Background: Postoperative cognitive dysfunction (POCD) and delirium are common in the elderly patients, given the controversial results of previous studies about the impact of anesthesia type on the occurrence of these complications. Objectives: This study was planned to compare the effects of general and regional anesthesia on the prevalence of POCD and delirium. Methods: A single-blind non-randomized clinical trial. Setting was in two academic hospitals. Ninety-four patients over 50 years old scheduled for hip fracture fixation. Patients were divided into two groups to receive either general (GA) or spinal (SA) anesthesia. Both Mini-Mental State examination (MMSE) and Wechsler tests were used before the operation and 3 times postoperatively to assess the cognitive function and detect early POCD. The DSM-IV criteria were also used for the diagnosis of delirium. The incidence of delirium and POCD and their precipitating factors were compared between the two groups. Results: Ninety-four patients with a mean age of 67.12 years were studied. The overall prevalence of POCD and delirium was 17.02%; however, it was significantly higher in the GA group rather than the SA group, 29.7%, and 4.25%, respectively (P < 0.001). There was a significant relationship between age (P = 0.048), ASA class (P = 0.034), and educational level with the incidence of POCD, meaning that the probability of developing cognitive impairment decreases with patients’ higher level of education and lower ASA-physical status. Also, the rate of POCD in men was significantly higher than in women (P = 0.026). Conclusions: The finding of this study showed that, if there is no specific contraindication, neuraxial anesthesia may be preferred over general anesthesia in elderly patients.

Background and Purpose: Heart failure (HF) is a chronic, debilitating disease, and physical limitations and progressive symptoms of which associated with this condition can reduce quality of life (QOL). Patient education regarding heart HF is one of the main components of self-care. In this respect, peer education is significant in improving health and creating a learning environment. This study was performed to determine the effect of peer education on QOL in HF patients. Methods:In this quasi-experimental study performed during 2016, 60 HF patients affiliated to Tehran University of Medical Sciences were randomly divided into intervention and control groups (n=30). After preparing the peer group, four peer-to-peer training sessions were conducted during one month. The Persian version of Ferrans and Powers' Quality Of Life Questionnaire was used for data collection, which was completed by both groups before, just, and one month after the intervention. SPSS version 21 was employed for data analysis.Results: No significant difference was observed between the two groups in overall QOL score and its domains before the intervention (P=0.31).The mean scores of QOL immediately after the intervention were 126.2±6.7 and 163.1±1.6 in the case and control groups, respectively. The mean scores of QOL one month after the intervention were 134.5±0.7 and 169.9±2.3 in the case and control groups, respectively. After the intervention, paired t-test showed that peer education had a significant relationship with QOL of the HF patients (P<0001). Conclusion:Based on this study, peer education intervention can be a beneficial educative-supportive approach, which might enhance QOL in HF patients.