtney TK, Connor JL. The links between fatigue, safety and performance. Accident Analysis & Prevention. 2011; 43(20): 498–515.##Sukwon K, Cranor BD, Ryu YS. Fatigue: Working under the influence. In: the proceedings of the XXIst. Annual International Occupational Ergonomics and Safety Conference Dallas, Texas, USA, 2009.## Watt T, Groenvold M, Bjorner JB, Noerholm V, Rasmussen NA, Bech P. Fatigue in the Danish general population. Influence of sociodemographic factors and disease. Journal of Epidemiology and Community Health. 2000; 54(11): 827-33.## Job R, Dalziel J. Defining fatigue as a condition of the organism and distinguishing it from habituation, adaptation, and boredom. In: Hancock PA, Desmond PA. Stress, Workload, and Fatigue, USA; 2001. 466-75.## Hendrich HW. Ergonomics: An International Perspective. In: Waldemar K, Williams SM. Occupational Ergonomics: Principle of Work Design. 1st ed. Boca Raton: CRC press; 2003. P. 18-30.## Mitzner TL, Fisk AD, Rogers WA, Mayhorn CB. Ergonomics and aging. In: Marras WS, Karwowskji W. Fundamentals and assessment tools for occupational ergonomics. 2nd ed. Boca Raton: USA; CRC press; 2006. P. 17-1-17-3.## Fisk AD, Rogers WA, Charness N, Czaja SJ, Sharit J. Toward better design for older adults. In: Fisk AD and et al. designing for older adults: principles and creative human factors approaches. 1st ed. Boca Raton: USA; CRC press; 2005. P. 7-9.## Kathleen FT. Assessment of fatigue in older adults: the FACIT fatigue scale (version 4). Try this: Best practices in nursing, care for older adults: general assessment series.2011; 19(11): 1-2.## Chandran V, Bhella S, Schentag C, Gladman D. Functional assessment of chronic illness therapyfatigue scale is valid in patients with psoriatic arthritis. Annals of the Rheumatic Diseases. 2007; 66(7): 936-39.## Al-shair K, Muellerova H, Yorke J, Rennard S.I, Wouters E, et al. Examining fatigue in COPD: development, validity and reliability of a modified version of FACIT-F scale. Health and Quality of Life Outcomes. 2012; 10: 100.## Webster K, Cella D, Yost K. The functional assessment of chronic illness therapy (FACIT) measurement system: properties, applications and interpretation. Health and Quality of Life Outcomes. 2003; 1(79): 1-7.## Choobineh A, Ghaem H, Ahmadi Nejad P. Development of the Persian version of the job content questionnaire: assessment of job stress among hospital nurses of Shiraz city. In: Proceedings of the 1st International Conference on Ergonomics. Tehran, Iran; 2008.##Ebadi M, Harirchi A, Shariati M, Garmaroudi Gh, Fateh A, Montazeri A. Determining the validity of general health 12 items questionnaire (GHQ-12). Payesh. 2000: 1(3): 39-46 [Persian].##Harkness J, Schoua-Glusberg A. Questionnaires in Translation. ZUMA-Nachrichten Spezial.1998; 3: p. 87-126.## Rennie WH. The role of human resource management and the human resource professional in the new economy [MSc thesis]. University of Pretoria; 2003.## Wilna D. The development of a model that incorporates ethics in the recruitment and selection process [MSc thesis]. University of Pretoria; 2004.## Cella D, Yount S, Sorensen M, Chartash E, Sengupta N, Grober J. Validation of the functional assessment of chronic illness therapy fatigue scale relative to other instrumentation in patients with rheumatoid arthritis. The Journal of Rheumatology. 2005; 32(5): 811-9.## ##

Self-Care Activities and Behavioral Intention toward Self-Care in Older Adults Suffering from Knee Osteoarthritis in Yazd, Iran 2 2 Introduction: Elderly patients suffer disproportionally from a number of chronically painful conditions, with arthritis leading the list. Osteoarthritis (OA) is the most common joint disorder and the most prevalent cause of joint pain across the spectrum of middle age to elderly. Enhancing behavioral intention toward self-care for OA, previously known as proximal predictor of self-care, is one of the fundamental strategies to improve self-management. The purpose of this study was to investigate to what extent a correlation between behavioral intention and self-care attempts exists; and status of intention toward self-care and self-care behaviors among older adults who are suffering from OA in Yazd city, Iran. Methods: A cross-sectional study was conducted and 87 elderly subjects (mean age of 64.59 ± 3.72 year-old) referred to selected medical centers in Yazd were randomly included. The data collection instrument was a questionnaire designed for the study which includes demographic variables, behavioral intention, and self-care behaviors categories of items. Data were analyzed with SPSS18 using suitable statistical tests. Results: The mean score of behavioral intention and self-care behaviors was 44.71 ± 4.63 (range: 11-55) and 44.75 ± 5.84 (range: 12-60) respectively. The results revealed that intention to use cane and swimming were less prevalent, intention to use suitable shoes, however, was at the highest interest among patients. It was approximately the same about reported self-care behaviors. The results also showed a significant correlation between behavioral intention and self-care behaviors (p = 0.00). Conclusion: Despite demonstrably prevalent intention and self-care behaviors, there are varies self-care behaviors under-looked yet, such as swimming and using the cane, which need to be more closely addressed in educational programs. 36 41 2015/06/12015/01/222015/02/22015/01/142015/02/252015/03/12015/01/222015/02/152015/03/1 1393/12/10 2015/06/12015/03/252015/04/152015/03/152015/04/292015/04/302015/03/282015/04/172015/05/1 1394/2/11 Sakineh Gerayllo Sakineh Gerayllo Department of Health Education, School of Public Health, Golestan University of Medical Sciences, Golestan, Iran Iran Zohreh Karimiankakolaki Zohreh Karimiankakolaki Department of Health Education, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran Iran zohrehkarimian68@yahoo.com Intention Aging Osteoarthritis Self-Care Behaviors Keshtcarran Z, Ghodsbin F, Soloki S, Razghi M, Zare N. The impact of self-care education on quality of life of those clients suffering from osteoarthritis in rehabilitation centers of Shiraz university of medical science. Journal of Babol University of Medical Sciences. 2010; 12(1): 65- 70.[Persian]##Yeganeh A, Motaghi A, Moghimi J. Correlation of quantified MRI, physical exam and knee radiography in patients with knee osteoarthritis. Tehran University Medical journal. 2011; 69 (3): 185-90. [Persian]## Mehdinasab S, Haddad poor A, Sarrafan N, Dashtbozorg A, Ebrahimi M. Prevalence and evaluation of risk factors in primary knee osteoarthritis. Journal of Medical. 2009; 9(2): 1-7. [Persian]## Mehrabian H, Shojaedin SS, Barati AH, Ghasemi M. Effects of aquatic exercise on the pain, symptoms, motor performance and quality of life of elderly women with knee osteoarthritis Journal of Research in Rehabilitation Sciences. 2012; 8(2): 337-45. [Persian]## Turk DC, Cohen M. Sleep as a marker in the effective management of chronic osteoarthritis pain with opioid analgesics. Seminars in Arthritis and Rheumatism. 2010; 39(6): 477-90## Bahramian H, Heydarian K. Effects of orthoses in the treatment of pain in patients with osteoarthritis of the knee. Iranian Journal of Ageing. 2009; 4(14): 59-65. [Persian]##Loew L, Brosseau L, Wells G A,Tugwell P, Kenny G, Reid R, et al. Ottawa panel evidencebased clinical practice guidelines for aerobic walking programs in the management of osteoarthritis. Archives of Physical Medicine and Rehabilitation. 2012; 93(7): 1269-85. ##Ebadi A, Moosavi GHA, Bayat N, Zamani B. Assessment of the incidence of osteoarthritis and its risk factors in patients with Knee join pain referring to out patient departments of Kashan. Feyz Journal of Kashan University of Medical Sciences. 2004; 10(3): 34-9. [Persian]##Thompson LR, Boudreau R, Newman AB, Hannon MJ, Chu CR, Nevitt MC, et al. The association of osteoarthritis risk factors with localized, regional and diffuse knee pain. Osteoarthritis and Cartilage. 2010; 18(10): 1244-49.##Tel H, Hizmetli S, Tel H, Yildirim m. Osteoartitli yaslilardo ozbakim gucu ve yasam kalitesi. Turkish Journal of Geriatrics. 2011; 14(1): 63-7.## Allen KD, Bosworth HB, Brock DS, Chapman JG, Chatterjee R, Coffman C J, et al. Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials. BMC Musculoskeletal Disorders. 2012; 13(60): 1-12.## Mohammad H, Farahani B, Zohur A, Panahi Azar S. self-care of based on Orem's theory in patients with coronary heart disease. Iranian Journal of Critical Care Nursing. 2010; 3(2): 87-91. [Persian]##Shahriari M, Jalalvandi F, Yousefi H, Tavkol K, Saneei H. The effect of a self-care program on the quality of life of patients with permanent pacemaker. Iranian Journal of Medical Education. 2005; 5 (1): 45-52. [Persian]## Glanz K, Lewismarcus F. Health behavior and health education theory research and practice. [Shafiei F, trans]. Publications Laden; 1999.## Norman P, Conner M, Bell R. The theory of planned behavior and smoking cessation. Health Psychology. 1999; 18(1): 89-94.## Ajzen I. From intentions to actions: A theory of planned behavior. In: Kuhl J, Beckmann J, editors. Action control: From cognition to behavior. Berlin: Springe; 1985.##Norman P, Smith L. The theory of planned behavior and exercise: An investigation into the role of prior behavior, behavioral intentions and attitude variability. European Journal of Social Psychology. 1995; 25(4): 403-15.##Dehdari T, Kharghani Moghadam M, Mansouri T, Saki A. Study of daily fruit consumption status among girl students who are living in dormitories and its predictors based on the theory of planned behavior constructs. Razi Journal of Medical Sciences. 2013; 20(106): 10- 19. [Persian]## Mehri A, Sedighi Somea Koochak Z. Application and comparison of the theories of health belief model and planned behavior in determining the predictive factors associated with seat belt use among drivers in Sabzevar. Iranian Journal of Medical Education. 2012; 11(7): 807-18. [Persian]##Ajzen I, Fishbein M. Understanding attitudes and predicting social behaviour. Englewood Cliffs, NJ: Prentic Hall; 1980.## Milne S, Orbell S, Sheeran P. Combining motivation and volitional interventions to promote exercise participation: protection motivation theory and implementation intention. British Journal of Health Psychology. 2002;7(2): 163-84.## ##