Disability In Iran Research Articles

Economic burden of sarcopenia-related disability in the elderly population: a study in Iran

ObjectiveSarcopenia is linked to escalating health costs, heightened risk of physical disability, diminished quality of life and an increased demand for care services. This study aimed to assess the economic impact of sarcopenia-related disability in Iran. A prevalence-based economic burden study was conducted utilizing the Population Attributable Risk (PAR) method, based on 2022 price index. Prevalence data for sarcopenia, categorized by gender and disease severity, were extracted from recent comprehensive studies. The relative risk of sarcopenia disability was determined from the most robust available evidence. Subsequently, direct medical costs, direct non-medical costs, and indirect costs for each individual with sarcopenia were computed and adjusted to 2022 values to estimate disability costs.ResultsTaking into account the prevalence of sarcopenia and the Iranian population across various age groups, 2,192,168 adults aged ≥ 60 years with sarcopenia in Iran were included. The total PAR of sarcopenia for men and women was estimated at 49% and 28%, respectively. The cumulative direct medical costs, direct non-medical costs, and indirect costs amounted to $215.1 million, $7.76 million, and $34.1 million, respectively. Additionally, the average total economic burden of sarcopenia-related disability in Iranian population aged ≥ 60 years was estimated at $257.1 million.

Disseminating the F-Words for Child Development to Parents of Children With Developmental Disabilities in Iran: A Qualitative Pilot Feasibility Study.

Attitudes toward childhood disability have historically focused on biomedical efforts on 'fixing'. The introduction of WHO's ICF framework for health and Canadian researchers' 'F-words' (functioning, fitness, fun, friends, family and future) have significantly changed the field. To explore whether the F-words ideas influenced parents' perspectives on their child's abilities and rehabilitation goals, this qualitative pilot study introduced the F-words to Iranian parents with a child with a developmental disability. This study was conducted in Tabriz, Iran, in 2023, using Iranian educational F-words materials built on ideas available on the CanChild F-words Knowledge Hub. Data were collected through semistructured interviews with five mothers of children <5 years old with a developmental disability before and after attending an 'F-words Awareness Session' and analysed using thematic analysis. In the preinterviews, six themes (and 20 subthemes) were identified: (i) routines (5); (ii) challenges (4); (iii) parental concerns (3); (iv) child's needs and priorities (3); (v) the role of parents in satisfying needs and challenges (2); and (vi) expectations of rehabilitation (3). In the postinterview, the same six themes and four additional subthemes emerged. Findings from the pilot study showed that the intervention had an impact on the attitudes and behaviours of participants. Specifically, teaching about the F-words reduced parents' emphasis on the concept of 'normality'. Families' positive response to the 'F-words Awareness Session' indicates their openness to incorporating this approach into their daily lives. These findings highlight the potential benefits of utilizing the F-words in rehabilitation in Iran. Studies like these can serve as a foundation for developing effective strategies for integrating the F-words into existing rehabilitation practices in Iran.

Motivation in caregiving among mothers of children with intellectual and developmental disabilities in Iran: A qualitative study

BackgroundThe motivation of caregivers plays a crucial role in the treatment, follow-up, and care of children with intellectual and developmental disabilities. Previous studies have focused on the older people and end-stage diseases, while giving less attention to the motivation of mothers caring for children with special needs. This study aimed to explore the motivations of mothers caring for children with intellectual and developmental disabilities in Iran.MethodsThis study employed a qualitative approach, guided by the Self-Determination Theory. Purposeful sampling was initially used, followed by theoretical sampling until data saturation was achieved. Data were collected through semi-structured interviews with 26 mothers of children with intellectual and developmental disabilities. Mayring’s seven-step directed content analysis approach was utilized for coding and categorization. The research adhered to ethical standards and ensured data trustworthiness through credibility, dependability, confirmability, and transferability measures.ResultsThe findings revealed that mothers’ caregiving motivations could be classified into four main categories: (I) intrinsic, (II) identified-extrinsic, (III) introjected-extrinsic, and (IV) external-extrinsic. Additionally, twelve sub-categories were identified within these four main categories.ConclusionThe findings revealed that mothers demonstrated varying levels of intrinsic and extrinsic motivations in caring for children with intellectual and developmental disabilities. By recognizing and enhancing the diverse sources of motivation, healthcare providers and policymakers can better support mothers in their caregiving roles, ultimately contributing to improved outcomes for both the mothers and their children.

Epidemiologic Depiction of Main Risk Factors of Brain Stroke in East Azerbaijan Province (The Northwest of Iran): A Hospital-Based Study

Background. Brain stroke is the second most common cause of death and the first cause of disability in Iran. Most stroke-related deaths occur in low- and middle-income countries. This epidemiological study was conducted due to insufficient studies and generally with a small sample size in the country, aiming at identifying the main risk factors for stroke in East Azarbaijan province. Methods. This cross-sectional study was performed using data gathered from 5430 patients with a definite diagnosis of brain stroke registered in the Tabriz Stroke Registration System (TSR) between February 2015 and June 2021 in the referral hospitals of East Azerbaijan. Analyses were performed using STATA software (version 17). Descriptive statistics were calculated, and a chi-square test was run. It is worth mentioning that any P&lt;0.05 was considered statistically significant. Results. The epidemiological profile of the main risk factors was presented in the framework of clinical trials and findings, clinical risk factors, and behavioral risk factors associated with brain stroke. The mean age of the patients was 69.52±15.72 years; 47.15% were female and 52.85% were male. The most common risk factors include: having high blood pressure (67.81%), snoring (32.06%), diabetes mellitus (22.23%), ischemic heart disease (17.55%), aspiration pneumonia (15.32%), smoking (13.65%), atrial fibrillation (10.15%), and hyperlipidemia (9.12%). Ischemic brain stroke (68.20%) was more common than hemorrhagic brain stroke (31.80%). Smoking was significantly higher in men than women (P&lt;0.001). The prevalence of hypertension (P&lt;0.001), atrial fibrillation (P=0.001), and hyperlipidemia (P&lt;0.001) was significantly higher in women than men. There was a direct and significant relationship between atrial fibrillation and age (P&lt;0.001) and female gender (P=0.001). Conclusion. The main risk factors for brain stroke include high blood pressure, snoring, diabetes mellitus, ischemic heart disease, aspiration pneumonia, smoking, atrial fibrillation, and hyperlipidemia, respectively. Hypertension is the most common risk factor among patients, so screening for asymptomatic cases is recommended. Educating people about common clinical manifestations can help expedite their early referral and treatment.

Barriers and enabling factors for utilizing physical rehabilitation services by Afghan immigrants and refugees with disabilities in Iran: a qualitative study

IntroductionIndividuals with a migrant background often underutilize physical rehabilitation services (PRS) compared to the host population. This disparity is attributed to various barriers, including limited access to information, language barriers, illiteracy, and cultural factors. To improve PRS utilization by Afghan immigrants and refugees in Iran, it is crucial to identify these barriers and enabling factors. In response, this study explored the barriers and enabling factors for utilizing PRS among Afghan immigrants and refugees with disabilities in Iran.MethodsThis qualitative study was conducted in Iran between January and March 2023. Participants were selected through convenient and snowball sampling. Individual, semi-structured interviews were carried out both in face-to-face and online formats. Data analysis occurred concurrently with data collection, using the directed content analysis approach.ResultsFindings from our research indicate that common barriers to PRS utilization among Afghan immigrants and refugees include insufficient insurance coverage, high service costs, expensive transportation and accommodation, limited knowledge about Iran’s health system, inadequate awareness of available supports, restricted access to PRS in remote areas, impatience among PRS providers, fear of arrest and deportation, a lack of trust in modern treatments, stringent immigration rules, high inflation rates limiting the ability to pay for PRS, and limited social support. On the other hand, several enabling factors were identified, such as strengthening insurance coverage, utilizing the capacities of charities and NGOs, providing information about available services, promoting respectful behavior by healthcare providers towards patients, facilitating cultural integration, and increasing immigrants’ awareness of available services and eligibility criteria.ConclusionThe barriers and enabling factors uncovered in this study offer valuable insights into the complexities surrounding PRS utilization by Afghan immigrants and refugees with disabilities in Iran. Understanding and addressing these factors is essential for developing targeted interventions and policies that can improve access and utilization, ultimately leading to enhanced health outcomes for this vulnerable population.

The effectiveness of green heart application to manage modifiable risk factors of coronary artery disease in Tehran Heart Center: Study protocol for a randomized controlled trial

The burden of cardiovascular disease (CVD) is diminishing in developed countries. However, in middle- and low-income countries the CVD death rates are growing. CVD is the most common cause of death and disability in Iran and accounts for nearly half of all mortalities in Iranians. Therefore, preventive strategies by risk factor modification are a top priority in the country.Recently, Mobile-Health (mHealth) technology has been the focus of increasing interest in improving the delivery of cardiovascular prevention, targeting a combination of modifiable risk factors.This parallel-group single-blinded randomized controlled trial study has been designed to evaluate the impact of using a mHealth application on risk factors control. Individuals aged between 25 and 75 years who have documented CVD by coronary angiography in Tehran Heart Center and have at least one uncontrolled risk factor from the three including hypertension, dyslipidemia, and current cigarette smoking will be included. We are going to randomize 1544 patients into two study arms as follows: 1- Intervention: usual care + mHealth 2- Control: usual care + paper-based recommendations and educational materials. After 3 and 6 months of follow-up, the status of risk factors will be determined through outpatient visits and face-to-face interviews for both arms. Outcome: Successful risk factor control will be measured after 3 and 6 months.Nowadays, mHealth is becoming increasingly popular, providing a good opportunity for constant monitoring of risk factors and changing health behavior in a target population. Meanwhile, providing evidence for the effectiveness of health intervention delivery using mobile technologies could help health providers encourage their at-risk population to stop smoking, control blood pressure and blood cholesterol, and participate in regular physical activity. While the burden of CVD is growing in developing countries, this type of intervention can be a cost-effective way to reduce it in these countries.

Caregivers’ concerns about the sexual and reproductive health of women with intellectual disability in Iran: a qualitative study

BackgroundWomen with intellectual disability (ID) have many sexual and reproductive problems. This study was conducted to explain the sexual and reproductive health considerations of women with ID from the perspective of their caregivers in a qualitative approach.MethodsThis study was a qualitative research conducted with a content analysis approach in Iran. The sampling method used was targeted sampling with maximum possible variation, which was continued until data saturation. For data collection, in-depth and semi-structured interviews were conducted with 21 participants, including 8 mothers, 6 caregivers, and 7 specialist caregivers who had experience working with women with intellectual disabilities. Data analysis was conducted using the conventional content analysis method proposed by Zhang and Wildemuth.ResultsTwo main themes, four categories and 12 subcategories emerged from the data analysis. The themes include “Reproductive health concerns” and” "Sexual health concerns”. This means that this group of women has many problems with menstrual hygiene and vaginal infections. On the other hand, caregivers were concerned about the manifestations of unconventional sexual behaviors and difficulties in controlling sexual behaviors as well as the risk of sexual abuse.ConclusionThe results of the present study show that it is not only necessary to provide women with ID with practical instructions on menstrual hygiene and sexual self-care, but also that regular examinations of the reproductive system by obstetricians or midwives, especially in care centers, seem essential.

Disability-adjusted Life Years of Hepatitis B in Iran during 2009–2019: An Analysis Based on the Global Burden of Disease Study 2019

Background and Purpose Hepatitis B virus infection is currently among the ten leading causes of death from infectious diseases in the world. The aim of the current study is spatial analysis related to life years adjusted by hepatitis B disability in Iran from 2009 to 2019. Materials and Methods The study is ecological. Using data from the Global Burden of Diseases (GBD), cause-specific mortality served as the basis for estimating disability-adjusted life years (DALYs). Time trend analysis of DALYs attributed to hepatitis B from 2009 to 2019 and spatial pattern analysis and identification of high-risk and low-risk clusters of DALYs attributed to hepatitis B in Iranian provinces were performed. Time trend changes were evaluated using joinpoint regression analysis. Results The most likely high-risk cluster with LLR=238.59 in the West of Iran includes the western provinces of the country (Lorestan, Kermanshah, Hamedan, Markazi, Khuzestan, and Ilam) (relative risk of occurrence 2.31). The three provinces of Lorestan (RR=2.22), Sistan and Baluchistan (RR=1.73), Golestan (RR=1.46) have the highest relative Khazar, and the three provinces of Gilan (RR=0.41), Mazandaran (CIR=0.48) and Kurdistan (CIR=0.51) had the lowest relative risk. During the years 2009 to 2019, the total DALYs decreased by 1.5% annually (p&lt;0.05). Conclusion According to the results of the disease control and prevention programs, it can be effective in reducing the disease burden in the country by giving priority to the provinces that are among the high-risk disease clusters.

Inpatient healthcare utilization among people with disabilities in Iran: determinants and inequality patterns

BackgroundPeople with disabilities (PWD) have different health service needs and different factors affect the utilization of these services. Therefore, the aim of this present study was to identify determinants of inpatient healthcare utilization among PWDs in Iran.MethodsThis research was a secondary data analysis of a cross-sectional study. The present study used data gathered for 766 PWDs (aged 18 years and older) within the Iranian Society with Disabilities (ISD) between September and December 2020. Multiple logistic regression models calculated adjusted odds ratios (aOR) and 95% confidence intervals in order to identify determinants of inpatient healthcare utilization among PWDs.ResultsData for 766 people with disabilities were analyzed. A large number of participants were over 28 years of age (70.94%), male (64.36%), and single (54.02%). In the present study, more than 71% of participants had no history of hospitalization during the last year. In this study, males [aOR 2.11(1.14–3.91), participants with Civil Servants health insurance coverage [aOR 3.44 (1.16 − 10.17)] and individuals in the 3th quartile of disability severity [aOR 2.13 (1.01 − 4.51)] had greater odds of inpatient healthcare utilization compared to the other groups. The value of the concentration index (C) for inpatient healthcare utilization was − 0.084 (P.value = 0.046). The decomposition analysis indicated that gender was the greatest contributor (21.92%) to the observed inequality in inpatient healthcare utilization among participants.ConclusionOur findings suggested that the likelihood of hospitalization among the study participants could be significantly influenced by factors such as gender, the health insurance scheme, and the degree of disability severity. These results underscore the imperative for enhanced access to outpatient services, affordable insurance coverage, and reduced healthcare expenditures for this vulnerable population. Addressing these issues has the potential to mitigate the burden of hospitalization and promote better health outcomes for disadvantaged individuals.

Factors Explaining the Change in Socioeconomic Inequality of Disability in Iran: A Repeated Cross-sectional Study.

More than 15% of the world's population live with some form of disability. Assessing socioeconomic inequalities in disability and monitoring its change over time can help policymakers to design and implement targeted interventions to reduce these inequalities. This study aimed to assess the change in socioeconomic inequality in disability in Iran from 2000 to 2010. Data for this cross-sectional study were obtained from 2 waves of Iran's demographic and health surveys (2000 and 2010). The Wagstaff normalized concentration index was used to measure the socioeconomic inequality of disability. Contributing factors to the inequality in 2000 and 2010 were investigated by concentration index decomposition. The Blinder-Oaxaca decomposition method was used to determine contributing factors of change in disability inequality. All analyses were conducted in Stata14. The negative and statistically significant concentration indices (-0.132 in 2000 and -0.165 in 2010, P < 0.001) suggested more concentration of disability among poor people. The absolute value of inequality was increased by 0.034 between the 2 points of time (P = 0.025). Level of education (123.5%), household size (12.9%), age (-35.1%), and residency (in terms of Iran's provinces) (-19.3%) were the contributing factors to the measured disability inequality in 2000. In 2010, level of education (105.8%), household size (30.5%), and urban residency (-46.3%) explained the measured inequality. Change in disability inequality was explained by household size (99.4%), province of residence (54.8%), education (36.9%), socioeconomic status (20%), urban residency (-90.3%), and age (-47.7%). Iran suffers from significant socioeconomic inequality in disability, and it significantly increased over time. Interventions such as increasing health literacy and providing suitable job opportunities for people with low education level, improving the socioeconomic status of extended households, and paying more attention to the balanced development in the provinces and urban and rural areas, and attending to prevention, treatment, and mitigation of disability adversities among poor young and elderly people could be recommended to tackle increased socioeconomic inequality in disability and its unfavorable consequences in Iran.

Epidemiology of Traumatic Brain Injury in Iran: A Systematic Review and Meta-Analysis.

Traumatic brain injury (TBI) is one of leading cause of death and disability in Iran that has serious consequences on people's health. Understanding of epidemiology of TBI can be helpful for policy making in health care management. Therefore, this study aimed to examine the epidemiology of TBI in Iran. PubMed, Web of Science, Scopus, Google scholar, and internal databases including, SID, Magiran, and IranMedex were searched to identify the relevant published studies up to Feb 2022. Moreover, the references list of key studies was scanned to find more records. The Joanna Briggs Institute (JBI) tool was used to assess the quality of included studies. The Excel and Comprehensive Meta-Analysis software were to analyze the data. Overall, 23,446 patients from 15 studies were included in the study. The overall mean age of the patients was 31.36 ± 0.13 yr (95%CI: 31.10 to 31.61). The majority of the patients were male (74.37%), with a male to female ratio of 3:1. The incidence rate of TBI was 15.3 to 144 per 100,000 population. The mortality rate of TBI was estimated to be 10.4% (95%CI: 5% to 19%). The most common causes of injury were road traffic accidents (RTAs) (60%; 95%CI: 49% to 70%), and falling (20%; 95%CI: 16% to 26%), respectively. The most frequent type of head injury was subdural hematoma. Our findings highlight that appropriate control and prevention strategies should be focused on male, road traffic accidents, and the group under 40 yr.

The Status of Rehabilitation in Iran: Barriers and Facilitators

Objectives Rehabilitation is one of the basic services for the elderly and people with disabilities and provides the possibility of equal opportunities and participation in the society. In fact, it is one of the main pillars of the health; however, less attention has been paid to this issue in Iran, and it does not have a specific place in the health system. The present study aims to find barriers and facilitators regarding rehabilitation programs for the elderly and people with disabilities in Iran. Methods &amp; Materials This is a qualitative study using content analysis method. Participants were 13 experts in different fields of rehabilitation who were selected using a purposive sampling method which continued until the data saturation. The data were collected using a semi-structured in-depth interview from February 2021 to February 2022. The interviews were transcribed verbatim, and then were analyzed by using conventional content analysis method and using constant comparative analysis. Results Two main categories of barriers and facilitators, each with 4 sub-categories were identified. The barriers were: High number of rehabilitation trustees, lack of awareness of officials and people, lack of attention to the role of the municipality in rehabilitation, and poor rehabilitation management. Facilitators were: Building culture in the field of rehabilitation and disability, improving the insight of officials, the role of rehabilitation specialists, benefiting from the experiences of other countries Conclusion The identified barriers and facilitators can help officials and policymakers in Iran to improve the status of rehabilitation and provide better services to people with disabilities.

The Rights of Disabled People in Iran: A Meta-synthesis Study

Objective There are so many people with disabilities worldwide. This condition has led to taking various national and international measures regarding the rights of people with disabilities. Protecting the rights of people with disabilities in the context of international methods is an important issue that has been explored for years. This study aims to explain the dimensions of the rights of people with disabilities in Iran. Materials &amp; Methods In this study, the meta-synthesis method was used, and the statistical population of the research articles was extracted from various research databases, such as Magiran, Normgaz, Regional Information Center for Science and Technology, Science Net Database, Nematan, Civilica, and Humanities Portal were selected. In this study, based on the inclusion criteria, such as title, abstract, content, and quality assessment of studies, 14 articles were finally selected for study analysis. In addition, the time frame of this research is from 2009 to 2020. Also, this study used the 7-step method of Sandelowski and Barros (2007) to analyze the research data. Results The most important rights of the disabled are employment, human value and dignity, education, belonging, proper design of urban furniture, access to health services, elimination of social discrimination, recreation and leisure, social security, freedom, and transportation. By reviewing and integrating the initial findings in this study, after going back and forth between sub-fields, 7 main fields of disability rights were obtained: cultural, economic, political, architectural and urban rights, social, medical, and legal rights. This study examined the content validity ratio and content validity index. The opinions of 8 experts in this field have been used to calculate this ratio. Concerning the content validity ratio, it should be said that it was acceptable for all dimensions. The Kappa index has been used to measure the reliability of the designed model; the kappa coefficient is calculated to be 87%, which is at a high level of the agreement due to the status of the kappa index. Conclusion Legally, people with disabilities have cultural, economic, political, architectural, urban, social, medical, and legal rights. Different and negative views of managers and individuals in society have led to disregarding the rights of people with disabilities. Lack of proper knowledge about people with disabilities and subsequent marginalization will have negative consequences. Proper knowledge of this phenomenon and awareness of the capabilities of people with disabilities is an effective step toward developing a country. Most people with disabilities have been deprived of their basic social, economic, political, and cultural rights. In this regard, pervasive stereotypes, attitudes, and discrimination have reinforced this injustice. It is worthwhile that by changing the perspective of the international community, government, and citizens, able-bodied people can live a just life alongside others. The Iranian government can assist people with disabilities in enacting and enforcing various laws on the rights of persons with disabilities.

Stewardship; The Missing Loop of Rehabilitation in the Health System: A Policy Brief.

Providing optimal rehabilitation services for people with disabilities has always been recognized as a major concern of health systems in all countries. Stewardship is one of the biggest challenges to provide rehabilitation services to people with disabilities in Iran. We advocate the Ministry of Health & Medical Education (MoHME) to take the lead as a steward of rehabilitation services in Iran, while the dedicated sections in the MoHME need to be determined, with a clear list of responsibilities and affiliations.

Availability of Physical Rehabilitation Facilities for People with Disabilities in Iran: A Comparative Study on Universal Health Coverage.

Iran, like many other countries, has committed to providing universal and equal access to health care and rehabilitation for people with disabilities by joining the Convention on the Rights of People with Disabilities. Thus, this study aimed to examine the availability of rehabilitation facilities on national and sub-national levels. This cross-sectional study was conducted between May and December 2019. The data of rehabilitation facilities including infrastructure and rehabilitation workforce in health system settings were obtained using rehabilitation master list. The data were collected from the Vice-Chancellor for the Treatment Ministry of Health and Medical Education, the Rehabilitation of the State Welfare Organization, and Licensing and Planning the Medical Council in the 32 provinces of Iran and analyzed using Excel version 2016. On the national level, the following situation was found: in inpatient settings: 1.1 beds per million population; in outpatient settings: physiotherapy 42.6, optometry 16.4, audiology 10.5,occupational therapy 8.2, speech therapy 8.1, orthotic & prosthetic 4.5, physical medicine & rehabilitation 3.8 centers; day-care centers 11.7 and rehabilitation centers 1.3 centers, community-based rehabilitation (CBR): 15.9 units, rehabilitation home care 2 centers, rehabilitation nursing home care 1.6 centers and medical rehabilitation home care 0.3; Long-term care centers: residential care 4.1 centers per million population. Regarding rehabilitation work force: physiotherapists 84, speech therapists 34.8, occupational therapists 32.5, optometrists 31.2, audiologists 27.9, prosthetists and orthotists 10.3 therapists and physical medicine & rehabilitation 5.1 specialists per million populations. On the sub-national level, there were no outpatient rehabilitation centers in 12 of the provinces and the distribution of day rehabilitation centers in the rich provinces was 10 times higher. The number of CBR units, rehabilitation home care and rehabilitation nursing home were 40, 22, and 23 times higher in rich provinces than in poor provinces, respectively and there were no medical rehabilitation home care centers in 21 provinces. Regarding long-term care, the residential care centers in the richest province were 8 times higher. According to the WHO report and the rehabilitation expert panel, it was concluded that the number of rehabilitation facilities including rehabilitation centers and workforce was limited in Iran and that the available centers were also poorly distributed in the provinces of the country. This made it difficult for people to have fair access to rehabilitation services. It appears that health policymakers should pay special attention to further developing rehabilitation facilities.

Factor Structure and Validation of the Electronic form of Persian Behavioral Rating Inventory of Executive Functions in Male School Students With Learning Disabilities

Background and Aims This study aims to evaluate the factor structure and validity of the electronic form of the Persian version of Behavioral Rating Inventory of Executive Functions (BRIEF) in male school students with learning disabilities. Methods This is a psychometric study using the structural equation modeling. Participants included 100 male school students with learning disabilities in Kerman for assessing the validity and 430 male school students with learning disabilities for assessing the convergent validity. They were selected by a random sampling method. The data were collected electronically using the Persian BRIEF and Nejati’s Executive Functions Questionnaire (EFQ). The reliability was determined by assessing internal consistency and split-half reliability. Results The results of exploratory factor analysis showed that the questionnaire had eight factors with good validity and reliability. The second-order confirmatory factor analysis confirmed the eight-factor model. The online Persian BRIEF score had a signifcant correlation with the EFQ score (P&lt;0.001). Conclusion The online Persian BRIEF can be used to assess the executive functions in male school students with learning disabilities in Iran.

COVID-19 Pandemic and Experiences of People With Disabilities in Iran

More than a billion people suffer from different disabilities and require special healthcare due to their special condition compared to others; however, they usually receive less healthcare and face difficulties accessing health and medical services which, in return, can result in adverse health consequences for them [1]. Hence, the emergence of diseases such as COVID-19 can exacerbate the problems of people with disabilities and expose them to extreme health risks due to their disabilities, and weak immune systems. Epidemiological evidence suggests that the COVID-19 is exceptionally contagious and can quickly spread. The transmission speed of COVID-19 is so rapid such that, after the first case detected in Wuhan, China in December 2019.

Developing and Accessing Psychometric Properties of The Persian Version of Behavior Assessment System for Children (3Rd Edition) in Children With Mild Intellectual Disabilities and Normal Children

Objectives: The present study aims to develop and evaluate the psychometric properties of the Persian version of Behavior Assessment System for Children, 3rd edition (BASC-3) in children with mild intellectual disabilities and normal children. Methods: This is a cross-sectional study conducted in 2017 on 438 girls and boys with mild intellectual disabilities and normal children aged 12-18 years who were selected using a cluster sampling method. The data collection tool was the Persian BASC-3 and its Parent Rating Scale (PRS-A) and Teacher Rating Scale (TRS-A). Data analysis was performed in SPSS v. 24 using descriptive and inferential statistics. Results: According to the results obtained from factor analysis, assessing correlation of subscale scores with total score, test-retest reliability, and Cronbach’s alpha showed that the Persian BASC-3 and its PRS-A and TRS-A forms had acceptable validity and reliability. Conclusion: The Persian BASC-3 and its parent and teachers forms have good psychometric properties and can be used to evaluate the behavioral and adaptive problems of normal adolescents and children and those with mild intellectual disabilities in Iran.

Catastrophic health expenditures for children with disabilities in Iran: A national survey

The aim of this study was to investigate thepercentage of households with disabled children aged 0-8years who had faced catastrophic health expenditures (CHEs) due to the health costs of these children in Iran. This cross-sectional study was carried out on 2000 households with disabled children aged 0-8years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Determinants of CHE were identified using logistic regression. 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR=18.89, 95%CI: 10.88-29.42), poor economic status of the household (Q1: Adjusted OR=20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR=8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR=13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR=6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR=2.71, 95%CI, 1.60-4.69), and type of basic health insurance (having Iranian Health Insurance: Adjusted OR=2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR=1.66, 95%CI, 1.06-2.61) significantly increased the chances of facing CHE. A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.

Knowledge, attitude, and practices of persons with disabilities towards COVID-19: Evidence from the Islamic Republic of Iran

Aims Understanding the knowledge, attitude, and practices of persons with disabilities about COVID-19 are essential for taking targeted prevention and control measures. This study aimed to explore the level of knowledge, attitude, and practices related to COVID-19 in persons with disabilities and identify obstacles and facilitators of promoting their knowledge, attitude, and practices. Instrument & Methods A mixed qualitative-quantitative study was conducted on 1067 Persons with disabilities in Iran in 2020. The researchers collected descriptive data using an online researcher-made questionnaire that included demographic and knowledge, attitude, and practices sections which its participants were selected randomly from all Persons with disabilities in Iran. Data were analyzed by SPSS 20 and using the Kruskal–Wallis and one-way ANOVA tests. To identify facilitators and barriers to improving knowledge, attitude, and practices, semi-structured interviews were done with 31 participants who were selected using purposeful sampling. Data were analyzed by content analysis approach. Findings The mean±SD scores of knowledge, attitude, and practice of persons with disabilities were 17.7±0.5, 16.6±0.7, 16.9±0.9, respectively, which were good. One-hundred sixty-one codes were identified, which were categorized into three themes and nine sub-themes. The main facilitators of KAP improvement among study participants were educational content developed during the pandemic and their dissemination using social media, community participation, and the empowerment of PWDs. Weak governance was mentioned as an essential barrier for knowledge, attitude, and practices improvement. Conclusion Further interventions are needed to increase the knowledge and improving attitudes and practice of Persons with disabilities during the crisis. Among them, the following are in priority: strengthening the governance arrangement of rehabilitation;increasing community participation;providing support packages and their fair distribution;empowering Persons with disabilities;preparing infrastructures for telerehabilitation;public awareness and, if needed, informing health workers about the specific needs of persons with disabilities and how to treat them respectfully. Copyright © 2021, the Authors.