The prevalence of depression, anxiety and stress in nurses working in Iranian hospitals: A systematic review and meta-analysis.

INTRODUCTION: Depression, anxiety, and stress are common problems among nurses. OBJECTIVE: This meta-analysis was conducted to investigate the prevalence of depression, anxiety, and stress among nurses working in Iranian hospitals. MATERIALS AND METHODS: Published studies on nurses working in Iranian hospitals were investigated in this meta-analysis. All national and international online databases, including Web of Science, PubMed, Scopus, Embase, Cochrane Library, Scientific Information Database (SID), MagIran, and IranMedex, as well as Google Scholar, were searched using related keywords without any time limits until September 2017. The heterogeneity of studies was assessed using the I2 index. Data were analyzed in STATA version 11.1. RESULTS: In 28 studies with a sample size of 6581 people, the prevalence of depression was 31% (n=2040) among Iranian nurses (31% in females and 28% in males) according to Beck's Depression Inventory (BDI); 30% (n=1974) (54% in females and 40% in males) according to the 21-Item Depression, Anxiety and Stress Scale (DASS-21); and 9% according to the General Health Questionnaire (GHQ-28). The prevalence of mild, moderate, and severe depression in nurses was 39%, 16%, and 20% according to the BDI; 8%, 24%, and 4% according to DASS-21; and 48%, 36%, and 16% according to GHQ-28, respectively. The prevalence of anxiety and stress was 85% and 67% in Beck's inventory, 28% and 38% in DASS-21, and 46% and 49% in GHQ-28, respectively. CONCLUSION: According to the BDI and DASS-21, about one-third of Iranian nurses have depression with a female predilection. Nurses play an essential role in improving the quality of treatment; therefore, health policymakers must pay attention to reducing depression among nurses.

Relationship between international tourism and concentrations of PM 2.5: an ecological study based on WHO data.

Tourism is regarded as a major global industry. Given the importance of identifying factors affecting the tourism industry and attracting international tourists, the present ecological study explored the impact of environmental pollution on the number of international tourists arrival using concentrations of PM2.5 (particulate matter 2.5 µm or less in size) in a multivariate framework under the context of 190 countries. Using panel data from 190 countries, the author explored the data on the number of international tourists arriving in countries in 2017 extracted from the World Bank (WB) website, and obtained the information about the concentrations of PM2.5 from the World Health Organization (WHO) website. Pearson's correlation coefficient and linear regression analysis were used to examine the correlation of the number of tourists with the variables of daily concentrations of PM2.5, societal safety, international conflict, and the relationship of tourist arrival with the studied variables, respectively. The number of countries with low, moderate, and high concentrations of PM2.5 in urban areas was 33, 116, and 41, respectively. This numbers for rural areas was 47, 102, and 42 countries, respectively. The mean concentrations of PM2.5 in the surveyed countries was 23.90 ± 15.81 and 25.69 ± 16.76 for rural and urban areas, respectively. The estimation results revealed that there was a significant correlation between the number of tourists with the concentrations of PM2.5 in the rural areas (p = 0.01). There was also a significant relationship between the human development index (HDI) and the concentration of PM2.5. A significant relationship was observed in the results of univariate linear regression analysis between tourist arrival with rural concentrations of PM2.5 (p = 0.02) and societal safety (p = 0.003). After adjusting the effect of societal safety variables, domestic and international conflict, the relationship between tourist arrivals and concentrations of PM2.5 in rural area remained significant (p = 0.02). The results imply that by reducing the concentration of PM2.5 the positive attitude of tourists for traveling to countries with healthy air can be earned.

Investigating prevalence job stress and illness among hospital staff providing health tourism services (HSPHTS) in Iran.

BACKGROUND: Health tourism or treatment tourism is one of threatening fields that causes (added s) increase in prevalence of job stress and illnesses among hospital staff of providing health tourism services (HSPHT). The aim of this study is to determine the prevalence of job stress and illnesses among hospitals staff of providing health tourism services in touristic cities as Tehran and Shiraz in Iran. METHODS: This cross-sectional, descriptive-analytical study was carried out among the staff of 10 hospitals providing health tourism services in cities of Tehran and Shiraz, Iran, in 2019. In these hospitals, 1250 staff were chosen by cluster sampling method from each job task as doctor, nurse, office worker, and paramedical and cleaner worker. Also, 1100 staff working in other general hospitals (non-HSPHTS) were selected as the control sample. Then, the demographic information and prevalence of job stress were gathered by Osipow job stress questionnaire and the illnesses were accumulated by self-reporting questionnaire. Finally, data were analyzed in SPSS 20 software. Chi-square and Pearson's parametric tests were used in the study. RESULTS: Prevalence of illnesses among HSPHTS was more than that in general hospitals (Pvalue < 0.05). The most prevalent illnesses were respiratory (11.08%), digestive (9.2%), and cutaneous (9.04%), respectively. Also, the prevalence of job stress among HSPHTS was more than that in general hospitals (Pvalue < 0.05). There was a significant relationship between prevalence of illnesses and job stress among the staff of hospitals and the increase in the number of visited tourists in the hospitals providing health tourism services. CONCLUSION: Results of the study showed that the prevalence of job stress (%33.76) and illnesses (%43.66) among the HSPHTS was respectively 2 and 2.6 times more than that among the staff of general hospitals. Thus, it is necessary to observe sanitary actions and considerations more seriously in these hospitals.