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Background & aim: Chronic illness in the child increases the mental health risk in parents. Parents also get new roles and responsibilities for the physical and emotional needs of their children in order to preserve and recreate the routine family activities. This study aimed to explain the challenges of parents with a daughter suffering from multiple sclerosis. Methods: This research was a qualitative study with a phenomenological approach that was carried out with the participation of parents of girls' members of MS Association of Ardabil. Inclusion criteria were; living with family since MS beginning, having the MS history, and willingness to participate in the study. Data were collected by semi-structured interview with 12 participants. Finally, the collected data were analyzed using a quantitative method. Results: Data analysis showed 3 themes and 8 sub-themes as; 1. Distress (anxiety and fear, discomfort, dissatisfaction, the future of waking and mental activity), 2. Compatibility barriers (economic burden and treatment problems), and 3. Restriction (isolation and despair). Conclusion: The challenges mentioned by parents in the current study were: mental and emotional distress such as anxiety, discomfort, and mental engagement. Also, most of the parents lost their social dynamicity and felt helpless and frustrated due to unsatisfied treatment results. Problems in the treatment process and economic burden were also among challenges preventing parents from coping with their child's disease. Providing these challenges to health care planners and managers can have a significant impact on the process of eliminating the problems.

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Introduction Providing care for patients by family caregivers causes in several consequences known as “Caregiving Burden”, which affects the caregiver's health and the whole family process, considered in holistic healthcare/nursing. This study aimed to evaluate the caregiving burden and social support in family caregivers of patients with cancer and their influencing factors in a local area in Iran. Methods In this cross-sectional study, 190 family members of patients with cancer were studied through convenient sampling method. Data were collected using demographic data sheet enriched with Karnofsky Performance Status Scale and Katz Index of Independence in Activities of Daily Living (ADL), and Zarit Burden Inventory and Medical Outcomes Social Support Survey questionnaires. Results The results indicated intermediate performance status and moderate independence in ADL in patients. The mean score of caregiving burden was 43.95 ± 17.48 which indicates moderate to severe burden. The average social support in the caregivers was 60.25 ± 23.81% which shows above the average social support. Both performance status and dependence in ADL of patient had statistically significant effect on the caregiving burden in caregivers. Also a statistically significant negative relationship was observed between caregiving burden and social support in primary family caregivers of patients with cancer. Discussion Considering the increasing importance of primary care provided by families, developing strategies for providing caregiver's needs through family care in cancer nursing is essential. So supporting caregivers through family nursing in holistic healthcare by providing social support, can play a significant role in reducing caregiving burden in healthcare services considering the qualified holistic healthcare/nursing.

Background & aim:In spite of existing documentations and contemporary theories emphasizing on both science and art aspects of nursing, literature review reveals that most of published studies rely on scientific side of nursing. The aim of this study is to explain the concept of nursing as art in the experiences of patients with open heart surgery. Methods: In current study with an Interpretative Phenomenology approach twenty patients were selected and entered into the study after open heart surgery in open heart surgery units of Vali-e-asr and Fatemeh Al-Zahra Hospitals (Mazandaran-Iran) in 2017. Patients were chosen by purposeful sampling method with maximum variety (age, sex, education…). Data were collected with deep, semi-structured, and individual interviews. All interviews were recorded, handwritten, and interpreted based on the van Manen interpretation phenomenology. Results: Three main themes were derived after analysis of phenomenon of nursing art as; a) "care by mother as an angel" with sub-themes of compassion, intimacy, sympathy, hope and morale, b) "care beyond expectations and profession" with sub-themes of technical merit and moral merit and c) "permanent presence" with sub-themes of physical presence and psychological presence. Conclusion: The findings confirmed that participants considered nursing as an art when they received professional nursing care described as "care by mother as an angel". Patient experiences provide a beautiful perspective of nursing which achieving such level of maturity and promotion requires fundamental changes in nurse education with serious consideration to ethical issues, humanity and artistic concepts of nursing.

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Background:In 1990, the Iranian Ministry of Health implemented a health plan to increase mothers’ knowledge of infant feeding using health workers and health volunteers. This study evaluates the effects of nutrition education on mothers’ knowledge and whether increase in mothers’ knowledge was associated with increase in growth of their children in Ardabil, Iran.Methods:A quasi-experimental study of the impact of written nutritional education and in-person nutritional education given to the participants (mothers) from urban health centers by health workers and health volunteers. Sixteen urban health centers located in Ardabil, Iran, were selected randomly for nutritional education. A group of 303 mothers with infants younger than 6 months of age from 16 health centers participated in this study. Height-for-age Z scores and weight-for age Z scores were calculated based on the National Center for Health Statistics reference values.Results:There were signifi cant differences between maternal nutritional knowledge before and after the intervention in all groups. However, the in-person method of instruction given by health workers was more effective in increasing mothers’ knowledge than those in non-health worker volunteers intervention group. There were also significant differences between the growth rates of infants’ heights and weights before and after the intervention.Conclusions and Global Health Implications:In line with the aims of the government’s plan, the education given by health volunteers from non-governmental organizations was effective. However, it was less effective than the one given by professional health workers.