Factors Influencing Childbearing Intentions in Young Couples Attending Premarital Counseling in Southeast Iran: A Conventional Content Analysis

Parenting concerns of young parents with cancer in China: A descriptive qualitative study.

BackgroundIn Iran, the total fertility rate is 1.8 and it is especially low in highly educated women. Also, there is a considerable difference between the ideal and realized fertility in this sub-population. Clear knowledge on the barriers to achieve the ideal family size is necessary to formulate policies.ObjectiveThe study aimed at explaining the barriers of childbearing in this sub-population.MethodsThis was a qualitative study using conventional content analysis. The study was conducted from April 2015 to January 2016 across the colleges of Kerman University of Medical Sciences in the southeast of Iran. The study population consisted of PhD students and faculty members who were studying and working in this university. We used semi-structured interviews to collect data. The sampling procedure was purposeful sampling and it continued until data saturation was achieved. Conventional content analysis was performed to analyze the gathered data.ResultsTwenty two participants took part, all of whom were married and half of whom were women. Eight of the participants were faculty members and the rest were PhD students. Two categories were extracted, including lake of enabling environment and personal preferences as the main barriers to childbearing in the highly educated subpopulation. Each of the categories included corresponding secondary and primary categories.ConclusionsDifferent factors affect childbearing decision making in highly educated people. Taking into account these barriers is important at the time of formulating pro-natalist policies.

ABSTRACTResearch on relationship education (RE) programs generally shows their effectiveness, but it is important to understand what the mechanisms of change are, how they occur within programs, and what participants experience. The purpose of this study was to explore couples' perceptions of the key components of their experience as participants of a Prep-based RE program. Research questions included: How do couples describe their experience of taking an 8-hour relationship education class? What elements had the biggest impact on their relationship? How has their relationship changed as a result of participation? Interview data from 39 married and cohabitating couples who participated in RE were analyzed using grounded theory methods. Six categories emerged from the analytic process, resulting in a model that provided explanatory detail of a typical RE program experience and its impact on the participants. These categories were: intentionality and awareness, context, relationship, workshop, impact (of RE), and couple interview. Couples described these categories as developing in a relatively chronological order, with Intentionality and Awareness being a central category that cut across the process and helped explain the impact of the program on the couple relationship. Implications for research, program development, and program facilitators providing RE are discussed.

To efficiently address the topics of research, influence, and reflexivity in qualitative research, we will investigate different vital aspects. This discussion will cover the role of the scholar, involving their biases, backgrounds, and beliefs, and how these aspects impact the research procedure. We will also investigate reflexivity, its significance in qualitative research, its definition, and its role in improving research trustworthiness and credibility. Ensuring transparency in the research process includes implementing systematic methods like peer debriefing, audit trails, and member checking. These methods expand the rigor and credibility of research outcomes and foster trustworthiness by including stakeholders, such as peers or respondents, in the critique and validation of the research procedure. By documenting decisions and actions as audit trails, validating interpretations as member checking, and seeking critical feedback from peers as peer debriefing, scholars can uphold ethical standards and contribute to advancing knowledge in their respective fields.

Evidence-Based Medical Education (EBME) is increasingly recognized as a key strategy for enhancing the quality and relevance of medical training. Despite its global endorsement, its implementation in many low- and middle-income countries (LMICs), including Iran, faces significant challenges. Highlighting the Iranian context is particularly important, as Iran represents a unique case of a rapidly expanding medical education system in a middle-income setting with distinct cultural and institutional dynamics. This study aimed to explore the factors that support or hinder the effective implementation of EBME in Iranian medical universities. This qualitative study employed a conventional content analysis approach and was conducted between January and May 2025 across five major academic medical centers in Iran (Tehran, Shiraz, Isfahan, Mashhad, and Iran Universities of Medical Sciences). A purposive sample of 25 participants, including medical educators, curriculum developers, academic leaders, national experts, and senior medical students, was selected to ensure diversity in perspective and role. Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman's content analysis framework. MAXQDA 2022 software supported data management and coding. Trustworthiness was ensured through member checking, audit trails, peer debriefing, and external validation. The analysis yielded eight main categories and 30 sub-categories representing barriers to EBME implementation, as well as eight main categories and 33 sub-categories as facilitators. Key barriers included insufficient faculty training, lack of institutional incentives, rigid curricula, cultural resistance, low student motivation, poor access to resources, absence of national policy guidelines, and misaligned assessment systems. For example, many faculty members lacked the necessary training to translate EBME principles into teaching practice, while students often demonstrated low motivation due to limited exposure to evidence-based approaches. Facilitators encompassed faculty competence and motivation, strong leadership support, innovative curriculum design, institutional and national-level professional development programs, active student engagement, improved access to educational technologies, supportive accreditation standards, and international collaboration. Illustratively, the presence of motivated faculty with prior EBME training and institutional support through professional development initiatives were repeatedly highlighted as drivers of successful adoption. The study highlights that effective EBME implementation in Iran requires a systemic approach addressing individual, institutional, and policy-level factors. Strategic investments in faculty development, curriculum reform, student engagement strategies, and the establishment of clear national policy frameworks, such as embedding EBME in accreditation standards and ensuring resource allocation, are essential for sustainable progress. The findings not only provide insights into the unique Iranian setting but also offer actionable strategies for practice and policy, particularly in strengthening EBME through faculty training, curriculum reform, and well-defined national guidelines.

Searching for health information is an important strategy in dealing with cancer that contributed to the improved management of cancer. This qualitative study aimed to explore the experiences of cancer patients seeking health information using the conventional content analysis approach. The 18 participants were selected by purposive sampling and data were collected through semi-structured in-depth interviews. Data were analyzed by software MaxQDA 10 based on conventional content analysis. Data analysis led to the emergence of three central categories, including "optimal cancer management," "poor information dissemination system," and "perceived health literacy." Knowing how cancer patients obtain health information can form the basis to promote patients' health literacy and design a health information dissemination system tailored to the patients' needs.

This study aimed to explore how athletes experience and perceive the use of artificial intelligence (AI) chatbots as a source of mental health support, focusing on effectiveness, usability, emotional connection, and limitations. A qualitative exploratory design was employed. Twenty-two athletes from diverse sports disciplines in Malaysia were recruited using purposive sampling. Data were collected through semi-structured, in-depth interviews conducted online to allow flexible participation and confidentiality. The sample size was guided by theoretical saturation, reached when no new themes emerged. All interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. NVivo 14 software supported systematic coding, with open, axial, and selective coding applied iteratively to generate categories and subthemes. Rigor and trustworthiness were ensured through member checking, peer debriefing, and an audit trail. Four main themes emerged: perceived effectiveness of AI chatbots, usability and interaction experience, emotional and relational dynamics, and barriers and limitations. Athletes reported improved mental well-being, reduced competition-related anxiety, and personalized coping strategies. They valued intuitive interfaces, empathetic conversational style, and privacy features, which encouraged engagement and disclosure. Chatbots fostered a sense of trust and emotional validation but sometimes lacked depth and produced repetitive responses. Barriers included occasional technical instability, insufficient long-term personalization, cultural mismatches, and data security concerns. Despite these limitations, participants viewed chatbots as valuable early support tools and stigma-free entry points to mental health care. AI chatbots show promise in enhancing access to psychological support for athletes, offering discreet, immediate, and personalized assistance. However, improving cultural sensitivity, personalization, technical reliability, and data transparency is crucial for sustained engagement and safety in sports mental health contexts.

Background: Considering the high goals of an organization, one of the most important tasks of organizations is to motivate employees as the strategic assets of the organization. The phenomenon of organizational insentience has been one of the main challenges in recent years and refers to a situation in which employees of the organization are not motivated toward their organizational environment. Accordingly, the present study aims to develop the scale of organizational insentience in the Red Crescent Society of the Islamic Republic of Iran.
 Methods: The present study was conducted through a mixed method in 2022. The qualitative part has been done using the grounded theory approach and based on semi-structured and in-depth interviews with 21 experts selected through purposive and snowball samplings. Furthermore, the quantitative part has been done by the structural equations modeling with partial least squares approach and Smart PLS3 software. The statistical population of the research in the quantitative part included all the executives (110 people) of the Tehran Red Crescent Organization. With a random sampling method based on Cochran formula, 85 people were selected, and for further confidence and reducing the sampling error, 90 individuals were selected for the sample. To collect data in a quantitative part, the researcher-made questionnaire regarding organizational insentience derived from the research model was used. It included 34 items in the form of a 5-point Likert scale. The reliability of the questionnaire was assessed through Cronbach's alpha coefficient, and combined reliability and validity were assessed through the construct validity method, both of which were confirmed based on the results.
 Results: In the qualitative part, after 3 stages of open, central and selective coding, the research model including 6 main categories (central category; causal, intervening, and background conditions; strategies and consequences of organizational insentience) and 29 sub-categories were presented. The results of the quantitative part showed that causal conditions with a significant value of (0.001) and path coefficient of (0.725) had a significant and positive effect on the central category, and intervening conditions with a significant value of (0.003) and path coefficient of (0.221), background conditions with a significant value of (0.002) and path coefficient of (0.410) and central category with a significant value of (0.023) and path coefficient of (0.334) had a positive and significant effect on strategies. Moreover, strategies with a significant value of (0.001) and path coefficient of (0.347) had a positive and significant effect on the individual and organizational consequences of insentience in Tehran Red Crescent population.
 Conclusion: The results demonstrated that the model presented in this study was a suitable model for knowledge and awareness of managers in the field of concepts and categories affecting organizational insentience. Therefore, it is recommended that the managers of the Red Crescent Society use the model presented in this study to minimize the phenomenon of organizational insentience and increase employees' productivity.

In recent years, the possibility for healthy women to consider or undertake oocyte freezing for non-medical reasons (OFNMR) allows women who want to have biological children, to enable motherhood at a later time, while protecting against age-related fertility decline. The present study explored the intended OFNMR among healthy Israeli women by looking at the interplay of age, childbearing intention and general self-efficacy – a personal resource. Two hundred fifty-one Israeli women were recruited through social networks and online forums related to women’s issues in general. Participants completed self-report questionnaires addressing socio-demographic data, childbearing intention, general self-efficacy, and OFNMR intention. The results revealed that the association between women’s age and OFNMR intention was insignificant. However, childbearing intention moderated the association between women’s age and OFNMR intention. Specifically, the association between age and OFNMR intention was positive and significant for women with childbearing intention while for women without childbearing intention, it was negative and significant. General self-efficacy was not found to be associated with OFNMR intention. The current study shed light on the role of childbearing intention in the context of fertility decisions, especially among women who verbalize their intention for OFNMR. Routine discussion between health-care professionals and women regarding childbearing intentions is recommended, especially with women nearing age-related decline in fertility

Background and aims: The consequences of health development with the exercise approach affect the 4 dimensions of physical, mental, economic, and social health. The aim of this study was to present a comprehensive model to determine the contributing factors, strategies, and outcomes of sport-based health development (SBHD). Methods: This qualitative study was conducted through the grounded theory approach. Data were collected through interviews with 24 experts and authorities in health, sports, and health development who were selected through purposive and snowball sampling. Open, axial, and selective coding were used for data analysis. Trustworthiness was ensured through member checking and peer debriefing. Results: Four hundred codes were drawn during open coding and were grouped into 127 subcategories during axial coding and nineteen main categories during selective coding. The nineteen categories were assigned to the five main dimensions of the paradigm model of grounded theory. The causal conditions of SBHD were personal, cultural, and social factors; its contextual conditions were attitudinal and attitudinal factors, media, planning, and legal factors; and its intervening conditions were environmental, infrastructural, interactional, and managerial factors. Its strategies were infrastructural development, attitudinal development, technical development, and support programs and its outcomes were improvement of physical health, financial development, social development, and improvement of mental health. Conclusion: Health and sport managers and authorities need to provide an appropriate context to facilitate engagement in sports among all individuals.

Prospects for Fertility Decline in Africa

IntroductionEnhancing health system preparedness requires the design, implementation, and evaluation of disaster exercises. Conducting these exercises improves preparedness planning and promotes staff awareness and capabilities in responding to emergencies and disasters. Given the existing challenges in designing and executing disaster exercises within the health sector, this study aims to identify the main challenges and barriers to the successful management of health sector disaster exercises.MethodThis study was a conventional qualitative content analysis. Data were collected through purposive sampling through in-depth, semi-structured individual interviews with 23 managers from various health sectors. Graneheim and Lundman’s conventional content analysis was employed to analyze the data, and Lincoln and Guba’s recommendations were utilized to ensure the trustworthiness of the data.ResultA total of 170 challenges (initial codes), organized into one them, five main categories and 15 subcategories, emerged after several rounds of data analysis and summarization, considering both similarities and differences. These main categories included “Organizational management”, “structural and administrative system”, “Ineffective policymaking”, “Cultural sensitivity and social participation”, and “organizing exercise steps”.ConclusionUnderstanding the obstacles and challenges in implementing discussion-based and operations-based exercises in emergencies and disasters derived from the experiences of exercise implementers in the health system can help health planners and managers proactively address these obstacles and by considering these challenges and striving to reduce them before designing an exercise they can maintain and improve preparedness of their community’s healthcare system through the implementation of successful and effective exercises.

BackgroundGiven the high-stakes environment of intensive care units, understanding how nurses navigate moral challenges and engage in ethical decision-making is critical for maintaining patient safety and care quality. One important process in this field is moral disengagement, which is growing in the nursing literature. However, there is a lack of foundational and qualitative studies addressing this issue. This study presents a qualitative content analysis aimed at exploring moral disengagement among nurses working in intensive care units.MethodThis qualitative study employed conventional content analysis from June to December 2024 in Tehran, Iran. Purposive sampling was used to recruit participants. Data were collected using in-depth, unstructured interviews at the beginning, followed by semi-structured interviews. Sampling continued until data saturation was reached, resulting in 30 interviews with 25 eligible intensive care unit nurses. The conventional qualitative content analysis approach developed by Graneheim and Lundman was employed.ResultsThree main categories with eight subcategories were identified from the initial 765 codes. The findings revealed three main categories: “cognitive justification of unethical behavior,” “protective strategies for personal security,” and “normalization of unconventional practices.” These categories include subcategories such as “externalization of responsibility,” “moral-cognitive justification,” “positive reframing of the event,” “preservation of job position and security,” “psychological stabilization,” “strategic violation of regulations for survival,” “reduction of emotional and psychological pressure,” and “protective framing of behavior.”ConclusionThis study reveals various aspects of moral disengagement among critical care nurses, which can pave the way for future studies to better understand the phenomenon, its related factors, and help with the development of preventive measures.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12910-025-01282-6.

Fertility and aging: do reproductive-aged Canadian women know what they need to know?

Because it deals with qualitative information, portfolio assessment inevitably involves some degree of subjectivity. The use of stricter assessment criteria or more structured and prescribed content would improve interrater reliability, but would obliterate the essence of portfolio assessment in terms of flexibility, personal orientation and authenticity. We resolved this dilemma by using qualitative research criteria as opposed to reliability in the evaluation of portfolio assessment. METHODOLOGY/RESEARCH DESIGN: Five qualitative research strategies were used to achieve credibility and dependability of assessment: triangulation, prolonged engagement, member checking, audit trail and dependability audit. Mentors read portfolios at least twice during the year, providing feedback and guidance (prolonged engagement). Their recommendation for the end-of-year grade was discussed with the student (member checking) and submitted to a member of the portfolio committee. Information from different sources was combined (triangulation). Portfolios causing persistent disagreement were submitted to the full portfolio assessment committee. Quality assurance procedures with external auditors were used (dependability audit) and the assessment process was thoroughly documented (audit trail). A total of 233 portfolios were assessed. Students and mentors disagreed on 7 (3%) portfolios and 9 portfolios were submitted to the full committee. The final decision on 29 (12%) portfolios differed from the mentor's recommendation. We think we have devised an assessment procedure that safeguards the characteristics of portfolio assessment, with credibility and dependability of assessment built into the judgement procedure. Further support for credibility and dependability might be sought by means of a study involving different assessment committees.