Objective The aim of this study was to explore the burden of care for patients undergoing hemodialysis from the experiences of family caregivers. Methods In this qualitative study, a content analysis approach was used for data collection and analysis. Participants were 16 family caregivers selected through purposive sampling from four medical education centers affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran. Semi-structured interviews were held to collect data. Results Four categories were developed as follows: ‘care challenges’, ‘ psychological vulnerabilities’, ‘the chronic nature of care ’and “care in the shade”. The categories led to the development of the main theme of ‘progressive exhaustion’ experienced by the family caregivers during the provision of care to patients undergoing hemodialysis. Conclusion Family caregivers have a significant role in the process of patient care, and this role leads them to progressive exhaustion; therefore, the overall health of the caregivers should be taken into account and more attention should be paid to their quality of life, social welfare, and satisfaction level.

The therapeutic relationship is widely accepted as the basic core and essence of the psychiatric nurse's role and is thus essential for providing quality mental health care. A detailed and clear perception of the issues that facilitate or obstruct this relationship is therefore important. The purpose of this study was to gain insights into the experiences of nurses working in psychiatry wards, of the barriers to the nurse-patient relationship. A qualitative content-analysis study was undertaken using a purpose-based sampling approach with the participation of 15 nurses employed in psychiatric wards in hospitals located in South Iran. Semi-structured interviews provided the source of data, and an inductive content-analysis approach was used for data analysis. The main concept extracted from the study was identified as 'the therapeutic relationship in the shadow', which captured the sense that this critical relationship is mostly unseen in the daily practice of the nurses interviewed. Factors that functioned as barriers to this relationship were classified into three main categories: nurse-related, patient-related and organization-related. The results of this study revealed that, despite the widely claimed importance of the nurse-patient relationship in psychiatric settings, this relationship is powerfully influenced by individual and organizational factors that have not been considered adequately in previous research. It is strongly recommended that greater consideration of these factors be given to care planning in psychiatric wards.

This study demonstrates that coping strategies stemming from the cultural beliefs of caregivers are very salient in their commitment to care; thus, the health-care team, especially nurses, should encourage family caregivers to use these strategies to maintain their physical and psychological health and to provide quality care for patients.

Aggression from psychiatric patients is a constant problem for care providers that causes major problems in the therapeutic environment, and may have negative effects on the quality of care. Since recognition of aggression with regard to cultural background leads to better control of aggression in the psychiatric wards, this study has been done to clarify Iranian nurses' experiences of aggression in psychiatric wards. A qualitative content analysis study was conducted to explore experiences of nurses. Data analysis revealed four themes: (1) Damage resulting from aggression, (2) Aggression catalysts, (3) Contagious nature of aggression, and (4) Various control strategies. There are various causes for in-patients' aggression, and nurses use various approaches to control it. These approaches are influenced by personnel, facilities, and ward environment. Identifying these factors and strategies can contribute to better management of aggression and, thus, better quality of care in psychiatric wards.