The experiences of family caregivers of people with severe mental illness in the Middle East: A systematic review and meta-synthesis of qualitative data

Abstract

Background There is a wealth of literature exploring the experiences of family caregivers of people with severe mental illness (SMI) in western countries, however, this topic has been neglected in the Middle East, despite families being the main source of caregiving in this context. The purpose of this review was to conduct a systematic review and qualitative meta-synthesis to explore the experiences of family caregivers living in countries in the Middle East caring for a relative with severe mental illness. Methods A systematic review and meta-synthesis were conducted, to comprehensively gain a thorough and detailed overview of what is known about family caregivers’ experiences from published qualitative research in the Middle East geographical area from inception to May 2021. The review protocol was pre-registered with PROSPERO (Ref: CRD42020165519). Results The review identified twelve qualitative studies that explored caregivers’ experiences of caring for relatives with SMI in Middle East countries. Family caregivers’ experiences were captured under seven overarching themes. The participants across all studies reported negative consequences of providing care, increased burden and emotional distress. Many experienced issues with family/marital relationships and stigmatizing attitudes and behaviours from their communities. Caregivers expressed the need for increased support which was perceived to have a critical role in improving family caregivers’ experiences. Conclusions The meta-synthesis revealed many challenges and issues that affect caregivers of people with SMI in the Middle East. Family caregivers experienced distress and burden, and reported significant impact on their psychological well-being. Their experiences highlight the urgent need to provide more support for family caregivers in Middle East countries.

Evaluating family knowledge about sexual health in patients with severe mental illness: a qualitative study in Iran

“…Therefore, it is obvious that in this society how prominent the role of SMI's families could be in managing the patients. Family members usually experience a high amount of burden [9] and stigma according to caring for the patients [2,44].…”

“…In societies that families are mostly accountable for SMIs' care, the impact of their attitudes and actions on patients' sexual health is very high [29,37]. In one hand, there is no systematic sexual health education even for general population in most Islamic country including Iran, and on the other hand general knowledge of SMIs' family for taking care of patients and themselves is negligible in middle east [2]. This fact is in line with our findings that SMIs' family get necessary information from unreliable and informal sources.…”

“…Up down attitude about the necessity of sexual health education should be upgraded and bottom up request for such education should be stimulated. This bidirectional movement is highly important for SMIs' families [2,41]. In addition of receiving information and advice from health care providers, SMIs' families need more support from other resources to reduce the burden [42].…”

“…Author details 1 Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2 Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran.…”

Perceived social support and family members of patients with mental disorders: A mixed method study

“…Therefore, the load of responsibility of looking after mentally ill patients is mostly on the family members ( 8 ). This situation and the consequences might have notable effects on the daily lives of caregivers and impose a risk to their mental and physical health ( 9 ). Providing continuous care for mentally ill patients isolates the caregivers and makes them more vulnerable to social hardships and economic crises ( 10 ).…”