Global prevalence of nosocomial infection: A systematic review and meta-analysis.

OBJECTIVES: Hospital-acquired infections (HAIs) are significant problems as public health issues which need attention. Such infections are significant problems for society and healthcare organizations. This study aimed to carry out a systematic review and a meta-analysis to analyze the prevalence of HAIs globally. METHODS: We conducted a comprehensive search of electronic databases including EMBASE, Scopus, PubMed and Web of Science between 2000 and June 2021. We found 7031 articles. After removing the duplicates, 5430 studies were screened based on the titles/ abstracts. Then, we systematically evaluated the full texts of the 1909 remaining studies and selected 400 records with 29,159,630 participants for meta-analysis. Random-effects model was used for the analysis, and heterogeneity analysis and publication bias test were conducted. RESULTS: The rate of universal HAIs was 0.14 percent. The rate of HAIs is increasing by 0.06 percent annually. The highest rate of HAIs was in the AFR, while the lowest prevalence were in AMR and WPR. Besides, AFR prevalence in central Africa is higher than in other parts of the world by 0.27 (95% CI, 0.22-0.34). Besides, E. coli infected patients more than other micro-organisms such as Coagulase-negative staphylococci, Staphylococcus spp. and Pseudomonas aeruginosa. In hospital wards, Transplant, and Neonatal wards and ICU had the highest rates. The prevalence of HAIs was higher in men than in women. CONCLUSION: We identified several essential details about the rate of HAIs in various parts of the world. The HAIs rate and the most common micro-organism were different in various contexts. However, several essential gaps were also identified. The study findings can help hospital managers and health policy makers identify the reason for HAIs and apply effective control programs to implement different plans to reduce the HAIs rate and the financial costs of such infections and save resources.

Anxiety during the COVID-19 pandemic in hospital staff: systematic review plus meta-analysis.

BACKGROUND: This study was conducted to systematically review the existing literature examining the prevalence of anxiety among hospital staff and identifying the contributing factors to address the complications of this disorder and develop effective programmes for reducing the complications of this mental health problem. METHODS: We searched the electronic databases including PubMed, EMBASE, Scopus, Web of Science and Google Scholar from January 2020 to February 2021. To perform meta-analysis, the random effects model was used. To assess the statistical heterogeneity of the included studies, the I2 index was used, and 95% CI was estimated. Data analysis was performed by R software. RESULTS: In the final analysis, 46 articles with the total sample size of 61 551 hospital staff members were included. Accordingly, anxiety prevalence among healthcare workers (HCWs) was 26.1% (95% CI 19% to 34.6%). The prevalence rates of anxiety in health technicians and medical students were 39% (95% CI 13% to 73%) and 36% (95% CI 15% to 65%), respectively, indicating a much higher prevalence than other hospital staff members. Furthermore, a positive significant relationship between prevalence of anxiety among HCWs and their age was approved (p<0.001). The prevalence rate of anxiety was higher among women 37.7% (95% CI 25.4% to 51.8%) than men 27.2% (95% CI 18.2% to 38.6%). CONCLUSION: The findings show a moderately high prevalence rate of anxiety in hospital staff. Due to the high prevalence of this mental health problem in health technicians, medical students and frontline health workers, it is highly suggested that healthcare institutions offer mental health programmes for these working groups in order to appropriately manage anxiety during the COVID-19 pandemic.

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.

The worldwide investigating nurses' attitudes towards do-not-resuscitate order: a review.

BACKGROUND: The acceptance or practical application of the do-not-resuscitate order is substantially dependent on internal or personal factors; in a way that decision-making about this issue can be specific to each person. Moreover, most nurses feel morally and emotionally stressed and confused during the process decision-making regarding DNR order. Therefore, the purpose of the present study was to evaluate nurses' attitudes towards DNR order in a systematic review. METHODS: This critical survey was conducted using a systematic review protocol. To this end, the most relevant articles published in domestic and foreign databases with no time limits until October 2018 were searched. The inclusion and exclusion criteria were articles on DNR order, studies about nurses' attitudes, descriptive and analytical research papers, as well as those with download links and full texts. The given articles were also assessed in terms of their quality and their main results were extracted. RESULTS: Of the total number of 1663 articles searched in the process of systematic review to investigate nurses' attitudes towards DNR order, 88 articles were included in the full-text review step and finally 10 articles, meeting the inclusion criteria, were found. Assessing the quality of articles included in this review showed that 8 articles, in general, were of good quality and 2 studies were characterized with moderate quality. The main factors associated with nurses' attitudes towards DNR order were grouped into three categories of (1) nurses' attitudes towards DNR order, (2) guidelines for DNR order, and (3) decision-making by patients and their families about DNR order. In most of the studies examined, nurses' attitudes towards DNR order were reported positive. CONCLUSION: It seemed that nurses were willing to get involved in DNR order and each hospital was recommended to develop a written DNR policy directing individuals and avoiding their confusion in this respect.

A systematic review of the prevalence of anxiety among the general population during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has had an adverse effect on the mental health of population worldwide. This study was conducted to systematically review the existing literature to identify the individuals at higher risk of anxiety with a view to provide targeted mental health services during this outbreak. METHODS: In this study, the studies focusing on anxiety prevalence among the general population during the COVID-19 pandemic were searched in the PubMed, EMBASE, Scopus, Web of Science (WoS) and Google Scholar from the beginning of Covid-19 pandemic to February 2021. RESULTS: 103 studies constituting 140732 people included in the review. The findings showed that anxiety prevalence was 27.3% (95% CI, 23.7%; 31.2%) among general population while the prevalence in COVID-19 patients was 39.6% (95% CI, 30.1%; 50.1%). Anxiety was significantly higher among females and older adults (p≤0.05). In addition Europe revealed the highest prevalence of anxiety 54.6% (95% CI, 42.5%; 66.2%) followed by America 31.5% (95% CI, 19%; 47.5%) and Asia 28.3% (95% CI, 20.3%; 38%). In the general population the highest prevalence of anxiety was in Africa 61.8% (95% CI, 57%-66.4%) followed by America 34.9% (95% CI, 27.7%-42.9%), Europe 30.7% (95% CI, 22.8%-40%) and Asia 24.5% (95% CI, 20.7%-28.9%). CONCLUSION: During the COVID-19 crisis, through identifying those who are more likely to be suffered from mental disorders at different layers of populations, it would be possible to apply appropriate supportive interventions with a view to provide targeted mental health services during the outbreak.