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Introduction: While elderly people enter the hospital in biological crisis, family caregivers enter the hospital in psychological crisis. But professional caregivers haven’t adequate knowledge of family caregivers' experiences. Therefore they forget that family caregivers are in suffering equally. Since suffering is a significant concept in nursing science and knowing and comprehending sources of suffering in family caregivers by professional caregivers is very important, this study is done to describe the nature and structure of sources of suffering in family caregivers of hospitalized elderly patients. Materials and Methods: This is a qualitative study with phenomenological method. Population of the research is all elderly patients' families that were hospitalized in one of the hospitals of Isfahan University of medical sciences. Sampling method was purposive and continued until data saturation. The numbers of participants are 12. Data were gathered through in-dept interview and data analysis done by “Parse” method that was not used in Iran. Results: The finding of this research is summarized in these core concepts: Patients and therapeutic interventions as source of suffering, hospital as source of suffering, disturbance in family and social life as source of suffering, self neglect as source of suffering. These concepts will be discussed in the full article. Conclusion: Participants' experiences reflect the need for planning interventions such as developing supportive groups, providing facility and instruments and continuous support for family caregivers during hospital stay. Also results show that educational programs are necessary for effective adaptation in family caregivers.

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Background: Nowadays, many Iranian families, depending on the family members’ level of interest, tend to keep pet animals. Psychological studies have rarely dealt with the impact of pets on family performance and individuals’ mental health. The purpose of this study was to compare family performance and mental health in individuals who own pets and those who do not. Materials and Methods: In this case-control study, 152 participants (80 pet keeping and 72 non-pet keeping) living in Isfahan were selected through stratified random sampling and completed Family Assessment Device (FAD), General Health Questionnaire (GHQ), and a demographic questionnaire. Data analysis was done through multivariate regression and covariance analysis. Results: The results indicated significant differences between the pet keeping and non-pet keeping groups in terms of anxiety, sleep disorders, relationships, and emotional involvement therefore, it can be concluded that non-pet keeping individuals have more anxiety and sleep disorder symptoms, whereas pet keeping individuals present more problems in terms of emotional involvement and their relationships(p<0.05). Conclusion: According to the results, it is suggested that in keeping pets, greater attention should be to cultural factors. Also, in some circumstances keeping pets should be recommended for reduction of anxiety and elevation of sense of security and relaxation.

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Background: Addiction is undoubtedly one of the biggest problems of human societies that every year governments spend enormous amounts of money on fighting it. Most addicts, besides their addiction, cause many psychological problems in their families therefore, the aim of this study was to compare the presence of these disorders between the families of addicts and non-addicts. Materials and Methods: This case-control study was done on a sample of 650 persons of opium addicts' and non-addicts' families using random sampling method. Data were collected through SCL-90-R questionnaire and were analyzed by Chi-square and t-test using SPSS software version 18. Results: There was a significant difference in psychiatric disorders in addicts' and non-addicts' families (p=0.005). Among the 9 psychiatric disorders under assessment, only anxiety, aggression, paranoia, and depression disorders in three types, including pathologic, borderline, and combined (pathologic-borderline), were significantly higher in addicts' families compared with non-addicts' families (p=0.005). Conclusion: Drug dependence disorder in one member of a family has a very important effect on the mental hygiene of the other family members and requires prevention and treatment in both.

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Background: Funnel plot is a graphical tool for investigating publication bias in meta-analysis studies. The aim of this study is to introduce another application of funnel plot that is monitoring one of the Iranian family performance indices and determining the position of each health center of Markazi province in terms of patient referral rates by general practitioners to specialists and to compare it with bar and caterpillar plots.

Materials and Methods: In order to draw the funnel plot, the average monthly percent of referrals for each district of Markazi province in 2011 was computed. In this study, Iranian Ministry of Health and Medical Education standard figure of 10% was considered as the limit of referral to the second level of Iranian health services. The 99% confidence interval of the control limit for each district was computed according to 3 standard deviations of the percent of referrals relative to the total patient visits.

Results: Based on funnel plot results, five out of ten districts were in the expected range of referral (Ashtian, Saveh, Tafresh, Khomein, and Komijan). However, in other five districts, the referral rate was greater than the expected rate (Arak, Shazand, Zarandiyeh, Delijan, and Mahallat). Mahallat district had the highest rate of referral.

Conclusion: The funnel plot was more informative than the other two plots Thus, it can be viewed as a useful tool in monitoring health programs throughout the country.

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Background: One of the amendments made in Iran's Health System was family physician program were introduced in 2004 . This study aimed to describe the experiences of physician and other health team members about general interest of this program.

Materiasl and Methods: This study is a qualitative and data collection method was in-depth interviews (semi-structured). Groups participants including 15 physicians, 15 midwives and 25 healthworker declare their experiences about of general advantage in this program. In total, 55 interviews were carried out in population. Purposive sampling fand content analysis with comparative of the methods were used.

Results: In this study, after continuous analysis of data 376 initial codes were obtained. After integration of theses codes 30 the secondary cods come out which consist of public or general interest and economic benefit, respectively. Moreover 4 sub-categories (improve of index of public health and care, health folder, insurance for rural, low referral to expert of physican), were created.

Conclusion: Based on the results the use of electronic folders instead of traditional folder and accelerate to acsess of information patient for promotion of care and finally delivery some facilitate for health team worker recommended.

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Abstract

Background: One of the problems in children with cerebral palsy is impaired eating and drinking liquids. The purpose of this study is to compare the effect of oral motor stimulations on feeding function in the children with spastic cerebral palsy by two medical and family centered approaches.

Materials and Methods: This research was a descriptive-analytical cross sectional study that performed on 40 children 2-8 year olds with spastic Cerebral Palsy from the rehabilitation clinics in the city of Arak. They were selected by simple and purposeful sampling. Applied instruments were Gross Motor Measure Function Classification System Expanded & Revised (GMFCS E&R) and oral motor assessment scale(OMAS). Data were analyzed by statistical tests such as: Kolmogorov-Smirnov, reporting mean, standard deviation, data analysis frequncy distribution table, independent t-test, dependent t-test, chi-square and MANOVA.

Results: The difference of swallowing function assessed by OMAS in both groups managed by family centered and clinician centered approach prior and post management statistialy was meaningful (p=0.001(. The difference between swallowing function of both groups post intervention was not meaningful in view of first and second assessor, also it had no statistical significance(p=0.89 , p=0.07)

Conclusion: In general, we can conclude that oral motor stimulation is effective on swallowing function of cerebral palsy children in both treated groups. The effect of these stimulations on swallowing function in children with cerebral palsy between clinician centered and family centered approaches was equal.

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Introduction: The coronavirus crisis is a multidimensional phenomenon that affects even the family. The impact of the situation on the family has been less discussed. Therefore, a qualitative study was conducted to explain families' experiences with patients suffering from COVID-19.
Methods: A qualitative study was conducted with a content analysis approach in 2021. Sampling started with purposive sampling and continued theoretically until information saturation was reached. The primary data collection tool was a semi-structured, in-depth interview in which
10 participants were interviewed. The participants were people from the family of a patient with COVID-19 who, while willing to participate in the study, were either involved in caring for the patient or were worried about the patient's infection. In addition, their patient recovered from Corona and was alive. The interview location was chosen according to the participants' opinion, whether it was at their home or a place that was convenient for them. The interviews were analyzed using the Granheim and Lundman method.
Results: After analyzing the data, initially, 391 codes, 16 subcategories, and finally, five themes were extracted. The five themes that emerged are the experienced symptoms of the disease with two subcategories (symptoms of the onset of the disease and the course of the symptoms), mental and emotional disturbances with seven subcategories (contagion anxiety, death anxiety, fear of the vague nature of the disease, torment of conscience, obsession, emotional suffering, and financial worries), sacrifice in care with two subcategories (suffering care and multiplicity of roles),  resilience in the path of care with three subcategories (supportive aspects, reduction of caregiving stress and obtaining information about the disease), Change and evolution in the course of life with two subcategories (individual growth and getting the meaning of life).
Conclusions: According to the present study, after one of the family members gets infected with Corona, the other members have a crisis. The individual, psychological, social, and economic dimensions of the family foundation are facing challenges. It needs the comprehensive support of the family as the first and most important institution of society. Although facing this crisis and accompanying challenges leads to the experience of special suffering, it lays the foundation for personal growth and a better understanding of the meaning of life. Therefore, it can be said that the experience of this crisis is not only from the social aspect but also from the individual aspect, along with tremendous positive and negative developments.