Psychosocial needs of female self-immolation survivors: a systematic review and meta synthesis of qualitative studies

Self-immolation is a traumatic method of self-harm, involving the intentional act of ending one's life. Due to advancements in medical care, there has been an increase in the number of survivors of severe burn injuries, including self-immolation. These survivors encounter various needs throughout their hospitalization and following discharge. This study aimed to investigate the psychosocial needs of female survivors of self-immolation in Middle Eastern countries.

Articles were retrieved from PubMed, Scopus, Web of Science (ISI), Cochrane Library, and the Persian SID database without time limits until March 2025. Inclusion criteria consisted of qualitative studies focusing on the psychosocial needs of women and girls' survivors of self-immolation during hospitalization and post-discharge in Middle Eastern countries with access to the full-text article. Out of 528 articles from various databases and five from manual search, 15 articles were included in this Meta synthesis after removing duplicates. The Critical Appraisal Skills Program (CASP) tool was utilized to evaluate the quality of the articles. A thematic synthesis approach guided the integration of findings from 15 qualitative studies. MAXQDA software was used for data management.

Out of the 15 included articles, 11 were conducted in Iran and four in Iraq. Four themes and 13 subthemes were identified from the combined findings: need for psychological and spiritual support, need for financial and legal assistance, the need for a comprehensive and high-quality treatment and rehabilitation program and the need for cultural and social transformations. Female survivors, upon returning to life, grapple with lingering mental disorders such as sadness, anxiety, and depression stemming from the incident. These women need high-quality and comprehensive treatment and rehabilitation programs to heal burn-related wounds, which also requires receiving financial and legal support, as well as support from the society.

Female survivors of self-immolation face challenges in psychological, physical, care, and socio-cultural aspects. Recognizing these needs by legal authorities and health systems can help reduce the burden on survivors and their families, enhance their quality of life, and facilitate their reintegration into society.