Background:The ankle-foot injuries are among the war-related injuries that cause many serious secondary problems for a lifetime.This nationwide study aimed to assess health-related quality of life and the ability to p...Background:The ankle-foot injuries are among the war-related injuries that cause many serious secondary problems for a lifetime.This nationwide study aimed to assess health-related quality of life and the ability to perform activities of daily living in veterans with ankle-foot injuries due to the Iran-Iraq war.Methods:A total of 1079 veterans with ankle-foot injuries were enrolled in a cross-sectional study from 2014 to 2016.Demographic characteristics,including age,gender,marital status,disability percent,educational level,employment and additional injuries,were collected.The ability to perform daily activities was assessed using the Barthel activities of daily living(ADL)and Lawton instrumental activities of daily living(IADL)Indexes.Physical and mental health-related quality of life(HRQOL)data were measured via the SF-36 subscales.The data were compared with those of bilateral lower limb amputees(BLLAs)and of the general Iranian population.Statistical analyses,including Pearson’s correlation coefficient,one-sample t-test and analysis of variance(ANOVA),were performed using SPSS16.0.A multiple linear regression model was used to determine the contribution of independent variables to the Physical Component Summary(PCS)and Mental Component Summary(MCS).Results:The highest and lowest scores were observed for mental health(48.93±20.69)and bodily pain(28.16±21.74),respectively.The mean scores of veterans with ankle-foot injuries on the SF-36 were significantly lower on all eight measures than those of the general Iranian male population and of the bilateral lower limb amputees(P<0.001).The mean scores of ADLs and IADLs were 83.9±16.3 and 5.3±2.0,respectively.The higher dependency in ADLs(P<0.001)and IADLs(P<0.001),the higher disability rate(P<0.001)and additional injury(P<0.001)were significant determinants of the PCS.ADL(P<0.001)and IADL(P<0.001)limitations,additional injury(P<0.001),history of hospitalization in the year preceding the study(P=0.007)and employment(P=0.001)were reported as determinants of the MCS.Conclusion:The results strongly suggest that veterans with ankle-foot injuries suffer from critically poor healthrelated quality of life.The main predicting factors of HRQOL were the disability to perform ADLs/IADLs,suffering two or more injuries,a history of hospitalization in the year preceding the study and unemployment.展开更多
Background: Osteomyelitis(OM) is an atypical consequence of ankle-foot trauma which is associated with long-term mental and physical morbidity and persistent pain. This study aimed to assess the health status of OM pa...Background: Osteomyelitis(OM) is an atypical consequence of ankle-foot trauma which is associated with long-term mental and physical morbidity and persistent pain. This study aimed to assess the health status of OM patients with war-related ankle-foot injuries.Methods: A total of 1129 veterans with ankle-foot injuries participated in a case-control study(2014–2016). Thirty patients with chronic OM of the ankle-foot were compared with 90 non-OM participants as the control group. Quality of life(QOL), life satisfaction and the ability to perform basic and instrumental activities of daily living were measured using the following questionnaires: short-form health survey(SF-36), satisfaction with life scale(SWLS), activity of daily living(ADL) and instrumental activity of daily living(IADL), respectively. OM patients were categorized according to their risk factors as A, B and C hosts using a modified version of the Cierny and Mader classification system. The one sample t-test, 2-independent sample t-test, ANOVA, Pearson correlation coefficient and multiple linear regression analyses were applied to analyze the data.Results: Ankle-foot pain leading to surgery(P <0.001) and orthosis usage(P =0.039) were more common in OM patients. There was no significant difference between the two groups in the prevalence of pulmonary and cardiovascular diseases or kidney failure and other related diseases. OM patients showed a significantly lower level of mental health compared to non-OM respondents(P=0.025). Approximately, 70.0% of ankle-foot injured veterans were dissatisfied with their life, and there was no difference between the two groups(P>0.05). Mobility was significantly lower in the OM patients than in the control group(P=0.023). Life satisfaction(P=0.001) and the ability to perform daily activities were the determinants for poor physical(P=0.018) and mental health-related quality of life(P=0.012). According to the Cierny and Mader classification system, they were all included in the type C host classification, with one major and/or three or more minor risk factors.Conclusion: A low level of quality and satisfaction of life and ability to perform activities of daily living were observed in OM patients with war-related ankle-foot injuries. Surgeries of the ankle and foot due to pain were much more common in OM patients than in non-OM participants. Since all the participants were classified as the C-host, health policy planning seems to be necessary.展开更多
Background: To identify health concerns of veterans with high-level lower extremity amputations.Methods: Through a cross-sectional study, general practitioners, an orthopedic specialist, psychologists, psychiatrists,p...Background: To identify health concerns of veterans with high-level lower extremity amputations.Methods: Through a cross-sectional study, general practitioners, an orthopedic specialist, psychologists, psychiatrists,physiotherapist and prosthetists examined 100 veterans using a short-form health-related quality of life questionnaire(SF-36) that assessed their ability to perform activities of daily living(ADL), instrumental activities of daily living(IADL) and life satisfaction(SWLS) after hip disarticulation or hemi-pelvectomy amputations. The assessment tool was designed to gather statistically useful information about their health needs.Results: The means of the Physical Component Summary(PCS), Mental Component Summary(MCS), SWLS, ADL and IADL were 48.58±29.6, 33.33±22.0, 19.30±7.7, 48.10±10.5 and 5.08±1.8, respectively. Somatization, depression, and anxiety were the most prevalent disorders;among the veterans who were visited by psychiatrists, 11.6% had a history of hospitalization in a psychiatry section, and 53.2% had a psychiatric visit. Regardless of their injury in battle, 34% of veterans were hospitalized. Hearing problems were common, and about four-fifths of the participants suffered from at least one orthopedic condition. Neuroma(49%) was the most common stump-related complication during orthopedic evaluations, though the prevalence of phantom pain was 81% during the pain assessment. A total of 87% of the participants had a history of wearing a prosthesis, but only 29% wore a prosthesis at the time of the present study.The Canadian-type of prosthesis was uncomfortable and not useful(27%) and excessively heavy(10%) according to the amputees.Conclusions: Understanding veterans’ characteristics and special needs are important to make sure that enough facilities and services are afforded to them. These findings emphasize the importance of paying close attention to different dimensions of health in veterans and can help health providers identify health needs and make regular assessments.展开更多
Background: To describe the mental health status of 78 child and adolescent survivors of post-war landmine explosions.Methods: Child and adolescent survivors of landmine explosions who were younger than 18 years old a...Background: To describe the mental health status of 78 child and adolescent survivors of post-war landmine explosions.Methods: Child and adolescent survivors of landmine explosions who were younger than 18 years old at the time of the study were identified and enrolled in this study. The mental health status of the participants was assessed by general health assessment and psychiatric examinations. Psychiatric assessment and diagnosis were undertaken using the Diagnostic and Statistical Manual for mental disorders(DSM-IV) criteria. A psychiatrist visited and interviewed each survivor and identified psychiatric disorders.Results: Seventy-eight child and adolescent survivors with a mean age of 16.11±2 years old were identified and agreed to participate in the study. The mean age of the victims at the time of injury was 8.2±3.12 years old(range 2–15). Thirty-seven(47.4%) of the adolescent survivors suffered from at least one psychiatric disorder. Twenty-nine survivors(37.1%) were newly diagnosed and needed to start medication and psychiatric treatment. The most common findings were anxiety disorders(34.6%), including posttraumatic stress disorder(PTSD) in 20(25.6%), and generalized anxiety disorder(GAD) in 7(9%) subjects. Mild-Moderate depression was found in 5(6.4%) subjects. No personality disorders were observed, and two patients suffered from mental retardation. The study results revealed a significant association between age of casualty, duration of injury and limb amputation, and types of psychological disorders.Conclusion: Child and adolescent survivors of landmine explosions had a high prevalence of psychiatric disorders.展开更多
Despite the passage of time,a large number of veterans are still affected by injuries acquired during Iran-Iraq war.In addition to their primary injuries,the majority of veterans also experience difficulty with long-t...Despite the passage of time,a large number of veterans are still affected by injuries acquired during Iran-Iraq war.In addition to their primary injuries,the majority of veterans also experience difficulty with long-term,secondary effects.Studies have shown that the most common of these include a range of disabilities,pain,and dramatic decline in mental health and quality of life.Improving living conditions and providing rehabilitation services to veterans has always been a main priority of authorities.The goal of this study was to explain the methods and materials with which these priorities were explored.展开更多
基金financially supported by the Janbazan Medical and Engineering Research Center.
文摘Background:The ankle-foot injuries are among the war-related injuries that cause many serious secondary problems for a lifetime.This nationwide study aimed to assess health-related quality of life and the ability to perform activities of daily living in veterans with ankle-foot injuries due to the Iran-Iraq war.Methods:A total of 1079 veterans with ankle-foot injuries were enrolled in a cross-sectional study from 2014 to 2016.Demographic characteristics,including age,gender,marital status,disability percent,educational level,employment and additional injuries,were collected.The ability to perform daily activities was assessed using the Barthel activities of daily living(ADL)and Lawton instrumental activities of daily living(IADL)Indexes.Physical and mental health-related quality of life(HRQOL)data were measured via the SF-36 subscales.The data were compared with those of bilateral lower limb amputees(BLLAs)and of the general Iranian population.Statistical analyses,including Pearson’s correlation coefficient,one-sample t-test and analysis of variance(ANOVA),were performed using SPSS16.0.A multiple linear regression model was used to determine the contribution of independent variables to the Physical Component Summary(PCS)and Mental Component Summary(MCS).Results:The highest and lowest scores were observed for mental health(48.93±20.69)and bodily pain(28.16±21.74),respectively.The mean scores of veterans with ankle-foot injuries on the SF-36 were significantly lower on all eight measures than those of the general Iranian male population and of the bilateral lower limb amputees(P<0.001).The mean scores of ADLs and IADLs were 83.9±16.3 and 5.3±2.0,respectively.The higher dependency in ADLs(P<0.001)and IADLs(P<0.001),the higher disability rate(P<0.001)and additional injury(P<0.001)were significant determinants of the PCS.ADL(P<0.001)and IADL(P<0.001)limitations,additional injury(P<0.001),history of hospitalization in the year preceding the study(P=0.007)and employment(P=0.001)were reported as determinants of the MCS.Conclusion:The results strongly suggest that veterans with ankle-foot injuries suffer from critically poor healthrelated quality of life.The main predicting factors of HRQOL were the disability to perform ADLs/IADLs,suffering two or more injuries,a history of hospitalization in the year preceding the study and unemployment.
基金financially supported by Janbazan Medical and Engineering Research Center(JMERC)
文摘Background: Osteomyelitis(OM) is an atypical consequence of ankle-foot trauma which is associated with long-term mental and physical morbidity and persistent pain. This study aimed to assess the health status of OM patients with war-related ankle-foot injuries.Methods: A total of 1129 veterans with ankle-foot injuries participated in a case-control study(2014–2016). Thirty patients with chronic OM of the ankle-foot were compared with 90 non-OM participants as the control group. Quality of life(QOL), life satisfaction and the ability to perform basic and instrumental activities of daily living were measured using the following questionnaires: short-form health survey(SF-36), satisfaction with life scale(SWLS), activity of daily living(ADL) and instrumental activity of daily living(IADL), respectively. OM patients were categorized according to their risk factors as A, B and C hosts using a modified version of the Cierny and Mader classification system. The one sample t-test, 2-independent sample t-test, ANOVA, Pearson correlation coefficient and multiple linear regression analyses were applied to analyze the data.Results: Ankle-foot pain leading to surgery(P <0.001) and orthosis usage(P =0.039) were more common in OM patients. There was no significant difference between the two groups in the prevalence of pulmonary and cardiovascular diseases or kidney failure and other related diseases. OM patients showed a significantly lower level of mental health compared to non-OM respondents(P=0.025). Approximately, 70.0% of ankle-foot injured veterans were dissatisfied with their life, and there was no difference between the two groups(P>0.05). Mobility was significantly lower in the OM patients than in the control group(P=0.023). Life satisfaction(P=0.001) and the ability to perform daily activities were the determinants for poor physical(P=0.018) and mental health-related quality of life(P=0.012). According to the Cierny and Mader classification system, they were all included in the type C host classification, with one major and/or three or more minor risk factors.Conclusion: A low level of quality and satisfaction of life and ability to perform activities of daily living were observed in OM patients with war-related ankle-foot injuries. Surgeries of the ankle and foot due to pain were much more common in OM patients than in non-OM participants. Since all the participants were classified as the C-host, health policy planning seems to be necessary.
基金financially supported by Janbazan Medical and Engineering Research Center(JMERC)
文摘Background: To identify health concerns of veterans with high-level lower extremity amputations.Methods: Through a cross-sectional study, general practitioners, an orthopedic specialist, psychologists, psychiatrists,physiotherapist and prosthetists examined 100 veterans using a short-form health-related quality of life questionnaire(SF-36) that assessed their ability to perform activities of daily living(ADL), instrumental activities of daily living(IADL) and life satisfaction(SWLS) after hip disarticulation or hemi-pelvectomy amputations. The assessment tool was designed to gather statistically useful information about their health needs.Results: The means of the Physical Component Summary(PCS), Mental Component Summary(MCS), SWLS, ADL and IADL were 48.58±29.6, 33.33±22.0, 19.30±7.7, 48.10±10.5 and 5.08±1.8, respectively. Somatization, depression, and anxiety were the most prevalent disorders;among the veterans who were visited by psychiatrists, 11.6% had a history of hospitalization in a psychiatry section, and 53.2% had a psychiatric visit. Regardless of their injury in battle, 34% of veterans were hospitalized. Hearing problems were common, and about four-fifths of the participants suffered from at least one orthopedic condition. Neuroma(49%) was the most common stump-related complication during orthopedic evaluations, though the prevalence of phantom pain was 81% during the pain assessment. A total of 87% of the participants had a history of wearing a prosthesis, but only 29% wore a prosthesis at the time of the present study.The Canadian-type of prosthesis was uncomfortable and not useful(27%) and excessively heavy(10%) according to the amputees.Conclusions: Understanding veterans’ characteristics and special needs are important to make sure that enough facilities and services are afforded to them. These findings emphasize the importance of paying close attention to different dimensions of health in veterans and can help health providers identify health needs and make regular assessments.
基金Foundation of Martyr and Veterans Af airsJanbazan Medical and Engineering Research Center (JMERC)the International Committee of the Red Cross
文摘Background: To describe the mental health status of 78 child and adolescent survivors of post-war landmine explosions.Methods: Child and adolescent survivors of landmine explosions who were younger than 18 years old at the time of the study were identified and enrolled in this study. The mental health status of the participants was assessed by general health assessment and psychiatric examinations. Psychiatric assessment and diagnosis were undertaken using the Diagnostic and Statistical Manual for mental disorders(DSM-IV) criteria. A psychiatrist visited and interviewed each survivor and identified psychiatric disorders.Results: Seventy-eight child and adolescent survivors with a mean age of 16.11±2 years old were identified and agreed to participate in the study. The mean age of the victims at the time of injury was 8.2±3.12 years old(range 2–15). Thirty-seven(47.4%) of the adolescent survivors suffered from at least one psychiatric disorder. Twenty-nine survivors(37.1%) were newly diagnosed and needed to start medication and psychiatric treatment. The most common findings were anxiety disorders(34.6%), including posttraumatic stress disorder(PTSD) in 20(25.6%), and generalized anxiety disorder(GAD) in 7(9%) subjects. Mild-Moderate depression was found in 5(6.4%) subjects. No personality disorders were observed, and two patients suffered from mental retardation. The study results revealed a significant association between age of casualty, duration of injury and limb amputation, and types of psychological disorders.Conclusion: Child and adolescent survivors of landmine explosions had a high prevalence of psychiatric disorders.
基金financially supported by Janbazan Medical and Engineering Research Center
文摘Despite the passage of time,a large number of veterans are still affected by injuries acquired during Iran-Iraq war.In addition to their primary injuries,the majority of veterans also experience difficulty with long-term,secondary effects.Studies have shown that the most common of these include a range of disabilities,pain,and dramatic decline in mental health and quality of life.Improving living conditions and providing rehabilitation services to veterans has always been a main priority of authorities.The goal of this study was to explain the methods and materials with which these priorities were explored.
