Abstract
Background & Objectives: The transition from adolescence to adulthood is a difficult journey, and the notion of a mental illness that may disrupt daily life makes it even more challenging. Mental health is considered one of the components of human health, which has a significant impact on other dimensions, and therefore, it is of special importance among researchers. The most important stratum of any society is the students of that society, and a large part of the country's population comprises teenage students (secondary stage). Considering that psychological problems among students have increased, it seems that the various factors reduce their mental health. In addition, mental health problems such as depression and high anxiety in adolescents often cause academic failure, physical diseases, poor performance, dropping out of school, despair, emptiness, substance dependence, and in some cases lead to suicide. Therefore, this research aimed to identify the factors affecting the mental health of female students with a meta–synthesis approach and develop a model and intervention based on it.
Methods: The present study was developmental in terms of its purpose, qualitative in terms of the nature of the data and the style of analysis, and documentary in terms of the data collection method. The research methodology was descriptive–analytical, and the research data were collected and analyzed using the meta–synthesis method. Utilizing the "qualitative meta–synthesis" methodology, a systematic review was conducted to evaluate the existing literature on adolescent mental health, emphasizing the scientific value of qualitative research. Using a systematic and meta–synthesis approach, this study employed the six–step method developed by Sandelowski and Barroso (2007). A thorough search was conducted in the PubMed, Embase, PsycINFO, ProQuest, Scopus, Magiran, Noormagz, and Ganj Irandoc databases to evaluate previous investigations. The search key terms were "adolescents in school or students," "health or mental health," and "qualitative." The statistical population included all studies from 2007 to 2022. According to the criteria of targeted selection, the final analysis was performed using 32 selected articles. MAXQDA10 software was used to improve the research, and each paper was evaluated thoroughly using the CASP (the Critical Appraisal Skills Programme checklist), a method proven effective in previous meta–syntheses. The researchers assessed the quality of each study using (CASP) qualitative appraisal checklist, a widely accepted tool for evaluating qualitative research designs. The CASP checklist guides assessing methodological quality and considers the validity and transferability of results.
Results: From 371 retrieved articles, 32 were selected, and based on them, the influential factors were classified into 5 main categories and 15 core codes. The effective factors identified in students' mental health were physical health (healthy nutrition and enough sleep, healthy activities, focus on physical health), internal coherence (stress and emotions management, self–actualization, positivity, and resilience), personal characteristics (faith and fairness, introspection and self–awareness, courage), environmental conditions (social, cultural, economic factors, education), and family conditions (emotional functioning of the family, treatment, and behavior of family members).
Conclusion: Based on the research findings, mental health is affected by five factors: physical health, internal cohesion, personal characteristics, environmental conditions, and family conditions. Therefore, therapists can take practical steps to increase students' mental health according to the above factors.
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