The safety, health, and well-being of healthcare workers during COVID-19: A scoping review.

The outbreak of the COVID-19 pandemic has affected the safety and well-being of healthcare workers. A scoping review was conducted to highlight the impact of COVID-19 on the safety, health, and well-being of healthcare workers and to shed light on the concerns about their perceived safety and support systems. A literature search was conducted in three different databases from December 1, 2019, through July 20, 2022, to find publications that meet the aim of this review. Using search engines, 3087 articles were identified, and after a rigorous assessment by two reviewers, 30 articles were chosen for further analysis. Two themes emerged during the analysis: safety and health and well-being. The primary safety concern of the staff was mostly about contracting COVID-19, infecting family members, and caring for patients with COVID-19. During the pandemic, the health care workers appeared to have anxiety, stress, uncertainty, burnout, and a lack of sleep. Additionally, the review focused on the suggestions of health care providers to improve the safety and well-being of workers through fair organizational policies and practices and timely, individualized mental health care.

Iran Quality of Care in Medicine Program (IQCAMP): Design and Outcomes.

BACKGROUND: Assessment of quality and cost of medical care has become a core health policy concern. We conducted a nationwide survey to assess these measures in Iran as a developing country. To present the protocol for the Iran Quality of Care in Medicine Program (IQCAMP) study, which estimates the quality, cost, and utilization of health services for seven diseases in Iran. METHODS: We selected eight provinces for this nationally representative short longitudinal survey. Interviewers from each province were trained comprehensively. The standard definition of seven high-burden conditions (acute myocardial infarction [MI], heart failure [HF], diabetes mellitus [DM], stroke, chronic obstructive pulmonary (COPD) disease, major depression, and end-stage renal disease [ESRD]) helped customize a protocol for disease identification. With a 3-month follow-up window, the participants answered pre-specified questions four times. The expert panels developed a questionnaire in four modules (demographics, health status, utilization, cost, and quality). The expert panel chose an inclusive set of quality indicators from the current literature for each condition. The design team specified the necessary elements in the survey to calculate the cost of care for each condition. The utilization assessment included various services, including hospital admissions, outpatient visits, and medication. RESULTS: Totally, 156 specialists and 78 trained nurses assisted with patient identification, recruitment, and interviewing. A total of 1666 patients participated in the study, and 1291 patients completed all four visits. CONCLUSION: The IQCAMP study was the first healthcare utilization, cost, and quality survey in Iran with a longitudinal data collection to represent the pattern, quantity, and quality of medical care provided for high-burden conditions.

Prevalence and causes of unreported needle stick injuries among health care workers: a systematic review and meta-analysis.

OBJECTIVES: Health care workers (HCWs) are exposed to needle needles daily. Despite individual studies, there is no statistics on the prevalence of unreported needle stick injuries (NSIs) have been reported. This study was performed to determine the prevalence and causes of unreported NSIs among HCWs. CONTENT: In present systematic review and meta-analysis study, three international databases (Web of Science, Scopus, PubMed) were searched from January 1, 2000 to December 31, 2018. The random model was used to determine the prevalence of unreported needle stick among HCWs. SUMMARY AND OUTLOOK: Forty-one studies performed on 19,635 health care workers entered the final stage. Based-on random effect model, pooled prevalence of unreported needle stick injuries was 59.9% (95% CI: 52.0, 67.7; I2=98.9%). The most common cause of unreported NSIs was: They were not worried about NSIs (n=12). The high prevalence of unreported needle sticks injuries indicates the urgency and necessity of paying attention to strategies to improve reporting among health workers.

Hypertension and Pre-Hypertension in Middle East and North Africa (MENA): A Meta-Analysis of Prevalence, Awareness, Treatment, and Control.

Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the Middle East and North Africa region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I2 test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I2 = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I2 = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I2 = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I2 = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I2 = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.

Nurses' Roles in Nursing Disaster Model: A Systematic Scoping Review.

BACKGROUND: Nurses have a continuous presence and crucial role in response to disasters. During disasters, nurses apply specific knowledge and skills to minimize victims' health and life-threatening risks. Nurses' roles in crisis are not clearly stated in resources. Thus, this study aimed to explore nurses' role in the nursing disaster model. METHODS: A scoping review was conducted using Joanna Briggs Institute framework. The review considered primary research and reviewed literature from following databases, including Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Scopus, and Google Scholar, as well as the reference lists of articles identified for full-text review. Eligibility criteria were outlined as a priori to guide the literature selection. RESULTS: Eight of 60 eligible articles met the inclusion criteria. The studies were conducted in different countries with no limit of time of published articles. The publications' design were three systematic reviews, one meta-synthesis, two qualitative types of research, one quasi-experimental, and one case study. The results showed nurses' roles in the three stages before, during, and after the crisis. CONCLUSION: This review provided a comprehensive understanding of the concept of the nursing role in the crisis, and nurses could be useful to save victims through preparing and implementing effective care at different stages of a crisis.

Incivility toward nurses: a systematic review and meta-analysis.

One important part of a nurse's job is to create and help maintain a safe work environment. Evidence shows that negative behaviors such as incivility are not uncommon in the nursing profession. This systematic review and meta-analysis aimed to examine the prevalence of incivility toward nurses. For this purpose, all observational studies that primarily investigated the rate of incivility toward nurses were selected. The electronic databases PubMed, Embase, Web of Sciences, Magiran, IranDoc, and Scopus were searched for studies published during the period of January 1, 1996 to December 31, 2019. The quality of studies was assessed using Hoy's Critical Assessment Checklist. The study was undertaken using the random effects model, and data were analyzed using STATA14. Data on 60 articles, including data on 30801 individuals, published between 1997 and 2019, entered the study. The findings showed the prevalence of incivility to be 55.10% (95%, CI: 48.05, 62.06). Due to the high prevalence of uncivil behavior, especially of the verbal type, nursing managers should identify risk factors in the workplace. Planners should develop programs to increase workplace safety, especially in centers that are most exposed to these behaviors. It is also recommended that future studies focus on implementation of effective evidence-based interventions based on organizational culture.

Global Prevalence and Device Related Causes of Needle Stick Injuries among Health Care Workers: A Systematic Review and Meta-Analysis.

Background: Healthcare workers (HCWs) suffer more than 2 million occupational needle-stick injuries (NSIs) annually. Goal: To determine the global prevalence and causes of NSIs among HCWs. Methods: In this systematic review and meta-analysis, three databases (PubMed, Web of science, and Scopus) were searched for reports from January 1, 2000 to December 31, 2018. The random effects model was used to determine the prevalence of NSIs among HCWs. Hoy et al.'s instrument was employed to evaluate the quality of the included studies. Findings: A total of 87 studies performed on 50,916 HCWs in 31 countries worldwide were included in the study. The one-year global pooled prevalence of NSIs among HCWs was 44.5% (95% CI: 35.7, 53.2). Highest prevalence of NSIs occurred in the South East Asia region at 58.2% (95%, CI: 36.7, 79.8). By job category, prevalence of NSIs was highest among dentists at 59.1% (95% CI: 38.8, 79.4), Hypodermic needles were the most common cause of NSIs at 55.1% (95% CI: 41.4, 68.9). Conclusion: The current high prevalence of NSIs among HCWs suggests need to improve occupational health services and needle-stick education programs globally.

Effect of aromatherapy on cancer complications: A systematic review.

PURPOSE: The aim of this study was to determine the effect of aromatherapy on cancer complications. METHODS: In this systematic review, international (PubMed, Web of Science, Scopus, EMBASE and CENTRAL) and national databases (SID and Magiran) were searched from inception of the databases to April 31, 2019. JBI and Jadad scales were used to assess the quality of the studies included. RESULTS: of 43 Studies conducted on 3239 cancer patients in 13 countries from 1995 to 2019, entered the final stage. The results showed that the aromatherapy improves the various physical and psychological complications, although few studies have shown that aromatherapy had no effect on skin reactions. CONCLUSION: Considering the various complications and costs in cancer patients, it seems that the aromatherapy can be used as a proper supplemental treatment to improve complications, although further studies are needed to determine the protocol and the standard dosage.

Prevalence of gestational diabetes mellitus in Eastern Mediterranean region: a systematic review and meta-analysis.

PURPOSE: Gestational diabetes mellitus (GDM) is one of the costly challenges in the health field. Despite the individual studies in the Eastern Mediterranean, there is no comprehensive study in this regard. The aim of this study was to determine the prevalence of GDM in the Eastern Mediterranean region. METHODS: In this meta-analysis and systematic review, three international databases (PubMed, Web of science and Scopus) were searched from inception until 30 December 2018. The Hui tool was used to assess the quality of the included studies. RESULTS: Thirty-three studies performed on 887166 participants were included in the meta-analysis. Based on the results of random effect method, the overall prevalence of GDM was 11.7%. Between six country with have three or more study, pooled prevalence for Saudi Arabi it was 3.6 times more than Israel (17.6 vs. 4.9%), and for Pakistan, Qatar, Bahrain and Iran were 15.3%, 14.7%, 12.2%, and 8.6%, respectively. CONCLUSION: Despite the high diversity of methods, the results of the present study indicate a high prevalence of GDM in the Eastern Mediterranean region, indicating more policymakers' interest in timely screening and proper management.

Surgical site infections in Eastern Mediterranean region: a systematic review and meta-analysis.

Background: Surgical site infections (SSIs) are the most common and costly type of hospital-acquired infections (HAIs) worldwide. Despite individual studies, there is also no clear statistics on the SSI prevalence rate in the East Mediterranean region. The aim of this study was to investigate the prevalence of SSI in the Eastern Mediterranean region. Methods: This systematic review and meta-analysis were performed by searching three international databases (Web of Science, PubMed and Scopus) from 1 January 2001 to 31 December 2018. The keywords used included 'Prevalence' OR 'incidence' OR 'surgical site infection' OR 'wound infection' OR 'Postoperative Wound Infections' and 'Middle east'. The Hoy et al.'s tool was used to evaluate the quality of the articles. Result: Out of 889 initial studies, 40 studies from 12 countries of the Eastern Mediterranean region were included in the final stage of the study. Based on the results of random effect method, the overall prevalence of SSI in 137,452 patients was 7.9% (95% Confidence Interval (CI): 7.1, 8.8; I2=96.7%). The prevalence of SSI in cardiac surgery and general surgery wards was 10 and 9.2%, respectively. The prevalence of SSI was lower in women than in males, although this difference was related to caesarean section. Conclusions: Considering the high prevalence of SSI in the Eastern Mediterranean region, timely diagnosis, proper prevention and postoperative control are necessary in the region using the same international guides in all countries.

Global prevalence of depression among breast cancer patients: a systematic review and meta-analysis.

PURPOSE: Depression in patients with breast cancer imposes huge costs to patients, families, and healthcare systems. The present study aimed at evaluating the global prevalence depression among patients with breast cancer. METHODS: In this meta-analysis, three electronic databases (PubMed, Web of Science, and Scopus) were searched from 1 January, 2000 until 30 March, 2019. The Hoy tool was used to evaluate the quality of the articles included in the meta-analysis. The search, screening, quality evaluation, and data extraction were carried out by two of the researchers. RESULTS: Of 47,424 studies, 72 studies performed in 30 countries entered the final stage of analysis. The global prevalence of depression was 32.2%. Specifically, the prevalence of depression was highest in the Eastern Mediterranean region and twice as high in middle-income countries as compared to developed countries. CONCLUSIONS: Regarding the high prevalence of depression in patients with breast cancer, it is vital to carry out screening within standard time periods and offer the necessary emotional support.

Hypertension and Pre-Hypertension Among Iranian Adults Population: a Meta-Analysis of Prevalence, Awareness, Treatment, and Control.

PURPOSE OF REVIEW: This meta-analysis and systematic review was conducted to evaluate hypertension and prehypertension prevalence, awareness, treatment, and control in Iranian adults population. RECENT FINDINGS: In this study, six international and national databases were searched from inception until August 30, 2018. Forty-eight studies performed on 417,392 participants were included in the meta-analysis. Based on the results of random effect method (95% CI), the overall prevalence of pre-hypertension, hypertension, awareness, treatment, and control were 31.6% (95% CI 24.9, 38.3; I2 = 99.7%), 20.4% (95% CI 16.5, 24.4; I2 = 99.9%), 49.3% (95% CI 44.8, 53.8; I2 = 98.5%), 44.8% (95% CI 28.3, 61.2; I2 = 99.9%), 37.4% (95% CI 29.0, 45.8; I2 = 99.3%), respectively. Considering the increasing prevalence of pre-hypertension, hypertension, as well as more than half of the participants were unaware of their disease and were not treated, the results of the present study can help policy-makers to increase hypertension awareness, control, and treatment, especially in high-risk individuals.

Effect of aromatherapy on post-partum complications: A systematic review.

INTRODUCTION: and purpose: Aromatherapy is a known popular method to reduce the symptoms of various physiologic processes and diseases. The aim of the study was to determine whether aromatherapy improves symptoms commonly experienced by women during the postpartum period. METHODS: In the present systematic review, four international databases (PubMed, Google Scholar, Web of Science, and Scopus) were searched from inception of databases through August 2018. References for each study were manually reviewed to ensure that relevant works were included. RESULTS: Thirty-four (34) articles were identified with 17 studies meeting eligibility criteria and included a total of 1400 women using a variety of aromatherapies. Results demonstrated that aromatherapy can improve symptoms commonly experienced in post-partum period, including depression, stress, pain, anxiety, and fatigue. CONCLUSION: There are therapeutic effects in use of aromatherapy during the post-partum period. Aromatherapy, however, should be used with caution as safety concerns have not been conclusively demonstrated.

Causes of Chronic Kidney Disease in Iranian Children: A Meta-Analysis and Systematic Review.

This study aimed to determine the causes of chronic kidney disease (CKD) in Iranian children. In this systematic review and meta-analysis study, international (PubMed, Web of Science, Scopus, and Google Scholar) and national (SID, Magiran) databases were searched for articles published through December 30, 2017. The quality of the studies was determined using the Hoy instrument. Out of 2,117 initial studies, 13 studies performed on a total of 3,596 children were included in the final stage of the study. Based on the results of the random effects method (95% CI), the main causes of chronic kidney disease in stages 1-4 (CKD) were CAKUT (37%) and glomerulonephritis (19.96%); in stage 5 (ESRD) they were CAKUT (40.82%) and urological disorders (27.44%). Considering the high prevalence of CAKUT, glomerulonephritis and urinary problems, the use of comprehensive approaches can be very effective in enhancing the knowledge of patients about the causes of kidney disease. The results obtained from the present study can assist policymakers in more accurately planning screenings of the causes of CKD in Iranian children.

Health-related quality of life of breast cancer patients in the Eastern Mediterranean region: a systematic review and meta-analysis.

PURPOSE: Breast cancer is the most common type of cancer in women around the world, and this applies to the Middle East as well. The goal of all medical care and treatment is to improve the quality of life (QoL) of patients. Accordingly, the present study aimed at evaluating the QoL of patients with breast cancer in the Middle East region. METHODS: In this meta-analysis, three electronic databases (PubMed, Web of Science, and Scopus) were searched from inception until August 2018. The hoy et tool was used to evaluate the quality of the articles included in the meta-analysis. The search, screening, quality evaluation, and data extraction were carried out by two of the researchers. RESULTS: Thirty-six studies conducted on 8347 Middle Eastern women with breast cancer entered the final stage. QoL was assessed by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire in 20 studies, with 6034 patients. The mean of the reported QoL was between 31.1 and 75.6. Based on the results of the random effect method, the overall mean of the QoL was 60.5 (95% confidence interval 56.0, 65.0; I2 = 99.0%). In six studies performed on 1053 individuals, QoL was classified as good, moderate, or poor. Less than one-third of patients (21%) had a good QoL. CONCLUSIONS: Since less than one-third of patients had a good QoL, it seems necessary to design and implement an integrated and multidimensional educational program to improve QoL of patients with breast cancer.

Knowledge, attitude, practice, and clinical recommendation toward infection control and prevention standards among nurses: A systematic review.

BACKGROUND: The purpose of this study was to systematically review the literature to describe nurses' knowledge and practice of and attitude toward infection control and prevention standards. METHODS: In the present systematic review, 4 electronic databases were searched from the inception of databases through March 2018. Quality of included studies was assessed using the Hoy tool. RESULTS: Eighteen studies conducted on 4,577 employed nurses and nursing students entered the final stage. Results indicated that nurses in most studies had adequate knowledge (n = 10, 40%-90%) and positive attitude (n = 4, 37%-100%). However, most studies reflected average and poor nursing practices with regard to adherence to infection control and prevention standards. The most frequent recommendations proposed for improving nurses' knowledge, attitude, and practice included periodic training via scientific conferences and relevant practical courses (n = 12), combining up-to-date theoretical and practical programs (n = 6), and training at the beginning of hospital employment (n = 4). CONCLUSIONS: The results of the present study indicate that although nurses in most studies had adequate knowledge of and positive attitude toward health care-associated infections, because of average and poor practices, they need systematic and integrated implementation of the presented recommendations.

Cancer Pain Management Among Oncology Nurses: Knowledge, Attitude, Related Factors, and Clinical Recommendations: a Systematic Review.

The current study evaluated the oncology nurse's knowledge, attitude, related factors of cancer-related pain management (CPM), and clinical recommendations for improving knowledge and attitude. In this systematic review, international databases (PubMed, EMBASE, Web of science (WOS), Science Direct, and Scopus) were searched for relevant studies published in English language from March 30, 2000 to March 30, 2018. The quality of the studies was evaluated using the Hoy instrument. Out of 888 initial studies, 12 studies performed on 3574 participants were included in the final stage of the review. Based on the results, most studies indicated that nurses had a poor (n = 4) or moderate (n = 4) knowledge of CPM. The lowest and the highest knowledge levels were 28.5% and 75%, respectively. According to most studies, nurses had a fair (average) (n = 4) or negative (n = 3) attitude toward CPM. The important factors related to the nurses' knowledge of CPM included previous pain-related education programs (n = 7) and having work experience with cancer patients (n = 4). The most important barrier was the deficit in staff's knowledge of pain (n = 2). The important clinical recommendations for improving nurses' levels of knowledge included the implementation of educational programs (n = 9), training programs (n = 3) on CPM and including CPM topics in nursing curricula (n = 5). This systematic review showed that most nurses had poor knowledge of CPM and a fair attitude toward CPM, indicating the importance of considering the barriers to knowledge, strengthening the positive relevant factors, and using clinical recommendations based on clinical guidelines such as including CPM topics in nursing curricula and implementing educational programs on CPM to improve the knowledge, attitude, and skills of oncology nurses. The results of the present study could be used by policymakers to provide care for cancer patients and manage their pain.

Quality of hemodialysis services in a poor population, Sistan and Baluchestan province, Iran: A descriptive, prospective study.

Managing patients with chronic kidney disease causes enormous financial burden on the Ministry of Health and Medical Education. In addition, there is a lack of feedback and adequate information in general. This study aimed at investigating quality-of-care indicators among hemodialysis (HD) patients. This descriptive, prospective study was conducted on 144 HD patients in Zabol and Iranshahr dialysis centers from March 21 to December 22, 2015. Measurement indicators included hemoglobin level, dialysis adequacy, albumin level, vascular access, and calcium and phosphorus levels. The mean hemoglobin and dialysis adequacy level at baseline were 10.58 ± 1.6 g/dL and 1.09 ± 0.18, respectively. At the end of the study, 49.6% of participants achieved target hemoglobin level. However, only 18.6% of patients achieved target dialysis adequacy at the end of the study. Dialysis adequacy was calculated by using an standard software for calculating the KT/V that provided by Iran ministry of health for all dialysis centers. The prevalence rate of use of central venous catheter was 43.2% at the end of the study. The majority of patients (59%) had albumin within normal limits and also achieved target in terms of calcium (52%) and phosphorus (59%) levels at the end of the study. Despite partial improvement in several indicators, none achieved target values which indicate the need for greater attention to quality-of-care indicators for correct planning, cost reduction, and efficiency improvement.

Effect of aromatherapy interventions on hemodialysis complications: A systematic review.

BACKGROUND AND PURPOSE: Aromatherapy, a CAM therapy, is a natural way of treating the mind, body and soul of individuals. The purpose of this study was to systematically review the literature to determine the effect of aromatherapy on hemodialysis complications. METHODS: In this systematic review, international (PubMed, Google Scholar, Web of Science, CINHAL, EMBASE and Scopus) and national databases (SID and Magiran) were searched from inception of the databases to 30 December 2017. RESULTS: The results showed that aromatherapy reduced some of the complications of hemodialysis, including anxiety, fatigue, pruritus, pain of arteriovenous fistula puncture, sleep quality, depression, stress and headache. In one case, it improved the quality of life of hemodialysis patients. CONCLUSION: Considering the complications and heavy costs of managing complications in patients undergoing hemodialysis, it appears that aromatherapy can be used as an inexpensive, fast-acting and effective treatment to reduce complications in hemodialysis patients.

Prevalence of Chronic Kidney Disease in Iranian General Population: A Meta-Analysis and Systematic Review.

The aim of this study was to determine the prevalence of CKD in the Iranian general population. In this systematic review and meta-analysis study, international (PubMed, Web of Science, Scopus, and Google scholar) and national databases (SID, Magiran) were searched until December 30, 2017. The quality of the studies was evaluated using the Hoy instrument. Out of 1170 initial studies, 9 studies with a total of 70 605 participants were included in the final stage of this study. Based on the results of the random effect method (95% CI), the overall prevalence of chronic kidney disease in 70 605 people was 15.14% (I2 = 99.77%). The prevalence of CKD in female patients (18.80%) was 1.7 times higher than in male patients (10.83). The results of the present study indicate a higher than the global average prevalence of CKD in Iran and the need for additional attention of policy makers on better planning for control and implementation of screening programs in high-risk populations, such as patients with hypertension and diabetes.