Dehbozorgi Raziye, Fereidooni-Moghadam Malek, Shahriari Mohsen, Moghimi-Sarani Ebrahim
School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Research Center for Psychiatry and Behavior Science, Shiraz University of Medical Sciences, Shiraz, Iran.
Front Psychiatry. 2022 Oct 19;13:995863. doi: 10.3389/fpsyt.2022.995863. eCollection 2022.
Caregivers are patients' family members or intimate friends who take care of individuals suffering from chronic mental illnesses without being paid. Evidence has supported the role of family-centered collaborative care in the treatment of patients with chronic mental illnesses. It has also been emphasized by national policies. However, carrying out this type of care is accompanied by challenges in Iran. Considering the importance of family participation in taking care of these patients as well as the necessity to determine its effective factors, the present study aimed to assess the barriers to family involvement in the care of patients with chronic mental illnesses.
A conventional content analysis was used to conduct this qualitative study. Thirty four health care providers, patients, and caregivers were interviewed unstructured in-depth face-to-face using purposive sampling. Until saturation of data, sampling and data analysis were conducted simultaneously. Graneheim and Lundman's method was used to record, transcribe, and analyze the interviews.
The results showed that there were many barriers to the collaboration of family in the care of patients with chronic mental illnesses. Accordingly, four main categories and twelve subcategories were extracted from the data as follows: "family-related barriers", "treatment-related factors", "disease nature threatening care", and "mental disease-associated stigma in the society".
The findings presented the barriers to family centers' collaborative care in patients with chronic mental illnesses and the necessary components of family involvement in the care to be used by healthcare managers and policymakers. The reported barriers emphasize the need for the development of structured approaches whose implementation is easy for health care providers, does not require a lot of time and resources, and can improve patient and family outcomes.
照顾者是患者的家庭成员或亲密朋友，他们无偿照顾患有慢性精神疾病的个体。有证据支持以家庭为中心的协作式护理在慢性精神疾病患者治疗中的作用。国家政策也强调了这一点。然而，在伊朗开展这类护理存在挑战。考虑到家庭参与照顾这些患者的重要性以及确定其影响因素的必要性，本研究旨在评估家庭参与慢性精神疾病患者护理的障碍。
采用传统内容分析法进行这项定性研究。通过目的抽样，对34名医疗保健提供者、患者和照顾者进行了非结构化的深入面对面访谈。在数据饱和之前，抽样和数据分析同时进行。采用格兰海姆和伦德曼的方法对访谈进行记录、转录和分析。
结果表明，家庭参与慢性精神疾病患者护理存在诸多障碍。据此，从数据中提取了四个主要类别和十二个子类别，如下所示：“家庭相关障碍”、“治疗相关因素”、“疾病性质威胁护理”以及“社会中与精神疾病相关的污名”。
研究结果揭示了家庭中心对慢性精神疾病患者协作式护理的障碍，以及医疗保健管理者和政策制定者在家庭参与护理中所需的要素。所报告的障碍强调需要制定结构化方法，这些方法对医疗保健提供者来说易于实施，不需要大量时间和资源，并且可以改善患者和家庭的结局。
