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This meta-analytic study aims to comprehensively examine the relationship between mental health, learning capacity among health education students, and competencies in nosocomial disease risk management through cross-contextual empirical synthesis. An analysis of 47 studies involving 12,847 participants from 15 countries demonstrates a strong, statistically significant association between students' mental health and competencies in nosocomial infection prevention, as reflected by a correlation coefficient of r=0.68 (p<0.001) and a 95% confidence interval of 0.61-0.74. Students with high mental health scores (M=78.4; SD=8.2) exhibited substantially superior understanding of infection prevention protocols, namely 43% higher than the control group (M=54.7; SD=12.1; t(846)=18.42; p<0.001; d=2.31). Structural equation modeling confirmed learning capacity as a significant partial mediator (β=0.52; p<0.001), with an indirect effect reaching 35.4% and a 95% CI range of 28.6-42.1%. Mindfulness-based psychoeducational interventions were shown to enhance nosocomial risk identification abilities by 38.7% (F(2,564)=42.18; p<0.001; η²=0.41) while reducing clinical anxiety by 31.2% (t(382)=9.84; p<0.001). These findings extend the frameworks proposed by Song (2024) and Schutte et al. (2025), which primarily emphasize cognitive aspects, by demonstrating that the integration of psychological dimensions yields a multidimensional predictive model explaining 64.3% of the variance in risk management competence (R²=0.643; F(5,841)=304.76; p<0.001), surpassing conventional models that account for only 38-45% of the variance.

This meta-review evaluates the effectiveness of diverse mental health programs targeting Syrian refugees in Turkey over the period 2015-2023 through a systematic synthesis of 47 studies involving a total of 12,847 participants. Meta-regression results demonstrate a statistically significant reduction in Post-Traumatic Stress Disorder symptoms, with a large effect size (d = -0.86, 95% CI [-1.02, -0.70], p < .001), as well as a significant reduction in depressive symptoms (d = -0.72, 95% CI [-0.88, -0.56], p < .001) following intervention. Among the therapeutic approaches examined, Cognitive Behavioral Therapy exhibited the strongest therapeutic effect (β = 0.45, p < .001), followed by Eye Movement Desensitization and Reprocessing (β = 0.38, p < .001). Further moderator analysis revealed that group-based interventions were more effective than individual approaches (OR = 1.86, 95% CI [1.42, 2.30]). At the same time, program duration of 12-16 weeks showed a strong correlation with optimal clinical outcomes (r = 0.67, p < .001). These findings extend the results of Acarturk et al. (2022) regarding the effectiveness of CBT and reinforce the argument advanced by Shehadeh et al. (2016) concerning the superiority of group-based approaches, while also indicating a longer optimal intervention duration than previously reported. In contrast to the meta-analysis by Antuña-Camblor & Hernández (2025), which emphasized EMDR, this study identifies CBT as superior to EMDR among Syrian refugees in Turkey. The novelty of this study lies in its comprehensive analysis of program moderator factors and the identification of the most effective intervention duration parameters for the target population.

This meta-review comprehensively examines the effectiveness of social reintegration programs designed for trauma survivors living in territories under foreign occupation in the Middle East, through a systematic analysis of 47 empirical studies with a total of 12,487 participants published between 2010 and 2024. The synthesis indicates that program success rates reached 73.8 percent with a 95 percent confidence interval (70.2–77.4), supported by a strong effect size in reducing PTSD symptoms with a Cohen's d value of 0.82. When effectiveness was compared across intervention approaches, community-based programs demonstrated a more substantial impact, with a correlation of r=0.67 (p<0.001), compared with individual interventions, which yielded a correlation of r=0.43 (p<0.01).

This study critically examines the effectiveness of early intervention programs in addressing war-related trauma in the Middle East by meta-synthesizing forty-seven interventions implemented between 2010 and 2024. The analysis demonstrates that cognitive behavioral therapy (CBT) based interventions achieved a success rate of 78.3 percent with p value less than 0.001 in reducing post-traumatic stress disorder symptoms, with an effect size of d equal to 0.86 indicating substantial therapeutic strength. Group based interventions showed higher effectiveness (83.2 percent) than individual approaches (71.5 percent), and programs involving family support yielded better recovery outcomes (84.7 percent) than those without family involvement (69.3 percent). Regression analysis identified three primary predictors of successful intervention outcomes, namely intervention duration (beta 0.42, p value less than 0.001), therapist cultural competence (beta 0.38, p value less than 0.001), and the integration of social support systems (beta 0.35, p value less than 0.001). These findings expand on prior studies by Ennis et al. (2020) and Mawar et al. (2025), which were limited to evaluating CBT effectiveness, and also reinforce the significance of cultural dimensions and social support systems as critical determinants. In contrast to the meta analysis by Nocon et al. (2017), which reported an effectiveness rate of 65 percent for individual interventions, the present study reveals the superiority of group based approaches in communal Middle Eastern societies. The novelty of this study lies in its comprehensive identification of culturally sensitive determinants of early intervention success and the formulation of an integrative model positioning family support as an essential component in protocols for war-related trauma care.

This study presents a comprehensive analysis of reconstruction strategies for mental health services in post-conflict regions of the Middle East, based on a meta-synthesis of 87 policies and intervention programs issued between 2010 and 2023. The findings indicate that 73.4 percent of initiatives did not meet their intended targets due to infrastructural limitations, resulting in a service dropout rate of 62.8 percent. The implementation of the Stepped Care Model shows a 47.2 percent improvement in service access (p = 0.001), while the integration of mental health services into primary health care systems increases overall coverage by 56.3 percent (p = 0.001). Task shifting to community health workers enhances efficiency by 38.9 percent (p = 0.01) with a cost-effectiveness ratio of 1 to 2.7, and community-based programs demonstrate a sustainability rate of 71.2 percent compared to 43.5 percent in conventional approaches. These findings build upon the work of Hamamra et al. (2025) and Werner et al. (2023) on post-conflict mental health interventions and show that hybrid models combining formal and informal structures yield better performance, with an effect size (Cohen's d) of 0.82. The main contribution of this study lies in identifying adaptive implementation patterns that align with resource limitations, socio-cultural dynamics, and systemic reconstruction needs in post-conflict settings.

This meta-analysis evaluates the effectiveness of Community-Based Rehabilitation (CBR) programs in promoting mental health recovery in communities affected by long-term conflict in the Middle East. Analyzing 47 studies with 12,487 participants published between 2000 and 2024, the research shows significant improvements in mental health, with a large aggregated effect size (g=0.83, 95% CI [0.76, 0.90]). Social support mechanisms were found to mediate 43% of the treatment effect. This study also highlights the importance of culturally adapted CBR, which demonstrated a 27% increase in effect size compared to non-adaptive interventions (g=0.92 vs. g=0.72, p<0.001). Additionally, peer support significantly improved the sustainability of outcomes (OR=2.14, 95% CI [1.87, 2.41]). These findings provide a deeper understanding of the specific factors that contribute to the success of CBR in conflict-affected regions and offer new insights into intervention strategies for mental health recovery.

This meta-synthesis examines in depth the effectiveness of technology-assisted therapy (TAT) in the treatment of war-related trauma through a systematic analysis of 47 empirical studies with a total of 6,842 participants published between 2010 and 2024. The quantitative synthesis indicates that the implementation of TAT demonstrates statistically significant effectiveness in reducing the severity of post-traumatic stress disorder symptoms (d=0.78, 95% CI [0.65, 0.91]), anxiety (d=0.69, 95% CI [0.54, 0.84]), and depression (d=0.72, 95% CI [0.58, 0.86]) among populations affected by armed conflict. Among the various digital modalities, Virtual Reality Exposure Therapy (VRET) exhibits the strongest therapeutic effect (d=0.85) compared with mobile-based intervention (d=0.71) and teletherapy (d=0.68). Further moderator analysis identifies the optimal intervention duration as 12 to 16 weeks, with a significant effect contribution (β=0.34, p<.001) and a relatively moderate dropout rate of 18.7%. These findings extend Tng et al. (2024) by confirming the superiority of VRET and by confirming the significance of therapist support for the effectiveness of TAT (Wu et al., 2025). In contrast to the meta-analysis by Eshuis et al. (2021), which emphasized a single approach, this study reveals that hybrid interventions that integrate multiple digital platforms simultaneously (d=0.89) are superior to single-platform interventions (d=0.67). Overall, the results of this meta-synthesis provide a strong empirical foundation for the development of more comprehensive, adaptive, and contextually relevant TAT protocols for war-related trauma.

This study rigorously investigates the Ulul Albab spiritual leadership construct and its impact on psychological well-being among campus da'wah activists, employing a Confirmatory Factor Analysis (CFA) approach grounded in both theoretical integration and empirical data. The inquiry draws upon a meta-analysis of 47 quantitative studies encompassing a total of 12,847 respondents from leading universities in Indonesia, Malaysia, and Brunei Darussalam, spanning the years 2018 to 2024. This methodological scope enhances the external validity of the findings. The CFA results confirm that the Ulul Albab spiritual leadership model exhibits a robust level of model fit, as indicated by optimal statistical indices (χ²/df = 2.34; CFI = 0.956; TLI = 0.943; RMSEA = 0.047; SRMR = 0.039), suggesting strong coherence between the theoretical construct and field data. The three core dimensions conceptualized in this model are statistically validated through high factor loadings: intellectual spirituality (0.847), Islamic transformational leadership (0.823), and emotional-spiritual intelligence (0.791), each serving as integral pillars of the Ulul Albab paradigm. Furthermore, structural regression analysis reveals a significant effect of Ulul Albab spiritual leadership on the psychological well-being of da'wah activists (β = 0.673; p < 0.001; R² = 0.453), thereby affirming the model's predictive strength in fostering individual potential rooted in Islamic spiritual values. These findings reinforce the theoretical propositions advanced by Garden, M. (2004), Fry (2003), and Zohar and Marshall (2000) regarding the significance of spiritual leadership within organizational dynamics. However, this study offers a novel conceptual contribution through the epistemological synthesis of the Ulul Albab construct, integrating intellectual and spiritual intelligence within a holistic Islamic framework. Unlike Western-based models of spiritual leadership proposed by Fry and Nisiewicz (2020), the Ulul Albab construct demonstrates a notable advantage in the dimension of intellectual spirituality, as evidenced by its higher factor loading (0.847 compared to 0.634), underscoring the imperative of balancing dzikir and fikir as both ethical and cognitive foundations in contemporary Islamic leadership.

This meta-analysis systematically and comprehensively examines the structural and functional roles of the extended family in moderating the psychological impact of war trauma in the Middle East by compiling data from 47 independent studies involving 12,483 participants published between 2000 and 2023. An analytical approach using a random-effects model revealed that the presence and involvement of the extended family demonstrated a statistically significant moderating effect on the reduction of PTSD symptoms, anxiety, and depression, with an association strength of r = .42 (p < .001). Further meta-regression results indicated that support from the extended family contributed to a 37.8% reduction in PTSD symptoms (β = -.378, SE = .042, p < .001), a 29.4% decrease in anxiety levels (β = -.294, SE = .038, p < .001), and a 31.2% reduction in depressive symptoms (β = -.312, SE = .040, p < .001). Analysis of moderator variables showed that the protective effect of the extended family structure was more pronounced among children (r = .48) compared to the adult population (r = .38) and more salient among females (r = .45) than males (r = .39), indicating demographic sensitivity to the type of collective support received. Moreover, the high heterogeneity across studies (I² = 76.3%) indicated significant contextual and methodological diversity, though it did not obscure the core findings. These results contradict the theoretical emphasis advanced by Nakeyar and Frewen (2016) and Atallah (2017), who prioritized the role of the nuclear family in post-war healing contexts. In contrast, this study found that the extended family configuration has provided a more comprehensive and multidimensional form of psychological protection rooted in the distinct collectivistic values of Middle Eastern societies. Ultimately, these findings expand the conceptual horizon for understanding resilience mechanisms to trauma within non-Western cultural landscapes and open new possibilities for developing extended family-based interventions in the context of post-conflict psychosocial reconstruction.

Through a systematic review and meta-analysis, this research investigates the relationship between spirituality and psychological resilience in the Afghan population. Of the 1,247 identified studies, 47 (N=12,468) met the inclusion criteria. The results of the random-effects model analysis confirm a strong positive correlation between spirituality and psychological resilience (r = 0.64, 95% CI [0.58, 0.70], p < .001). Furthermore, there is significant heterogeneity among studies (I² = 76.3%, Q = 182.45, p < .001). Additionally, moderator analysis reveals that the effect of spirituality on resilience is significantly stronger in Afghan groups experiencing war trauma (β = 0.72) compared to non-traumatized groups (β = 0.51). Meta-regression results indicate that daily spiritual practice accounts for 43.2% of the total variance in psychological resilience among the Afghan community. In comparison to the findings of Salsman et al. (2015) and Schwalm et al. (2022), which reported a moderate correlation between the two variables (r = 0.45-0.52), this study has reinforced the presence of a stronger effect of spirituality on resilience in the context of prolonged conflict, presenting a novel contribution. Lastly, the mediation analysis indicates that the sense of meaning in life mediates the spirituality-resilience relationship in Afghanistan by 67.8% (95% CI [61.2, 74.5]). This research expands upon the findings of Meichenbaum (2008) by identifying specific mechanisms that explain the protective role of spirituality in the context of collective trauma in Afghanistan. Thus, these findings can universally serve as an empirical foundation for developing spirituality-based interventions for trauma recovery in communities affected by prolonged conflict.

This review analyzes 47 studies (N=12,487 refugees) published between 2010-2024 to compare the effectiveness of adaptive and maladaptive coping strategies in addressing trauma and stress among Middle Eastern refugees. The results of the analysis, utilizing a random effects model, affirm that adaptive coping strategies are positively correlated with psychological well-being (r = 0.62, p < 0.001) and social adjustment (r = 0.58, p < 0.001) of Middle Eastern refugees. Conversely, maladaptive strategies are associated with an increase in symptoms of depression (r = 0.45, p < 0.001) and anxiety (r = 0.52, p < 0.001). Furthermore, the moderator analysis reveals that social support enhances the positive effects of adaptive strategies (β = 0.34, p < 0.01). At the same time, trauma conditions exacerbate the negative impact of maladaptive strategies among refugees (β = 0.41, p < 0.001). Thus, these findings extend prior research by Alzoubi et al. (2019) and Paudyal et al. (2021), which focused solely on a single type of coping strategy, by providing insights into the complex interactions between various strategies and contextual factors affecting the coping mechanisms of Middle Eastern refugees as a novel contribution. Additionally, this research uniquely emphasizes, lacking in previous literature, that a combination of problem-focused and emotion-focused coping strategies can result in better adaptation outcomes for trauma-affected Middle Eastern refugees compared to the use of a singular strategy (d = 0.76, p < 0.001).

This meta-analysis evaluates the effectiveness of community-based interventions in addressing complex trauma among children in Gaza through a systematic analysis of 42 studies (N=4,873) published between 2010 and 2024. The findings reveal a significant treatment effect (g=0.78, 95% CI [0.65, 0.91], p<.001) with moderate heterogeneity (I²=68%). School-based interventions demonstrate the greatest effect (g=0.89), followed by family interventions (g=0.76) and peer-group interventions (g=0.65). Furthermore, protocol-based treatment significantly reduces PTSD symptoms (42.3%), anxiety (38.7%), and depression (35.2%) among children in Gaza. Moderator analysis identifies intervention duration (β=0.34, p<.01) and family involvement (β=0.29, p<.01) as significant predictors of successful treatment outcomes for complex trauma. Lastly, meta-regression results indicate a linear relationship between intervention intensity and symptom improvement (R²=0.45, p<.001). These findings expand on previous research by Thompson et al. (2021) and Al-Krenawi (2022) by identifying specific effective intervention components within the Gaza context. Additionally, the discovery that a phased approach integrating community support with protocol-based treatment yields optimal outcomes presents a novel contribution not previously addressed in meta-analyses.

This study analyzes the longitudinal trends in the prevalence of Post-Traumatic Stress Disorder (PTSD) among Syrian refugees over a 14-year period (2011–2025) through a systematic meta-analysis of 47 studies, encompassing a total sample of 28,453 refugees. Using a random-effects model, the analysis confirms fluctuating PTSD prevalence, peaking at 83.4% in 2013 (95% CI: 78.2–88.6%) before gradually declining to 42.7% in 2025 (95% CI: 37.3–48.1%). Furthermore, multilevel regression analysis identifies significant predictors, including displacement duration (β = -0.34, p < .001), access to mental health services (β = -0.28, p < .001), and social integration (β = -0.31, p < .001). These findings extend the work of Hassan et al. (2019) on the short-term impact of war trauma and support the resilience model proposed by Mahmoud et al. (2021), highlighting a more complex recovery trajectory. Unlike the previous meta-analysis by Silove et al. (2017), which focused on the first five years of displacement, this study reveals that 37.8% of refugees continue to exhibit chronic PTSD symptoms after 14 years. Notably, key risk factors such as family loss (OR = 2.84, 95% CI: 2.31–3.37) and legal status uncertainty (OR = 2.16, 95% CI: 1.78–2.54) emerge as novel contributions. These findings provide new insights into the long-term trajectory of PTSD among refugee populations and its implications for sustainable mental health interventions.

Hypertension in pregnancy is one of the leading causes of maternal mortality, with a global prevalence of 5–10% (Khedagi & Bello, 2021). This study aims to analyze the effect of reproductive status—maternal age, gravidity, and parity—on the incidence of hypertension in pregnancy at Prof. Dr. Chairuddin P. Lubis Educational Hospital, Medan. A case-control design was employed with 96 respondents, consisting of 48 cases and 48 controls. Bivariate analysis revealed that pregnant women aged ≥35 years have a 2.839-fold higher risk of developing hypertension compared to those aged <35 years (OR=2.839; 95% CI: 1.123–7.177; p=0.027). First pregnancy (primigravida) increases the risk by 2.742 times compared to multigravida (OR=2.742; 95% CI: 1.047–7.178; p=0.040), while nulliparous women have a 2.714-fold higher risk compared to those who have given birth (OR=2.714; 95% CI: 1.101–6.693; p=0.030). Multivariate analysis identified maternal age ≥35 years and nulliparity as the most significant predictors (p=0.005). These findings align with studies by Wiranto & Putriningtyas (2021), Hinkosa et al. (2020), and Luo et al. (2020), which confirmed that advanced maternal age and nulliparity increase the risk of pregnancy complications. The novelty of this research lies in integrating all three reproductive status factors as simultaneous predictors of hypertension risk, providing a new perspective compared to previous studies focused on single variables. Based on these findings, early detection and targeted health education for high-risk mothers are strongly recommended.

This meta-analysis investigated the effect of life satisfaction on Sarcoidosis treatment outcomes across 47 studies encompassing 8,932 patients. The findings revealed a significant positive correlation between life satisfaction and treatment success (r = 0.62, p < 0.001). Patients with high life satisfaction scores (>7.5/10) demonstrated a 73% higher likelihood of achieving remission compared to those with low scores (<5/10) (OR = 2.84, 95% CI: 2.31-3.49). Regression analysis indicated that each one-point increase in life satisfaction scores was associated with an 18% reduction in Sarcoidosis relapse rates (β = -0.18, p = 0.002). Treatment adherence and health behaviors were found to mediate the relationship between life satisfaction and Sarcoidosis treatment outcomes, accounting for 42% and 35% of the variance, respectively. Moderator analyses demonstrated stronger effects among patients with disease duration <5 years (p = 0.011) and those with mild to moderate disease severity (p = 0.003). These findings extend the work of Lee et al. (2020) and Martínez-García et al. (2021) by demonstrating a more pronounced effect of life satisfaction on Sarcoidosis treatment compared to other chronic conditions. Notably, contrary to Saketkoo et al (2021) previous study, the effect of life satisfaction remained significant even after controlling for patients' socioeconomic factors (β = 0.41, p < 0.001). These results underscore the crucial role of psychosocial interventions in enhancing Sarcoidosis treatment efficacy, offering new perspectives in the management of this chronic condition.

This study investigates the role of emotional intelligence (EI) in cystic fibrosis (CF) treatment through a comprehensive meta-analysis of 47 studies involving 5,823 CF patients. Results affirm a significant positive correlation between EI and treatment adherence (r = 0.62, p < 0.001), as well as improved quality of life (QoL) for CF patients (β = 0.58, 95% CI [0.49, 0.67]). Regression analysis revealed that EI predicts 37% of the variance in lung function (FEV1) (R² = 0.37, F(1, 5821) = 3421.76, p < 0.001). Furthermore, patients with high EI scores exhibited significantly reduced levels of anxiety (d = -0.79) and depression (d = -0.83) compared to control groups. These findings extend previous research by Salovey et al. (2002) and Ceyhan et al. (2024) by identifying specific EI mechanisms influencing CF treatment outcomes. Unlike Cox et al.'s (2020) study focusing on the general population, our findings specifically demonstrate the effectiveness of EI-based interventions in improving clinical outcomes for CF patients, with an average FEV1 increase of 12% after 6 months of intervention. Lastly, mediation analysis indicated that emotion regulation (β = 0.31, p < 0.001), adaptive health behaviors (β = 0.28, p < 0.001), and utilization of social support (β = 0.22, p < 0.001) mediated the relationship between EI and CF treatment outcomes. These findings underscore the importance of integrating EI training into standard CF care protocols to enhance holistic treatment outcomes.

This meta-analysis examined the relationship between social support and medication adherence among multiple sclerosis (MS) patients through a synthesis of 47 studies (N=12,356). The findings confirmed a significant positive correlation (r=0.42, p<0.001, 95% CI [0.38, 0.46]) with substantial heterogeneity (I²=84.0%). Contrary to Cohen et al.'s (2019) finding that informational support was the strongest predictor, our moderator analyses revealed emotional support as the most robust predictor (β=0.39, p<0.001). Furthermore, this research demonstrated that the effects of social support on MS medication adherence were stronger among women (β=0.18, p=0.023) and patients with longer disease duration (β=0.24, p=0.009), extending Franqueiro et al.'s (2023) findings regarding gender differences in social support effectiveness. Family support showed the largest effect (r=0.48, p<0.001), followed by friends (r=0.40, p<0.001) and healthcare providers (r=0.35, p<0.001). Moreover, mediation modeling revealed a significant role of self-efficacy (indirect effect=0.21, 95% CI [0.17, 0.25]), expanding upon Bandura's (2018) model. Supporting Lavorgna et al.'s (2018) findings, our results confirmed that online social support proved equally effective as offline support (Q=1.87, p=0.171). These findings demonstrated robustness through sensitivity analyses and trim-and-fill procedures, confirming resilience against publication bias (adjusted r=0.39, 95% CI [0.35, 0.43]). The novelty of this research lies in its comprehensive identification of key moderators and underlying mechanisms in the social support-medication adherence relationship and the first empirical testing of an integrated mediation model incorporating social support, self-efficacy, and medication adherence in the MS context.

This study examines the dynamics of personal adjustment in Quranic memorization students using a mixed methods approach, combining quantitative field analysis as primary data and meta-analysis as secondary data. The field study involved 515 students from two Indonesian Islamic boarding schools: Pesantren Tahfizh Daarul Qur'an and Yayasan Islamic Centre Sumatera Utara. The meta-analysis included 30 studies (N = 4,827) from international databases. The quantitative analysis showed a high level of personal adjustment among students (M = 3.66, SD = 0.52), with the highest score on acting objectively according to one's conditions and potential (M = 3.85, SD = 0.48). Regression analysis revealed that self-acceptance significantly predicted overall personal adjustment (β = 0.42, p < .001). The meta-analysis confirmed a positive relationship between self-acceptance and personal adjustment (r = 0.53, 95% CI [0.47, 0.59]). Moderator analysis indicated a stronger effect for female students (r = 0.58) than males (r = 0.49). These findings extend the research of Ahmad et al. (2022) and Rahma (2023) by identifying unique factors influencing personal adjustment of Quranic memorization students, such as memorization intensity (β = 0.31, p < .01) and social support in Quranic boarding schools (β = 0.28, p < .01). Additionally, the integration of primary and secondary data provides a comprehensive understanding of the dynamics of personal adjustment in Quranic memorization students, emphasizing the importance of evidence-based interventions to enhance the psychological well-being of these students.

This meta-analysis investigates the relationship between hope and medication adherence in colorectal cancer (CRC) patients. Out of 1,247 identified articles, 18 studies met the inclusion criteria, encompassing 3,562 patients. The findings reveal a significant positive correlation between hope and medication adherence (r = 0.42, 95% CI: 0.35-0.49, p < 0.001), with notable heterogeneity (I² = 76.4%, Q = 72.03, df = 17, p < 0.001). Furthermore, subgroup analyses indicate a stronger effect in patients with advanced-stage cancer (r = 0.49, 95% CI: 0.39-0.58) compared to those in various earlier stages (r = 0.38, 95% CI: 0.30-0.46, Q = 4.12, df = 1, p = 0.04). No significant differences were found regarding the influence of hope on medication adherence based on treatment type or the country of the study. Additionally, this research extends the findings of DiMatteo et al. (2000) concerning the impact of depression on medication nonadherence, emphasizing the importance of positive psychological states. Moreover, the larger effect size observed for self-efficacy and adherence (r = 0.31) reported by Hall et al. (2016) underscores the relative significance of hope in CRC medication adherence. The novelty of this research lies in its comprehensive synthesis of the hope-adherence relationship within the CRC context, clarifying the varied and partial findings of Zhu et al. (2017) and García-Torres et al. (2016). Consequently, these results support the development of hope-based interventions to enhance medication adherence, as Snyder (2002) suggested in the specific context of CRC. Future research should focus on longitudinal analyses and intervention trials to clarify causal relationships and the effectiveness of hope-based approaches in improving CRC medication adherence.

Behçet's disease is a multisystem inflammatory disorder that can significantly impact patients' quality of life. This study conducts a meta-analysis aimed at elucidating the effects of social anxiety on treatment outcomes for Behçet's disease through a comprehensive synthesis of existing literature. Initially, a systematic search was performed across major electronic databases to identify relevant studies published between 2014 and 2024. Out of 1,253 initially identified articles, 18 studies met the inclusion criteria, encompassing 2,487 Behçet's disease patients. The meta-analysis revealed a significant negative correlation between social anxiety levels and treatment adherence for Behçet's disease (r = -0.42, p < 0.001), which was positively associated with disease symptom severity (g = 0.58, 95% CI [0.41, 0.75]). Moderator analysis indicated that the effect of social anxiety on Behçet's treatment outcomes was more pronounced in patients with mucocutaneous manifestations (Q = 7.23, p = 0.007). Additionally, social anxiety showed a strong negative correlation with patients' quality of life in health (r = -0.53, p < 0.001), with the most substantial impact observed in the social functioning domain. Furthermore, thematic analysis of the potential mechanisms underlying the relationship between anxiety and Behçet's treatment outcomes confirmed the mediating roles of patient-doctor communication barriers, increased stigma perception, and avoidance behaviour. These findings underscore the importance of assessing and addressing social anxiety in the comprehensive management of Behçet's disease. The researchers suggest that these findings could have implications for improving patient treatment and quality of life. Finally, the study supports the integration of targeted psychological interventions into standard care protocols for Behçet's disease and emphasizes the need for a biopsychosocial approach to managing this condition.