Meta-analysis of the prevalence of depression among breast cancer survivors in Iran: an urgent need for community supportive care programs.

OBJECTIVES: Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients' quality of life, disease progress, and survival. METHODS: The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design. RESULTS: The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I2 =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity. CONCLUSIONS: Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.

Community health assessment: Knowledge, attitude and practice of women regarding water-pipe smoking in Bandar Abbas.

Based on the results of seventh round of community health assessment (CHA) in suburban areas of Bandar Abbas, "water-pipe smoking in women" was one of the major concerns of community members. Therefore, the present study designed to assess the knowledge, attitude and practice of women towards water-pipe smoking and related factors. High consumption of water-pipe among women was ranked as a prioritized health problem. To diagnose the problem, for creating action plan, the present cross - sectional study was conducted on 205 women aged over 18 randomly selected from Green-Tree region in suburb of Bandar Abbas city. All statistical analyses were performed using SPSS 24 software with 5% as the significant level. 205 women with a mean age of 36.9 (standard deviation:12.86) years, and a water-pipe prevalence of 15.1% were analyzed. The significant predictors of knowledge were educational level (ß = 0.182, p-value = 0.037), and being water-pipe smoker (ß = -0.251, p-value < 0.001); while for attitude they were educational level (ß = 0.221, p-value = 0.002), family size(ß = 0.152, p-value = 0.023), and subjective social status(ß = 0.149; p-value = 0.035); and for practice they was smoking waterpipe in parents (ß = -0.276, p-value < 0.001).The development action plans based on "CHA" could improve public health and enhance the performance of the community through improved education, policies and health interventions.