Systematic Reviews最新文献

{"title":"The impact of changes to work circumstances enforced by COVID-19 on anxiety: a systematic review.","authors":"Stefania D'Angelo, Elena Zaballa, Georgia Ntani, Ilse Bloom, Karen Walker-Bone","doi":"10.1186/s13643-025-02950-9","DOIUrl":"https://doi.org/10.1186/s13643-025-02950-9","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic enforced changes on employment circumstances for all workers but older workers experiencing job loss are less likely to return to work than younger individuals. Under normal circumstances, job loss is a well-recognised risk factor for poor mental health, while it is unclear whether working from home is beneficial or harmful to mental health. We systematically reviewed the literature to explore the association between enforced changes in employment (job loss, working from home or being furloughed) and anxiety in the adult population, with a particular focus on older workers.</p><p><strong>Methods: </strong>The protocol was registered in June 2021 in the International Prospective Register of Systematic Reviews database. We searched Medline, Embase, PsycInfo and CINAHL (January 2020-July 2023) databases for studies including older adults (some of the study sample were workers aged over 50 years). Results were presented by narrative review, complemented by a vote-counting technique and effect direction plots to summarise the relationship between exposures and anxiety.</p><p><strong>Results: </strong>Forty-eight studies from several countries met the inclusion criteria, including 39 cross-sectional and nine longitudinal studies. The prevalence of anxiety varied between studies due to different tools and cut-offs chosen, reaching as high as 63% in one study. The vote-counting method showed convincing evidence that job loss since lockdown negatively impacted anxiety overall and among people aged 50 and over. Inconsistent results were observed across studies investigating the effect of working from home or furlough on anxiety.</p><p><strong>Conclusion: </strong>Disruption of employment during the pandemic and related lockdowns has increased anxiety levels in the adult population and among older workers. More research is needed to know how persistent these effects are and to identify strategies to support those most affected.</p><p><strong>Systematic review registration: </strong>The protocol of the systematic review was registered in June 2021 in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42021260499), and it is provided as supporting information (Additional File 1).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"195"},"PeriodicalIF":3.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart rate variability and suicidal thoughts and behaviour: study protocol for a systematic review.","authors":"Sonja Omlor, Norbert Scherbaum, Inken Höller, Thomas Forkmann","doi":"10.1186/s13643-025-02954-5","DOIUrl":"https://doi.org/10.1186/s13643-025-02954-5","url":null,"abstract":"<p><strong>Background: </strong>As 700,000 people per year commit suicide worldwide, improvements in suicide prevention and the prediction of suicide attempts or suicide in clinical care are mandatory. This systematic review aims to examine heart rate (HR) and heart rate variability (HRV) as risk factors for the development of suicidal thoughts and behaviour in clinical and non-clinical populations.</p><p><strong>Methods and analysis: </strong>The systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA). We will retrieve relevant literatures across the following databases: PubMed, PsycINFO, Cochrane Library and Web of Science. Additionally, we will manually search the reference lists of all relevant articles. If studies are published or translated in English and measure HRV or HR and suicidal thoughts or behaviour, they will be included. Two reviewers will independently complete the article selection, data extraction and risk of bias ratings. A third reviewer will resolve disagreements. Tabular and narrative synthesis will be done accordingly and a risk of bias assessment will be conducted by the QUIPS (Quality In Prognosis) tool.</p><p><strong>Discussion: </strong>This systematic review will present evidence from which conclusions can be made regarding the relationship between HRV and HR and suicidal thoughts and behaviour. By identifying risk factors associated with suicidality and differentiating between factors for suicidal thoughts versus behaviour, this review will potentially contribute theoretically to our understanding of the causal factors involved in influencing increasing levels of suicidality.</p><p><strong>Ethics and dissemination: </strong>This is a systematic review of published literature and thereby ethical approval was not sought. Results will be disseminated through conferences and publications in relevant peer-reviewed journals.</p><p><strong>Strength and limitations of this study: </strong>The results will have important implications for risk prediction for suicidal thoughts and behaviour. The protocol follows the PRISMA guidelines (Page et al.,BMJ 372:n71,2021). Thus, two reviewers will perform data extraction and risk of bias evaluation separately. We will exclude non-English translated or published studies, which might be a limitation and bias against non-English-speaking countries.</p><p><strong>Systematic review registration: </strong>PROSPERO registration number: CRD42023460068.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"193"},"PeriodicalIF":3.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the lived experiences of depression among youths and their guardians in sub-Saharan Africa: a systematic review protocol.","authors":"Precious Makiyi, Michael Udedi, Moses Kumwenda, James January","doi":"10.1186/s13643-025-02873-5","DOIUrl":"https://doi.org/10.1186/s13643-025-02873-5","url":null,"abstract":"<p><strong>Background: </strong>The intersection between mental health and culture is more prominent when we study how different mental health conditions present in different cultures. There is enough evidence to suggest that mental health conditions like depression, for instance, present differently in Western and non-Western societies. Most phenomenological studies on youth depression have been done in high-income countries. This systematic review, therefore, seeks to understand how depression is experienced by youths (10-24 years) and their carers in SSA.</p><p><strong>Methods: </strong>Two research assistants (with the help of P. M.) shall independently search articles on the following databases: PubMed, PsycINFO, Embase, HealthSTAR, CINAHL, Google Scholar, Web of Science, and Scopus. Two reviewers will then independently evaluate the selected articles based on a systematic search strategy, extract relevant data, and synthesize findings using meta-aggregation techniques. We will use the Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA) guidelines in reporting results. The protocol is registered with the PROSPERO database (CRD42024556661).</p><p><strong>Discussion: </strong>The results from this systematic review will help researchers especially in SSA to have a better understanding of how depression is experienced by adolescents in the region and its impact on their guardians. This has a potential of informing a diagnostic or screening tool that is sensitive to the context of SSA.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024556661. Date of registration: 10th June 2024.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"194"},"PeriodicalIF":3.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between stroke injury sites and incidence of post-stroke pain: a systematic review and meta-analysis.","authors":"Zhifa Zhang, Sehui Ma, Bin Feng, Xiaoying Li, Yufen Zhang, Lei Pei","doi":"10.1186/s13643-025-02930-z","DOIUrl":"https://doi.org/10.1186/s13643-025-02930-z","url":null,"abstract":"<p><strong>Background: </strong>Post-stroke pain (PSP) is a prevalent and debilitating complication of stroke recovery, mainly characterized by allodynia and hyperalgesia. While certain brain lesion sites, particularly thalamic lesions, have been implicated in an increased risk of PSP, evidence regarding the specific contributions of stroke injury sites to PSP development remains inconsistent. This meta-analysis aimed to synthesize available data on the relationship between stroke lesion sites and PSP incidence, providing a more detailed understanding to inform clinical management.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature searches were performed across four major databases, including Embase, Scopus, Web of Science, and PubMed, up to December 31, 2024. Studies were included if they assessed the association between stroke lesion sites and PSP and reported 95% confidence intervals (CIs) for relevant outcomes. A random-effects model was used to pool incidence estimates, and heterogeneity across studies was evaluated. Subgroup analyses were conducted based on different PSP subtypes, including post-stroke shoulder pain (PSSP) and central post-stroke pain (CPSP).</p><p><strong>Results: </strong>From an initial pool of 14,631 screened studies, 25 met the eligibility criteria, involving a total of 3,812 stroke patients. The meta-analysis revealed a higher incidence of PSP (49% [95% CI: 0.41-0.56]) in patients with left-sided cerebral stroke compared to those with right-sided stroke. Subgroup analyses indicated significant associations between left-sided stroke lesions and both PSSP (50% [95% CI: 0.39-0.61]) and CPSP (41% [95% CI: 0.37-0.45]). Additionally, thalamic lesions were significantly associated with PSP in 36% (95% CI: 0.17-0.58) of cases. Despite some heterogeneity (I² = 96%), no significant publication bias was detected based on funnel plot analysis and Egger's test (P = 0.164).</p><p><strong>Conclusions: </strong>This meta-analysis provided significant association between left-sided cerebral stroke and the increased incidence of PSP, particularly in patients with PSSP and CPSP. Thalamic stroke was notably associated with the development of PSP. These results underscore the importance of considering stroke injury sites in the assessment and management of PSP during stroke rehabilitation. Recognizing these associations can aid in the development of targeted therapeutic strategies, ultimately improving stroke patients' outcomes and quality of life.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42019139928.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"192"},"PeriodicalIF":3.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of the pretreatment Naples prognostic score in gastrointestinal cancer patients: an updated meta-analysis with 28 studies.","authors":"Huayang Pang, Fengsheng Dai, Lihui Chen, Menghua Yan, Zhou Zhao, Hao Sun","doi":"10.1186/s13643-025-02944-7","DOIUrl":"10.1186/s13643-025-02944-7","url":null,"abstract":"<p><strong>Background: </strong>The Naples prognostic score (NPS) has been extensively documented as a promising prognostic biomarker in various malignancies. The objective of this study is to systematically investigate the correlation between the pretreatment NPS and survival outcomes in patients with gastrointestinal (GI) cancer.</p><p><strong>Methods: </strong>This meta-analysis was prospectively registered with PROSPERO (CRD42024567576). We conducted a systematic literature search using electronic databases, including Web of Science, PubMed, and Embase, from inception until July 1st, 2024. The primary endpoints assessed were long-term survival outcomes. Pooled hazard ratios (HR) with corresponding 95% confidence intervals (CI) were calculated using a random-effects model during the pooled analysis. Additionally, prediction intervals (PI) were generated to capture the variability of the pooled effect across different study settings.</p><p><strong>Results: </strong>A total of 28 studies, including 10,874 patients with GI cancer, were included in this meta-analysis. The results unequivocally demonstrated a significant association between elevated NPS and worse OS, bolstered by the robust PIs. Moreover, the elevated NPS was found to be significantly related to poor DFS, while the evidence remained uncertain due to heterogeneous PIs. Additionally, findings from a single study suggested that a high NPS may be associated with poor CSS.</p><p><strong>Conclusion: </strong>Our evidence suggests that the pretreatment NPS could be a valuable prognostic biomarker in GI cancer patients, particularly for OS. This information can be utilized by clinicians to stratify patients and develop personalized treatment plans.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"191"},"PeriodicalIF":3.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of combined transcranial direct current stimulation and gait training in Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials.","authors":"Shutao Qiu, Yixin Wei, Chaoran Gao, Xiangxiang Zhang, Qiang Gao","doi":"10.1186/s13643-025-02924-x","DOIUrl":"10.1186/s13643-025-02924-x","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is the second most common neurodegenerative disorder worldwide. Transcranial direct current stimulation (tDCS) and gait training have been demonstrated as effective treatments for patients with PD. However, the effects of combined tDCS and gait training on PD remain unclear. This systematic review and meta-analysis aimed to evaluate the effects of combined tDCS and gait training in PD patients.</p><p><strong>Methods: </strong>We conducted literature searches in EMBASE, PubMed, Web of Science, Cochrane Library, the Chinese National Knowledge Infrastructure databases, VIP, Wanfang, SinoMed, and the Chinese Medical Association Journal Database to identify the effects of combined transcranial direct current stimulation and gait training in PD patients.</p><p><strong>Results: </strong>Eight randomized controlled trials with a total of 183 PD patients were analyzed. Statistically significant improvements were observed only in double support time, both immediately after intervention (MD = 0.04, 95% CI, 0.02 to 0.06, I² = 0%, P = 0.0003) and at follow-up (MD = 0.02, 95% CI, 0.00 to 0.03, I² = 0%, P = 0.02). No significant differences were found in gait velocity, stride length, cadence, Time Up and Go test, Freezing of Gait Questionnaire, Parkinson's Disease Questionnaire-39, Berg Balance Scale, Six-Minute Walking Test, or Unified Parkinson's Disease Rating Scale Part III between the combined tDCS and gait training group and the gait training alone group (P > 0.05 for all outcomes). Heterogeneity across studies was low to moderate (I² = 0-85%).</p><p><strong>Conclusions: </strong>tDCS combined with gait training compared with gait training alone did not make a statistically significant improvement in efficacy in patients with PD.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"187"},"PeriodicalIF":3.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of cognitive behavioral therapy on depressive symptoms in parents of children with special needs: a systematic review and meta-analysis of randomized controlled trials.","authors":"Ying Guo, Jiajun Lan, Haoran He","doi":"10.1186/s13643-025-02945-6","DOIUrl":"10.1186/s13643-025-02945-6","url":null,"abstract":"<p><strong>Objective: </strong>This study conducts a systematic review and meta-analysis of randomized controlled trials (RCTs) that evaluate the effects of cognitive behavioral therapy (CBT) on depressive symptoms in parents of children with special needs. Additionally, it examines potential moderators of treatment outcomes, including the type of child diagnosis and the dosage of intervention.</p><p><strong>Methods: </strong>A comprehensive Literature search was performed in PubMed, Web of Science, Scopus, PsycINFO, and the Cochrane Library up to April 15, 2025. Peer-reviewed RCTs published in English that compared at least one structured CBT intervention to an inactive or active control group were included. Hedges' g was utilized to calculate standardized mean differences (SMDs) in depression scores. Random- or fixed-effects models were employed based on heterogeneity (I²). Subgroup analyses and meta-regression were conducted to identify moderators. The risk of bias was assessed using the Cochrane ROB2 tool, and publication bias was evaluated using funnel plots and Egger's test.</p><p><strong>Results: </strong>A total of 13 RCTs involving 1,441 parents were included. An initial random-effects model showed a slight, non-significant reduction in depressive symptoms (SMD = -0.33, 95% CI [-0.72, 0.07]; I² = 89%). After excluding two outliers, a random-effects analysis indicated a significant effect (SMD = -0.24, 95% CI [-0.47, 0.00], p = 0.046; I² = 75.9%). Subgroup analyses revealed that CBT was most effective for parents of children with neurodevelopmental disorders (NDDs), in trials using waitlist control groups, involving both parents, and when delivered over a short duration (6-8 weeks). Meta-regression demonstrated that child diagnosis type (β = 0.83, p = 0.000) and parental age (β = 0.04, p = 0.053) were significant moderators. The optimal therapeutic effect was achieved at a total intervention dose of 4 h (SMD ≈ -0.5), with parents aged 37.9 years demonstrating the most significant improvement, suggesting the necessity for individualized adjustment of the intervention protocol.</p><p><strong>Conclusion: </strong>CBT demonstrated a moderate and significant effect in alleviating depressive symptoms among parents of children with special needs, particularly in the context of NDDs. This effect was most pronounced when interventions were implemented with moderate-to-high intensity, in a short-term format, and involved both parents. Furthermore, tailoring interventions according to the child's diagnosis and the total dosage of the intervention proved essential for optimizing outcomes.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"190"},"PeriodicalIF":3.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping strategies for reducing inequalities in adult elective surgical care in the United Kingdom: a living scoping review protocol.","authors":"Katherine-Helen Hurndall, Jonathan Clarke, Ana-Luisa Neves, Ara Darzi","doi":"10.1186/s13643-025-02927-8","DOIUrl":"10.1186/s13643-025-02927-8","url":null,"abstract":"<p><strong>Background: </strong>Equitability of healthcare and timely access to services are essential components of healthcare quality, yet persistent health inequalities and inequity of access remain global challenges. The COVID-19 pandemic further exacerbated these disparities, underscoring the urgency to address health inequalities. In the United Kingdom (UK), despite longstanding recognition and efforts to tackle health inequalities, progress has been slow, with the pandemic highlighting stark disparities in healthcare outcomes and access. Renewed governmental initiatives and regional strategies aim to address these disparities, including within elective surgical care.</p><p><strong>Methods and analysis: </strong>This living scoping review protocol follows established methodological frameworks to map current evidence on strategies to reduce health inequalities in elective surgical care in the UK. Electronic databases (OVID Medline, Embase, Health Management Information Consortium, CINAHL) and grey literature sources will be systematically searched, with no time limit set, to identify relevant studies and documents. Selection criteria include articles describing strategies or policies aiming to reduce health inequalities in elective surgical care for adults in the UK, along with their impact on health outcomes. Data will be charted, collated, and summarised to provide a narrative description of findings.</p><p><strong>Discussion: </strong>This is the first living scoping review to map the available evidence on strategies to reduce inequalities in elective surgical care, across the whole patient pathway, in the UK. It is anticipated that this living review will be useful in informing future research, policy, and good practice. The findings of the scoping review will be submitted for peer-reviewed publication, presented at academic conferences, and discussed with a steering committee to inform future studies.</p><p><strong>Systematic review registration: </strong>The protocol was submitted to the Open Science Framework on 30/05/2024.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"189"},"PeriodicalIF":3.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living with pain-a systematic review on patients' subjective experiences.","authors":"Maria Christidis, Essam Ahmed Al-Moraissi, Tasnim Miah, Laura Mihasi, Artin Razavian, Nikolaos Christidis, Giancarlo De la Torre Canales","doi":"10.1186/s13643-025-02953-6","DOIUrl":"10.1186/s13643-025-02953-6","url":null,"abstract":"<p><strong>Background: </strong>Understanding the subjective experiences of patients living with chronic, acute, and cancer pain can significantly enhance the selection of treatment approaches, care, and support, ultimately improving their quality of life. This qualitative systematic review aimed to analyze if the patients' subjective experiences of living with pain differ between acute, chronic, and cancer pain states.</p><p><strong>Methods: </strong>After registration in PROSPERO (CRD42023491745), an electronic search was conducted in the databases Medline (Ovid), Embase (embase.com), Cochrane (Wiley), Web of Science (Clarivate Analytics), and CINAHL (EBSCO) from their inception to 19 April 2024. Out of 8443 articles, 62 articles were included. The inclusion criteria that were applied were as follows: (1) participants aged 18 or older; and (2) participants' subjective experiences of chronic, acute, or cancer pain. The exclusion criteria were as follows: (a) studies presented in other languages than English, Spanish, Portuguese, Greek, and Scandinavian languages; (b) editorials, letters, legal cases, case series, and case-control studies; (c) studies and articles based on duplicated data; (d) study population with ages below 18 years. Forty-four articles regarding chronic pain, thirteen regarding cancer pain, and five regarding acute pain were included. Methodological limitations were assessed using the CASP tool for quality appraisal in qualitative evidence synthesis. Certainty of evidence was assessed with GRADE-CERQual. All included studies showed moderate (n = 18) to high (n = 44) confidence.</p><p><strong>Results: </strong>Based on the qualitative synthesis in GRADE-CERQual, four main themes were identified: (1) impact of pain on social life, work life, and family life; (2) challenges in healthcare access; (3) psychological impact and emotional struggles from pain; and (4) barriers to effective pain management.</p><p><strong>Conclusions: </strong>Taken together, patients with chronic, acute, or cancer pain face challenges in social, work, and personal lives. They often lack recognition and support from healthcare providers, relying on self-managed methods and facing barriers to effective management. Therefore, future research examining how the different pain types affect the lives of the patients and at the same time exploring personalized and collaborative treatment approaches is warranted. In conclusion, patients' experiences of living with pain remain unexplored in clinical practice. Understanding the impact of various pain types on mental health, self-esteem, daily life, and relationships is crucial. Also, how personalized treatments, collaborative healthcare access, and long-term management strategies can improve quality of life for patients living with pain.</p><p><strong>Systemic review registration: </strong>PROSPERO CRD42023491745.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"188"},"PeriodicalIF":3.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of antenatal care dropout among pregnant women in Africa: a systematic review and meta-analysis.","authors":"Eneyew Talie Fenta, Destaw Endeshaw, Ousman Adal, Abiyu Abadi Tareke, Natnael Kebede, Amare Mebrat Delie, Eyob Ketema Bogale, Tadele Fentabel Anagaw, Misganaw Guadie Tiruneh","doi":"10.1186/s13643-025-02906-z","DOIUrl":"10.1186/s13643-025-02906-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Antenatal care (ANC) is a comprehensive healthcare service designed to support pregnant women through education, monitoring, and interventions to promote a healthy pregnancy and ensure a positive childbirth. Regular ANC visits play a crucial role in preventing complications, managing existing health conditions, and promoting the overall well-being of both the mother and the unborn child. Dropout from ANC visits results in potential complications during pregnancy, and these complications can involve the mother's health, the fetus's health, or both. Common complications of pregnancy include high blood pressure, gestational diabetes, anemia, preeclampsia, preterm labor, stillbirth, and miscarriage. The objective of this study is to estimate the prevalence of dropout from antenatal care and determinant factors among pregnant women in Africa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review and meta-analysis included with open or free access to full text all full, English-language original research articles, and doctoral dissertations on observational studies (cross-sectional, case control, or cohort) conducted worldwide between 2000 and December 15, 2023, which were published in peer-reviewed journals that report dropout rates from prenatal care and its determinants. We follow PRISMA checklist. Using keywords, papers were retrieved from the electronic databases PubMed, Cochrane Library, Google Scholar, and gray literature. Stata 17 was used to conduct the meta-analysis. The Egger's regression, Begg's test, and funnel plot were employed to investigate publication bias. To ascertain the level of heterogeneity, the I&lt;sup&gt;2&lt;/sup&gt; statistics were employed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The overall magnitude of antenatal care dropout among pregnant women, as pooled from the 16 studies, was found to be 29.44%, with a 95% confidence interval (CI) ranging from 19.16% to 39.72%. The pooled odds ratio showed that rural pregnant women (AOR = 3.55, 95 CI (1.17-5.92). women who had no formal education (AOR = 3.88, 95 CI (- 0.24-8.00), inaccessible PHC facilities (AOR = 5.90, 95 CI (0.54-11.26), lack of support from family or husband (AOR = 4.91 CI (- 1.31-11.19), and women with poor economic status (AOR = 2.50, 95 CI (1.19-3.81) were determinant factors for maternal dropout from antenatal care service.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This systematic review and meta-analysis revealed that the prevalence of antenatal care dropout was high based on the included 16 articles. According to the review, pregnant women's antenatal care dropout was significantly correlated with living in a rural area, being unable to access a primary health facility, lacking formal education, not having support from her husband or family, and having low socioeconomic status. These findings suggest that various socio-economic and geographical factors play a significant role in determining whether pregnant women continue with antenatal care services","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"186"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}