Global quality of life in breast cancer: systematic review and meta-analysis

BACKGROUND

Breast cancer (BC) is the most common cancer among women worldwide. We conducted a systematic review and meta-analysis to cover the existing research gap and contribute to existing knowledge to provide both researchers and clinicians with a better profile on the topic and consequently help improve the quality of life (QoL) of patients with BC.

METHODS

A comprehensive review of original articles published in English from January 2000 to October 2021 from databases including Embase, Scopus, PubMed and Web of Science was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

RESULTS

Based on the meta-regression which examined a total of 9012 patients with BC, the QoL score calculated by EORTC QLQ-C30 was 64.72 (95% CI 59.24 to 70.20), while the score obtained from FACT-B was 84.39 (95% CI 64.24 to 104.54) and the scores from QLQ-BR23 and SF-36 were 66.33 (95% CI 62.76 to 69.90) and 57.23 (95% CI 47.65 to 66.82), respectively. A meta-analysis affirmed a significant direct relationship between the QoL score of patients with BC and their age (p=0.03). The results also revealed that the QoL scores of patients who had completed treatment were higher than those who were currently under treatment.

CONCLUSION

The present systematic review identified several factors that affect the QoL of women with BC worldwide and provided several implications for developing policy interventions to effectively improve the QoL of women with BC. In this way, clinicians can sufficiently give advice to their patients with the purpose of improving their QoL. PROSPERO registration number CRD42022309791.

Challenges and prerequisites of risk management program in the operating rooms of Iranian hospitals: A qualitative study

BACKGROUND

The World Health Organization (WHO) considers a safe operating room as one of the necessities of hospitals that support patients. Achieving safety in surgical operations in all countries of the world is the basic goal of healthcare centers and organizations; hence, the present study investigated the challenges and prerequisites for the implementation of an active risk management program in the operating rooms of Iranian hospitals.

MATERIALS AND METHODS

This qualitative-phenomenological study was conducted in 2022. Data were collected using semi-structured interviews, targeted sampling, and the participation of 20 experts (health policy and management experts and academic officials and faculty members of universities) and executive staff (nurses and operating room technicians, doctors and surgical specialists, and officials of surgical departments) and were analyzed using the framework analysis method.

RESULTS

In the resulting qualitative study, the challenges and prerequisites for active risk management in the operating room from the point of view of experts and executive staff were divided into three sub-themes. These three themes include managerial challenges and prerequisites, organizational resources (financial resources, human resources, equipment, and facilities), and cultural issues.

CONCLUSION

Considering managerial prerequisites, organizational resources (financial, human, equipment, and facilities), cultural issues, and removing challenges, an active risk management program in the operating room can be implemented correctly. With the correct implementation of this program, injuries in the operating room for personnel and patients will be greatly reduced, and the satisfaction of beneficiaries and the productivity of the hospital will be greatly increased.

Global Prevalence of Suicide in Patients With Cancer: A Systematic Review and Meta-Analysis

AIM

Given that patients with cancer may commit suicide due to physical and mental problems, the present study objectives were to identify particular risk factors of different subgroup of patients including type of cancer, gender, age, type and time of suicide, and geographical region to facilitate early care and psychosocial support.

METHODS

A comprehensive review of databases including Embase, Scopus, PubMed, and Web of Science was conducted for original articles published in English from January 2000 to March 2022. It is based on the PRISMA checklist.

RESULTS

After reviewing 69 articles selected from 15 countries, the total prevalence rate of suicide among 34,157,856 patients with cancer was estimated 67,169, at 0.013 (95% CI, 0.008-0.021). The highest suicide prevalence was related to gastrointestinal cancer, estimated at 0.204 (95% CI, 0.161-0.255). A gender-based meta-analysis showed that the prevalence of suicide/suicidal ideation was higher among men, estimated at 0.013 (95% CI, 0.008-0.023) compared with women, at 0.006 (95% CI, 0.002-0.017).

CONCLUSION

Based on study results, suicide-prevention strategies should be aimed at patients younger than 40 years of age to effectively resolve their mental health disorders and promote their self-efficacy in successful management of the disease.

Global depression in breast cancer patients: Systematic review and meta-analysis

BACKGROUND

Breast cancer is known as one of the most common diseases among women, the psychological consequences of which are common in women and affect various aspects of their lives, so this study aims to investigate the prevalence of depression among women with breast cancer globally.

METHOD

The present meta-analysis was performed by searching for keywords related to breast cancer and depression in 4 main databases: PubMed, Embase, Web of Sciences and Scopus in the period of January 2000 to November 2021 and the results of the study using R and CMA software were analyzed.

RESULTS

A total of 71 studies were selected in English and the results of the analysis showed that the prevalence of depression in women with breast cancer is 30.2%, with Pakistan having the highest (83%) prevalence of depression and Taiwan having the lowest (8.3%). And in the WHO regions, EMRO region had the highest (49.7%) rate and SEARO region had the lowest (23%) prevalence of depression. Also, with increasing age, the prevalence of depression among women with breast cancer increases.

CONCLUSION

Community and family support for women with breast cancer, holding psychology and psychotherapy courses, lifestyle modifications and training in this area can be effective in preventing the reduction of the prevalence of depression, and given the pivotal role of women in family affairs, this This can be in line with the work of health system policymakers.

Global prevalence of suicide in patients living with HIV/AIDS: A systematic review and meta-analysis

BACKGROUND

In fact, people living with HIV are at a greater risk of mental health disorders. Based on lack of necessary information in this area the present systematic review and meta-analysis study was conducted to determine the magnitude of committed suicides among HIV/AIDS people as well as their associated factors in a global setting.

METHOD

Firstly we registered the protocol of study in PROSPRO. Then the publications were searched in the 4 main databases from January 2000 to April 2022. After removing duplication and inappropriate studies we applied inclusion and exclusion criteria. Finally 60 studies were included for analysis. Comprehensive meta-analysis software were used for analyzing.

RESULTS

After reviewing 60 articles published from January 2000 to April 2021 in 24 countries, the total prevalence rate of suicide among 61,904 patients was estimated at 0.249 (95 % CI, 0.2-0.306). Findings indicated that the highest suicide prevalence was related to single patients estimated at 0.257 (95 % CI, 0.184-0.347). A gender-based meta-analysis depicted that the prevalence of suicide/ suicidal ideation was higher among females estimated at 0.22 (95 % CI, 0.15-0.29) compared with men at 0.17 (95 % CI, 0.11-0.23).

CONCLUSION

Health planners and policymakers should develop suicide-prevention strategies aimed at female patients in younger age groups who live alone and are deprived of social support to effectively promote their self-efficacy in successful management of the disease. Integrating mental health services into anti-retroviral therapy for HIV/AIDS patients is also suggested in order to effectively design integrated programs for the management of individuals living with HIV/AIDS.

Global systematic review and meta-analysis of health-related quality of life in Behcet's patients

Background

Behcet's disease (BD) is a chronic fatal illness with a relapsing remitting nature and significant organ-threatening morbidity and mortality. The aim of this research was to examine studies which were conducted on investigation of prevalence of quality of life among patients with Behcet's disease.

Methods

A total of 13 articles were extracted from four main databases including PubMed, EMBASE, Scopus, and Web of Science from the onset of 2000 to January 2021. All studies published in English with the purpose of examining quality of life (QOL) among patients with BD or investigating its main determinants were included.

Results

Totally, 1137 BD patients participated in 13 studies. Based on random effect analysis, the total score of physical health-related QOL was 46.7 (95% CI=41.26 to 52.13) and the total score of mental health-related QOL was 49.01 (95% CI=43.83 to 54.18) representing a moderate level of QOL among BD patients. Furthermore, weighted effect size analyses showed a significant correlation between QOL and variables such as patients' age, gender, disease duration and depression (pvalue: 0.00).

Conclusion

As the symptoms of BD worsen over time, patients confront with more severe body pain, mobility restrictions, and difficulties in chewing, eating, speaking and swallowing which negatively affect social interactions of patients and reduce their QOL. Furthermore, depression was proved to act as a deteriorating factor for Health-Related Quality of Life (HRQOL) among BD patients. Thus, patients need to be psychologically supported by a specialized team and be informed during the course of treatment to gain useful information about the disease, treatment approaches and coping strategies.

Assessing Quality of Services for the Elderly Residents in Nursing Homes of Tabriz, Iran in 2019

Background: Environmental characteristics, as well as the quality of health care services provided to older adults group, are among significant determinants of elderly quality of life. The present study was done to assess the quality of services delivered to elderly residents in nursing homes located in Tabriz, Iran in 2019. Materials & Methods: This cross-sectional study was conducted on the elderly living in nursing homes in Tabriz, Iran, of whom 74 residents met the inclusion criteria and were included. The researchers referred to the nursing homes and recruited the participants with regard to the inclusion and exclusion criteria. Results: Out of the 74 older adults, 35 and 39 cases were respectively male and female. The largest age group (43.2%) was related to those between 60 and 69 years old. Also, 71.6% of the elderly had been residing in nursing homes for 6-20 months. The rate of service quality in terms of the medical, psychological, welfare, and social domains was 66%, 48%, 68%, and 65%, respectively. Besides, no significant relationship was observed between demographic variables and total scores of service quality (P>0.05). Conclusion: Paying attention to psychological services, including providing counseling and social work services, adapting the centers, and creating recreational departments can lead to an increase in psychological quality and ultimately, overall service quality.