Table 2 Fieldwork phase results

Reduced maternal sensitivity

1. Decline of belief in good mothering ability

2. Doubts about the adequacy of the physical and mental capacity to take care of the child

3. Dual emotions of being able or enable to take care of the child

4. Mother's physical and emotional unavailability

5.Not responding to children's needs

Dissatisfaction with the condition of the children (in the early stages of illness)

Confusion about responding to the role expectations

The separation of child from mother due to the impatience caused by complications of treatment

Frequent referrals to follow up the disease

Impatience and the inability to love children

Lack of attention to details in care for child

Indifference to children's educational affairs

"The disease made me bored to do the children's affair, before my disease I was doing them enthusiastically, but now it seems like a wave is coming and it will disappear my strong sprit." (Participant 7)

"At the beginning of the illness, everything was meaningless for me. The joy of taking care of the kids and helping them to do their homework was not interesting for me." (Participant 5)

"At the early stages of illness, I was just thinking about myself, I had even forgotten my children, and I was unaware of what they ate, wore, and did at home." (Participant 4)

"I am injecting ampoules and I go to the clinic every three months to check on my condition. I am currently under the supervision of a doctor and immunotherapy. This morning I got up at 6 am, then I told my husband that I am tired of this illness and he tried to make me calm.” (Participant 2)

“My daughter used to tell me all that happened at school after she came back, but now my impatience has made her unable to talk to me much and she distanced herself from me."(Pparticipant 17)

"When I get lethargic and my physical problems overwhelm me, I can't tolerate anyone. After the illness, I didn't have the patience to love others as much as I used to, because I'm not in a good mood due to my illness." (Participant 14)

"The importance I assume to some of the details is lessened because of my physical weakness, I'm not obsessed with doing homework and taking care of my children. In past I used to paint and play with my children but now I don’t."( Participant 10)

The imbalance between roles

1. Simultaneously taking care of yourself and your child

2. The difficulty of coordinating self and child-care activities

3. Simultaneous roles with illness

Simultaneous role of illness and being employed

The responsibilities of a single parent living simultaneously with the disease

Responsibility of providing the expenses of a single parent family simultaneously with the illness

The multitude tasks of self and child-care with special circumstances

The duties of a woman as a mother and wife simultaneously with illness

Interference of disease follow up and care for children affairs

“I worked for patients of welfare state before my illness as a welfare worker, and I am still working for them, and this has made my responsibility much more." (Participant 20)

"Shortly after I separated from my husband, I became ill and took on the responsibility of a single-parent family, including expenses of my illness and my family, on the other hand, the burden of illness increased my workload." (Participant 17)

"My little son is mentally retarded and it takes a lot of time to look after him since I got sick and went to the doctor regularly, looking after my nutrition, medication and time management for doing my affair is very hard." (Participant 6)

"As a mother of two four- and five-year-old children, I have a lot to do for my children, like cleaning up, feeding and taking them to the kindergarten and etc. On the other hand, I have to take care of my husband, and when I get home from work, I don't want to be frustrated, but since I got this problem (breast cancer), my job and taking care of my family have involved me." (Participant 2)

"Every three month I have to go to the clinic to check my disease and between these intervals, if I have a problem, I will go to the doctor and this wastes my time and I can't make lunch for my children and husband." (Participant 6)

Role failure

1. Inefficiency in maternal role duties

2. Lack of quality in care for child

3. Failure in playing the role of education and socialization

4. Inability to protect the child

5. Inability to play a caring role

6. Inadequacy in mothering expectations as a good mothering

Decrease of ability to take care of children prior to illness

Not completing the works

Breaking down child care practices (children's school and recreation programs)

Wasting time of childcare that caused by follow-up treatments

Lack of interaction with children

Not accompanying children in social situations

Neglecting the nutrition and hygiene of children

Inability to regulate children and home affairs

"I go out with the passion to do what I need to do, but after a while my body gets tired and I feel unable to finish my work even for cleaning the children's bedroom ….” (Participant 9)

"The disease has ruined my previous way of life, the cancer has changed my life, I can't use my right hand to do things, because of surgery, I can't do the heavy work and I have to ask for help to do my work… I used to accompany my daughter to the door for going to school, but now I can't ….”(Participant 19)

"Getting involved with the illness and hospitalization for surgery and chemotherapy left me unaware of the kids and now I have to waste a lot of time for my disease follow up, because I go to another city for my treatments, so I don't have enough time to be with my children." (Participant 15)

"I can't talk to the kids calmly and without fear, and I am unable to provide the time they need to have a normal life. I haven't been able to talk to my kids much since I got sick. I do not have the patience to love the children because I'm not in mood as always due to my illness."(Participant 3)

"Sometimes I have a severe headache that I can't go out with my kids for fun or party too much and they complain about it. After my illness I can't spend enough time with my children." (Participant 8)

“The drugs I use have made me less energetic, and I can't cook good food for children. Sometimes my kids' affairs and my housework get messed up as if I have no more control over things.”( Participant 13)