Shati Mohsen, Alami Ali, Mortazavi Seyede Salehe, Eybpoosh Sana, Emamian Mohammad Hassan, Moghadam Manije
Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
Med J Islam Repub Iran. 2020 Nov 10;34:152. doi: 10.47176/mjiri.34.152. eCollection 2020.
Older adults are at higher risk for severe illness and death associated with coronavirus disease 2019 (COVID-19). As Iran was affected by COVID-19 pandemic, the elderly population soon were told to self-isolate for a very long time. We aimed to identify the coverage, efficacy, and integrity of self-isolation and its predictors in the Iranian older adults (≥60 years) from February 19 to 19 March 2020. Quota sampling was performed to recruit respondents from 16 cities that were selected based on their population size (4, 7, and 5 cities for localities with ≤500 000, 500 000-1 000 000, and ≥1 000 000 populations) and geographical direction (West = 4 cities; North, East, South, Center = 3 each). At least 30 respondents per locality were selected. Phone interviews of 558 respondents (out of 560; response rate = 99.6%) were performed by local trained interviewers using a validated interview form. Association between age, sex, and living condition (with family vs alone) was assessed with Pearson Chi Square and logistic regression analyses. Complete self-isolation was reported by 61% of the respondents. In 72%, self-isolation led to 80%-100% contact reduction. Self-isolation was broken by 26% of the respondents. Females had better self-isolation behaviors (OR adjusted: 2.3, 95% CI: 1.5, 3.3) and higher contact reduction rates (p: 0.067). They kept the integrity of self-isolation better (OR adjusted: 1.8; 95% CI: 1.2, 2.7). Those aged older than 80 years were 2.3-folds more likely to completely self-isolate than younger elderly (95% CI adjusted: 1.2, 4.3). Living alone did not significantly predict self-isolation features in the elderly. About one third of the interviewed Iranian older adults did not adhere to important self-isolation measures, with males and younger ages showing lower adherence. With the relaxation of social distancing measures, protection measures of the elderly should be strengthened. Given that prolonged self-isolation adversely affects physical and mental health status of the elderly, it is highly recommended to think of creative and gender-specific methods that best tailor the needs of this population in Iran.
老年人感染2019冠状病毒病（COVID-19）后出现重症和死亡的风险更高。由于伊朗受到COVID-19大流行的影响，老年人群很快被告知要长时间自我隔离。我们旨在确定2020年2月19日至3月19日期间伊朗老年人（≥60岁）自我隔离的覆盖率、效果和完整性及其预测因素。采用配额抽样方法，从16个根据人口规模（人口≤50万、50万-100万、≥100万的地区分别为4个、7个和5个城市）和地理方向（西部=4个城市；北部、东部、南部、中部各3个城市）选定的城市中招募受访者。每个地区至少选择30名受访者。由当地经过培训的访谈员使用经过验证的访谈表格对560名受访者中的558名（回复率=99.6%）进行电话访谈。采用Pearson卡方检验和逻辑回归分析评估年龄、性别和生活状况（与家人同住与独居）之间的关联。61%的受访者报告完全自我隔离。72%的受访者表示自我隔离使接触减少了80%-100%。26%的受访者打破了自我隔离。女性的自我隔离行为更好（调整后的比值比：2.3，95%置信区间：1.5，3.3），接触减少率更高（p值：0.067）。她们更好地保持了自我隔离的完整性（调整后的比值比：1.8；95%置信区间：1.2，2.7）。80岁以上的老年人完全自我隔离的可能性是年轻老年人的2.3倍（调整后的95%置信区间：1.2，4.3）。独居并不能显著预测老年人的自我隔离特征。约三分之一接受采访的伊朗老年人没有遵守重要的自我隔离措施，男性和年轻人的遵守率较低。随着社交距离措施的放松，应加强对老年人的保护措施。鉴于长时间的自我隔离会对老年人的身心健康状况产生不利影响，强烈建议想出有创造性的、针对性别的方法，以最好地满足伊朗这一人群的需求。
