title: A model to explain suicide by self-immolation among Iranian women: A grounded theory study.
abstract: BACKGROUND
  Self-immolation is a common method of suicide among Iranian women. There are several contributing motives for attempting self-immolation, and exploration of the process of self-immolation incidents will help interventionists and clinicians develop prevention programs.
  
  
  METHODS
  A grounded theory study using face-to-face, recorded interviews was conducted with surviving self-immolated patients (n=14), their close relatives (n=5), and medical staff (n=8) in Kermanshah, Iran. Data were analyzed using constant comparison in open, axial, and selective coding stages.
  
  
  RESULTS
  A conceptual model was developed to explain the relationships among the main categories extracted through the grounded theory study. Family conflicts emerged as the core category. Cultural context of self-immolated patients offered a contextual condition. Other important categories linked to the core category were mental health problems, distinct characteristics of the suicidal method, and self-immolation as a threat. The role of mental health problems as a causal condition was detected in different levels of the self-immolation process. Finally, adverse consequences of self-immolation emerged as having important impact.
  
  
  CONCLUSIONS
  The conceptual model, derived through grounded theory study, can guide design of prevention programs. The pivotal role of family conflicts should be emphasized in mental health interventions. The impact of adverse consequences of self-immolation on further suicidal processes necessitates post-suicide prevention programs. Further research to design specific interventions is recommended.
authors.affiliation: Department of Nursing, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran; Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden. Electronic address: hrkhankeh@hotmail.com.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Khankeh
authors.affiliation: Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran. Electronic address: alihosse@gmail.com.
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Hosseini
authors.affiliation: Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Electronic address: rezaie.phd.ot@gmail.com.
authors.forename: Leeba
authors.initials: L
authors.lastname: Rezaie
authors.affiliation: Department of Psychiatry, Farabi Hospital, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran. Electronic address: jshakerimd@yahoo.com.
authors.forename: Jalal
authors.initials: J
authors.lastname: Shakeri
authors.affiliation: Department of Psychology, University of Alabama at Birmingham, USA. Electronic address: schwebel@uab.edu.
authors.forename: David C
authors.initials: DC
authors.lastname: Schwebel
mesh_terms: D000328:Adult; D000367:Age Factors; D002056:Burns / Q000209:etiology*; D005260:Female; D066296:Grounded Theory; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D007398:Interpersonal Relations; D007492:Iran; D008605:Mental Health Services / Q000592:standards; D008875:Middle Aged; D008962:Models, Theoretical; D009042:Motivation; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology*; D055815:Young Adult
keywords: Conceptual model; Grounded theory; Iranian women; Self-immolation