Dehbozorgi Raziye, Shahriari Mohsen, Fereidooni-Moghadam Malek, Moghimi-Sarani Ebrahim
Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
Nursing and Midwifery School, Isfahan University of Medical Sciences, Isfahan, Iran.
BMC Palliat Care. 2025 Mar 14;24(1):69. doi: 10.1186/s12904-025-01703-8.
Chronic mental diseases are enduring and recurring, and need constant care and a collaborative approach for management. Based on clinical guidelines, family interventions can improve the quality of care for individuals with chronic mental diseases.
Specifically, the study examined family involvement in the care of people suffering from schizophrenia, major depressive disorder, and bipolar mood disorder by adapting international clinical guidelines.
The resource toolkit for guideline adaptation was selected as the adaptation process. Seven databases were searched for international clinical guidelines. Independent reviewers utilized the Appraisal of guidelines for research and evaluation II tools to assess guidelines that met the inclusion and quality criteria. The recommendations from the guidelines were combined with those from the systematic review and qualitative research, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and COnsolidated criteria for REporting Qualitative research checklists. Rephrased recommendations with redundant or overlapping content were excluded from the Iranian context due to the cultural, religious and belief changes of the people, as well as the lack of necessary facilities. Translations of the selected recommendations were made into Persian, along with modified recommendations.
A total of 573 recommendations from 17 books, 10 national documents, 16 guidelines, 27 articles, and 31 English and Persian theses were identified. After the initial review (referred to as RAND/UCLA Appropriateness Method 1), 467 recommendations received an appropriate score, 106 had an uncertain score, and none of them received an inappropriate score. After merging the recommendations, they received 433 good grades and 98 uncertain grades. After the face-to-face meeting of the research team, 7 were merged due to similarity, and 91 recommendations were made in a hybrid panel of experts (RAND/UCLA Appropriateness Method 2). Finally, 524 recommendations were identified that applied to the psychiatric medical centers in Iran. The examined and revised recommendations suggest healthcare professional interventions for family involvement in the care of patients with schizophrenia, major depressive disorder, and bipolar mood disorder referred to medical centers in Iran. The adapted recommendations emphasize the need for family-centered collaborative care ( interventions which satisfy the needs of patients with chronic mental diseases and their caregivers, considering their preferences and capabilities.
慢性精神疾病具有持续性和复发性，需要持续护理以及采用协作方法进行管理。根据临床指南，家庭干预可提高慢性精神疾病患者的护理质量。
具体而言，该研究通过调整国际临床指南，考察了家庭在精神分裂症、重度抑郁症和双相情感障碍患者护理中的参与情况。
选择指南调整资源工具包作为调整过程。检索了七个数据库以查找国际临床指南。独立评审人员利用《研究与评价指南II》工具评估符合纳入标准和质量标准的指南。指南中的建议与系统评价和定性研究中的建议相结合，遵循系统评价和Meta分析的首选报告项目以及定性研究报告的合并标准核对清单。由于人们的文化、宗教和信仰变化以及缺乏必要设施，在伊朗背景下，排除了内容冗余或重叠的重新表述的建议。将选定建议翻译成波斯语，并进行了修改。
共识别出17本书、10份国家文件、16份指南、27篇文章以及31篇英文和波斯文论文中的573条建议。经过初步评审（称为兰德/加州大学洛杉矶分校适宜性方法1），467条建议获得适宜分数，106条分数不确定，没有一条获得不适宜分数。合并建议后，它们获得433个良好等级和98个不确定等级。在研究团队面对面会议后，7条因相似性而合并，在专家混合小组中提出了91条建议（兰德/加州大学洛杉矶分校适宜性方法2）。最后，确定了524条适用于伊朗精神病医疗中心的建议。经过审查和修订的建议提出了医疗保健专业人员对家庭参与伊朗医疗中心精神分裂症、重度抑郁症和双相情感障碍患者护理的干预措施。调整后的建议强调了以家庭为中心的协作护理的必要性（即满足慢性精神疾病患者及其护理人员需求的干预措施，同时考虑他们的偏好和能力）。
