Comparison of Knowledge and Attitude of Health Care Providers towards Aging Phenomenon in Yazd and Hamadan, Iran 2 2 Introduction: Health care providers play a central role as the main members of the health care service providers team for the elderly and their knowledge and attitudes towards the aging phenomenon can play an important role in the quality of health care services provision for the elderly. Therefore, the present study aims to comparatively investigate knowledge and attitude of health care providers about the aging phenomenon in comprehensive health centers of Yazd and Hamadan, Iran. Methods: The cross-sectional study conducted on 220 health care providers who were enrolled in the study from comprehensive health centers in Yazd and Hamadan by cluster sampling. The data were collected by a questionnaire including demographic information, Kogan's attitude towards old people scale, and Palmore Facts on Aging Quiz .Data were analyzed by SPSS using descriptive statistics, independent t-test, ANOVA, and Pearson correlation coefficient. Results: Mean score of knowledge about aging (range: 0-25) was 12.24 ± 2.43 in Yazd and 12.17 ± 2.51 in Hamadan. Mean score of attitude towards aging (range: 34-204) was 121.49 ± 10.53 in Yazd and 119.40 ± 11.21 in Hamadan. There was no statistically significant difference in knowledge (p = 0.828) and its three dimensions (misconceptions about aging, psychosocial status and physical condition), and attitude (p = 0.152) and its three levels (negative, neutral and positive attitude) between health care providers in Yazd and Hamadan. There was a significant, positive correlation between knowledge and attitude in both Yazd (p < 0.01, r = 0.656) and Hamadan (p < 0.01, r = 0.718). Conclusion: The knowledge of health care providers in both cities was moderate and had positive attitude towards aging. Considering the moderate knowledge of health care providers about the aging, effective steps can be taken to promote knowledge and improve the attitudes of health care providers by providing educational curricula on physical, psychological, social and spiritual health of the elderly people and holding in-service training programs. 65 71 2018/09/11 1397/6/20 2019/09/14 1398/6/23 Mohammad Ali Morowatisharifabad Mohammad Ali Morowatisharifabad Department of Ageing Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Amir Hossein Bahram Amir Hossein Bahram Department of Ageing Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran ah.bahram1368@gmail.com Reza Bidaki Reza Bidaki Research Center of Addiction and Behavioral Sciences, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Seyedeh Mahdieh Namayandeh Seyedeh Mahdieh Namayandeh Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Knowledge Attitude Aging Health Personnel Forooghan M, Amanian D, Hosseini MA. The effect of the training program about management of elders’ common problems on the level of job stress in caregivers of nursing homes. Journal of Research Development in Nursing and Midwifery. 2013; 10(2): 54-62. [Persian]##Gharanjik A, Mohammadi Shahbolaghi F, Ansari G, Najafi F, Ghaderi S, Ashrafi K, et al. The prevalence of depression in older Turkmen adults in 2010. Salmand Iranian Journal of Ageing. 2011; 6(3): 34-9. [Persian]##Fakhrzadeh H, Sharifi F. Cardiovascular diseases in the elderly. Journal of Gorgan University of Medical Sciences. 2012; 14(3):1-9. [Persian]##Adkins DM, Mayhew SL, Gavaza P, Rahman S. Pharmacy students’ attitudes toward geriatric nursing home patients. American Journal of Pharmaceutical Education. 2012; 76(5): 1-6.##Purfarzad Z, Ghamari zadre Z, Farmahini farahani M, Ghorbani M. Teachers and student nurses’ attitudes towards caring for older adults in Arak, 2012. Journal of Clinical Nursing and Midwifery. 2014; 3(2): 46-56. [Persian]##Mellor P, Chew D, Greenhill J. Nurses’attitudes toward elderly people and knowledge of gerontic care in a multi-purpose health service(MPHS). The Australian Journal of Advanced Nursing. 2007; 24(4): 37-41.##Rathnayake S, Athukorala Y, Siop S. Attitudes toward and willingness to work with older people among undergraduate nursing students in a public university in Sri Lanka: A cross sectional study. Nurse Education Today. 2016; 36: 439-44.##Asayesh H, Qorbani M, Parvaresh Masoud M, Rahmani Anarki H, Ansari H, Mansourian M, et al. General practitioner attitude toward elders: using Kogan's attitudes questionnaire. Iranian Journal of Diabetes and Metabolism. 2014; 13(6): 479-86. [Persian]##Ravanipour M, Dadaeen A, Jahanpour F, Husseini S. Measuring nurses' knowledge about the facts of aging period in educational hospitals of Bushehr in 2012 .Journal of Geriatric Nursing. 2015; 1(2): 55-67. [Persian]##Bleijenberg N. Dutch nursing students’ knowledge and attitudes towards older people- a longitudinal cohort study. Journal of Nursing Education and Practice. 2012; 2(2): 1-8.##Hanson RM. 'Is elderly care affected by nurse attitudes?' A systematic review. British Journal of Nursing. 2014; 23(4): 225-9.##Statistical Centre of Iran. Statistical Yearbook of the Islamic Republic of Iran 2016 [Internet]. Iran: Statistical Center of Iran: 2017. Available from: https://www.amar.org.ir/english/Iran-Statistical Yearbook/ Statistical-Yearbook-2016-2017##Askarzadeh mahany M, Arab M, Alizadeh M, Haghdust A. Nurses' knowledge about aging and attitudes toward older people. Iran Journal Of Nursing. 2008; 21(55): 19-27. [Persian]##Kogan N. Attitudes toward old people in an older sample. Journal of Abnormal and Social Psychology. 1961; 62(3): 616-22.##Erdemir F, Kav S, Citak E, Hanoglu Z, Karahan A. A Turkish version of Kogan’s attitude toward older people (KAOP) scale: reliability and validity assessment. Archives of Gerontology and Geriatrics. 2011; 52(3): 162-5.##Lambrinou E, Sourtzi P, Kalokerinou A, Lemonidou C. Attitudes and knowledge of the Greek nursing students towards older people. Nurse Education Today. 2009; 29(6): 617-22.##Ghorbani A, Karimzadeh T, Azadmanesh Y. Nutritional assessment in elderly hospitalized patients in Qazvin teaching hospitals in 2011. Salmand Iranian Journal of Ageing. 2013; 8(1): 33-40. [Persian]##Ryan A, Melby V, Mitchell L. An evaluation of the effectiveness of an educational and experimental intervention on nursing students’ attitudes towards older people. International Journal of Older People Nursing. 2007; 2(2): 93-101.##Reje N, Heravi-Karimooi M, Montazeri A, Foroughan M, Vaismoradi M. Psychometric properties of the Iranian version of the Kogan's Attitudes Toward Older People Scale. Japan Journal of Nursing Science. 2012; 9(2): 216-22.##Palmore E. Facts on aging: a short quiz. The Gerontologist. 1977; 17(4): 315-20.##Reje N, Heravi Karimooi M, Montazeri A, forooghan M. Psychometric of persion version questionnaire of knowledge about facts of aging(FAQI). Paiesh Journal. 2011; 2(11): 246-51. [Persian]##Liu Z, Pu L, Wang H, Hu X. Survey of attitude towards and understanding of the elderly amongst Chinese undergraduate medical students. Asian Biomedicine. 2014; 8(5): 615-22.##Forouzandeh S, Foroughan M, Hosseini MA, Farhadi A, Biglarian A. The relationship of nursing home caregivers’ awareness and attitude towards elderlies with their job. Journal of North Khorasan University of Medical Sciences. 2018; 9(3): 445-52. [Persian]##Tabiei Sh, Saadatjoo SA, Hoseinian SZ, Naseri MS, Eisanejad L, Ghotbi M, et al. Nurses` knowledge and attitude towards care delivery to the aged with cardiovascular diseases. Modern Care Journal (Scientific Quarterly of Birjand Nursing & Midwifery Faculty). 2010; 7(3): 41-7. [Persian]##Celik SS, Kapucu S, Tuna Z, Akkus A. Views and attitudes of nursing students towards ageing and older patients. Australian Journal of Advanced Nursing. 2010; 27(4): 24-30.##Boduroglu A, Yoon C, Luo T, Park DC. Age-related stereotypes: A comparison of American and Chinese cultures. Gerontology. 2006; 52(5): 324-33.## ##

Effect of a 6-Week Balance Training Program with Shuttle Balance on Balance, Gait Speed, and Fear of Falling in Elderlies 2 2 Introduction: Falls are considered as the major health problem in ageing and the damages caused by falls (such as fractures, disability, heavy costs on government and family, and death) are the major concern of the World Health Organization. So, determination of risk factors and specific ways to prevent falls in the elderlies are of great importance. The aim of this study was to evaluate the effect of a six-week shuttle balance exercises on balance, gait speed, and risk of falling in elderlies. Methods: This ranomised controlled trial study was conducted with the pre-test and post-test design among the elderlies in Tehran, Iran. To conduct the study, 30 healthy men and women older adulth were randomly divided into the experimental (n = 16) and control (n = 14) groups. Members of the experimental group participated in the six-week exercise program, which was held in three 90-minute sessions per week. The intervention involved five exercises conducted in presence of the researcher. Data were collected using the valid and reliable instruments of Berg Balance Scale, Timed Up and Go Test, and the Falls Efficacy Scale Intrnational. Data were analyzed by independent t-test, paired sample t-test, and analysis of covariance at the significance level of 95% using SPSS 19. Results: The study findings showed that balance training with shuttle balance improved the participants' balance, gait speed, and fear of falling significantly (p < 0.05). Conclusion: The six-week balance exercises with shuttle balance improved the participants' walking gait and reduced the risk of falling in elders. These results highlight the beneficial effects of shuttle balance over other devices, such as more security, adjustability of height in chair arms, and possibility to enhance its exercise programs. Therefore, balance shuttle can be applied to improve balance, increase gait speed, and reduce falling risk in elderlies. 72 78 2018/09/112018/11/14 1397/8/23 2019/09/142019/12/28 1398/10/7 Zahra Mohammadian Zahra Mohammadian Department of Health and Sport Medicine, University of Tehran, Tehran, Iran Iran Zahra.md70@gmail.com Reza Rajabi Reza Rajabi Department of Health and Sport Medicine, University of Tehran, Tehran, Iran Iran Hooman Minoonejad Hooman Minoonejad Department of Health and Sport Medicine, University of Tehran, Tehran, Iran Iran Aynaz Samadzade Aynaz Samadzade Department of Health and Sport Medicine, University of Tehran, Tehran, Iran Iran Shuttle Balance Balance Gait Speed Fear of Falling Older Adults Khaje Nemat K, Sadeghi H, Sahebozamani M The effect of 8 weeks of strength training on static and dynamic balance in healthy men. Sport Medicine. 2014: 6(1): 45-55. [Persian]##Iranmanesh H, Arab Ameri E, Farrokhi A, Iranmanesh H. The effect of single task and dual task balance training on the balance of older adults. Journal of Development and motor Learning. 2014; 6(2): 195-215.##De Oliveira MR, Da Silva RA, Dascal JB, Teixeira DC. Effect of different types of exercise on postural balance in elderly women: A randomized controlled trial. Archives of Gerontology and Geriatrics. 2014; 59(3): 506-14.##Rugelj D. The effect of functional balance training in frail nursing home residents. Archives of Gerontology and Geriatrics. 2010; 50(2): 192-7.##Gschwind YJ, Kressig RW, Lacroix A, Muehlbauer T, Pfenninger B, Granacher U. A best practice fall prevention exercise program to improve balance, strength/power, and psychosocial health in older adults: study protocol for a randomized controlled trial. BMC Geriatrics. 2013; 13(1): 1-13.##Huang Y, Liu X. Improvement of balance control ability and flexibility in the elderly Tai Chi Chuan (TCC) practitioners: A systematic review and meta-analysis. Archives of Gerontology and Geriatrics. 2015; 60(2): 233-8.##Granacher U, Roth R, Muehlbauer T, Kressig RW, Laser T, Steinbrueck K. Effects of a new unstable sandal construction on measures of postural control and muscle activity in women. Swiss Medical Weekly. 2011; 14: 1-7.##Choi J-H, Kim N-J. The effects of balance training and ankle training on the gait of elderly people who have fallen. Journal of Physical Therapy Science. 2015; 27(1): 139-42.##Langley FA, Mackintosh SF. Functional balance assessment of older community dwelling adults: a systematic review of the literature. The Internet Journal of Allied Health Sciences and Practice. 2007; 5(4): 1-11.##Pau M, Leban B, Collu G, Migliaccio GM. Effect of light and vigorous physical activity on balance and gait of older adults. Archives of Gerontology and Geriatrics. 2014; 59(3): 568-73.##Pasquetti P, Apicella L, Mangone G. Pathogenesis and treatment of falls in elderly. Clinical Cases in Mineral and Bone Metabolism. 2014; 11(3): 222-5.##Hanachi P, kaviyani G. Impact of mini trampoline exercise on dynamic balance in elderly women, Tehran, Iran. Hormozgan Medical Journal. 2010; 14(2): 148-155. [Persian]##Lee C-W, Cho G-H. Effect of stationary cycle exercise on gait and balance of elderly women. Journal of Physical Therapy Science. 2014; 26(3): 431-3.##El-Khoury F, Cassou B, Latouche A, Aegerter P, Charles M-A, Dargent-Molina P. Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial. The BMJ. 2015; 351: 1-11.##Cimadoro G, Paizis C, Alberti G, Babault N. Effects of different unstable supports on EMG activity and balance. Neuroscience Letters. 2013; 548: 228-32.##Martínez-Amat A, Hita-Contreras F, Lomas-Vega R, Caballero-Martínez I, Alvarez PJ, Martínez-López E. Effects of 12-week proprioception training program on postural stability, gait, and balance in older adults: a controlled clinical trial. The Journal of Strength and Conditioning Research. 2013; 27(8): 2180-8.##Hirase T, Inokuchi S, Matsusaka N, Okita M. Effects of a balance training program using a foam rubber pad in community-based older adults: a randomized controlled trial. Journal of Geriatric Physical Therapy. 2015; 38(2): 62-70.##Pirouzi S, Motealleh AR, Fallahzadeh F, Fallahzadeh MA. Effectiveness of treadmill training on balance control in elderly people: a randomized controlled clinical trial. Iranian Journal of Medical Sciences. 2014; 39(6): 565-70.##Ogaya, S, Ikezoe T, Soda N, Ichihashi. Effects of balance training using wobble boards in the elderly. The Journal of Strength and Conditioning Research. 2011; 25(9): 2616-22.##Schilling BK, Falvo MJ, Karlage RE, Weiss LW, Lohnes CA, Chiu LZ. The Schilling BK, Falvo MJ, Karlage RE, Weiss LW, Lohnes CA, Chiu LZ. Effects of unstable surface training on measures of balance in older adults. The Journal of Strength & Conditioning Research. 2009. 23(4): 1211-6.##Abdoli B, Shams A, Shamsipour Dehkordi P. The effect of practice type on static and dynamic balance in elderly 60-75 year old women with no history of falling. Daneshvar. 2012; 19(97): 43-50. [Persian]##Bohannon RW. Reference Values for the timed up and go test: a descriptive meta-analysis. Journal of Geriatric Physical Therapy. 2006; 29(2): 64-8.##Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age and Ageing. 2005 ; 34(6): 614-9##Khajavi D. Validation and Reliability of Persian Version of Fall Efficacy Scale-International (FES-I) in Community-Dwelling Older Adults. Salmand: Iranian Journal of Ageing. 2013; 8 (2):39-47. [Persian]##Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Canadian Journal of Public Health= Revue Canadienne de Sante Publique. 1992; 83: 7-11.##Davatgaran K, Moghadam M, Salavati M. The reliability of postural balance measures in single and dual tasking in healthy elders. Salmand: Iranian Journal of Ageing. 2009; 4 (3): 17-25. [Persian]##Mansouri R, Rajabi R, Minoonejad H. Comparing the amount of EMG activity of the selected involved muscles in ankle strategy in female athletes while standing on one leg on shuttle balance and wobble board. Journal of Arak University of Medical Sciences. 2015; 18 (2): 70-79. [Persian]##Nam H-C, Cha H-G, Kim M-K. The effects of exercising on an unstable surface on the gait and balance ability of normal adults. Journal of Physical Therapy Science. 2016; 28(7): 2102-4.## ##

The Relationship between Sleep Quality and Quality of Life of Retired Elders 2 2 Introduction: Survey about the issues and problems related to elderly in order to improve their Quality Of Life (QOL) of this increasing population has become a universal concern. Even though aging is a natural process but many effective factors such as rest and sleep pattern can affect this process. So this study aimed to determine the relationship between sleep quality and QOL of the retried elderly members of Isfahan retirement center Methods: This descriptive-analytic study was done on 192 retired older adults were referred to Isfahan retirement center by simple random sampling. The information collected via demographic variables, Pittsburgh Sleep Quality Index and Elderly Quality of Life Questionnaire (LIPAD). Finally the data analysis by software SPSS 21 and descriptive statistical tests, Pearson correlation coefficient, t-test and ANOVA. Results: The results showed that the mean score of sleep quality in the elderly was 6.63 ± 3.41 (range 0-21), which show their sleep quality were poor. The mean score of their QOL were 61.15 ± 9.97 (range 0-93). In addition there were significant and positive correlations between sleep quality and QOL and its dimensions in the retried elderly (p < 0.05). Conclusion: The findings of this study suggest that poor sleep quality in retired elderly people is associated with lack of QOL. Therefore, paying attention to this issue is important in health supporting programs. 79 83 2018/09/112018/11/142018/11/27 1397/9/6 2019/09/142019/12/282019/11/27 1398/9/6 Somayeh Sharifi Somayeh Sharifi Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Iran Zeinab Heidari Zeinab Heidari Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Iran Saba Bromand Saba Bromand Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Iran Nilofar Binayi Nilofar Binayi Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Iran Mahrokh Keshvari Mahrokh Keshvari Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Iran keshvari@med.mui.ac.ir Aging Sleep Quality Quality of Life Statistical Center of Iran. Population of the country in terms of sex in urban and rural areas by province; (Persian) [Internet]. 2016 [Cited 2017 July 28]. Available from: https://www.amar.org.ir/Portals/0/census/1395/results/tables/jamiat/tafsili/kol/1-jamiat.xls##Léger D, Poursain B, Neubauer D, Uchiyama M. An international survey of sleeping problems in the general population. Current Medical Research and Opinion. 2008; 24(1): 307-17.##Reid KJ, Martinovich Z, Finkel S, Statsinger J, Golden R, Harter K, et al. Sleep: a marker of physical and mental health in the elderly. The American Journal of Geriatric Psychiatry. 2006; 14(10): 860-6.##Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2002; 27(7): 1255–73.##Cotroneo A, Gareri P, Lacava R, Cabodi S. Use of zolpidem in over 75-year-old patients with sleep disorders and comorbidities. Archives of Gerontology and Geriatrics, Supplement. 2004; 11(9): 93-6.##Izadi F, Adib M, Afazel MR. Quality of sleep and it's related factors in the hospitalized elderly patients of Kashan hospitals in 2007. Feyz. 2009; 12(4): 52-60. [Persian]##Phillips DT. Relationships between sleep quality, perceived cognition, and quality of life in older adults [PhD thesis]. California: North central University; 2006.##Mokhtari F, Ghasemi N. Comparison of elderly's “quality of life and mental health living in nursing homes and members of retired club of Shiraz city”. Salmand: Iranian Journal of Ageing. 2011; 5 (4): 53-63. [Persian]##Wu HC, Lai JN, Hwang JS. Quality of life and sleep quality amongst climacteric women seeking medical advice in Northern Taiwan. Sleep Medicine. 2012; 13(7): 906-12.##Kord A, Moosavi S, Masooleh SH, Behnampoor N. Assessment of the correlation between lifestyle and quality of sleep in elderly who referred to retirement center in Rasht, 2007. Journal of Holistic Nursing and Midwifery. 2007; 17(2): 15-22. [Persian]##Lo CM, Lee PH. Prevalence and impacts of poor sleep on quality of life and associated factors of good sleepers in a sample of older Chinese adults. Health and Quality of Life Outcomes. 2012; 10(72): 1-7.##Najimi A, Moazemi Goudarzi A. Healthy lifestyle of the elderly: a cross-sectional study. Journal of Health System Research . 2012; 8(4):581-87. Persian##Buysse DJ, Reynolds CFI, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research 1989; 28: 193-213##Ahmadi S, Khankeh H, Mohammadi F, Fallahi M, Reza Soltani P. The effect of sleep restriction treatment on quality of sleep in the elders. Salmand: Iranian Journal of Ageing. 2010; 5 (2): 7-15. [Persian]##De Leo D, Diekstra FW, Lonnqvist J, Trabucchi M, Cleiren H P D, Giovani B, et al. LEIPAD , An internationally applicable instrument to access quality of life in elderly. Behavioral Medicine. 1998, 24(1): 17-29.##Hesamzadeh A, Maddah SB, Mohammadi F, Fallahi Khoshknab M, Rahgozar M. Comparison of elderly's "quality of life" living at homes and in private or public nursing homes. Salmand: Iranian Journal of Ageing. 2010; 4 (4): 66-74. [Persian]##Sajadi H, Biglarian A. Quality of life among elderly women in Kahrizak charity foundation, Tehran, Iran. Payesh. 2007. 6(2): 105-108. [Persian]##Hsu H, Lin M. Exploring quality of sleep and its related factors among menopausal women. The Journal of Nursing Research. 2005; 13 (2): 153-64.##Onji IM, Bagheri HA, Afazel MR. Sleep quality and its related factors in inpatient elderly of Kashan Hospitals in 2006. Feyz Journal. 2008; 12 (4): 107-12. [Persian]##Lee TW, Ko IS, Lee KJ. Health promotion behaviors and quality of life among community dwelling elderly in Korea: a cross-sectional survey. International Journal of Nursing Studies. 2006; 43(3): 293-300.##Nosratabadi M, Saber M. Social support and health-related quality of life in elderly people covered by the Welfare organization of Kerman city. Health & Development Journal. 2014; 3(3): 189-199. [Persian]##Habibi Sola A, Nikpour S, Sohbatzadeh R, Haghani H. Quality of life in elderly people of west of Tehran. Iranian Journal of Nursing Research. 2008. 2(7): 29-35. [Persian]##Ribeiro Do Valle C, Valle E, Valle L, Alves Fior C. Quality of life and sleep disorders in elderly. Sleep Medicine. 2013; 14(1):291.##Şenol V, Soyuer F, Argün M. Quality of life of elderly nursing home residents and its correlates in Kayseri. A descriptive-analytical design: A cross-sectional study. Health. 2013; 5(2): 212-21.##Ancoli-Israel S, Cooke JR. Prevalence and comorbidity of insomnia and effect on functioning in elderly populations. Journal of the American Geriatrics Society. 2005; 53(7): 264–71.##Avidan AY. Sleep disorders in the older patient. Primary Care .2005; 32(2), 563–86.##Nejati V, Ashayeri H. Health-related quality of life among elderly in Kashan. Iranian Journal of Psychiatry and Clinical Psychology. 2008, 14(1): 56-61. [Persian]##Rezaeipandari H, Morowatisharifabad MA, Hashemi SJ, Bahrevar V. Sleep quality among older adults in Mehriz, Yazd province, Iran. Elderly Health Journal. 2015; 1(1): 5-11.##Li J, Dong Q, Liu JJ, Dong YH, Yang LS, Ye DQ, Huang F. Sleep and quality of life among rural elderly in Anhui province. Zhonghua Liu Xing Bing Xue Za Zhi. 2010; 31(4): 405-8.##De Belvis AG, Avolio M, Spagnolo A, Damiani G, Sicuro L, Cicchetti A, et al. Factors associated with health-related quality of life: the role of social relationships among the elderly in an Italian region. Public Health. 2008; 122(8): 784-93##Mohaqeqi Kamal H, Sajadi H, Zare H, Beiglarian A. Elderly quality of life: a comparison between pensioners of social security organization and national retirement fund (Qom County, 2006). Journal of Health Administration. 2007; 10(27): 49-56## ##

Risk Factors for Falls among Older People: a Population-based Case-Control Study 2 2 Introduction: Falling is one of the most common problems of the elderly people with a multi factorial nature and frequent cases. This study aimed to determine the risk factors of falls in old people covered by Mashhad University of Medical Sciences. Methods: This retrospective case-control study was conducted on 15,600 elderly participants. Data were extracted from Sina Electronic Health Record System (SinaEHR®, Iran). The obtained data were analyzed using STATA through odds ratio formula. Results: Risk factors of falls in the elderly subjects included age, fear of falling, higher body mass index, diabetes, anemia, gastrointestinal problems, hypothyroidism, use of sedatives, and smoking, after adjusting the potentially confounding effects of other variables. Conclusion: The current study provides evidence that patient-related factor such as diabetes, anemia, hypothyroidism and smoking are associated with falls in the elderly. The results of the present research can be used by health policy-makers to reduce fall-related costs of the old people by focusing on care services and high-risk individuals. 84 91 2018/09/112018/11/142018/11/272018/12/7 1397/9/16 2019/09/142019/12/282019/11/272019/12/15 1398/9/24 Vida Vakili Vida Vakili Department of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Iran Ali Taghipour Ali Taghipour Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Iran Ehsan Mosa Farkhani Ehsan Mosa Farkhani Deputy of Health, Mashhad University of Medical Sciences, Mashhad, Iran Iran FarkhanyE1@mums.ac.ir Hamid Reza Bahrami Hamid Reza Bahrami Faculty of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Iran Behnaz beygi Behnaz beygi East Educational Research Division of Drug Abuse and Addictive Behavior, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Iran Ebrahim Pirizadeh Ebrahim Pirizadeh Department of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Iran Fall Elderly Risk Factors Case-Control Study Jafarian Amiri SR, Zabihi A, Aziznejad Roshan P, Hosseini SR, Bijani A. Fall at home and its related factors among the elderly in Babol city Iran. Journal of Babol University of Medical Sciences. 2013; 15(5): 95-101. [Persian]##Najafi Ghezlcheh T, Ariapour S, Jafari Oori M. Epidemiology and relationship of fall and fear of falling in the elderly residing at kamrani nursing home, tehran, iran. Salmand: Iranian Journal of Ageing. 2016; 10(4): 152-161. [Persian]##Iranfar M. Physical hazards of residences and elderly fall. Journal of Safety Promotion and Injury Prevention. 2017; 5(4): 237-42. [Persian]##Hojati H, Dadgari A, Mirzaie SM. Investigation of validity and reliability of persian version of Johns Hopkins fall risk assessment tool among the elderly. Qom University of Medical Sciences Journal. 2018; 12(2): 45-53. [Persian]##Kong QH, Wang Y, Song CG, Liu YS, Qin HY, Feng YD, et al. Prospective analysis of the risk factors for falls in lymphoma patients. European Journal of Oncology Nursing. 2014; 18(5): 540-4.##Safavi Bayat Z, Zorriasatain F. Determining risk factors associated with falling among elderly at residential care facilities in Tehran. Journal of Qazvin University of Medical Sciences. 2008; 11(4): 66-70. [Persian]##Hergenroeder AL, Wert DM, Hile ES, Studenski SA, Brach JS. Association of body mass index with self-report and performance-based measures of balance and mobility. Physical Therapy. 2011; 91(8): 1223–34.##World Health Organization. WHO global report on falls prevention in older age [Internet] 2007. Avalable from: https://extranet.who.int /agefriendlyworld/wp-content/uploads/2014/06 / Who-Global-report-on-falls-prevention-in-older-age .pdf.##Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Archives of Physical Medicine and Rehabilitation. 2001; 82(8): 1050-6.##Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: results from a randomized trial. Gerontologist. 1994; 34(1): 16-23.##Safavi Bayat Z, Zoriasatain F. Determining risk factors associated with falling among elderly at residential care facilities in Tehran. Journal of Qazvin University of Medical Sciences. 2008; 11(4): 66-70. [Persian]##Salarvand, Birjandi. Factors related to falling down in older adults. Iran Journal of Nursing. 2009; 22 (61) :51-60. [Persian]##Al-Aama T. Falls in the elderly: spectrum and prevention. Canadian Family Physician Medecine de Famill Canadien. 2011; 57(7): 771–6.##Swanenburg J, de Bruin ED, Uebelhart D, Mulder T. Falls prediction in elderly people: a 1-year prospective study. Gait & Posture. 2010; 31(3): 317-21.##von Heideken Wågert P, Gustafson Y, Kallin K, Jensen J, Lundin-Olsson L. Falls in very old people: The population-based Umeå 85+ Study in Sweden. Archives of Gerontology and Geriatrics. 2009; 49(3): 390-6.##Pereira CL, Baptista F, Infante P. Men older than 50 yrs are more likely to fall than women under similar conditions of health, body composition, and balance. American Journal of Physical Medicine & Rehabilitaion. 2013; 92(12): 1095-103.##Abbasi M, Daniali SSH, Hazrati M. Lifestyle of fallen elderly patients referred to Isfahan hospitals. Iran Journal of Nursing. 2017; 30(107): 20-31. [Persian]##Iranfar M, Ainy E, Soori H. Fall epidemiology in the elderly residents of care centers in Tehran-1390. Salmand: Iranian Journal of Ageing. 2013; 8(2): 30-8. [Persian]##Andresen EM, Wolinsky FD, Miller JP, Wilson MM, Malmstrom TK, Miller DK. Cross-sectional and longitudinal risk factors for falls, fear of falling and falls efficacy in a cohort of middle-aged African Americans. The Gerontologist. 2006; 46(2): 249-57.##Lopes KT, Costa DF, Santos LF, Castro DP, Bastone AC. Prevalence of fear of falling among a population of older adults and its correlation with mobility, dynamic balance, risk and history of falls. Brazilian Journal of Physical Therapy. 2009; 13(3): 223-9.##Boyd R,Stevens JA. Falls and fear of falling: burden, beliefs and behaviours. Age and Ageing. 2009; 38(4): 423-8.##Maleki M, Imanian Kh, Safavi Bayat Z, Mehrabi Y. Assessment of the risk of falls related to imbalance among patients with Multiple Sclerosis referred to the MS Society of Tehran 2014. Advances in Nursing & Midwifery. 2015; 25(90): 1-8. [Persian]##Eyvarigh MR, Mohammadi F, Azimian J, Motallebi SA. The effect of a simple balance training program on fall prevention in the elderly women hospitalized in razi psychiatric hospital, Tehran. Iranian Journal of Rehabilitation Research in Nursing. 2017; 3(4): 42-8. [Persian]##Parvareshan S, Shamsalinia A, Jahanshahi M. Falling in the elderly and its relation to diabetes, a review article. Caspian Journal of Health and Aging. 2017; 1 (1) :30-35. [Persian]##Dharmarajan TS, Avula S, Norkus EP. Anemia increases risk for falls in hospitalized older adults :an evaluation of falls in 362 hospitalized, ambulatory, long-term care, and community patients. Journal of the American Medical Director Association. 2006; 7(5): 287-93.##Reardon G, Pandya N, Bailey R. Falls in nursing home residents receiving pharmacotherapy for anemia. Clinical Interventions in Aging. 2012; 7: 397-407.##Vakili Sadeghi M, Hosseini S.R, Pourali S, Bijani A. Association between Anemia and Falls in the Elderly. Journal of Babol University of Medical Sciences. 2017; 19(5): 14-22. [Persian]## ##

Multidimensional Approach to Frailty among Rural Older People: Applying the Tilburg Frailty Indicator 2 2 Introduction: Frailty is a common geriatric syndrome. Studies of frailty and old age have been able to help reduce its underlying causes and complication. Understanding the frailty and its associated factors in developing countries such as Iran, can help gather information on conditions of the elderly and better plan for this age population. Therefore, the present study was implemented to investigate the prevalence and determinants of frailty in the rural elderly population of Shabestar, East Azarbayjan, Iran. Methods: This cross-sectional study was conducted among 565 rural older people in Shabestar, Iran during 2018-2019. The data collection tool was the Tilburg Frailty Indicator. The participants were selected by using stratified and simple random approach. Descriptive statistics, t-test, one-way ANOVA and logistic regression were used to perform data analysis. Results: Of the participants, 46.7% were detected as being frail. The associations between the prevalence of frailty and sociodemographic characteristics such as age, gender, marital status, types of lifestyle, educational level, and income status were statistically significant (p < 0.05). Regression analysis showed that age (β = -0.84, p < 0.05), the number of medications used (β = -2.72, p < 0.001), hypertension (β = -0.633, p < 0.006), diabetes (β = -535, p < 0.045) and the history of fall during the last year (β = -4.21, p < 0.001) were the most important predictors of frailty among non-institutionalized rural older people. Conclusion: The study confirms the importance of common chronic medical conditions and sociodemographic characteristics in the development of frailty syndrome among older adults. The descriptive nature of the study implies observational trials to clarify more deeply relationship between frailty and the determinants found. 92 101 2018/09/112018/11/142018/11/272018/12/72019/01/7 1397/10/17 2019/09/142019/12/282019/11/272019/12/152019/10/1 1398/7/9 Mirdavoud Mousavisisi Mirdavoud Mousavisisi Department of Health Education & Promotion, Faculty of Health, Tabriz University of Medical sciences, Tabriz, Iran Iran Seyed Morteza Shamshirgaran Seyed Morteza Shamshirgaran Healthy Aging Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran Iran Hassan Rezaeipandari Hassan Rezaeipandari Department of Health Education & Promotion, Faculty of Health, Tabriz University of Medical sciences, Tabriz, Iran Iran Hossein Matlabi Hossein Matlabi Department of Health Education & Promotion, Faculty of Health, Tabriz University of Medical sciences, Tabriz, Iran Iran Frailty Older Adults Prevalence Determinants Wiener JM, Hanley RJ. Measuring the activities of daily living among the elderly: a guide to national surveys. US Department of Health and Human Services. 2007:1-22.##Selection of the results of the general census of population and housing in Iran in 2016. Statistical Center of Iran; 2017. Available from: https://www.amar.org.ir/english/Population-and-Housing-Censuses.##Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013; 381(9868): 752-62.##van Assen MA, Pallast E, Fakiri FE, Gobbens RJ. Measuring frailty in Dutch community-dwelling older people: reference values of the Tilburg Frailty Indicator (TFI). Archives of Gerontology and Geriatrics. 2016; 67: 120-9.##Moritz I, Stein CLE, Ageing W. A life course perspective of maintaining independence in older age prepared for WHO by Inka Moritz and Claudia Stein under the guidance of WHO's Ageing and Health. 1999.##Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, et al. Frailty: an emerging research and clinical paradigm—issues and controversies. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2007; 62(7): 731-7.##Coelho T, Paúl C, Gobbens RJ, Fernandes L. Determinants of frailty: the added value of assessing medication. Frontiers in Aging Neuroscience. 2015; 7: 1-8.##Morley JE, Vellas B, Van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. Journal of the American Medical Directors Association. 2013; 14(6): 392-7.##Kojima G. Frailty as a predictor of future falls among community-dwelling older people: a systematic review and meta-analysis. Journal of the American Medical Directors Association. 2015; 16(12): 1027-33.##Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2007; 62(7): 722-7.##Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2001; 56(3): 146-57.##Song X, Mitnitski A, Rockwood K. Prevalence and 10‐year outcomes of frailty in older adults in relation to deficit accumulation. Journal of the American Geriatrics Society. 2010; 58(4): 681-7.##Runzer-Colmenares FM, Samper-Ternent R, Al Snih S, Ottenbacher KJ, Parodi JF, Wong R. Prevalence and factors associated with frailty among Peruvian older adults. Archives of Gerontology and Geriatrics. 2014; 58(1): 69-73.##Sánchez‐García S, Sánchez‐Arenas R, García‐Peña C, Rosas‐Carrasco O, Ávila‐Funes JA, Ruiz‐Arregui L, et al. Frailty among community‐dwelling elderly Mexican people: Prevalence and association with sociodemographic characteristics, health state and the use of health services. Geriatrics & Gerontology International. 2014; 14(2): 395-402.##Moreira VG, Lourenço RA. Prevalence and factors associated with frailty in an older population from the city of Rio de Janeiro, Brazil: the FIBRA-RJ Study. Clinics. 2013; 68(7): 979-85.##Strawbridge WJ, Shema SJ, Balfour JL, Higby HR, Kaplan GA. Antecedents of frailty over three decades in an older cohort. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences. 1998; 53(1): 9-16.##Gale CR, Cooper C, Aihie Sayer A. Prevalence of frailty and disability: findings from the english longitudinal study of ageing. Age and Ageing. 2015; 44(1): 162-5.##Nguyen TN, Cumming RG, Hilmer SN. A review of frailty in developing countries. The Journal of Nutrition, Health & Aging. 2015; 19(9): 941-6.##Abdi M, Dabiran S. Validity and reliability of Tilburg frailty indicatr in assess of prevalence and risk factors of this syndrome in Iranian elderly. In: The First Iranian Congress of Social Medicine. 2017 Feb 14-18; Tehran, Iran. p. 65. [Persian]##Espinoza SE, Hazuda HP. Frailty in Older Mexican‐American and European‐American Adults: is there an ethnic disparity?. Journal of the American Geriatrics Society. 2008; 56(9): 1744-9.##Santos-Eggimann B, Cuénoud P, Spagnoli J, Junod J. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. The Journals of Gerontology. 2009; 64(6): 675-81.##Hirsch C, Anderson ML, Newman A, Kop W, Jackson S, Gottdiener J, et al. The association of race with frailty: the cardiovascular health study. Annals of epidemiology. 2006; 16(7): 545-53.##Song X, MacKnight C, Latta R, Mitnitski AB, Rockwood K. Frailty and survival of rural and urban seniors: results from the Canadian Study of Health and Aging. Aging clinical and experimental research. 2007; 19(2): 145-53.##Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community‐dwelling older persons: a systematic review. Journal of the American Geriatrics Society. 2012; 60(8): 1487-92.##Hoogendijk EO, van Hout HP, Heymans MW, van der Horst HE, Frijters DH, van Groenou MIB, et al. Explaining the association between educational level and frailty in older adults: results from a 13-year longitudinal study in the Netherlands. Annals of epidemiology. 2014; 24(7): 538-44.##Szanton SL, Seplaki CL, Thorpe RJ, Allen JK, Fried LP. Socioeconomic status is associated with frailty: the Women’s Health and Aging Studies. Journal of Epidemiology & Community Health. 2010; 64(1): 63-7.##Herr M, Robine J-M, Aegerter P, Arvieu J-J, Ankri J. Contribution of socioeconomic position over life to frailty differences in old age: comparison of life-course models in a French sample of 2350 old people. Annals of Epidemiology. 2015; 25(9): 674-80.##Romero‐Ortuno R. Frailty Index in Europeans: association with determinants of health. Geriatrics & Gerontology International. 2014; 14(2): 420-9.##Yu P, Song X, Shi J, Mitnitski A, Tang Z, Fang X, et al. Frailty and survival of older Chinese adults in urban and rural areas: results from the Beijing Longitudinal Study of Aging. Archives of Gerontology and Geriatrics. 2012; 54(1): 3-8.##Shamshirgaran SM, Ghorbani Z. Prevalence of hypertension and pre-hypertension among people 35 and older in Khameneh: results of pilot phase of Azar cohort study. In: Proceeding of the 8th Iranian Epidemiology Congress and the 1st International Congress of Clinical Epidemiology; 2016 April 27-29; Ilam, Iran, 2016.##Ghorbani Z, Shamshirgaran SM, Ghafari S, Najafipour F. Prevalence of diabetes and pre-diabetes among people 35 and older in Khameneh: results of pilot phase of Azar cohort study. In: Proceeding of the 8th Iranian Epidemiology Congress and the 1st International Congress of Clinical Epidemiology; 2016 April 27-29; Ilam, Iran, 2016.##Foroughan M. Jafari Z, Shirin bayan P, Ghaemi Farahani Z, Rahgozar M. Validation of mini-mental state examination (MMSE) in the elderly population of Tehran. Advances in Cognitive Science. 2008;10(2): 29-37.##Gobbens RJ, van Assen MA, Luijkx KG, Wijnen-Sponselee MT, Schols JM. The Tilburg frailty indicator: psychometric properties. Journal of the American Medical Directors Association. 2010; 11(5): 344-55.##Yang F, Chen Q-W. Evaluation of frailty and influencing factors in old people in hospital institution: Evidence for a phenotype of frailty. Medicine. 2018; 97(3): 1-7.##de Albuquerque Sousa ACP, Dias RC, Maciel ÁCC, Guerra RO. Frailty syndrome and associated factors in community-dwelling elderly in Northeast Brazil. Archives of Gerontology and Geriatrics. 2012; 54(2): 95-101.##Abizanda P, Romero L, Sánchez-Jurado PM, Martínez-Reig M, Gómez-Arnedo L, Alfonso SA. Frailty and mortality, disability and mobility loss in a Spanish cohort of older adults: the FRADEA study. Maturitas. 2013; 74(1): 54-60.##Bandeen-Roche K, Seplaki CL, Huang J, Buta B, Kalyani RR, Varadhan R, et al. Frailty in older adults: a nationally representative profile in the United States. The Journals of Gerontology. 2015; 70(11): 1427-34.##Evenhuis HM, Hermans H, Hilgenkamp TI, Bastiaanse LP, Echteld MA. Frailty and disability in older adults with intellectual disabilities: results from the healthy ageing and intellectual disability study. Journal of the American Geriatrics Society. 2012; 60(5): 934-8.##Çakmur H. Frailty among elderly adults in a rural area of Turkey. Medical science monitor: international medical journal of experimental and clinical research. 2015; 21: 1232-42.##Puts MT, Lips P, Deeg D. Static and dynamic measures of frailty predicted decline in performance-based and self-reported physical functioning. Journal of Clinical Epidemiology. 2005; 58(11): 1188-98.##Schuurmans H, Steverink N, Lindenberg S, Frieswijk N, Slaets JP. Old or frail: what tells us more? The Journals of Gerontology. 2004; 59(9): 962-5.##Purser JL, Kuchibhatla MN, Fillenbaum GG, Harding T, Peterson ED, Alexander KP. Identifying frailty in hospitalized older adults with significant coronary artery disease. Journal of the American Geriatrics Society. 2006; 54(11): 1674-81.##Alvarado BE, Zunzunegui M-V, Béland F, Bamvita J-M. Life course social and health conditions linked to frailty in Latin American older men and women. The Journals of Gerontology. 2008; 63(12): 1399-406.##Gruenewald TL, Seeman TE, Karlamangla AS, Sarkisian CA. Allostatic load and frailty in older adults. Journal of the American Geriatrics Society. 2009; 57(9): 1525-31.##Ng TP, Feng L, Nyunt MS, Larbi A, Yap KB. Frailty in older persons: multisystem risk factors and the Frailty Risk Index (FRI). Journal of the American Medical Directors Association. 2014; 15(9): 635-42.##Aspray T, Yarnall A, Croxson S, Chillala J, Sinclair A. British Geriatrics Society. Best Practice Guide. Diabetes. 2009.##Garcia-Garcia FJ, Avila GG, Alfaro-Acha A, Andres MA, Aparicio ME, Aparicio SH, et al. The prevalence of frailty syndrome in an older population from Spain. The Toledo Study for Healthy Aging. The Journal of Nutrition, Health & Aging. 2011; 15(10): 852-6.##Lee JS, Auyeung T-W, Leung J, Kwok T, Woo J. Transitions in frailty states among community-living older adults and their associated factors. Journal of the American Medical Directors Association. 2014; 15(4): 281-6.##Theou O, Rockwood MR, Mitnitski A, Rockwood K. Disability and co-morbidity in relation to frailty: how much do they overlap? Archives Of Gerontology And Geriatrics. 2012; 55(2): 1-8.##Shi J, Song X, Yu P, Tang Z, Mitnitski A, Fang X, et al. Analysis of frailty and survival from late middle age in the Beijing Longitudinal Study of Aging. BMC Geriatrics. 2011; 11(17): 2-8.##Bandeen-Roche K, Xue QL, Ferrucci L, Walston J, Guralnik JM, Chaves P, et al. Phenotype of frailty: characterization in the women's health and aging studies. The Journals of Gerontology. 2006; 61(3): 262-6.##Ensrud KE, Ewing SK, Taylor BC, Fink HA, Cawthon PM, Stone KL, et al. Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Archives of Internal Medicine. 2008; 168(4): 382-9.##Rockwood K, Howlett SE, MacKnight C, Beattie BL, Bergman H, Hébert R, et al. Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging. The Journals of Gerontology. 2004; 59(12): 1310-7.##Jürschik P, Nunin C, Botigué T, Escobar MA, Lavedán A, Viladrosa M. Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: the FRALLE survey. Archives of Gerontology And Geriatrics. 2012; 55(3): 625-31.##Shamliyan T, Talley KM, Ramakrishnan R, Kane RL. Association of frailty with survival: a systematic literature review. Ageing Research Reviews. 2013; 12(2): 719-36.##Biritwum R, Minicuci N, Yawson A, Theou O, Mensah G, Naidoo N, et al. Prevalence of and factors associated with frailty and disability in older adults from China, Ghana, India, Mexico, Russia and South Africa. Maturitas. 2016; 91: 8-18.##Rockwood K, Theou O. Frailty in aging: biological, clinical and social implications. Interdisciplinary Topics in Gerontology and Geriatrics. 2015; 41.##Ferrucci L, Cavazzini C, Corsi A, Bartali B, Russo C, Lauretani F, et al. Biomarkers of frailty in older persons. Journal of endocrinological investigation. 2002; 25(10): 10-15.##Cassel CK, Leipzig R, Cohen HJ, Larson EB, Meier DE. Geriatric medicine: an evidence-based approach: New York: Springer; 2003.##Kirkwood TB. Understanding the odd science of aging. Cell. 2005; 120(4): 437-47.##Rockwood K. What would make a definition of frailty successful?. Age and Ageing. 2005; 34(5): 432-4.## ##

Effect of Warm Foot Bath on Fatigue among Diabetic Older Adults 2 2 Introduction: Fatigue is one of the most common causes of disability in most elderly people affected with diabetes. Considering the growing population of this group, the present study aimed to determine the effect of warm foot bath on the fatigue of the elderly people with diabetes. Methods: The randomized clinical trial study was carried out on 66 elderly diabetic patients who had referred to the Diabetes Research Center in Yazd. Eligible participants were selected by convenience sampling and randomly divided into two experimental and control groups. Participants of the experimental group performed a warm foot bathing for 20 minutes during two weeks. The Piper Fatigue Scale was completed in three steps (at the beginning of the study, two and four weeks after intervention). Data were analyzed by SPSS software, using ANOVA for repeated measures, independent t-test, Chi-Square and Fisher exact test. Results: The mean ± standard deviation of fatigue in the three phases of evaluation in the experimental group was 5.91 ± 0.81, 4.80 ± 1.19, 4.55 ± 1.57 and in the control group was 5.95 ± 0.97, 6.06 ± 1.13 and 5.79 ± 1.33, respectively. The difference in the mean of fatigue scores in both groups after the intervention was significant (p < 0.001). Conclusion: Revealing the positive effects of warm foot bathing, this method, as a non-pharmacological and easy-to-use method, is recommended to improve fatigue condition in the elderly patients with diabetes. 102 107 2018/09/112018/11/142018/11/272018/12/72019/01/72019/01/18 1397/10/28 2019/09/142019/12/282019/11/272019/12/152019/10/12019/12/22 1398/10/1 Farahnaz Farnia Farahnaz Farnia Research Center for Nursing and Midwifery Care, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran sedighehalsadat Mokhtari sedighehalsadat Mokhtari Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran s.sadat.mokhtari@gmail.com Masoud Rahmanian Masoud Rahmanian Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Fatigue Warm Foot Bath Diabetes Mellitus Elderly Singh R, Lohia P, Chand H. Assessment and comparison of emotional health of institutionalized and non-institutionalized elderly of Uttarakhand. Journal of Human Ecology. 2017; 60(1): 29-33.##North American Nursing Diagnosis Association: Definitions and classification, 1999-2000. North American Nursing Diagnosis Association; 1999.##De Rekeneire N, Leo-Summers L, Han L, Gill TM. Epidemiology of restricting fatigue in older adults: the precipitating events project. Journal of the American Geriatrics Society. 2014; 62(3): 476-81.##Hardy SE, Studenski SA. Fatigue and function over 3 years among older adults. The Journals of Gerontology. 2008; 63(12): 1389-92.##World Health Organization. Global health risks: mortality and burden of disease attributable to selected major risks [Internet]. 2015. Available from: https://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf.##Sadeghi E, Gozali N, Tabrizi FM. Effects of energy conservation strategies on cancer related fatigue and health promotion lifestyle in breast cancer survivors: A randomized control trial. Asian Pacific Journal of Cancer Prevention. 2016; 17(10): 4783-90.##Weijman I, Kant I, Swaen GM, Ros WJ, Rutten GE, Schaufeli WB, et al. Diabetes, employment and fatigue-related complaints: a comparison between diabetic employees,“healthy” employees, and employees with other chronic diseases. Journal of Occupational and Environmental Medicine. 2004; 46(8): 828-36.##Drivsholm T, de Fine Olivarius N, Nielsen AB, Siersma V. Symptoms, signs and complications in newly diagnosed type 2 diabetic patients, and their relationship to glycaemia, blood pressure and weight. Diabetologia. 2005; 48(2): 210-4.##Chentli F, Azzoug S, Mahgoun S. Diabetes mellitus in elderly. Indian Journal of Endocrinology and Metabolism. 2015; 19(6): 744-52.##Menting J, Nikolaus S, van der Veld WM, Goedendorp MM, Tack CJ, Knoop H. Severe fatigue in type 1 diabetes: exploring its course, predictors and relationship with HbA1c in a prospective study. Diabetes Research and Clinical Practice. 2016; 121:1 27-34.##Fritschi C, Fink A. Fatigue in adults with type 2 diabetes–An overview of current understanding and management approaches. Diabetes Management. 2012; 8(2): 84-7.##Mänty M, de Leon CF, Rantanen T, Era P, Pedersen AN, Ekmann A, et al. Mobility-related fatigue, walking speed, and muscle strength in older people. The Journals of Gerontology. 2012; 67(5): 523-9.##Aboutorabi R, Saeedi M. The effect of antiaging COQ10 plus on the treatment of diabetic neuropathy. Medical Journal of Mashhad University of Medical Sciences. 2014; 57(6): 793-8. [Persian]##Moreh E, Jacobs JM, Stessman J. Fatigue, function, and mortality in older adults. The Journals of Gerontology. 2010; 65(8): 887-95.##Fritschi C, Quinn L. Fatigue in patients with diabetes: a review. Journal of Psychosomatic Research. 2010; 69(1): 33-41.##Fritschi C, Quinn L, Hacker ED, Penckofer SM, Wang E, Foreman M, et al. Fatigue in women with type 2 diabetes. The Diabetes Educator. 2012; 38(5): 662-72.##Morelli V. Fatigue and chronic fatigue in the elderly: definitions, diagnoses, and treatments. Clinics in Geriatric Medicine. 2011; 27(4): 673-86.##Hasanpour-Dehkordi A, Nikfarjam M. Effects of aerobic exercise and yoga on fatigue and general health of patients with multiple sclerosis: a randomized trial. Journal of Clinical and Diagnostic Research. 2016; 10(6): 1-6.##Unal KS, Akpinar RB. The effect of foot reflexology and back massage on hemodialysis patients' fatigue and sleep quality. Complementary Therapies in Clinical Practice. 2016; 24: 139-44.##Özdemir G, Ovayolu N, Ovayolu O. The effect of reflexology applied on haemodialysis patients with fatigue, pain and cramps. International Journal of Nursing Practice. 2013; 19(3): 265-73.##Karimi M, Nourozi Tabrizi K, Mohamadi F, Biglarian AA. The effect of slow stroke back massage on elderlies with Multiple Sclerosis in Kahrizak Charity Foundation in 2014. Iranian Journal of Rehabilitation Research in Nursing. 2016; 2(4): 49-56. [Persian]##Bagheri-Nesami M, Shorofi SA, Nikkhah A, Espahbodi F, Koolaee F-SG. The effects of aromatherapy with lavender essential oil on fatigue levels in haemodialysis patients: A randomized clinical trial. Complementary Therapies in Clinical Practice. 2016; 22: 33-7.##Rad M, Berzouei F, Mohebi M. The Effect of Humor Therapy on Fatigue Severity and Quality of Life in Breast Cancer Patients Undergoing External Radiation Therapy. Journal of Advances Medical Biomedical Research. 2016; 24(103): 102-14. [Persian]##McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. The Cochrane Database of Systematic Reviews. 2015; (2).##Li WJ.The Effect of warm-water footbath on fatigue, sleep and quality of life of stroke patients. Paper presented at the 25th International Nursing Research Congress; 2014 Jul 24-28; Hong Kong.##Delshad A, Baloochi T, Shamshiri M, Shareinia H, Radmanesh R. Polypharmacy and its related factors among elderlies. Bimonthly Iran Journal of Nursing. 2013; 26(83): 1-9. [Persian]##Becker BE. Aquatic therapy: scientific foundations and clinical rehabilitation applications. The Journal of Injury, Function, and Rehabilitation. 2009; 1(9): 859-72.##Kozier B. Fundamentals of nursing: concepts, process and practice. Pearson Education; 2008.##Madadi ZAA, Azimian J, Falahatpishe F, Heidari MA. Effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients. International Journal of Research in Medical Sciences. 2017; 5(2): 631-5.##Weber D, Brown A. Physical agent modalities. Physical medicine rehabilitation. Philadelphia: Saunders Company: 2000.##Yamamoto K, Aso Y, Nagata S, Kasugai K, Maeda S. Autonomic, neuro-immunological and psychological responses to wrapped warm footbaths—a pilot study. Complementary Therapies in Clinical Practice. 2008; 14(3): 195-203.##Yoon SY, Kwon MJ. The effect of foot bath therapy on post-operation pain, stress, HRV in hand replantation patients. Korean Journal of Occupational Health Nursing. 2011; 20(2): 105-12.##Miyazato K, Matsukawa K. Decreased cardiac parasympathetic nerve activity of pregnant women during foot baths. Japan Journal of Nursing Science. 2010; 7(1): 65-75.##Yang HL, Chen XP, Lee KC, Fang FF, Chao YF. The effects of warm-water footbath on relieving fatigue and insomnia of the gynecologic cancer patients on chemotherapy. Cancer Nursing. 2010; 33(6): 454-60.##Roshanravan M, Jouybari L, Bahrami H, Vakili M, Sanagoo A, Amini Z. Effect of foot reflexology on fatigue in patients undergoing hemodialysis: a sham-controlled randomized trial. Journal of Mazandaran University of Medical Sciences. 2016; 26(137): 32-41. [Persian]##Piper BF, Lindsey AM, Dodd MJ, Ferketich S, Paul SM, Weller S. The development of an instrument to measure the subjective dimension of fatigue. In Management of Pain, Fatigue and Nausea. UK: Macmillan Education; 1989.##Sabouhi F, Kalani L, Valiani M, Mortazavi M, Bemanian M. Effect of acupressure on fatigue in patients on hemodialysis. Iranian Journal of Nursing and Midwifery Research. 2013; 18(6):429-34.##Anilda SJ, Thenmozhi P. Effectiveness of hot water foot bath on level of fatigue among elderly patient. International Journal of Science and Research. 2015; 4(8):574-6.##Tanaka M, Yamada H, Nakamura T, Watanabe Y. Effects of pellet stove on recovery from mental fatigue. Medical Science Monitor. 2012; 18(3): 148-53.##Seo S, Han H, Yeon S. Contribution of foot bath to fatigue relief measured by using smart phone applied questionnaires. International Journal of Advanced Science and Technology. 2018;113(1):113-22.##Singh R, Kluding PM. Fatigue and related factors in people with type 2 diabetes. The Diabetes Educator. 2013; 39(3): 320-6.##Murphy SL, Alexander NB, Levoska M, Smith DM. Relationship between fatigue and subsequent physical activity among older adults with symptomatic osteoarthritis. Arthritis Care & Research. 2013; 65(10): 1617-24.##Tsay SL. Acupressure and fatigue in patients with end-stage renal disease–a randomized controlled trial. International Journal of Nursing Studies. 2004; 41(1): 99-106.##O’Regan P, Hegarty J. The importance of self-care for fatigue amongst patients undergoing chemotherapy for primary cancer. European Journal of Oncology Nursing. 2017; 28: 47-55.##Borji M, Motaghi M. The relationship between physical activity, social support and fatigue severity of eldry Ilam in 2016. Iranian Journal of Rehabilitation Research in Nursing. 2017; 3(4)50-7. [Persian]## ##

Health Status and Health Patterns in Urban-rural Dwelling Elderly in Nakhonratchasima Province, Thailand 2 2 Introduction: As rapid urbanizing spreads throughout Thailand, the combination of urban-rural lifestyle has been gradually found. These changes may effect on health pattern of the older adults. This study was aimed to explore the incidence of health problems and life styles of the elderly in urban-rural areas. Methods: A random interview survey with qualitative approach was used. Data were randomly collected from 14 areas in central sub-districts of Nakhonratchasima province, Thailand. Twenty-five older adults in each area were interviewed. The recording forms consisted of demographic data, perceived health status and health problems, medication use, activities of daily living, instrumental activities of daily living, mental health, social and religious activities, and accommodation and environment. Non-invasive physical examinations of the elderly were performed by weighing, measuring height and testing muscle strength with one leg standing. Results: Most of the elderly reported having at least one chronic disease and/or degenerative problems that had impact on their daily lives. Forty percent rated their health status as moderate to poor, 18% encountered falls while 18% were hospitalized in the past six months. Only one-third underwent an annual health check–up while 30% of the female had cancer cervix screening. Most of the elderly could perform daily tasks on their own with assistive instruments and were healthy in mind. However, many of them drank tap water without boiling or filtering. Conclusion: The older adults in the urban-rural areas had access to health care services and had a good health status. However, their health promotion and prevention behaviors are questionable. 108 116 2018/09/112018/11/142018/11/272018/12/72019/01/72019/01/182019/03/14 1397/12/23 2019/09/142019/12/282019/11/272019/12/152019/10/12019/12/222019/09/14 1398/6/23 Nutthita Petchprapai Nutthita Petchprapai Department of Adult and Elderly Nursing, Institute of Nursing, Suranaree University of Technology, Thailand Thailand nutthita2004@hotmail.com Elderly Health Status Suburban Health Well-being Health Patterns HelpAge International East Asia/Pacific Regional Office. The changing well-being of the Tha elderly: An update from the 2011 survey of older persons in Thailand [Internet]. 2013. Available from: https://www.helpage.org/silo/files/the-changing-wellbeing-of-thai-elderly-an-update-from-the-2011-survey-of-older-persons-in-thailand.pdf.##Nantsupawat W. Geriatric Nursing: Challenging of the aging society. Khon Kaen: Khon Kaen Karn Pim, Ltd. Part; 2009.##World Health Organization. Older population and health system: A profile of Thailand [Internet]. 2015. Available from https://www.who.int/ageing/projects/intra/phase_one/alc_intra1_cp_thailand.pdf.##Park NS, Jang Y, Ko JE, Chiriboga DA. Factors affecting willingness to use hospice in racially/ethnically diverse older men and women. American Journal of Hospice and Palliative Medicine. 2015; 33(8): 770-6.##Cockayne NL, Duffy SL, Bonomally R, English A, Amminger PG, Mackinnon A, et al. The beyond ageing project phase 2 - a double-blind, selective prevention, randomised, placebo-controlled trial of omega-3 fatty acids and sertraline in an older age cohort at risk for depression: study protocol for a randomized controlled trial. Trials. 2015; 16(247): 1-16.##Department of Older Person. Situation of the Thai elderly 2014 [Internet]. 2014. Available from: http://www.dop.go.th/download/knowledge/knowledge_th_20161608145327_1.pdf.##National Institute for Health and Care Excellence Guideline. Older people with social care needs and multiple long-term conditions [Internet]. 2015. Available from: https://www.nice.org.uk/guidance/ng22/resources/older-people-with-social-care-needs-and-multiple-longterm-conditions-pdf-1837328537797##Chayovan N, Node J. Survey on health status of the elderly in Thailand. Bangkok: The Institute of Population Studies, Chulalongkorn University; 1998.##Tan KK, He HG, Chan SW, Vehviläinen-Julkunen K. The experience of older people living independently in Singapore. International Nursing Review. 2015; 62(4): 526-35.##Rozanova J, Keating N, Eales J. Unequal social engagement for older adults: constraints on choice. Canadian Journal on Aging. 2012; 31(1): 25-36.##Monma T, Takeda F, Noguchi H, Tamiya N. Age and sex differences of risk factors of activity limitations in Japanese older adults. Geriatrics & Gerontology International. 2015; 16(6): 670-8.##Nakade M, Takagi D, Suzuki K, Aida J, Ojima T, Kondo K, et al. Influence of socioeconomic status on the association between body mass index and cause-specific mortality among older Japanese adults: The AGES cohort study. Preventive Medicine. 2015; 77: 112-8.##Lee Y. Zurlo KA. Spousal caregiving and financial strain among middle-aged and older adults. International Journal of Aging & Human Development. 2015; 79(4): 302-21.##Wu F, Guo Y, Chatterji S, Zheng Y, Naidoo N, Jiang Y, et al. Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global AGEing and adult health (SAGE) wave 1. BMC Public Health. 2015; 15(88): 2-13.##Office for National Statistic yearbook Thailand 2019 [Internet]. 2019. Available from: http://service.nso.go.th/nso/nsopublish/pubs/e-book/SYB-2562/files/assets/basic-html/index.html#1##Laohaprasitiporn P, Jarusriwanna A, Unnanuntana A. Validity and reliability of the Thai version of the Barthel index for elderly patients with femoral neck fracture. Journal of the Medical Association of Thailand. 2017; 100(5): 539-48.##Aroonsang P, Sritanyarat W, Lertrat P, Subindee S, Surit P, Theeranut A, et al. Health profile of older persons in health care institute and in community. Journal of Nursing and Health. 2012; 35(2): 15-24.##Nilmanut S, Kuptniratsaikul V, Pekuman P, Tosayanonda O. The study of the center for epidemiologic studies-depression scale (CES-D) in Thai people in Siriraj hospital. Journal of Rehabilitaion Medicine. 1997; 6(3): 25-29.##Michel J, Beattie L, Martin F, Walson J, editors. Oxford textbook of geriatric medicine (3rd eds). USA: Oxford University Press; 2017.##Halter J, Ouslander J, Studenski S, High K, Asthana S, Supiano M, et al. Hazzard's Geriatric Medicine and Gerontology (7th eds). USA: McGraw-Hill Education; 2017.##Sriwichien T. A study of the nutritional status and the factors relating to malnutrition status of the elderly receiving health service from pompet community medical center. Journal of Preventive Medicine Association of Thailand. 2016;6(2):119-30.##Glangkarn S, Promasatayaprot V, Porock D, Edgley A. Measuring quality of life in Thai women with breast cancer. Asian Pacific Journal of Cancer Prevention. 2011; 12(3): 637-44.##Mukem S, Sriplung H, McNeil E, Tangcharoensathien V. Breast cancer screening among women in Thailand: analyses of population-based household surveys. Journal of Medical Association of Thailand. 2014; 97(11): 1106-18.##Senanarong V, Harnphadungkit K, Prayoonwiwat N, Poungvarin N, Sivasariyanonds N, Printarakul T, et al. A new measurement of activities of daily living for Thai elderly with dementia. International Psychogeriatrics. 2003; 15(2): 135-48.##Shim YS, Yang DW, Kim HJ, Park Y, Kim SY. Characteristic differences in the mini-mental state examination used in Asian countries. BMC Neurology. 2017; 17: 1-9##Birrer RB, Vemuri SP. Depression in later life: A diagnostic and therapeutic challenge. American Family Physician. 2004; 69(10): 2375-82.##Burke WJ, Wengel SP. Late-life mood disorders. Clinics in Geriatric Medicine. 2003; 19(4), 777-97.##Thanakwang K. Family support, anticipated support, negative interaction, and psychological well-being of older parents in Thailand. Psychogeriatrics. 2015; 15(3): 171-8.##Eamsamai S, Mhuansit R, Thongmag C. An elderly care model among caregiving volunteers at Phukrang Municipality, Amphur Praputthabat, Saraburi Province. Nursing Journal of the Ministry of Public Health. 2013; 22(3): 77-87.##Sangsithisawat W, Pitaksanurat S. Contamination of Coliform bacteria in rural households’ drinking water. Khon Kaen University Research Journal of Humanities and Social Sciences. 2011; 16(8): 1025-35.## ##

Narrative Group Therapy to Improve Aging Perceptions and Reduce Thanatophobia (Death Anxiety) in Older Adults 2 2 Introduction: Narrative therapy is a psychological intervention focusing on remembering and reconstruction of the people's life events in ways that are of benefit to them, and reduce the impact of challenges in their lives. This study was performed to examine the effect of narrative group therapy (NGT) on aging perceptions and death anxiety among older adults. Methods: Forty-seven subjects, elderly nursing home residents (Tehran, Iran) with the mean age of 69.2 ± 2.55 were selected and assigned to intervention (n = 24), and control groups (n = 23). The intervention group received eight 90 min weekly sessions of NGT, and data were collected at the baseline, post-test and one month follow-up. Results: Compared to the control and baseline, NGT intervention was positively influenced the aging perceptions of participants, especially their emotional representations, as well as their beliefs about aging consequences and control over experiences relating to aging. NGT was also found to be effective in the reduction of death anxiety, which were also sustained over the time with significant interaction effect between group and test times (p < 0.05). Conclusion: To our knowledge, this is the first study investigating the psychological interventions for aging perceptions, as well as NGT for death anxiety in older adults. The intervention was effective to improve the aging perceptions and reduce death anxiety and could be recommended for elderly nursing home residents 117 123 2018/09/112018/11/142018/11/272018/12/72019/01/72019/01/182019/03/142019/10/11 1398/7/19 2019/09/142019/12/282019/11/272019/12/152019/10/12019/12/222019/09/142019/12/21 1398/9/30 Zhale Nozari Zhale Nozari Department of General and Clinical Psychology, Faculty of Psychology and Educational Sciences, Allameh Tabataba’i University, Tehran, Iran Iran AbdolAllah Mo'tamedi AbdolAllah Mo'tamedi Department of General and Clinical Psychology, Faculty of Psychology and Educational Sciences, Allameh Tabataba’i University, Tehran, Iran Iran a_moatamedy@yahoo.com Hosein Eskandari Hosein Eskandari Department of General and Clinical Psychology, Faculty of Psychology and Educational Sciences, Allameh Tabataba’i University, Tehran, Iran Iran Zahra Ahmadivand Zahra Ahmadivand Department of Psychology, Faculty of Literature and Humanities, Payame Noor University, Mahabad, Iran Iran ahmadivandza@gmail.com Narrative Group Therapy Aging Perceptions Death Anxiety Older Adults Kobylarek, A, editor. Aging: Social, biological and psychological dimensions. Wroclaw: Agenca Wydawnicza; 2012.##Warmoth K, Tarrant M, Abraham C, Lang I. Older adults' perceptions of aging and their health and functioning: a systematic review of observational studies. Psychology. Health & Medicine. 2016; 21: 531-50.##Barker M, O'Hanlon A, McGee H, Hickey A, Conroy R. Cross-sectional validation of the aging perceptions questionnaire: a multidimensional instrument for assessing self-perceptions of aging. BMC Geriatrics. 2007; 7: 1-13.##Levy B. Stereotype embodiment: a psychosocial approach to aging. Current Directions in Psychological Science. 2009; 18: 332–336.##Robertson DA, Kenny RA. Negative perceptions of aging modify the association between frailty and cognitive function in older adults. Personality and Individual Differences. 2016; 100: 120–125.##Sindi S, Juster RP, Wan N, Nair NP, Ying Kin N, Lupien SJ. Depressive symptoms, cortisol, and cognition during human aging: the role of negative aging perceptions. Stress. 2012; 15(2): 130-137.##Freeman AT, Santini ZI, Tyrovolas S, Rummel-Kluge C, Haro JM, Koyanagi A. Negative perceptions of aging predict the onset and persistence of depression and anxiety: findings from a prospective analysis of the Irish Longitudinal Study on Aging (TILDA). Journal of Affective Disorders. 2016; 199: 132-8.##Mohammadpour A, Sadeghmoghadam L, Shareinia H, Jahani S, Amiri F. Investigating the role of perception of aging and associated factors in death anxiety among the elderly. Clinical Interventions in Aging. 2018; 13: 405-10.##Kotter-Grühn D. Changing negative views of aging: implications for intervention and translational research. Annual Review of Gerontology & Geriatrics. 2015; 35(1): 167–86.##Iverach L, Menzies RG, Menzies RE. Death anxiety and its role in psychopathology: reviewing the status of a transdiagnostic construct. Clinical Psychology Review. 2014; 34(7): 580–93.##Randall E. Existential therapy of panic disorder: A single system study. Clinical Social Work Journal. 2001; 29: 259–267.##Furer P, Walker J. Death anxiety: A cognitive–behavioral approach. Journal of Cognitive Psychotherapy. 2008; 22(2): 167–182.##Lo C, Hales S, Jung J, Chiu A, Panday T, Rydall A, et al. Managing Cancer and living meaningfully (calm): phase 2 trial of a brief individual psychotherapy for patients with advanced cancer. Palliative Medicine. 2014; 28(3): 234-42.##Richman J. The role of psychotherapy and humor for death anxiety, death wishes, and aging. Omega: Journal of Death and Dying. 2006-2007; 54(1): 41–51.##Heidari F, Amiri A, Amiri Z. The effect of person-centered narrative therapy on happiness and death anxiety of elderly people. Abnormal and Behavioural Psychology. 2016; 2(3): 1-5.##White M. Maps of narrative practice. New York: WW Norton & Company; 2007.##Stokes LD, Poulsen SS. Narrative therapy for adoption issues in families, couples, and individuals: rationale and approach. Journal of Family Psychotherapy. 2014; 25(4): 330-47,##Lopes RT, Gonçalves MM, Fassnacht DB, Machado PP, Sousa I. Long-term effects of psychotherapy on moderate depression: a comparative study of narrative therapy and cognitive-behavioral therapy. Journal of Affective Disorders. 2014; 167: 64-73.##Rodríguez Vega B, Bayón Pérez C, PalaoTarrero A, Fernández Liria A. Mindfulness-based narrative therapy for depression in cancer patients. Clinical Psychology &. Psychotherapy. 2014; 21(5): 411-9.##Garte-Wolf S. Narrative therapy group work for chemically dependent clients with HIV/AIDS. Social Work with Groups. 2011; 34(3-4): 330-8.##Morgan ML, Brosi WA, Brost, MW. Restoring older adults’ narratives about self and substance abuse. The American Journal of Family Therapy. 2011; 39(5): 444–55.##Young E. Narrative therapy and elders with memory loss. Clinical Social Work Journal. 2010; 38: 193-202.##Dastbaaz A; Yeganehfarzand SH; Azkhosh M, Shoaee F. The effect of group counseling "Narrative Therapy" to reduce depression and loneliness among older women. Iranian Rehabilitation Journal. 2014; 12(20): 11-15.##Poole J, Gardner P, Flower M, Cooper C. Narrative therapy, older adults, and group work?: practice, research, and recommendations. Social Work with Groups. 2009; 32(4): 288–302.##Ibrahim AA, Ai-Lami F, Al-Rudainy R, Khader YS. Mental disorders among elderly people in Baghdad, Iraq, 2017. Inquiry. 2019; 56: 1-8.##Koller SH. Ethics in research with human beings: some issues about Psychology. Ciência & Saúde Coletiva. 2008; 13(2): 399-406.##Kraskian-Mujembari A, Haghi-Asgarabadi F, Jomehri F. Determination of the psychometric properties of the aging perception questionnaire. Journal Of Research In Behavioural ScienceS. 2017; 15: 142-50. [Persian]##Miremadi M, Heravi-Karimooi M, Reje N, Sharifnia H, Montazeri A. Validation of the Persian version of Aging Perceptions Questionnaire (APQ). Payesh. 2018; 17(2): 199-207. [Persian]##Templer, D I. The construction and validation of a death anxiety scale. The Journal of General psychology. 1970; 82(2): 165-77.##Tomas J, Gomez J. Psychometric properties of the Spanish form of Templers death anxiety scale. Psychological Reports. 2002; 91(3): 116-20.##Tavakoli MA, Ahmadzadeh B. Investigation of validity and reliability of Templer death anxiety scale. Journal of Clinical Psychology Andishe va Raftar. 2011; 6(21): 72–80. [Persian]##Corey G. Student manual for theory and practice of group counseling. Pacific Grove, CA: Brooks/Cole; 2012.##White M, Epston D. Narrative means to therapeutic ends. New York :WW Norton & Company;1990.##Cohen J, Cohen P, West SG, Aiken LS. Applied multiple regression / correlation analysis for the behavioral sciences. (3rd ed.), Mahwah: Routledge; 2003.##Slotman A, Cramm JM, Nieboer AP. Validation of the Dutch Aging Perceptions Questionnaire and development of a short version. Health and Quality of life outcomes. 2015; 13: 1-13.##Sexton E, King-Kallimanis BL, Morgan K, McGee H. Development of the Brief Aging Perceptions Questionnaire (B-APQ): a confirmatory factor analysis approach to item reduction. BMC Geriatrics. 2014; 14: 1-11.##Sridevi G, Swathi P. Swathi GS. Death anxiety, death depression, geriatric depression and suicidal ideation among institutionalized and non-institutionalized elders. International Journal of Scientific and Research Publications. 2014; 4: 1-8.##Moreno P, De La Fuente Solana E, Rico M, Fernández L. Death anxiety in institutionalized and non-institutionalized elderly persons in Spain. Omega. 2008; 58(1):61–76.##Assari S, Moghani Lankarani M. Race and gender differences in correlates of death anxiety among elderly in the United States. Iranian Journal of Psychiatry and Behavioral Sciences. 2016; 10(2): 1-7.##Lillevoll KR, Kroger J, Martinussen M. Identity status and anxiety. A Meta-Analysis. Identity. 2013; 13(3): 214-27## ##