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The findings of this study can help healthcare teams break the bad news of cancer diagnosis in a more effective, satisfactory, and culture-based manner for patients and their families.

Introduction: Hemodialysis is currently the most common alternative treatment in patients with renal failure in the world. Today, despite the support provided by healthcare providers for these patients, they still express dissatisfaction with the quality of care and find it inadequate. However, there have been few studies investigating the needs of in-patients receiving hemodialysis care in Iran. Thus this research was undertaken to study the needs and demands of such patients. Methods: This qualitative research was conducted from June to November 2016 to investigate the view points of the patients, their families and health care providers about improving quality of care in dialysis unit. At first, the sampling was based on a purposeful sampling method. A total of 35 participants (patients, their families and health care providers) were interviewed. The interviews were analyzed via Graneheim & Lundman qualitative content analysis. Results: Data analyses led to the production of 700 primary codes, 54 subcategories and 27 secondary categories out which 4 main categories of modification of physical stressors, requirement of support and the requirement of improved quality of Health Care service and improved facilities and equipment requirement. Conclusion: Planning for modification of physical stressors, improved support of patients, enhancing the quality of care services provided by the treatment team, upgrading the facilities and equipment and the adoption of an interdisciplinary approach are all believed to improve the care services among in-patients receiving hemodialysis treatment.

Aim To explore and analyse diabetes management challenges in the patients visiting a diabetes unit in Iran. Background Managing a chronic disease like diabetes needs the patients' follow‐up and coherent care delivery system. In fact, it requires a systematic and organised care delivery system with skilful and specialist team. Methods This qualitative research was conducted at a specialized poly‐clinic of Isfahan insurance organisation in 2016. The research participants were the members of clinic diabetes unit (physician, nurse, secretary, clinic director) and 21 type 2 diabetic patients of the clinic who were selected using purposeful sampling method. Data were collected by semi‐structured interviews and analysed using content analysis. Results The qualitative findings of this research were obtained in two main categories including the following: (a) weak care delivery system and (b) defective diabetes self‐care. Conclusions The results of this research have demonstrated that there are system‐centred and patient‐centred challenges in diabetes management, and they can affect the patients’ health outcomes. Implications for nursing management Since diabetes is one of the health system priorities, the findings of this study can be a warning for managers and policy makers to plan seriously to reform diabetes management system infrastructures.

Hospitalized children are often inadequately treated for their pain. Paediatric nurses experience these inadequacies more than other health-care team members. This research was an attempt in the form of a phenomenological study to reveal some major barriers in children pain management as the nurses had perceived. Sixteen nurses were interviewed in the medical, surgical and infectious paediatric wards of a hospital in Iran. Data analysis were based on Colaizzi method that surfaced three main themes in different areas namely: organizational barriers, limitations relating to child's characteristics and barriers relating to the nature of disease and its treatments. The study results have shown organizational limitations added to the lack of authority for administering some medical intervention, inadequate equipment and utilities and unavailability of opioids as the main pain controlling and restricting factors. Additional factors that relate to the child specifications like age, temperament, behaviour, expression and gender affect the assessment and treatment of pain. The results revealed identified barriers in real context. It seems that some guidelines are needed to achieve optimal pain management.