الفهرس 
DedicationOnly 14 pages are availabe for public view
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Abstract
Summary
Aging process is a normal, irreversible, physiologic process. It has the sum of changes that normally occur in an organism with the passage of time Therefore, leads to a gradual decrease in the physical and mental capacity of the elderly, in addition to a growing risk of comorbidities, variety of physical and psychological health problems.
The aim of this study:
The aim was to assess the effect of comorbidities on physical function and on psychological wellbeing among elderly At Qena city.
Research design: descriptive design was used in this study.
Sample and setting:
Apurposive sample was used, the study conducted on 350 elderly who were selected from the elderly club of Qena city and outpatient clinic of at Qena general hospital.
The following tools were utilized for data collection:
Tool (I): A structured questionnaire sheet for collecting the needed data. It consisted of two parts:
Part (1): It includes socio-demographic data as, age, sex, residence, marital status, income, occupation, and level of education…...etc.
Part (2): previous history, using of hearing and vision aids ,presence of care giver and their educatin .
Tool (II): charlson Comorbidity Index (CCI):
The tool is used to identify comorbidities and percent of the total number of comorbidities or diseases for each elderly of the studied sample.
Tool (III): The late life function and disability instrument (LLFDI)
The tool is composed of two primary components, but the function component only was used to assess physical function for the elderly of the studied sample.
Tool (IV): The WHO-5 Well-Being Index
The WHO-5 Well-Being Index is a self-assessment instrument consisting of five multiple choice questions. designed to measure the level of psychological well-being.
Method
I- Administrative stage:
An official letter of approval was obtained from the dean of the faculty of nursing to the director of Qena general hospital,to the director of the elderly club of Qena City to carry out the study. The letter included a permission to carry out the study and explained the purpose and nature of the study.
II-Pilot study:
Pilot study was carried out before the starting of data collection on10% (35 elderly) of the elderly patients who fulfilled the inclusion criteria to test the clarity, feasibility of the interview questionnaire and to estimate the time needed to fill it. They were excluded from the total sample. based on the result of the pilot study the necessary modifications and the questionnaire was reconstructed for ready to be use.
III- Ethical Consideration:
• The research proposal was approved by the ethical committee in the faculty of nursing Assiut university.
• There was no risk for study subject during application of the research
• The study followed common ethical principles in clinical research.
• Written consent was obtained from the directors of the places and oral from the patients that are willing to participate in the study, after explaining the nature and purpose of the study.
• Confidentiality and anonymity were assured.
• The study subject had the right to refuse to participate or withdraw from the study without any rationale at any time.
• The study subject privacy was considered during the collection of data.
IV- Data collection:
data collection was carried out from 1st of December 2019 for eight months to the 30th of July 2020. The researchers collected data three days per week. Saturday and Sunday at Qena general hospital outpatient clinics and Wednesday at the elderly club of Qena City.
The main results of the study revealed the following:
- The studied elderly age ranged from 60 to more than 70 years, with (51.7%) of the elderly were females and married. (35%) of the elders were had university educated, (30.3%) were had secondary education. before retirement more than one third of them (36%) were employee followed by (24.3%) were free business. (49.9%) were from urban. (92.9%) were lived with their families.
- Most of the studied elders (84%) were having hypertension, more than half of the studied elderly (81%) were having three diseases and more.
- Concerning the functional activity of the elderly, more than half from the elders (61.4%) were having moderate limitation in physical activity.
- Concerning the elderly psychological wellbeing more than half v (60.6%) from the elders had poor psychological well-being.
- There was a highly statistically significance difference (p=0.00) with (CCI) all demographic characteristics of the the elderly except sex (p=0.157).
- there was a highly statistically significance difference (p=0.00) with the function component score of (LLFDI) and all the demographic characteristics of studied eldely except sex (p=0.83).
- there was a highly statistically significance difference (p=0.00) with the WHO-5 Well-Being Index and all demographic characteristics of studied elderly except sex (p=0.102).
- there was Negative correlation (R= - 0.671) (P=0.00) between the charlson Comorbidity Index (CCI) and the function component score of (LLFDI).
- there was negative correlation (R=-0.604) (P=0.00) between the charlson Comorbidity Index (CCI) and the WHO-5 Well-Being Index.
- there was positive correlation (R=0.868) (P=0.00) between function component score (LLFDI) and WHO-5 Well-Being Index.
Based on the results of the present study, it could be concluded that:
- Most of the studied sample had hypertension and DM, more than half of them had three diseases and more, they had moderate limitations in functional activities and poor psychological wellbeing. Comorbidities have an effect on the physical function and well-being among the elderly: there are a negative correlation between charlson Comorbidity Index (CCI) and the function component score of (LLFDI) and with WHO-5 Well-Being Index and there is positive correlation between function component score of the (LLFDI) and the WHO-5 Well-Being Index.
The following recommendations are suggested: -
• Increasing awareness through providing health education programs regarding comorbidities and psychological wellbeing for the elders and elderly caregivers provided by gerontological nurses.
• Providing rehabilitation program to improve the function activities and psychological wellbeing among the elderly with comrbidties.
• Providing follow-up for elderly patients with poor physical function and psychological well-being.
• Further research must be conducted to explore association between comorbidities, physical function and the psychological well-being.