Document Type : Original Article


1 Department of Medical Surgical Nursing, Nursing and Midwifery Research Center, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery

3 Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan


Background: Multiple sclerosis (MS) is a chronic disease prevalent in young and middle‑aged
people. Patients with MS often have numerous complicated needs and, consequently, require
a broad range of health services. Results of a number of studies indicate that patients’ needs
are only partially met. Aims: This study was conducted to explore the challenges of healthcare
delivery to patients with MS in Iran. Materials and Methods: In this qualitative case study,
43 participants selected through purposeful sampling were interviewed using semi‑structured
method in the cities of Isfahan and Tehran in 2012–2013. Besides the interview, documentations
relevant to healthcare delivery were collected from different sources, including websites of
all Iranian universities of medical sciences, insurance organizations, patients’ weblogs, news
agencies, the MS Center forum for MS patients, and MS Payam bimonthly. The data were
analyzed through the constant comparative analysis. Results: The data were categorized
into four main categories, including functional challenges (diagnosis problems, failure to
pay attention to patient needs, failure to follow‑up, and miscommunication), administrative
challenges (resource allocation and supervision), policy‑making challenges (lack of
comprehensive services, bureaucracy, and problems in provision of medications), and structural
challenges (difficult access to services, lack of comprehensive centers, space limit, and long
wait). Conclusion: Despite all attempts of governmental and nongovernmental organizations
for healthcare delivery to MS patients, these services cannot satisfy all needs of the patients.
In this regard, service providers and administrators should pay more attention to the needs
and expectations of patients and their families.


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