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Mastering the Art of Collaboration: Supporting Family Caregivers of Mental Health Patients by Service Providers in Iran

  • Mohammad Akbari
  • Mousa AlaviEmail author
  • Jahangir Maghsoudi
  • Alireza Irajpour
  • Violeta Lopez
  • Michelle Cleary
Original Article
  • 39 Downloads

Abstract

Responsive support systems, designed and promoted by policy makers, are critical in supporting family caregivers. The purpose of this study was to explore viewpoints of service providers in supporting family caregivers of mental health patients in Iran. In this qualitative study, a purposive sample of 29 service providers and policy makers consented to participate in semi-structured interviews. Data were analyzed through qualitative content analysis and three main categories and seven sub-categories were identified. The main categories were: interpersonal collaboration, intra-organization collaboration and inter-sectorial collaboration. A common theme in this study was that service providers play a key role in coordinating responsive support services for Iranian family caregivers of mental health patients across all levels. The increasing complexity of the health care system and resource limitations have created complex problems, which require the use of participatory approaches by the various specialties, disciplines and departments to provide complementary services and mutual support. This approach is the best way of ensuring that service users receive the most relevant services from the right service providers in the right place as and when needed.

Keywords

Responsive support system Family caregivers Mental health disorders Qualitative Iran 

Notes

Acknowledgements

This study is derived from a Ph.D. thesis of Nursing sponsored by the Isfahan University of Medical Sciences. The authors are thankful to the Vice Chancellor and participants. We also thank Dr. Sancia West for her review of this article.

Author Contributions

All authors have agreed on the final version and meet at least one of the following criteria recommended by the ICMJE (http://www.icmje.org/recommendations/).

Funding

This work was supported by the Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Iran.

Compliance with Ethical Standards

Conflict of interest

The authors declare that there is no conflict of interest.

References

  1. Aflakseir, A., & Coleman, P. G. (2009). The influence of religious coping on the mental health of disabled Iranian war veterans. Mental Health, Religion and Culture, 12(2), 175–190.Google Scholar
  2. Akbari, M., Alavi, M., Irajpour, A., Maghsoudi, J., Lopez, V., & Cleary, M. (2018). Support needs for family caregivers of clients with mental illness in Iran: A qualitative study. Issues in Mental Health Nursing.  https://doi.org/10.1080/01612840.2018.1445324.Google Scholar
  3. Alavi, M., Irajpour, A., Abdoli, S., & SaberiZafarghandi, M. B. (2012). Clients as mediators of interprofessional collaboration in mental health services in Iran. Journal of Interprofessional Care, 26(1), 36–42.  https://doi.org/10.3109/13561820.2011.623803.Google Scholar
  4. Amoah, P. A., & Phillips, D. R. (2017). Strengthening the referral system through social capital: A qualitative inquiry in Ghana. Healthcare, 5(4),80.  https://doi.org/10.3390/healthcare5040080.Google Scholar
  5. Angle, H. L., & Perry, J. L. (1981). An empirical assessment of organizational commitment and organizational effectiveness. Administrative Science Quarterly, 26(1), 1–14.Google Scholar
  6. Awad, A. G., & Voruganti, L. N. P. (2012). The burden of schizophrenia on caregivers. PharmacoEconomics, 26(2), 149–162.Google Scholar
  7. Bagheri, S., Fallah, V., & Niazazari, K. (2015). The evaluation of developing techniques of altruism and martyrdom culture. Advances in Environmental Biology, 9(3), 416–423.Google Scholar
  8. Barker, E. T., Greenberg, J. S., Seltzer, M. M., & Almeida, D. M. (2012). Daily stress and cortisol patterns in parents of adult children with a serious mental illness. Health Psychology, 31(1), 130–134.  https://doi.org/10.1037/a0025325.Google Scholar
  9. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.Google Scholar
  10. Chang, Y.-C., & Chou, F.-C. (2015). Effects of home visit intervention on re-hospitalization rates in psychiatric patients. Community Mental Health Journal, 51(5), 598–605.Google Scholar
  11. Damari, B., Alikhani, S., Riazi-Isfahani, S., & Hajebi, A. (2017). Transition of mental health to a more responsible service in Iran. Iranian Journal of Psychiatry, 12(1), 36–41.Google Scholar
  12. Davari, M., Haycox, A., & Walley, T. (2005). Health care challenges in Iran. Iranian Journal of Public Health, 34(Sup), 30–31.Google Scholar
  13. Forouzan, A. S., Rafiey, H., Padyab, M., Ghazinour, M., Dejman, M., & Sebastian, M. S. (2014). Reliability and validity of a mental health system responsiveness questionnaire in Iran. Global Health Action, 7(1), 24748.  https://doi.org/10.3402/gha.v7.24748.Google Scholar
  14. Glasby, J., & Lester, H. (2004). Cases for change in mental health: Partnership working in mental health services. Journal of Interprofessional Care, 18(1), 7–16.Google Scholar
  15. Gostin, L., Hodge, J. G., Valentine, N., & Nygren-Krug, H. (2003). The domains of health responsiveness: A human rights analysis. (Health and Human Rights Working Paper Series, No. 2). Geneva: World Health Organization. Retrieved from http://origin.wpro.who.int/health_services/people_at_the_centre_of_care/documents/Series_2_Domains_of_health_responsiveness.pdf.
  16. Greenhalgh, T. (2015). Health literacy: Towards system level solutions. BMJ.  https://doi.org/10.1136/bmj.h1026.Google Scholar
  17. Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82.Google Scholar
  18. Haresabadi, M, Bibak, B, Bayati, H, & Akbari, M (2013). Assessing burden of family caregivers of patients with schizophrenia admitted in IMAM REZA hospital-Bojnurd. Journal of Medical University of North Khorasan, 4(2), 165–171.Google Scholar
  19. Heller, T., Gibbons, H. M., & Fisher, D. (2015). Caregiving and family support interventions: Crossing networks of aging and developmental disabilities. Intellectual and Developmental Disabilities, 53(5), 329–345.  https://doi.org/10.1352/1934-9556-53.5.329.Google Scholar
  20. Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. West Sussex: Wiley.Google Scholar
  21. Hooshmand, E., Tourani, S., Ravaghi, H., & Ebrahimipour, H. (2014). Challenges in evaluating clinical governance systems in Iran: A qualitative study. Iranian Red Crescent Medical Journal, 16(4), e13421.  https://doi.org/10.5812/ircmj.13421.Google Scholar
  22. Hudson, P., Trauer, T., Kelly, B., O’Connor, M., Thomas, K., Summers, M., … White, V. (2013). Reducing the psychological distress of family caregivers of home-based palliative care patients: Short-term effects from a randomised controlled trial. Psycho-Oncology, 22(9), 1987–1993.  https://doi.org/10.1002/pon.3242.Google Scholar
  23. Irajpour, A., & Alavi, M. (2015). Health professionals’ experiences and perceptions of challenges of interprofessional collaboration: Socio-cultural influences of IPC. Iranian Journal of Nursing and Midwifery Research, 20(1), 99–104.Google Scholar
  24. Irajpour, A., Alavi, M., Abdoli, S., & Saberizafarghandi, M. B. (2012). Challenges of interprofessional collaboration in Iranian mental health services: A qualitative investigation. Iranian Journal of Nursing and Midwifery Research, 17(2 Suppl1), S171.Google Scholar
  25. Janati, A., Amini, A., Adham, D., & Naseriasl, M. (2017). Referral system in Iran’s health sector and world’s leading countries. Research Journal of Pharmacy and Technology, 10(6), 1597–1602.Google Scholar
  26. Lindsey, M. A., Chambers, K., Pohle, C., Beall, P., & Lucksted, A. (2013). Understanding the behavioral determinants of mental health service use by urban, under-resourced Black youth: Adolescent and caregiver perspectives. Journal of Child and Family Studies, 22(1), 107–121.Google Scholar
  27. Marshall, C., & Rossman, G. (2006). Designing qualitative research (4th ed.). Thousand Oaks: Sage.Google Scholar
  28. Möller-Leimkühler, A. M., & Wiesheu, A. (2012). Caregiver burden in chronic mental illness: The role of patient and caregiver characteristics. European Archives of Psychiatry and Clinical Neuroscience, 262(2), 157–166.  https://doi.org/10.1007/s00406-011-0215-5.Google Scholar
  29. Mosadeghrad, A. M. (2014). Factors influencing healthcare service quality. International Journal of Health Policy and Management, 3(2), 77–89.  https://doi.org/10.15171/ijhpm.2014.65.Google Scholar
  30. Noghani, F., Seyedfatemi, N., Karimirad, M.-R., Akbarzadeh, A., & Hasanpour-Dehkordi, A. (2016). Health related quality of life in family caregivers of patients suffering from mental disorders. Journal of Clinical and Diagnostic Research, 10(11), VC05–VC09.  https://doi.org/10.7860/JCDR/2016/19671.8792.Google Scholar
  31. Omotosho, A., Adegbola, O., & Adebo, A. (2016). A patient-based hospital referral decision support system. Survival, 155(10), 38–43.Google Scholar
  32. Osaro, E., & Charles, A. T. (2014). Harmony in health sector: A requirement for effective healthcare delivery in Nigeria. Asian Pacific Journal of Tropical Medicine, 7(Supplement 1), S1–S5.Google Scholar
  33. Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Effective Practice and Organisation of Care Group. Cochrane Database Syst Rev.  https://doi.org/10.1002/14651858.CD000072.pub3. .Google Scholar
  34. Rofcanin, Y., Las Heras, M., & Bakker, A. B. (2017). Family supportive supervisor behaviors and organizational culture: Effects on work engagement and performance. Journal of Occupational Health Psychology, 22(2), 207–217.  https://doi.org/10.1037/ocp0000036.Google Scholar
  35. Rowe, J. (2012). Great expectations: A systematic review of the literature on the role of family carers in severe mental illness, and their relationships and engagement with professionals. Journal of Psychiatric and Mental Health Nursing, 19(1), 70–82.  https://doi.org/10.1111/j.1365-2850.2011.01756.x.Google Scholar
  36. Sadock, B. J., & Kaplan, V. A. (2011). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. New York: Lippincott Williams & Wilkins.Google Scholar
  37. Shamsaei, F., Cheraghi, F., & Esmaeilli, R. (2015). The family challenge of caring for the chronically mentally Ill: A phenomenological study. Iranian Journal of Psychiatry and Behavioral Sciences, 9(3), e1898.  https://doi.org/10.17795/ijpbs-1898.Google Scholar
  38. Shamsaei, F., Kermanshahi, S. M. K., Vanaki, Z., & Holtforth, M. G. (2013). Family care giving in bipolar disorder: Experiences of stigma. Iranian Journal of Psychiatry, 8(4), 188–194.Google Scholar
  39. Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014). The global prevalence of common mental disorders: A systematic review and meta-analysis 1980–2013. International Journal of Epidemiology, 43(2), 476–493.Google Scholar
  40. Supper, I., Catala, O., Lustman, M., Chemla, C., Bourgueil, Y., & Letrilliart, L. (2015). Interprofessional collaboration in primary health care: A review of facilitators and barriers perceived by involved actors. Journal of Public Health, 37(4), 716–727.Google Scholar
  41. Thompson, R., Dancy, B. L., Wiley, T. R., Najdowski, C. J., Perry, S. P., Wallis, J., … Knafl, K. A. (2013). African American families’ expectations and intentions for mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 40(5), 371–383.Google Scholar
  42. Thornicroft, G., Cooper, S., Bortel, T. V., Kakuma, R., & Lund, C. (2012). Capacity building in global mental health research. Harvard Review of Psychiatry, 20(1), 13–24.Google Scholar
  43. Vagharseyyedin, S. A. (2015). Experiences of wives of Iranian war veterans with posttraumatic stress disorder regarding social relationships. Public Health Nursing, 32(2), 122–131.Google Scholar
  44. Valentine, N. B., de Silva, A., Kawabata, K., Darby, C., Murray, C. J., & Evans, D. B. (2003). Health system responsiveness: Concepts, domains and operationalization. In Health systems performance assessment: Debates, methods and empiricism (pp. 573–596). Geneva: World Health Organization.Google Scholar
  45. Whiston, L., Barry, J. M., & Darker, C. D. (2017). Participation of patients and family members in healthcare services at the service and national levels: A lesson learned in Dublin, Ireland. Patient Education and Counseling, 100(3), 583–591.Google Scholar
  46. Wildeman, S. (2013). Protecting rights and building capacities: Challenges to global mental health policy in light of the convention on the rights of persons with disabilities. Journal of Law, Medicine and Ethics, 41(1), 48–73.Google Scholar
  47. Zendjidjian, X., Richieri, R., Adida, M., Limousin, S., Gaubert, N., Parola, N., … Boyer, L. (2012). Quality of life among caregivers of individuals with affective disorders. Journal of Affective Disorders, 136(3), 660–665.Google Scholar
  48. Ziebland, S., & McPherson, A. (2006). Making sense of qualitative data analysis: An introduction with illustrations from DIPEx (personal experiences of health and illness). Medical Education, 40, 405–414.Google Scholar
  49. Zwarenstein, M., Goldman, J., & Reeves, S. (2009). Interprofessional collaboration: Effects of practice based interventions on professional practice and healthcare outcomes. Cochrane Database Syst Rev, 8;(3), CD000072.  https://doi.org/10.1002/14651858.CD000072.pub2.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Student Research Center, Faculty of Nursing and MidwiferyIsfahan University of Medical SciencesIsfahanIran
  2. 2.Nursing and Midwifery Care Research Center, Faculty of Nursing and MidwiferyIsfahan University of Medical SciencesIsfahanIran
  3. 3.Nursing & Midwifery Care Research Center, Mental Health Nursing Department, Faculty of Nursing & MidwiferyIsfahan University of Medical SciencesIsfahanIran
  4. 4.Nursing & Midwifery Care Research Center, Critical Care Nursing Department, Faculty of Nursing & MidwiferyIsfahan University of Medical SciencesIsfahanIran
  5. 5.Alice Lee Centre for Nursing Studies, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  6. 6.School of Health SciencesUniversity of TasmaniaSydneyAustralia

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