Title: Study of the process of improving the quality of family life of women with MS in Tehran

Abstract: 

This study has been conducted with the purpose of analyzing the life quality of women with Multiple Sclerosis (MS) in Iran through the approach of grounded theory. To this end, a number of 13 women with MS who had referred to Sina Hospital in Tehran during the first half of the years 1397-1388 were selected by theoretical sampling method. Data were collected through semi-structured interviews. Additionally, other tools such as unstructured observation, informal interview, field note, document review, and memo writing were used. Data collection was conducted continuously until ensuring data saturation. In this study, the relationships between the main categories were identified by conditional relationship guide. The relationships between these processes for the development of the central category were identified by Reflective Coding Matrix. Based on interactions and relationship between main categories,6 process developed.  The processes based on time of events respectively were: investigating and find treatment, changing in perceived dignity struggling to maintain or regain, searching for the support and supporting, efforts to achieve favorable stability and retrieving means of dignity. The context of study was social determinants factors and included five major categories: patients’ family’s wisdom, care workers’ wisdom. These three major categories were named as personal determinants.   The core category of this theory was reset and frequent objectives. 

Multiple sclerosis is a chronic autoimmune disease of the central nervous system that usually occurs between the ages of 20 and 40 and affects women more than men (McRoss et al., 2003: 144-145). Several studies show that the significant decrease in the quality of life in these patients compared to other chronic diseases is caused by the inability to perform daily life activities (Sengalchi et al., 2012: 203).
Although according to the statistics recorded in the World Health Organization (2008), the global average of this disease is between 5 and 30 per hundred thousand people. The most important goal of this study is to identify the dimensions affecting the quality of life of women with MS, hence the research questions are:How does MS disease affect the quality of family life of affected women?

In a study conducted by Rafati et al. (2018) in Mashhad city, attention was paid to the effect of anxiety, depression and tension in the family relationships of patients with MS. In this study, it has been stated that the most important factors contributing to the dissatisfaction of MS patients are misdiagnosis caused by lack of accuracy, feelings of inferiority and annoyance. In this study, the knowledge of the health staff is reported to be the most important factor in increasing satisfaction and reducing tension and anxiety in patients' family relationships. Paying attention to important issues such as authority, independence, respect for patients' privacy not only directly affects the treatment process but also the satisfaction of the patient's family.

This qualitative study was conducted with the aim of analyzing the quality of life of 13 women with MS. To start this qualitative research and understand the quality of family life of these patients, purpose-based sampling was first used. Sampling and data collection continued at the same time as their analysis, and according to the results of data analysis of previous interviews and other sources of subsequent participants, as well as the questions that should be asked in the interviews. Later, they would be asked, it would be determined. In fact, with the progress of the study, theoretical sampling was used and continued until theoretical saturation was reached.