| 1. |
- Dejman, Masoumeh, et al.
(författare)
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Explanatory model of help-seeking and coping mechanisms among depressed women in three ethnic groups of Fars, Kurdish, and Turkish in Iran.
- 2008
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Ingår i: Arch Iran Med. - 1029-2977. ; 11:4, s. 397-406
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Tidskriftsartikel (refereegranskat)abstract
- Explanatory model of help-seeking and coping mechanisms among depressed women in three ethnic groups of Fars, Kurdish, and Turkish in Iran.Dejman M, Ekblad S, Forouzan AS, Baradaran-Eftekhari M, Malekafzali H.Department of Psychiatry, Welfare and Rehabilitation University, Tehran, Iran. dejmanms@hbi.ir.BACKGROUND: As one of the most prevalent diseases globally and as an important cause of disability, depressive disorders are responsible for as many as one in every five visits to primary care doctors. Cultural variations in clinical presentation, sometimes make it difficult to recognize the disorder resulting in patients not being diagnosed and not receiving appropriate treatment. To address this issue, we conducted a qualitative pilot study on three ethnic groups including Fars, Kurdish, and Turkish in Iran to test the use of qualitative methods in exploring the explanatory models of help-seeking and coping with depression (without psychotic feature) among Iranian women. METHODS: A qualitative study design was used based on an explanatory model of illness framework. Individual interviews were conducted with key informant (n=6), and depressed female patients (n=6). A hypothetical case vignette was also used in focus group discussions and individual interviews with lay people (three focus groups including 25 participants and six individual interviews; n=31). RESULTS: There were a few differences regarding help-seeking and coping mechanisms among the three ethnic groups studied. The most striking differences were in the area of treatment. Non-psychotic depressive disorder in all ethnicities was related to an external stressor, and symptoms of illness were viewed as a response to an event in the social world. Coping mechanisms involved two strategies: (1) solving problems by seeking social support from family and neighbors, religious practice, and engaging in pleasurable activities, and (2) seeking medical support from psychologists and family counselors. The Fars group was far more likely to recommend professional treatment and visiting psychiatrists whereas the other two ethnic groups (i.e., Turks and Kurds) preferred to consult family counselors, psychologists or other alternative care providers, and traditional healers. CONCLUSION: The study has educational and clinical implications. Cultural reframing of the patient's and family's perceptions about mental illness and depression may require community education. Family counseling, family therapy, and also religious practices can be used to empower the patient.
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| 2. |
- Dejman, Masoumeh, et al.
(författare)
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Psychometric Study Using Item Response Theory of an Instrument Developed for Assessment of Iranian Mental Health Problems
- 2022
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Ingår i: Iranian Journal of Psychiatry and Behavioral Sciences. - : Brieflands. - 1735-8639 .- 1735-9287. ; 16:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Currently, in addition to the undeniable impact of cultural factors on mental health problems’ diagnosis and treatment methods, the use of rapid, short, and intervention-based instruments can be effective in the accurate diagnosis of mental health problems, especially in the health system of developing countries.Objectives: This study aimed to validate an instrument developed for screening patients with common mental health problems using item response theory (IRT).Methods: The study was conducted in Semnan province (with Persian ethnicity), Iran, from August 2017 to February 2018. A 101-item tool consisted of district common mental health problems (i.e., depression, anxiety, and obsession), along with a functional checklist. The development of the instrument involved a pilot study and psychometric testing. The IRT-based analysis was used as the item-reduction method to evaluate the shortened tool as an appropriate screening tool. The participants were healthy individuals and patients with depression, anxiety, and obsessive-compulsive disorder (OCD). The data were analyzed using Stata software (version 15.1).Results: The study participants were 160 individuals (58.2% male) with a mean age of 36.3 ± 11.2 years. All item impact factors were within the range of 1.8-5. The mean values of clarity, simplicity, relevance, and scale-level content validity index/averaging calcu-lation method of the instrument were 96.73 ± 0.70, 97.64 ± 0.61, 98.2 ± 1.9, and 97.09 ± 0.63, respectively. Cronbach’s alpha and internal consistency coefficient were 0.88 and 0.7. Moreover, 13, 5, and 12 items were excluded using IRT from depression, anxiety, and OCD dimensions based on the threshold criteria, respectively.Conclusions: Iranian screening tools for mental health problems can provide qualified information with the least error and the most precision in appropriate early diagnosis and decrease the burden of mental health problems in the national healthcare system.
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| 3. |
- Forouzan, Ameneh Setareh, et al.
(författare)
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Service users and providers expectations of mental health care in Iran : a qualitative study
- 2013
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Ingår i: Iranian Journal of Public Health. - 2251-6085. ; 42:10, s. 1106-1116
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mental disorders are known to be an important cause of disabilities worldwide. Despite their importance, about two thirds of mentally ill people do not seek treatment, probably because of the mental health system's inability to decrease the negative side effects of the interaction with the mental health services. The World Health Organization has suggested the concept of responsiveness as a way to better understand the active interaction between the health system and the population. This study aimed to explore the expectations of mental health service users and providers.Methods: Six focus group discussions were carried in Tehran, the capital of Iran. In total, seventy-four participants comprising twenty-one health providers and fifty-three users of mental health system were interviewed. Interviews were analyzed through content analysis. The coding was synchronized between the researchers through two discussion sessions to ensure the credibility of the findings. The results were then discussed with two senior researchers to strengthen plausibility.Results: Five common domains among all groups were identified: accessibility, quality of interpersonal relationships, adequate infrastructure, participation in decisions, and continuity of care. The importance of cultural appropriateness of care was only raised by service users as an expectation of an ideal mental health service.Conclusions: Both users and providers identified the most relevant expectations from the mental health care system in Iran. More flexible community mental health services which are responsive to users? experiences may contribute to improving the process of care for mental health patients.
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