ارتباط وضعیت سلامت عمومی (روش گلدبرگ) با موقعیت اقتصادی-اجتماعی و مشخصات دموگرافیک در مجروحین شیمیایی سردشت

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه زیست شناسی، دانشکده علوم پایه، دانشگاه شاهد، تهران، ایران

2 گروه فیزیولوژی، دانشکده پزشکی، دانشگاه شاهد، تهران، ایران

3 مرکز تحقیقات ایمونولوژی، دانشگاه شاهد، تهران، ایران

4 گروه ایمونولوژی، موسسه بیوشیمی و بیوفیزیک، دانشگاه تهران، تهران، ایران

5 گروه سلول‌های جنسی و شبیه سازی، پژوهشکده تحقیقاتی فناوری جنین دام، دانشگاه شهرکرد، شهرکرد، ایران

چکیده

مقدمه و هدف: جمهوری اسلامی ایران در زمان جنگ تحمیلی به مدت پنج سال بوسیله رژیم صدام حسین مورد یورش شیمیایی قرار گرفت که این مسئله آسیب های جسمی و روانی بسیاری را به همراه داشت. هدف از این مطالعه بررسی وضعیت سلامت عمومی و ارتباط آن با موقعیت اقتصادی اجتماعی غیرنظامیان سردشت بود.
مواد و روش ها: این مطالعه بخشی از پژوهش غضنفری، واعظ مهدوی و همکاران از سال 1387 است. جامعه مورد مطالعه 28 نفر از جانبازان شیمیایی سردشت بود که با استفاده از پرسشنامه سلامت عمومی (GHQ) گلدبرگ ارزیابی شدند که با نمرات از 0 (برای بهترین) تا 84 ارزش گذاری شدند. همچنین ارتباط سطح سلامت عمومی آنان با موقعیت اقتصادی اجتماعی در نظر گرفته شد. همچنین، سطح تحصیلات، شدت مواجهه، درصد جانبازی و کیفیت زندگی مورد ارزیابی قرار گرفت.  جهت آنالیز داده‌ها از تحلیل واریانس و رگرسیون غیر خطی استفاده شد. نتایج: میانگین سلامت عمومی در گروه نرمال، خفیف و شدید (بر اساس شدت جراحت) به ترتیب 0/50، 5/51 و 8/29 به دست آمد که بیانگر اختلاف در سلامت عمومی گروه شدید با دو گروه خفیف و نرمال (05/0>P) بود. همچنین بین متغیرهای موقعیت اقتصادی اجتماعی، سطح تحصیلات، کیفیت زندگی، شدت مواجهه و درصد جانبازی مجروحین با سلامت عمومی ارتباط معنی داری در بیشتر گروه‌ها وجود داشت.
نتیجه گیری: نتایج نشان دادند که بهبود موقعیت اقتصادی اجتماعی نقش بسزایی در سلامت عمومی و روانی افراد دارد. به طوری که موقعیت اقتصادی اجتماعی پیش‌بینی کننده مهم اثرات مخرب گاز خردل بر سلامت عمومی و روانی بوده و بر وضعیت بهداشتی واقعی تاثیرگذار است.

کلیدواژه‌ها


عنوان مقاله [English]

Relationship of general health status (Goldberg method) with socioeconomic position and demographic features in Sardasht chemical veterans

نویسندگان [English]

  • Leila Nasiri 1
  • Mohammadreza Vaezmahdavi 2
  • Tooba Ghazanfari 3
  • Sussan Kaboudanian Ardestani 4
  • Hossein Hassanpour 5
1 Department of Biology, Faculty of Basic Sciences, Shahed University, Tehran, Iran
2 Department of Physiology, Faculty of Medicine, Shahed University, Tehran, Iran
3 Immunoregulation Research Center, Shahed University, Tehran, Iran
4 Department of Immunology, Institute of Biochemistry and Biophysics, University of Tehran, Tehran , Iran
5 Department of Gametes and Cloning, Research Institute of Animal Embryo Technology, Shahrekord University, Shahrekord, Iran
چکیده [English]

Background and Objective: The Islamic Republic of Iran was chemically attacked by the Saddam Hossein’s enemy for five years during the imposed war and this issue caused many physical and psychological injuries. The aim of this study was to investigate the general health status and its relationship with the socio-economic status of non-army citizens of Sardasht.
Materials and Methods: This study was part of the research of Ghazanfari, Vaezmahdavi, et al since 2008. The study population was 28 chemical warfare veterans in Sardasht who were evaluated using the Goldberg General Health Questionnaire (GHQ), rating from 0 for best to 84 the worth health situation. Also, the relationship between the general health situation and socio-economic status were considered. In addition, the level of education, severity of exposure, injury rate and quality of life were evaluated.
Results: The mean of general health in normal, mild and severe exposure groups was 50.0, 51.5 and 29.8, respectively, which indicates difference in general health of between group severe with group mild and normal (P<0.05). Also, there was a significant relationship between the variables of socio-economic status, level of education, quality of life, intensity of exposure and the percentage of casualties with general health in most groups. Data were analyzed by one-way analysis of variance and nonlinear regression.
Conclusion: The results showed that improving socio-economic status plays an important role in public and mental health. So, the socio economic status is a significant predictor contributing destructive effects of mustard gas on general and mental health and influences actual health situation.

کلیدواژه‌ها [English]

  • Socio-economic status
  • General Health Questionnaire (G.H.Q)
  • Sardasht Chemical veterans
  1. Croddy E, Wirtz JJ. Weapons of Mass Destruction: Nuclear weapons: ABC-CLIO; 2005.
  2. Ghabili K, Agutter PS, Ghanei M, Ansarin K, Panahi Y, Shoja MM. Sulfur mustard toxicity: history, chemistry, pharmacokinetics, and pharmacodynamics. Critical Reviews in Toxicology 2011;41(5):384-403.
  3. Smart JK. History of chemical and biological warfare: an American perspective. Medical Aspects of Chemical and Biological Warfare Washington, DC: Office of the Surgeon General 1997:9-86.
  4. Eghtedardoost M, Ghazanfari T, Sadeghipour A, Hassan ZM, Ghanei M, Ghavami S. Delayed effects of sulfur mustard on autophagy suppression in chemically-injured lung tissue. International Immunopharmacology 2020;80:105896.
  5. Schnurr PP, Ford JD, Friedman MJ, Green BL, Dain BJ, Sengupta A. Predictors and outcomes of posttraumatic stress disorder in World War II veterans exposed to mustard gas. Journal of Consulting and Clinical Psychology 2000;68(2):258.
  6. World Health Organization. (‎2003)‎. Investing in mental health. World Health Organization. https://apps.who.int/iris/handle/10665/42823
  7. Vaez Mahdavi MR, Nasiri L, Ghazanfari T. Evaluation of health and social inequalities in the occurrence of different types of chronic stress and their effect on immunoregulation. Immunoregulation 2021;4(1):3-16.
  8. Esmaeili A, Mansouri S, Moshavash M. Income inequality and population health in Islamic countries. Public Health 2011;125(9):577-84.
  9. Cheraghian B, Nedjat S, Mansournia MA, Majdzadeh R, Mohammad K, Vaez-Mahdavi MR, et al. Different patterns of association between education and wealth with non-fatal myocardial infarction in Tehran, Iran: A population-based case-control study. Medical Journal of the Islamic Republic of Iran 2015;29:160.
  10. Ezoji A, Arani AA, Vaez Mahdavi MR, Jahangard E. The impact of human capital (health and education) on labor productivity; a composite model approach-a case study of Iran. Iranian Economic Review 2019;23(2):373-97.
  11. Kiadaliri AA, Asadi-Lari M, Kalantari N, Jafari M, Mahdavi MRV, Faghihzadeh S. Absolute and relative educational inequalities in obesity among adults in Tehran: Findings from the Urban HEART study-2. Obesity Research & Clinical Practice 2016;10:S57-S63.
  12. Kuruvilla A, Jacob K. Poverty, social stress & mental health. Indian Journal of Medical Research 2007;126(4):273.
  13. Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychological Medicine 1979;9(1):139-45.
  14. Noorbala A, Bagheri YSA, Vaez Mahdavi MR, Asadi LM, Faghihzadeh S, Mohammad K, et al. Mental health changes in Tehran during a 12-year period: Comparing national health and disease survey in 1999 and equality project in 2011. 2014.
  15. Duncan GJ, Daly MC, McDonough P, Williams DR. Optimal indicators of socioeconomic status for health research. American Journal of Public Health 2002;92(7):1151-7.
  16. Robert S, House JS. SES differentials in health by age and alternative indicators of SES. Journal of Aging and Health 1996;8(3):359-88.
  17. Pearce N, Davey Smith G. Is social capital the key to inequalities in health? American Journal of Public Health 2003;93(1):122-9.
  18. Manrique-Garcia E, Sidorchuk A, Hallqvist J, Moradi T. Socioeconomic position and incidence of acute myocardial infarction: a meta-analysis. Journal of Epidemiology & Community Health 2011;65(4):301-9.
  19. Muntaner C, Eaton WW, Diala C, Kessler RC, Sorlie PD. Social class, assets, organizational control and the prevalence of common groups of psychiatric disorders. Social Science & Medicine 1998;47(12):2043-53.
  20. Oakes JM, Kaufman JS. Methods in social epidemiology: John Wiley & Sons; 2017.
  21. Ghazanfari T, Faghihzadeh S, Araghizadeh H, Soroush MR, Yaraee R, Mohammad HZ, et al. Sardasht-Iran cohort study of chemical warfare victims: Design and Methods. Archives of Iranian medicine 2009;12(1):5-14.
  22. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Quality of Life Research 2005;14(3):875-82.
  23. Ghaedamini Harouni G, Vaez Mahdavi MR, Naghdi S, Armoon B, Fazaeli AA, Ghiasvand H, et al. Decomposing disparity in adult individual’s mental health in Tehran among lower and higher economic groups; an Oaxaca-Blinder analysis on urban heart Survey-round 2. African Health Sciences 2018;18(4):1018-26.
  24. Nariman A, Akbarzadeh M, Hamzeh M. Evaluation of general health in medical students of AJA university of medical sciences, 2009 .Annals of Military and Health Sciences Research 2010; 8(1):49-55.
  25. Nourbala A, Bagheri YS, Mohammad K. The validation of general health questionnaire-28 as a psychiatric screening tool. Hakim Research Journal 2009;11(4):47-53.
  26. Saberian M, Hajiaghajani S, Ghorbani R, Behnam B, Maddah S. The mental health status of employees in Semnan University of Medical Sciences (1385). Koomesh 2007;8(2):85-92.
  27. Taghavi M. Assessment of the validity and reliability of the general health questionnaire. J Psychology. 2001;5(3):381-98.
  28. Zarea K, Bahrani H. Study of mental health in status the operation room students who are educating in Ahvaz Jundishapur University of Medical Science in 2011. Jentashapir Journal of Cellular & Molecular Biology 2013;4(1):23-31.
  29. Asadi LM, Vaez Mahdavi MR, Faghihzadeh S, Montazeri A, Kalantari N, Maher A, et al. The application of urban health equity assessment and response tool (Urban HEART) in Tehran concepts and framework. Medical Journal of The Islamic Republic of Iran 2010;24(3);175-185.
  30. Asadi-Lari M, Hassanzadeh J, Torabinia M, Vaez-Mahdavi MR, Montazeri A, Ghaem H, et al. Identifying associated factors with social capital using path analysis: A population-based survey in Tehran, Iran (Urban HEART-2). Medical Journal of the Islamic Republic of Iran 2016;30:414.
  31. Vergara-Moragues E, González-Saiz F. Predictive Outcome Validity of General Health Questionnaire (GHQ-28) in Substance Abuse Patients Treated in Therapeutic Communities. Journal of Dual Diagnosis 2020;16(2):218-27.
  32. Asadi-Lari M, Khosravi A, Nedjat S, Mansournia M, Majdzadeh R, Mohammad K, et al. Socioeconomic status and prevalence of self-reported diabetes among adults in Tehran: results from a large population-based cross-sectional study (Urban HEART-2). Journal of Endocrinological Investigation 2016;39(5):515-22.
  33. Ghaedamini Harouni G, Sajjadi H, Rafiey H, Mirabzadeh A, Vaez-Mahdavi M, Kamal SHM. Current status of health index in Tehran: A multidimensional approach. Medical Journal of The Islamic Republic of Iran 2017;31:29.
  34. Karami G-R, Ameli J, Roeintan R, Jonaidi-Jafari N, Saburi A. Impacts of mustard gas exposure on veterans mental health: A study on the role of education. Industrial Psychiatry Journal 2013;22(1):22.
  35. Kawana N, Ishimatsu S-i, Kanda K. Psycho-physiological effects of the terrorist sarin attack on the Tokyo subway system. Military Medicine 2001;166:23-6.
  36. Mousavi B, Khateri S, Soroush M, Ganjparvar Z. Sulfur mustard exposure and mental health in survivors of Iran–Iraq war with severe lung injuries. Toxin Reviews 2017;36(4):265-9.
  37. Romano Jr JA, King JM. Psychological casualties resulting from chemical and biological weapons. Military Medicine 2001;166:21-2.
  38. Pechura CM, Rall DP. Relationship of mustard agent and Lewisite exposure to carcinogenesis.  Veterans at Risk: The Health Effects of Mustard Gas and Lewisite: Washington (DC): National Academies Press (US) 1993.
  39. Schnurr PP, Friedman MJ, Green BL. Post-traumatic stress disorder among World War II mustard gas test participants. Military Medicine 1996;161(3):131-6.
  40. Jankowski MK, Schnurr PP, Adams GA, Green BL, Ford JD, Friedman MJ. A mediational model of PTSD in World War II veterans exposed to mustard gas. Journal of Traumatic Stress 2004;17(4):303-10.
  41. Riddle JR, Brown M, Smith T, Cameron Ritchie E, Brix KA, Romano J. Chemical warfare and the Gulf War: a review of the impact on Gulf veterans' health. Military Medicine 2003;168(8):606-13.
  42. Luo X, Edwards CL, Richardson W, Hey L. Relationships of clinical, psychologic, and individual factors with the functional status of neck pain patients. Value in Health 2004;7(1):61-9.
  43. Tannenbaum C. Effect of age, education and health status on community dwelling older men’s health concerns. The Aging Male 2012;15(2):103-8.
  44. Razavi SM, Negahban Z, Pirhosseinloo M, Razavi MS, Hadjati G, Salamati P. Sulfur mustard effects on mental health and quality-of-life: a review. Iranian Journal of Psychiatry and Behavioral Sciences 2014;8(3):11.