Nurses' moral courage and related factors: A systematic review

BACKGROUND

Nurses face various ethical conflicts when taking care of patients, and such conflicts require moral courage. This systematic review was conducted with the aim of investigating moral courage and its related factors among nurses.

METHODS

To find related studies, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The PubMed, Web of Science, Google Scholar, Scopus, Embase and Science Direct databases were searched using keywords such as Courage, Moral Courage, and Nurses, and no lower time limit was imposed when conducting the searches. The identified studies were published between January 2000 and March 2023. Quality of articles was assessed using the STROBE checklist.

RESULTS

The pooled sample size for the 19 included studies was 7863. All studies were observational and cross-sectional. The results showed that three categories of factors most related to moral courage are individual, moral, and factors related to the organization. Underlying factors of each category are also provided within this paper.

CONCLUSION

Moral courage is an integral part of nursing, which as a profession, is becoming even more challenging with the advancement of science and technology. Therefore, there is a need for nurses and especially nursing managers to be considerate of factors affecting moral courage of nurses, with a view to strengthening the positive factors and reducing the negative impacts.

Global prevalence of sleep disorders during menopause: a meta-analysis

BACKGROUND

Sleep disorders are conditions that have long-term effects on health, quality of sexual function, productivity at work, and overall quality of life. Considering that reports on menopausal sleep disorders are heterogeneous, the aim of this research was to determine the global prevalence of sleep disorders during menopause by meta-analysis.

METHODS

PubMed, Google Scholar, Scopus, WoS, ScienceDirect, and Embase databases were checked with suitable keywords. All screening stages of articles were reviewed based on PRISMA and their quality was determined based on STROBE. Data analysis, examination of heterogeneity, and publication bias of factors affecting heterogeneity were performed in CMA software.

RESULTS

The overall prevalence of sleep disorders among postmenopausal women was 51.6% (95% CI: 44.6-58.5%). The upper prevalence of sleep disorders was among postmenopausal women at 54.7% (95% CI: 47.2-62.1%). The upper prevalence of sleep disorders in the same population category was related to restless legs syndrome with a prevalence of 63.8% (95% CI: 10.6-96.3%).

CONCLUSION

In this meta-analysis, sleep disorders during menopause were found to be common and significant. Therefore, it is recommended that health policymakers offer pertinent interventions in relation to the health and hygiene of sleep for women in menopause.

Global prevalence of constipation in older adults: a systematic review and meta-analysis

BACKGROUND AND OBJECTIVE

Constipation is one of the most common functional disorders of the gastrointestinal tract in older adults. To date, no systematic review or previous meta-analysis has estimated the global prevalence of constipation in older adults. The prevalence of this disorder has been reported differently in different studies; therefore, this study aims to systematically review the publications and to perform a meta-analysis of the prevalence of constipation in older adults.

METHODS

The electronic databases PubMed, Google Scholar, Scopus, Web of Science, and ScienceDirect were systematically searched for studies reporting the prevalence of constipation in older adults up to February 2022. To perform the analysis, the random effects model was used, and heterogeneity was assessed by Cochran's Q test and expressed as I2.

RESULTS

Out of 5341 evaluated publications, 36 met the eligibility criteria. These studies included 58,405 older adults aged 60-93 years. The overall prevalence of constipation in older adults was 18.9% (95% confidence interval [95% CI]: 14.7-23.9%). The prevalence of constipation in older adults according to Rome II criteria was 16.2% (95% CI: 6.8-33.7), based on Rome III criteria was 19.2% (95% CI: 12.6-28.1), and based on Rome IV criteria was 10.3% (95% CI: 5.8-17.7). The highest prevalence of constipation was found in older adults in Africa at 32.3% (95% CI: 21.5-45.4), and the lowest in Asia at 13.6% (95% CI: 9.1-19.9). Concerning diagnostic tools, the highest prevalence of constipation was found if a self-reporting tool was applied with a value of 19.7% (95% CI: 15.8-24.3).

CONCLUSION

The results suggest that health policymakers should pay more attention to the prevention of constipation in older adults, including raising public awareness to the importance of nutrition and diet and physical activity in older adults.

Determining the relationship between over-care burden and coping styles, and resilience in mothers of children with autism spectrum disorder

BACKGROUND

Stress and over-care burden are problems for mothers of children with Autism Spectrum Disorder (ASD). Therefore, it seems necessary to evaluation of coping with stress according to the burden of care for these mothers. This study aimed to determine the relationship between care burden with coping styles and resilience of mothers of children with ASD.

METHODS

The present study is a descriptive-analytical study performed on mothers of children with ASD in Kermanshah, Iran. Participants in the study were selected by convenience sampling. A Demographic questionnaire, Caregiver Burden Inventory (CBI), Connor-Davidson Resilience Scale (CD-RISC), and Coping strategies questionnaire (CSQ) were used for collecting data. Then it was analyzed through an independent t-test, ANOVA, and Pearson correlation test.

RESULTS

The mean total score of the burden of care was 95.5 ± 9.1, resilience was 52.7 ± 8.7, and coping styles were 92.4 ± 8.4. Mothers of children with autism experience a severe burden of care and moderate levels of resiliency. There was also a significant negative correlation between the burden of care and resilience) p < 0.001, r = -0.536), but no significant correlation was found between burden of care and coping style) p = 0.937, r = -0.010).

CONCLUSION

According to the results of this study, it is necessary to pay more attention to the factors affecting resiliency. Also, considering the significant relationship between burden of care and resiliency, teaching strategies to increase resiliency can be used in the educational program for mothers with autistic children.

The global prevalence of myocardial infarction: a systematic review and meta-analysis

BACKGROUND

Myocardial infarction (MI) is one of the life-threatening coronary-associated pathologies characterized by sudden cardiac death. The provision of complete insight into MI complications along with designing a preventive program against MI seems necessary.

METHODS

Various databases (PubMed, Web of Science, ScienceDirect, Scopus, Embase, and Google scholar search engine) were hired for comprehensive searching. The keywords of "Prevalence", "Outbreak", "Burden", "Myocardial Infarction", "Myocardial Infarct", and "Heart Attack" were hired with no time/language restrictions. Collected data were imported into the information management software (EndNote v.8x). Also, citations of all relevant articles were screened manually. The search was updated on 2022.9.13 prior to the publication.

RESULTS

Twenty-two eligible studies with a sample size of 2,982,6717 individuals (< 60 years) were included for data analysis. The global prevalence of MI in individuals < 60 years was found 3.8%. Also, following the assessment of 20 eligible investigations with a sample size of 5,071,185 individuals (> 60 years), this value was detected at 9.5%.

CONCLUSION

Due to the accelerated rate of MI prevalence in older ages, precise attention by patients regarding the complications of MI seems critical. Thus, determination of preventive planning along with the application of safe treatment methods is critical.

The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis

Background

Autism spectrum disorder (ASD) is one of the serious developmental disorders that is usually diagnosed below the age of three years. Although the severity of the disease’s symptoms varies from patient to patient, the ability to communicate with others is affected in all forms of ASD. This study aimed to determine the prevalence of ASD in high-risk groups by continent.

Methods

The present study was conducted by systematic review and meta-analysis from 2008 to July 2021. Databases such as Science Direct, PubMed, Scopus, SID, Magiran, Web of Science (WoS), and Google Scholar from 2008 to July 2021 were searched to find related studies. Data were analysed using Comprehensive Meta-Analysis software (Version 2).

Results

A total of 74 studies with 30,212,757 participants were included in this study. The prevalence of ASD in the world was 0.6% (95% confidence interval: 0.4–1%). Subgroup analyses indicated that the prevalence of ASD in Asia, America, Europe, Africa and Australia was 0.4% (95% CI: 0.1–1), 1% (95% CI: 0.8–1.1), 0.5% (95% CI: 0.2–1), 1% (95% CI: 0.3–3.1), 1.7% (95% CI: 0.5–6.1) respectively.

Conclusion

ASD imposes a heavy health burden on communities around the world. Early detection of ASD can reduce the incidence of developmental disorders and improve patients’ communication skills. Therefore, health policymakers need to be aware of the prevalence and increasing trend of ASD to implement appropriate planning and interventions to reduce its consequences.

The effect of obstructive sleep apnea on the increased risk of cardiovascular disease: a systematic review and meta-analysis

BACKGROUND

Obstructive sleep apnea (OSA) is a disorder characterized by intermittent airway obstruction during sleep. The association between OSA and the incidence of cardiovascular disease (CVD) has been investigated in many studies; however, the results are not entirely consistent between studies. The aim of this study was to investigate the relationship between OSA and the risk of CVD through a meta-analysis of cohort studies.

METHODS

A systematic review and meta-analysis of literature was conducted using the PubMed, WoS, Embase, ScienceDirect, Scopus, and Web of Science databases up to the year 2020. In order to analyze the eligible studies, the stochastic effects model was used and the heterogeneity of the studies with the I² index was investigated. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2).

RESULTS

A total of 24 studies were included in the meta-analysis according to the inclusion criteria. Twelve studies reported CVD results, 11 studies reported stroke results, 9 studies reported mortality results, and 8 studies reported CVD results. The odds ratio of CVD in patients with OSA 1.71 (1.17-2.27: 95% confidence interval) stroke in patients with OSA, 1.86 (1.28-2.69: 95% confidence interval), mortality in patients with OSA, 1.77 (1.37-2.29: 95% confidence interval) and CHD in patients with OSA, and 1.48 (1.06-2.28: 95% confidence interval) was obtained.

CONCLUSION

OSA is considered a cardiovascular risk factor. There is a relationship between the severity of OSA and the risk of cardiovascular disease. OSA increases the risk of heart attack, CHD, and death from cardiovascular disease.

Evaluation of skin lesions in diabetic patients: a systematic review and meta-analysis

BACKGROUD

Prevalence of skin lesions among diabetic patients is a major health concern. Therefore, this systematic review and meta-analysis study was conducted to determine the prevalence of skin lesions in diabetic patients.

METHODS

To identify and select relevant articles, the SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) databases were searched without a lower time limit and until April 2020. The random effects model was used to perform the analysis, and the heterogeneity of studies was assessed using the I2 index. Data were analyzed within the Comprehensive Meta-Analysis (Version 2) software.

RESULTS

After evaluating the 22 final articles with a total sample size of 8406, the prevalence of skin lesions among diabetes patients were found as 70.3% (95% CI: 63-76.7%). Moreover, according to the meta-regression analysis, the effect of 'sample size' on th prevalence of skin lesions was significantly different in diabetes patients (p < 0.05).

CONCLUSION

The results of this study show that skin lesions are common in diabetes patients. Therefore, appropriate policies needs to be adopted to improve the situation and to monitor patients and outcomes at all levels.

Clinical effects of curcumin in enhancing cancer therapy: A systematic review

BACKGROUND

Curcumin is herbal compound that has been shown to have anti-cancer effects in pre-clinical and clinical studies. The anti-cancer effects of curcumin include inhibiting the carcinogenesis, inhibiting angiogenesis, and inhibiting tumour growth. This study aims to determine the Clinical effects of curcumin in different types of cancers using systematic review approach.

METHODS

A systematic review methodology is adopted for undertaking detailed analysis of the effects of curcumin in cancer therapy. The results presented in this paper is an outcome of extracting the findings of the studies selected from the articles published in international databases including SID, MagIran, IranMedex, IranDoc, Google Scholar, ScienceDirect, Scopus, PubMed and Web of Science (ISI). These databases were thoroughly searched, and the relevant publications were selected based on the plausible keywords, in accordance with the study aims, as follows: prevalence, curcumin, clinical features, cancer.

RESULTS

The results are derived based on several clinical studies on curcumin consumption with chemotherapy drugs, highlighting that curcumin increases the effectiveness of chemotherapy and radiotherapy which results in improving patient's survival time, and increasing the expression of anti-metastatic proteins along with reducing their side effects.

CONCLUSION

The comprehensive systematic review presented in this paper confirms that curcumin reduces the side effects of chemotherapy or radiotherapy, resulting in improving patients' quality of life. A number of studies reported that, curcumin has increased patient survival time and decreased tumor markers' level.

Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis

BACKGROUND

The COVID-19 pandemic has had a significant impact on public mental health. Therefore, monitoring and oversight of the population mental health during crises such as a panedmic is an immediate priority. The aim of this study is to analyze the existing research works and findings in relation to the prevalence of stress, anxiety and depression in the general population during the COVID-19 pandemic.

METHOD

In this systematic review and meta-analysis, articles that have focused on stress and anxiety prevalence among the general population during the COVID-19 pandemic were searched in the Science Direct, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases, without a lower time limit and until May 2020. In order to perform a meta-analysis of the collected studies, the random effects model was used, and the heterogeneity of studies was investigated using the I2 index. Moreover. data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software.

RESULTS

The prevalence of stress in 5 studies with a total sample size of 9074 is obtained as 29.6% (95% confidence limit: 24.3-35.4), the prevalence of anxiety in 17 studies with a sample size of 63,439 as 31.9% (95% confidence interval: 27.5-36.7), and the prevalence of depression in 14 studies with a sample size of 44,531 people as 33.7% (95% confidence interval: 27.5-40.6).

CONCLUSION

COVID-19 not only causes physical health concerns but also results in a number of psychological disorders. The spread of the new coronavirus can impact the mental health of people in different communities. Thus, it is essential to preserve the mental health of individuals and to develop psychological interventions that can improve the mental health of vulnerable groups during the COVID-19 pandemic.