title: Iranian family caregivers' challenges and issues in caring of multiple sclerosis patients: A descriptive explorative qualitative study.
abstract: BACKGROUND
  The broad spectrum of problems caused by multiple sclerosis (MS) imposes heavy responsibility to caregivers in caring of their patients. Therefore, they encounter many issues and challenges in this situation. The purpose of this study was to explore the experiences and challenges of MS family caregivers.
  
  
  METHODS
  A qualitative design, based on a thematic analysis approach, was used to reach the study aim. Data were collected and analyzed concurrently through in-depth unstructured interviews, field notes, and observations that were held with 23 participants (14 family caregivers and 9 MS patients) at two referral centers in Ahvaz, Iran.
  
  
  RESULTS
  THREE MAJOR THEMES WERE EXTRACTED FROM THE ANALYSIS OF THE TRANSCRIPTS: "emotional exhaustion of caregivers," "uncertain atmosphere of caring," and "insularity care." The first theme consisted of three subthemes: "stressful atmosphere of caring," "conflict and animism," and "continuing distress affecting the caregiver." The second theme consisted of three subthemes: "unstable and complicacy of disease," "caring with trial and error," and "frequent hospitalization of patients," and the third theme consisted of two subthemes: "caring gap and disintegration" and "lack of sufficient support."
  
  
  CONCLUSIONS
  This study will be useful to healthcare system for managing the challenges of MS patients' family caregivers. Improving the conditions and performance of family caregivers is crucial in order to provide high-quality care to people with MS.
authors.affiliation: Department of Nursing, Faculty of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Masoudi
authors.affiliation: Faculty of Nursing and Midwifery, Khorasgan (Isfahan) Branch, Islamic Azad University, Isfahan, Iran.
authors.forename: Heidar Ali
authors.initials: HA
authors.lastname: Abedi
authors.affiliation: Department of Midwifery, Reproductive Health Research Center Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Parvin
authors.initials: P
authors.lastname: Abedi
authors.affiliation: Member of Faculty in Medicine School, Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Seyed Ehsan
authors.initials: SE
authors.lastname: Mohammadianinejad
keywords: Challenges and issues; Iran; family caregivers; multiple sclerosis; nursing; qualitative research