Prevalence of Fatigue in Patients With Cancer: A Systematic Review and Meta-Analysis

CONTEXT

Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness among patients with cancer.

OBJECTIVES

The objective of this meta-analysis is to examine the present status of fatigue prevalence in patients with cancer.

METHODS

The following databases were searched: PubMed, MEDLINE, EMBASE, PsycINFO, Cochrane Library, from inception up to February 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I²) statistics.

RESULTS

A total of 129 studies (N = 71,568) published between 1993 and 2020 met the inclusion criteria. The overall prevalence of fatigue was 49% (34,947 of 71,656 participants, 95% CI = 45-53) with significant heterogeneity between studies (P < 0.000; τ² = 0.0000; I² = 98.88%). Subgroup analyses show that the prevalence of fatigue related to type of cancer ranged from 26.2% in patients with gynecological cancer to 56.3% in studies that included mixed types of cancer. In advanced cancer stage patients, the highest prevalence of fatigue (60.6%) was reported. Fatigue prevalence rates were 62% during treatment and 51% during mixed treatment status. The prevalence of fatigue decreased from 64% in studies published from 1996 to 2000 to 43% in studies published from 2016 to 2020. Metaregression identified female gender as a significant moderator for higher prevalence of fatigue, whereas mean age is not associated with fatigue.

CONCLUSION

This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce fatigue and improve the quality of life of patients with cancer.

Implementation of marketing concept and organizational culture in SMEs in Al Buraimi – Oman

Purpose

The purpose of this paper is to contribute to the understanding of relationship between implementation process of marketing concepts and the culture at the small- to medium-sized enterprise (SME) level of the Omani economy. The marketing culture and behavior provide a comprehensive insight into the implementation process of marketing concepts in SME sector in Oman. This paper seeks to explore the marketing culture of the firm’s members and to what extent they can support or create barriers to the successful implementation of the marketing concept in Al Buraimi region – Oman.

Design/methodology/approach

A quantitative approach was used to explore the impact of organizational culture on the implementation of marketing concepts on SMEs; to achieve the objective of this study, the paper based on a sample of 240 of SME sector in Al Buraimi. Simple Random Sampling was used for the sample distribution. The IBM analysis program Statistical Package for Social Sciences was used to process the data sets.

Findings

The findings of this study support the argument about the positive relationship between the implementation of marketing concepts and organizational culture. In the Omani context, organizational culture is related to the whole society’s culture, which has changed over recent years due to changes in lifestyle and consumer behavior. All of this affects the SME sector and its ability to create new ideas for the marketing process.

Originality/value

The paper finds that there is a logic and structure to the culture and the implementation process of marketing concepts. It helps to identify the impact of the culture of the SME on the implementation of marketing in the SME sector on the Omani economy in light of the new orientation on the part of decision makers in terms of increasing the importance of non-oil activities.

Discrete event simulation and pharmacy process re-engineering

PURPOSE

The purpose of this paper is to describe a case study undertaken at Al Buraimi Hospital in Oman, which used computer simulation and the Delphi approach to improve efficiency by reducing prescription dispensing waiting times.

DESIGN/METHODOLOGY/APPROACH

This study's framework was based on a discrete event simulation (DES) to identify the as-is pharmacy process and to create a to-be (future situation) to achieve an improvement in pharmacy workflow and service quality. Owing to healthcare environment complexity, and to gain a deeper understanding about Al Buraimi Hospital pharmacy problems, a Delphi technique was also used.

FINDINGS

Based on Delphi, and according to the expert panel suggestions, two alternative scenarios were proposed to improve Al Buraimi Hospital pharmacy efficiency: fast-track and direct-dispensing, which should help to reduce the prescription dispensing waiting time process by 7.3 and 9.8 min, respectively.

RESEARCH LIMITATIONS/IMPLICATIONS

The main limitation is the pharmacists' shortage, which may affect the prescription dispensing process's quality as insufficient manpower to check the prescriptions may increase the medication errors' risk.

ORIGINALITY/VALUE

Based on this case study's real-world data, findings can be used to improve public healthcare sector pharmacy efficiency. The DES can be used in healthcare services to describe and test actual and proposed situations.