Seeking comfort: women mental health process in I.R. Iran: a grounded theory study

Psychosocial factor is considered as intermediate social determinant of health, because it has powerful effects on health especially in women. Hence deeper understanding of the mental-health process needed for its promotion. The aim of this study was to explore women's experience of the mental-health problem and related action-interactions activities to design the appropriate interventions. In-depth interviews with women 18-65 years were analyzed according to the grounded theory method. The selection of Participants was based on purposeful and theoretical sampling. In this study, a substantive theory was generated; explaining how female with the mental-health problem handled their main concern, which was identified as their effort to achieve comfort [core variable]. The other six categories are elements in this process. Daily stress as a trigger, satisfaction is the end point, marriage is the key point and action-interaction activities in this process are strengthening human essence, Developing life skills and help seeking. Better understanding the mental-health process might be useful to design the interventional program among women with mental-health problems

qualitative study of community-based health programs in Iran: an experience of participation in I.R. Iran

Community-based health programs [CBHPs] with participatory approaches has been recognized as an important tool in health promotion. The goal of this study was to understand the nature of participation practice in CBHP and to use the data to advocate for more participation-friendly policies in the community, academy and funding organizations. In this qualitative study, 13 CBHPs, which were active for last 5 years have been assessed using semi-structural in-depth interviews with programs principal and managers and focus group discussions with volunteers and service users. Data analysis was based on the deductive-inductive content analysis considering the participatory approaches in these programs. The results show that, the main category of participation was divided to community participation and intersectional collaboration. The community participation level was very different from "main," "advisory" or "supporting" level. The process of recruitment of volunteers by the governmental organization was centralized and in non-governmental organizations was quite different. According to respondents opinion, financial and spiritual incentives especially tangible rewards, e.g., learning skills or capacity building were useful for engaging and maintaining volunteers' participation. For intersectional collaboration, strong and dedicated partners, supportive policy environment are critical. It seems that maintaining partnership in CBHP takes considerable time, financial support, knowledge development and capacity building

How Iranian women conceptualize mental health: an explanatory model

In Iran, more than 25% of women suffer from mental disorders. Mental disorders and subclinical problems are associated with socioeconomic problem .At the community level, mental health promotion can reduce social damage. The aim of this study as a part of community based mental health promotion intervention was to explore how mental health in Iranian women is viewed. According to a qualitative method in 2012, participants were selected by purposeful sampling from married women 18 to 65 years who are residents in Tehran. Fifteen in depth individual interviews were conducted with regard to the concept of mental health, causal pathway and help-seeking behavior according to explanatory model. Mental health was perceived as the same of emotional well-being. It conceptualized not only lack of mental disorder but also sense of satisfaction and healthy functioning. According to participant`s view, the causal pathway of mental health problems were classified to individual, familial and social factors. Physical and behavioral problems were related to individual factor, Lack of marital adjustment was one of the most important issues in familial item and in social factor, cultural context and socio- economic problems were extracted .In help seeking process, all of the participants believed that the religion has important effect in mental health. Marital adjustment is an important stage in process of mental health in women

Service users and providers expectations of mental health care in Iran: a qualitative study

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. 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. 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. 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

Barrier and facilitators of HIV related risky sexual behavior

This study was conducted to identify the determinants of protective behavior in relation to HIV transmission. Since the risk of transmission is higher among those who have extramarital intercourse, the study sample constituted of such people. We started this study in 2010 and finished it in 2011. Participants were divided into low-risk and high-risk groups. High-risk people included sex workers and those who presented at drop- in centers. interviewers were 18 men and women in low-risk group and 12 men and women in the high-risk group. Data were collected through in-depth interviews and were analyzed using the thematic framework method. In both groups, protective behavior was influenced by willingness to protect, intention or decision to protect, and personal, social, and environmental barriers and facilitators. In terms of willingness, behavior was influenced to preserve sexual pleasure by avoiding condoms. In terms of barriers and facilitators, trust in partner, misperceptions, condom inaccessibility, unplanned sex, fear of contracting the disease, partner's wish, ethical commitments were mentioned by both groups, stigma of condom possession by the low-risk group, and partner's force was mentioned by the high-risk group. Educational programs need to focus on changing the concept that "condoms reduce sexual pleasure". In addition, interventional programs to strengthen factors such as self-efficacy, ethical commitments, faithfulness, and correct beliefs such as undue trust in partner, misconception of being safe, unplanned sex, and the stigma of possessing condoms can be very effective in changing high-risk sexual behavior