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Background & Aim: Increase in cancer prevalence results in feeling fear of being diagnosed with cancer among individuals. Understanding concerns of patients diagnosed with cancer helps health care professionals to provide appropriate caring plans. This study aimed to understand main concerns of patients who confront cancer diagnosis.

Methods & Materials: This was a qualitative study with content analysis approach. Fifteen patients with cancer were selected from a specialized hospital, an oncology clinic, and Emdad Center of Cancer patients in Sari using a purposeful sampling method during May 2011 to June 2012. The sample size was completed regarding data saturation. Data were collected using interviews, observations and recording field notes. All interviews were tape-recorded and transcribed verbatim. Data were analyzed using descriptive content analysis and the Granhim and Landmann method.

Results: Three categories including 485 primary codes were emerged. The derived codes were as follows: 1) sever personal and family disturbance 2) imagination of despair and 3) unclear imagination of future. The main code included in all derived codes was life threatening nature of cancer.

Conclusion: The findings showed that life threatening nature of cancer is a source of fear that makes the disease frightening. Clinical staff and nurses should pay more attention to concerns of patients with cancer and design their care plan accordingly.

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Background & Aim: Although the number of kidney donors is increasing in the country, few relatives decide to donate. Decision making on kidney donation to a relative faces many challenges, while how to make this decision is still ambiguous. The aim of the present study was to explore the way of decision making about kidney donation to a relative.
Methods & Materials: The present study was a qualitative study conducted in 2015. The thematic analysis approach was used to analyze the data. In this study, 16 relative donors from the kidney transplant centers of all the teaching hospitals affiliated to Tehran University of Medical Sciences (Imam Khomaini, Shariati, Sina) were selected through purposive sampling. Then, 16 face-to-face, in-depth, semi-structured interviews were conducted. Data were analyzed using the thematic analysis approach proposed by Clark & Braun (2006).
Results: Data analysis led to the identification of two themes “being resolute in decision making” and “mulling over the decision”. The first theme was comprised of three subthemes including donation with a heartfelt desire, consistency in decision making, discretion in decision making, and the second theme was consisted of two subthemes including unsteady in decision making and bargaining in decision making.
Conclusion: Decision making on kidney donation to a relative faces a variety of challenges influenced by the donor’s family background, the supportive role of family members, kinship ties and a sense of love for relatives. By providing knowledge and awareness to donors to address ambiguities and subjective questions, they can have an important role in developing the culture of relative’s kidney donation.
 

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Background & Aim: White lie is one of the inevitable challenges that creates an ethical dilemma during the patient care process. White lie remains an abstract concept in caring process. The aim of this study was to analyze the concept of white lie in the caring process using a hybrid model.
Methods & Materials: A hybrid model of concept analysis including three phases was used in this study. In the theoretical phase, different databases including PubMed, CINAHL, Scopus, Science Direct, Google scholar, SID and Magiran were searched for finding relevant articles published in 1980-2018. The keywords were truth, white lie, care and deception (in Persian and English). In the fieldwork phase, semi-structured in depth interviews were conducted with nurses. In next step, by combining the two previous stages, the final analysis was performed.
Results: In the theoretical phase, the attributes of the concept were determined, including “harmlessness”, “without personal motivation” and “use in compulsion situations”. In the fieldwork phase, three main categories such as “the sweetness of the bitter truth”, “harmless sentences to prevent harm” and “temporary relief to balance the situation” were identified from the data analysis. By merging the concepts extracted from the theoretical and fieldwork phases, “white lie in the patient care process” was defined as “an ethical decision without personal motivation, which is chosen in unstable situations to prevent predictable harms to the patient in facing the bitter truth”.
Conclusion: Although a definition of white lie was developed based on the above three phases, the further development of this concept requires a deeper look at the Iranian-Islamic culture. Therefore, further research is recommended in other medical centers in the country.
 

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Background & Aim: With the increasing phenomenon of elder abuse in today's societies, understanding the facilitating and inhibiting factors related to abuse seems necessary. The purpose of this study was to explain the facilitators of elder abuse in Iranian society.
Methods & Materials: This is a qualitative study that used a thematic analysis approach to collect and analyze data in order to explain the elderly’s perceptions of the facilitators of abuse. In this study, 20 elderly people in the community were selected by purposeful sampling. The data were collected by in-depth, semi-structured and face-to-face individual interviews. The Braun and Clark’s thematic analysis was used to analyze the data.
Results: The results of data analysis led to the identification of three themes including role modeling, evacuation of failures, and cultural-familial context of the society. The third theme had three sub-themes intergenerational gap, parenting style and society’s indifference.
Conclusion: Abuse is the result of a combination of causes and factors. The elderly’ experiences suggest that abuse goes beyond a personal matter and is rooted in cultural, social, and economic practices. Today, it is not acceptance of each other and disregard for the expectations of the other party that gives rise many contradictions and abuses at the family and community level.