Prevalence of burnout among nurses in Iran: a systematic review and meta-analysis.

AIM: This study aimed to summarize the available information in the literature to make an accurate estimate of the prevalence of burnout among Iranian nurses. BACKGROUND AND INTRODUCTION: Burnout is a work-related stress syndrome that has negative impact on healthcare providers, patients and healthcare delivery systems. METHOD: A comprehensive search of literature using international [PubMed, Scopus and the Institute for Scientific Information (ISI)] and Iranian scientific data bases [Scientific Information Database (SID), IranMedex and Magiran] was conducted to identify English and Persian language studies, published between 2000 and 2016, that examined the prevalence of burnout among nurses in Iran. The I-squared test and Chi-squared-based Q-test suggested heterogeneity of reported prevalence among the qualified studies; thus, a random-effects model was applied to estimate the overall prevalence of burnout among nurses in Iran. RESULTS: Based on 21 selected articles with 4180 participants, the overall prevalence of burnout among Iranian nurses was estimated to be 36% [95% confidence interval (CI), 20-53%] in Iran. Meta-regression indicated that sample size and year of data collection, mean age of samples, female to male ratio and geographic regions were not statistically significantly associated with the prevalence of burnout. Also, based on Egger's test and funnel plot, there is no publication bias among studies included in the analysis. CONCLUSION: Professional burnout affects more than one-third of nursing staff in Iran; thus, effective interventions and strategies are required to reduce and prevent burnout among nurses. IMPLICATION FOR NURSING AND HEALTH POLICY: Due to the negative consequences of burnout on patients, nurses and organizations, nursing and healthcare managers should intervene to prevent and reduce burnout among nurses in Iran. Policy attention should focus on developing effective interventions to prevent and minimize the burden of burnout among nurses in Iran. Nurses' involvement in the policy-making process is crucial in the implementation of effective programs and initiatives tailored to address the higher prevalence of burnout among Iranian nurses.

What explains socioeconomic inequalities in dental flossing? Cross-sectional results from the RaNCD cohort study.

INTRODUCTION: The magnitude and underlying determinants of socioeconomic inequality in dental flossing are poorly understood in Iran. This study aimed to measure and decompose socioeconomic inequalities in dental flossing in Ravansar, Iran. METHODS: Data of 10,002 individuals aged 35-65 years who participated in the Ravansar Non- communicable Diseases (RaNCD) cohort study in Kermanshah province, western Iran, were analyzed. Based on an asset-based method, socioeconomic status (SES) was measured using principal component analysis (PCA). The concentration index and curve were employed to measure socioeconomic inequality in dental flossing. Decomposition analysis was used to estimate the contribution of each determinant to the overall inequality. RESULTS: Of 10,002 participants, 11.74% were found to practice dental floss. The normalized CI for dental flossing was 0.327 in the entire population, 0.323 in females and 0.329 in males, indicating that the use of dental floss is more concentrated among high-SES individuals. The decomposition analysis indicated that SES (50.58%) and level of education (44.90%) respectively contributed the most to this inequality. Place of residence (10.55%) and age group (2.7%) were the next main contributors, respectively. CONCLUSIONS: We found a low prevalence of dental flossing among participants in RaNCD study. We also observed a relatively high degree of pro-rich inequality in dental flossing. The observed inequality was mainly explained by socioeconomic status, level of education and place of residence. Policy interventions should consider these factors to reduce inequalities in dental flossing.

Epidemiological data, outcome, and costs of burn patients in Kermanshah.

Burn injuries in both developed and developing countries cause long-term disability, mortality, and socio-economic costs that are imposed on patients, families, and societies. This study was carried out to investigate the epidemiology, outcome, and cost of hospitalization of 388 burn patients admitted to the Imam Khomeini Hospital Burn Center in Kermanshah, Iran, between 21 March 2011 and 20 March 2012. The data about demographics, cause of burns, degree of burns, outcome of burns, burned body surface (BBS), length of stay (LOS), and cost of hospitalization were collected by reviewing medical records and analysed by SPSS 16. The patients' mean age was 27 years. The male/female ratio in burn patients was 1.14/1. The mean BBS was 36.06%. The mean LOS was 9.04 days. Flame (67.0%) and hot liquids (21.9%) were the major causes of burn. Burn injuries were more common in the upper limbs (81.4%), lower limbs (70.9%), and head and neck (65.2%). 11.6% of patients had all the regions involved. The fatality rate was 18.8%. The mean cost per patient was 20,463,227 Iran Rials (IRR). The cost per one percentage of burn and one day of hospitalization was 562,632 IRR and 2,263,631 IRR, respectively. The main factors relevant to death were identified including the extent of burn, gender, age, causes, and degree of burn. In addition, LOS proved to have a higher impact on costs than burn percentage.

Les brûlures, soit dans les pays développés soit dans ceux en développement, causent des invalidités à long terme, des décès et des coûts socioéconomiques imposés aux patients, aux familles et aux sociétés. Cette étude a été réalisée pour évaluer les résultats et les coûts de l'hospitalisation de 388 patients brûlés admis au Centre des Brûlés chez l'hôpital Imam Khomeini à Kermanshah, Iran, entre le 21 mars 2011 et le 20 mars 2012. Les données sur les caractéristiques démographiques, les causes des brûlures et leur degré, les résultats finaux, la surface corporelle brûlées (SCB), la durée du séjour hospitalier (DSH) et le coût de l'hospitalisation ont été recueillies moyennant l'examen des dossiers médicaux et analysées par SPSS 16. L'âge moyen des patients était de 27 ans. Le sex ratio homme / femme chez les patients brûlés était de 1,14/1. La SCB moyenne était de 36,06%. La DSH moyenne était de 9,04 jours. Les flammes (67,0%) et les liquides chauds (21,9%) étaient les principales causes des brûlures, qui se produisaient avec majeure fréquence aux membres supérieurs (81,4%), aux membres inférieurs (70,9%) et à la zone tête/cou (65,2%). Dans 11,6% des cas toutes les régions corporelles étaient intéressées. Le taux de la mortalité était de 18,8%. Le coût moyen par patient était de 20.463.227 Rials iraniens (IRR). Le coût par point de pourcentage de brûlure et par journée d'hospitalisation était de 562.632 IRR et de 2.263.631 IRR, respectivement. Les principaux facteurs pertinents à la mort ont été identifiés, notamment l'extension de la brûlure, le sexe, l'âge, les causes et le degré de brûlure. En outre, nous avons trouvé que la DSH causait un impact plus important sur les coûts que le pourcentage de brûlure.

Catastrophic health expenditures in kermanshah, west of iran: magnitude and distribution.

BACKGROUND: Health policy makers are concerned about protecting people from catastrophic health expenditures and subsequent impoverishment. This study aimed to describe the magnitude and distribution of catastrophic health expenditures in Kermanshah western Iran. METHODS: In this descriptive study, during May 2008, 189 households were chosen by "Systematic Random sampling" among the community of Maskan in Maskan Center for Population. After getting the informed consent forms signed, data ere collected using a questionnaire by interviewing the head of the families. The cut-off point for catastrophic expenditure was defined as health expenditures over 40% of household's capacity to pay. RESULTS: From a total of 189 households, 22.2% (42) households (95% CI 16.3%- 28.1%) incurred catastrophic health expenditures. Out of 42 households, for 11.9%, the head of family was female. 40.5 % had one member younger than 12 years old, 26.2% had one member older than sixty years old, and 9.5% were households with at least one member with chronic condition. In addition, 19% were uninsured. In addition, because of financial burden of health expenditures 21.4% of the households sold their jewels, 16.7% used up their savings and 47.6% were in debt. CONCLUSION: Compared to 2% of general population facing catastrophic health expenditure, 22.2% was a high proportion. Our study revealed the importance of protecting households against the cost of ill-health.