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Social support and health services are crucial for mothers and families during their infants’ first year. The aim of this study was to explore the effect of self-isolation imposed by the COVID-19 pandemic on mothers’ access to social and health care systems support during their infants’ first year. We utilized a qualitative design using feminist poststructuralism and discourse analysis. Self-identifying mothers (n = 68) of infants aged 0 to 12 months during the COVID-19 pandemic in Nova Scotia, Canada completed an online qualitative survey. We identified three themes: (1) COVID-19 and the Social Construction of Isolation, (2) Feeling Forgotten and Dumped: Perpetuating the Invisibility of Mothering, and (3) Navigating and Negotiating Conflicting Information. Participants emphasized a need for support and the associated lack of support resulting from mandatory isolation during the COVID-19 pandemic. They did not see remote communication as equivalent to in-person connection. Participants described the need to navigate alone without adequate access to in-person postpartum and infant services. Participants identified conflicting information related to COVID-19 as a challenge. Social interactions and interactions with health care providers are crucial to the health and experiences of mothers and their infants during the first year after birth and must be sustained during times of isolation.

Using the 5A model can lead to increased exercise tolerance and decreased dyspnea in COPD patients. Therefore, this self-management program is recommended as an effective way to improve their functional status.

Background and aims:Chronic obstructive pulmonary disease (COPD) is a progressive process that leading to major clinical problems in patients. There is no highly effective treatment for these patients and therapists only try to relieve the symptoms. But, there are interventions such as self-management program for improvement of health level in patients. 5A model, known as behavior change counseling model is an evidence-based approach for behavior change and self-management. Thus this study was performed to investigate the effects of self-management program based on 5A model on some of clinical parameters in COPD patients.Methods:this clinical trial was performed on 50 COPD patients that referred to Apadana sub-special clinic in Ahvaz. Patients were randomly assigned to control and intervention groups. The control group received usual care and the intervention group received usual care plus a self-management program based on the 5A model (includes: Assess Advise, Agree, Assist and Arrange stage). Patients were assessed by six-minute walking test and the Borg scale for exercise tolerance level and dyspnea severity at baseline and after 3 months. Chi-square and t-test in the SPSS software were used to data analysis.Results:There was no significant difference between the groups in exercise tolerance at base line; but, they were significantly different at the end of 3 months (P=0.007). In addition, a significant reduction was found in patients' dyspnea in the intervention group, compared with the control group after 3 months (P<0.0001).Conclusion:with attention to effectiveness of self-management program based on 5A model on increase of exercise tolerance and decrease of dyspnea in COPD patients, use of this program is recommended as benefit method for decline major difficult of disease without spend cost for frequent refer to medical center.