Data Saturation Research Articles

Factors influencing spousal support for women with perinatal depression in seeking formal assistance: a qualitative study

ObjectiveSeeking formal help can significantly improve the outcomes of perinatal depression (PND). However, currently, women with PND are not consistently seeking formal help. Research indicated that spouses played a crucial role in helping women recognize PND and encouraging them to seek formal help. This study aimed to explore the factors that prevent spouses from supporting women with PND in seeking formal help, based on the Knowledge-Attitude-Practice (KAP) theory.MethodsThis is a qualitative study, utilizing semi-structured interviews to explore the factors that influence spouses to support women with PND to seek formal help. The interviews were conducted at a tertiary hospital in Shanghai, China from September 2023 to October 2023. Purposive sampling was used, and the sample size was determined by data saturation. Data analysis was conducted using Colaizzi’s seven-step method.ResultsTwelve spouses had a mean age of 34.92 years (SD 5.81); n = 7 (58.33%) were new fathers. The influencing factors identified in this study can be explained by KAP theory, ultimately three major themes and six sub-themes emerged: (1) individual knowledge factors: lack of proper recognition of PND, (2) individual attitude factors: negative attitude toward PND screening and treatment and (3) service provider factors: imbalance between supply and demand for perinatal mental health services.ConclusionSpouses who lacked supportive behavior were influenced by individual factors, including knowledge factors and attitude factors, as well as service provider factors. These identified factors can guide future research and the development of interventions to improve perinatal mental health services and encourage family support in seeking formal help.

Learning from the best: How medical-students construct role models in general practice during the COVID-19 pandemic and what factors influence this process, a qualitative study.

Background Role-modelling has been found to strongly influence speciality choice for medical students either positively or negatively. There is a deficit in recruitment toward general practice, set to exacerbate the shortfall in GP numbers over the coming decade in the face of spiralling demand. In medical school, students acquire knowledge, skills and start to form their professional identity by observation and interaction with medical educators through the process of role-modelling. Given the significance of this process, the present study attempted to explore the “lived experience” of medical students encountering potential role models during their GP placement using a qualitative method. Methods Following a design based upon the principles of Grounded Theory 10 qualitative interviews were conducted with third-year medical student volunteers at Warwick Medical School. Interviews were recorded, transcribed and analysed using theoretical axial coding demonstrating data saturation in key themes. Results Analysis of data gave insights regarding student perception of positive and negative role modelling in three corresponding domains: Personal Attributes, Student Relationship and Patient Relationships. Conclusions The findings offer unique insights into the influence and impact of GP role-modelling on medical student’s experiences and perceptions during a time of the Covid-19 pandemic and the immediate post-pandemic period and add to the wider body of literature by exploring the influences GP role-modelling has on medical student training experience. The findings support easily implementable recommendations to strengthen positive role modelling in the GP medical student placement context.

Coping with cancer pain: a qualitative study to explore pain perception and self-coping strategies of patients with cancer in Sri Lanka

Pain is one of the most debilitating symptoms of cancer, substantially diminishing one’s quality of life. The level of pain experienced is eventually determined by the pain coping strategies adopted...

Examining dimensions of career intentions: insights from medical and nursing students at a private not-for profit university in Vietnam.

Understanding students' career intentions through evidence-based approaches is crucial for developing effective career guidance and intervention strategies. Although there has been considerable attention in this field, research remains limited, particularly in low- and middle-income countries (LMICs) in Asia. These regions have unique socioeconomic conditions and cultural norms that potentially shape decision-making processes. This study provides insights into the career intentions of medical and nursing students and identifies the key determinants influencing their choices at a newly established private institution (VinUniversity) in Vietnam. This study employs a mixed-methods design. The quantitative phase involved a survey of all undergraduate medical and nursing students. The qualitative phase consisted of in-depth 11 individual interviews with a purposive sample until data saturation. A total of 198 students (77%) participated in the quantitative phase. The majority of students (75.8%) expressed interest in clinical practice, with preferences notably high for surgical specialties (30.9%), internal medicine (10.1%), and pediatrics (10.1%). 22.7% of students expressed a desire to work overseas, and a significant number (70.7%) indicated the lack of a career guidance program. Qualitative data revealed that personal interest, family influence, financial stability, and societal appreciation were primary influencers in career choice. The study underscores the complex interplay between personal interests, family influence, financial considerations, and societal expectations in shaping career choices. The persistent low interest in family medicine and primary care continued to be a concern. This study provides further insights into the career intentions and influencing factors among medical and nursing students at VinUniversity. The implications for practice include implementing tailored career guidance programs, offering diverse elective tracks that incorporate global health experiences, and establishing structured mentorship programs. It is also recommended to measure the impact of these interventions through longitudinal follow-up studies to enhance career satisfaction, better prepare future healthcare professionals, and contribute to the improvement of healthcare systems.

Mother's Experience of Caring for Children with Stunting in the Riverside of Banjar Regency

Introduction: Stunting is one of the most common impacts of chronic malnutrition in the world. Banjar Regency is one of the regencies in South Kalimantan that has experienced a significant increase in stunting cases. Mothers often act as the primary caregivers of children, thus all actions taken by mothers related to care including fulfilling nutritional needs can affect the health and nutritional status of their children. It is important for a mother to have good knowledge about fulfilling nutrition for children, fulfilling immunizations, maintaining sanitation and treating infectious diseases in children. One way to gain knowledge is from experience. Mothers with stunted children have experiences that can be lessons regarding the actions taken during treatment, the obstacles felt and how to prevent stunting in the next generation. Objective: This study aims to explore the experiences of mothers in caring for children with stunting in the riverside of ??Banjar Regency. Method: A qualitative approach with a phenomenological design was used in this study. Data were collected using the in-depth interview method and analyzed using the sequence: transcribing, categorizing, using N-Vivo 12. The population in this study were all mothers who had stunted children in the riverside of ??Banjar Regency. In this study, mothers who became participants were selected using a purposive sampling method, namely data was taken from information from health center officers in Banjar Regency with inclusion criteria having experience caring for children with stunting, being able to communicate well and being willing to be participants. Data saturation was obtained on the 16th participant. Result: The results of this study identified 5 themes, namely children's eating habits, children's conditions, mothers' efforts, mothers' difficulties and the role of fathers. Children's eating habits include incomplete menus, eating little, eating irregularly, eating without side dishes, and snacks before eating. The condition of stunted children in this study was slow development, frequent illness, and poor sleep quality. Mother’s efforts were to provide exclusive breastfeeding and routinely go to posyandu. The difficulties faced by mothers were difficulty in accessing health facilities, economic problems, children who did not want to be separated from their mothers, confusion in handling stunting and the presence of a closed mouth movement in children. The role of fathers included collaborating with mothers in parenting and being less involved in parenting. Conclusion: The conclusion obtained in this study was that 5 themes were obtained from the experience of mothers in caring for children with stunting in the riverside of Banjar Regency.

Nursing students' experiences of professional competence evaluation by Objective Structured Clinical examination method: a qualitative content analysis study.

Clinical education is a significant part of medical education, and paying attention to clinical evaluation is important. One of the challenges in the teaching-learning process is evaluating students' performance. Learners, as the main stakeholders of the educational system, may have different experiences of evaluation quality. Awareness of these experiences is effective in improving the quality of clinical evaluation. Therefore, this study was conducted to "explore the experiences of nursing students for evaluation of professional competence by using the objective structured clinical examination (OSCE)". This study was conducted with a qualitative descriptive research approach and conventional content analysis method in 2022-2024. The participants included 12 undergraduate nursing students at Maragheh University of Medical Sciences, who were selected by purposeful sampling, and their experiences were collected using semi-structured and in-depth interviews until reaching data saturation. The data analysis of the interviews led to the extraction of 268 primary codes, 7 subcategories, 2 categories, and 1 theme: "Credibility and stability". The category "Exam's accuracy in measuring competence " included 3 sub-categories: "Challenges in objective adaptation ", " Communication and organizational challenges for exam preparation " and " Inadequate simulation of stations and exam environment ", and the category " Exam power for repeatability" included 4 sub-categories: " Characteristics of the students ", " Lack of evaluators' skills and mastery ", " Inefficiency of the evaluation tool " and " Disturbance in executive affairs". OSCE can be used in self-evaluation, creating motivation and strengthening different dimensions of students' learning, as well as discovering weaknesses and strengths for planning by managers and faculties. According to the results of this study, many factors such as management before and during the exam, characteristics of the evaluators, prevailing educational conditions in the faculty, and the method of clinical training are effective in achieving the "reliability and sustainability" required in the OSCE.

Exploring the experiences of medical students regarding the factors affecting academic achievement: a qualitative study.

Academic achievement is one of the most important criteria in assessing students' ability to complete their university studies and reach the graduation stage. Students in medical sciences are considered the primary recipients of educational services and are the best source for identifying problems in medical or clinical education, as they are directly and indirectly involved in this interaction process. This study was conducted in the years 2022-2023 using conventional content analysis at Tabriz University of Medical Sciences. A total of 23 students from various faculties of this university were selected through purposive sampling, and their experiences and perspectives were utilized until data saturation was reached. Data was collected through semi-structured, in-depth individual interviews using an interview guide. Content analysis was performed using the conventional content analysis method. Two main themes were extracted with the titles "Facilitators of Academic Achievement" and "Barriers to Academic Achievement ". "Teacher-related Factors," "Assessment and Evaluation," "Student-related Factors," "Learning Environment," and "Support Systems" were the categories derived from the analysis of the data for academic achievement, and "Poor Educational Quality and Teaching Methods," "Lack of Interdisciplinary Collaboration and Integration," "Inappropriate Educational Planning and Administration," "Communication Issues," and "Contextual barriers," were the categories derived for "Barriers to Academic achievement" based on 238 codes and 36 subcategories. Since factors such as satisfaction with educational and welfare facilities and academic motivation impact the quality of education, examining these variables from students' perspectives is beneficial for formulating regulations, providing appropriate facilities, planning for the training of capable students, and selecting suitable educational and learning processes.

Unveiling the roadblocks: exploring substance use disorder treatment policies in Iran through a qualitative lens.

Different countries, including Iran, have implemented various policies to address substance use disorder. This study aims to describe the policies related to substance use disorder treatment and identify challenges related to these policies in Iran since the beginning of the Iranian Revolution in 1979. This qualitative study utilized document analysis and interviews with policymakers and implementers. We reviewed a total of 22 documents related to substance use disorder treatment and harm reduction. The results from document analysis complemented and validated the interview data. The research population comprised policymakers and implementers, including individuals directly involved in formulating and implementing substance use disorder treatment policies. Purposive sampling was employed, with a snowball strategy utilized to maximize diversity. Data saturation was achieved after conducting 32 semi-structured interviews. Conventional content analysis was used for data analysis. In general, the policy landscape for substance use disorder treatment in the Islamic Republic of Iran can be divided into two periods: the "Moral Model" era (1979-1993) and the "Disease Model" era (1993-present). Challenges within the content of substance use disorder treatment policies in Iran encompass the lack of law revisions, existence of contradictions in laws and nature of disease, the absence of evidence-based policymaking, and an inadequate comprehensive perspective on the phenomenon of substance use disorder. The presence of multiple authorities with different perspectives on substance use disorder and its treatment, coupled with the application of personal preferences in policymaking and the absence of evidence-based policymaking, have contributed to weaknesses in decision-making and policy formulation. The true philosophy of Disease Model appears not to have been fully grasped by health policymakers in Iran, as all Disease Model policies have been pursued with an emphasis on abstinence and quitting. Iran and other nations facing similar challenges should place more reliance on evidence-based approaches and shift away from the "Moral Model" paradigm to develop more effective substance use disorder treatment policies.

Parents' experiences of their children's obesity management at the children's hospital on Reunion Island.

Parents' perspectives on their child's obesity (BMI >IOTF-30) management are essential to ensure positive outcomes. This study explored parents' experiences in managing their children's obesity and investigated the sociocultural and environmental factors influencing such management on Reunion Island, a French overseas department in the Indian Ocean. This qualitative study used a general inductive analysis approach. Semi-structured telephone interviews were conducted from France, between January and April 2019, with nine parents of children treated in the Childhood Obesity Unit of the Children's Hospital on Reunion Island. The interviews were analysed by using thematic analysis until data saturation. Four main themes emerged reflecting the stages of parents' experiences during treatment: a life history with feelings of justification and guilt, acceptance, involvement and activism. Cultural food traditions were a barrier to implementing healthier habits. Support and advice from the healthcare services alleviated feelings of isolation and motivated parents to be more proactive in their children's obesity management. Parents' involvement motivated their children and improved their relationships. Parent's involvement is essential in managing children's obesity. To maximise treatment outcomes, tailored interventions that address parents' unique family dynamics and sociocultural perspectives are key.

Rapid Transition to Virtual Learning in Postgraduate Medical Education during the COVID-19 Pandemic in Tanzania: A Qualitative Study.

The effect of the progressive utilization of virtual learning (VL) in postgraduate medical education (PGME) is contentious. During the COVID-19 pandemic, VL was up-scaled to bridge the education delivery gap. How this impacted learning experiences in PGME is an area that needs to be explored for the progressive context-specific application of VL. This phenomenological study aimed to explore the postgraduate medical faculty's and residents' experiences with the rapid shift to VL. Through an interpretivist paradigm, this study used in-depth individual semi-structured interviews and prompts to explore the full breadth of the participants' experiences. A purposive sampling method was used, and qualitative content analysis was employed in an iterative process until data saturation. Data was collected between January 2021 and July 2021. Member checking was done to ensure validity. The AKU-ERC granted ethical approval, with reference AKU/2020/098/fb. Ten participants were recruited for the study. Positive experiences were greater access to learning materials and improved learner confidence. In contrast, limited supervision, and lack of assurance of participants' engagement emerged as a negative VL experience. The components of critical thinking and problem-solving skills were unaffected by virtual case-based learning. However, the aspects of acquiring clinical and surgical skills emerged as a difficulty in accepting VL as a valid mode for attaining these competencies. To improve experiences of VL, participants' drive, engagement, technological inadequacies, and instructional design should be optimized.

Experiences of treating problematic over the counter and prescription only medication use in substance misuse services

Abstract Introduction There are growing concerns about the misuse of over the counter (OTC) and prescription only medication (POM), due to the associated negative socioeconomic and health implications1. To improve care delivery, stigma needs to be addressed and more needs to be known about the perspectives of staff who are working in substance misuse services (SMS)2. Aims To use confidential semi-structured interviews, to explore the experiences of community English SMS staff who have supported adults that have misused OTC/POM. Methods This research was conducted across five community adult English SMS operated by a national treatment provider. Individuals were eligible for participating in semi-structured interviews if they had current experience of working in a community SMS role which involved supporting adults who had misused OTC/POM, were at least 18 years of age and provided informed consent. Potential participants self-identified as being eligible and interested in being included, after receiving the participant information sheet. The interviews explored their experience of working in SMS and supporting people who have misused OTC/POM, and potential changes to current SMS provision. Thematic analysis of the audio-recording transcripts was undertaken using NVivo®. This research was funded by a Research Award from Pharmacy Research UK and the College of Mental Health Pharmacy [PRUK_CMHP-2019-2-RG]. This research was approved by Humankind/EDP and Aston University’s Life and Health Sciences Ethics Committees (ID#1655). Results Organising interviews was challenging due to pandemic-related work pressures, between October 2020 and January 2021. Thematic analyses of twenty SMS staff transcripts was undertaken and data saturation was thought to have been achieved. Three overarching themes were identified: characteristics of OTC/POM misuse; different groups of people; and negative experiences (with six sub-themes: lack of awareness of risk of harm; unmanaged health conditions; withdrawal symptoms; side-effects; problematic behaviours; and treatment pathways). Oral dependent use of opioids (especially codeine products), benzodiazepines and gabapentinoids predominated. Polypharmacy and the use of other substances sometimes occurred. OTC/POM misuse was associated with a wide range of adverse socioeconomic, physical, and psychological effects. Unmanaged withdrawal symptoms caused concern, contributed to perpetuating misuse, and sudden cessation in supplies created risks. Discussion and Conclusion This study had a unique focus on the experiences of third sector English SMS staff. OTC/POM misuse (and withdrawal symptoms) should be routinely enquired about during healthcare reviews, and tailored harm reduction, pharmacological and psychosocial interventions offered. Increased awareness, vigilance for associated safeguarding issues, and more training is required. SMS should sensitively consider how to incorporate the views of staff with lived experience to further optimise service delivery co-production. As staff were all employed by the same SMS provider, future research, conducted in SMS operated by other providers, and covering a wider geography, may enable more information to be shared, more participants to be recruited, and the results more generalisable. Repeat interviews and member-checking may improve assurance in the findings. The possible need for different SMS for those who only misuse OTC/POM without exacerbating stigma requires further exploration. Future research should identify if demographic characteristics and treatment needs differ by OTC/POM type.

Emergency Verbal Consent for Intrapartum Research: A Grounded Theory Study.

To understand the experiences of women, birth partners and health professionals of verbal followed by retrospective written consent in a prospective cohort study of a device to manage postpartum haemorrhage (PPH). Grounded Theory. Tertiary facility in North-West England, UK. We used purposive and theoretical sampling to recruit 51 participants; 12 women, 12 birth partners, 16 obstetricians and 11 midwives. Semi-structured interviews were conducted, using a topic guide for focus, until data saturation was achieved. Data were analysed using framework analysis technique. Most women wanted sufficient information to make a decision at the time of the event, rather than in advance, and preferred not to be overwhelmed with detail. A key factor in making the decision to participate was a positive and trusting relationship with the attending obstetrician. Obtaining consent for research in emergencies was viewed by obstetricians as requiring a different approach and more challenging than consent for standard procedures in an emergency. This is one of the first studies to explore verbal followed by retrospective written consent processes with women, clinicians and observers. This was acceptable to all, however information needs to be appropriate, and those discussing consent require adequate training (199/200).

Exploring challenges and enablers for community pharmacists using electronic prescriptions (Wasfaty) in Makkah region, Saudi Arabia: a qualitative study using the theoretical domains framework

BackgroundTransition to electronic prescribing (e-prescribing) systems, such as Wasfaty, represents a significant advancement in healthcare. Introduced by the Saudi Arabian Ministry of Health in 2019, Wasfaty aims to enhance medication availability and streamline healthcare delivery. This study explores the challenges and enablers community pharmacists face when using the Wasfaty system in Saudi Arabia. This study uses the Theoretical Domains Framework (TDF) to analyse behavioural and contextual factors influencing pharmacists’ adoption of electronic prescriptions. TDF identifies key challenges and enablers across multiple behavioural domains, making it well-suited for understanding complex healthcare implementation processes.MethodsA qualitative study design was employed using the Theoretical Domains Framework (TDF) to understand factors affecting Wasfaty use. Participants were purposively sampled, focusing on community pharmacists experienced with Wasfaty prescriptions. Recruitment and interviews occurred from June to August 2024. Data saturation was achieved at 18 interviews. Transcripts were coded and mapped into TDF domains to identify barriers and enablers.ResultsFive key TDF domains influenced Wasfaty use: environmental context and resources; social influences; beliefs about capabilities; social/professional role and identity; and knowledge. Challenges included high prescription volumes, medication shortages, technical difficulties, resistance from elderly patients, and inconsistent training. Some pharmacists reported inadequate training as a barrier, while others highlighted effective programs as enablers.ConclusionSignificant barriers, such as insufficient training and high prescription volumes, impede effective Wasfaty use. However, continuous training, prior experience with electronic systems, and organisational support were crucial enablers. Addressing these challenges through targeted interventions can enhance e-prescription efficiency, improving patient care and outcomes. Findings underscore the importance of ongoing professional development and supportive work environments in fostering pharmacists’ competence in electronic systems.

Data saturation in qualitative research: A literature review in entrepreneurship study from 2004–2024

This systematic literature review examines data saturation in qualitative research within the context of entrepreneurship studies from 2004 to 2024. Data saturation, a critical concept in ensuring the rigor of qualitative research, remains inadequately defined in terms of sample size and assessment criteria across various studies. This review synthesizes 11 empirical studies, focusing on strategies such as stopping criterion, code frequency counts, and comparative methods for determining saturation. It identifies sample sizes ranging from 7 to 39 interviews, with an average saturation occurring between 10 and 12 interviews. Furthermore, the study explores the influence of different sampling methods and homogeneity of study populations on saturation outcomes. Despite the reliability of existing methods, the findings underscore the need for greater transparency and consistency in reporting saturation criteria. The review offers valuable insights for entrepreneurial researchers aiming to design qualitative studies, emphasizing the importance of tailored saturation standards based on research objectives and methodologies. This research contributes to a clearer understanding of data saturation in entrepreneurial studies and highlights the necessity for further empirical investigation into saturation across diverse qualitative methods.

Self protective health care in childhood cancer survivors from the perspective of survivors, parents, and professionals: a qualitative study

IntroductionChildhood cancer survivors experience many health problems that they must protect themselves from their destructive physical and psychological effects. Understanding experiences of children about self-protective care will help health care providers manage long-term care plans. Therefore, this study was conducted with the aim of exploring self-protection care in childhood cancer survivors.MethodsThis is a phenomenological study that was conducted in the clinics and cancer care centers of Urmia and Khoy in Iran. 27 participants were selected by purposive sampling until data saturation. The data was collected using a semi-structured and in-depth face to face interview. Content analysis approach used for data analysis and MAXQUDA 10 software used for data management.ResultsData analysis led to the emergence of “self-protection health care” as a main category, two categories “maintaining physical health” and “keeping a strong mindset” and 9 sub-categories including “abstain activities that may cause harm”, “refusing contact with others for possible infection”, “monitoring symptoms and side-effects of cancer coming back”, “avoiding unhealthy diet”, “knowing about cancer from similar others”, “keep away negative thoughts and emotions”, “drawing on spiritual resources”, “creating a bridge to life again” and “being healthy for the sake of one’s family”.ConclusionAccording to the results of this study, self-protection is one of the most important cares for childhood cancer survivors. Over time, the influence of the clinical team and parents on children’s health care diminishes. Therefore, they should promote their health and well-being behaviors and use a variety of protective approaches to self-care.

Role of traditional healers in the management of microbial keratitis in eastern Nepal.

Microbial Keratitis (MK) is a leading cause of corneal blindness due to infection and its consequences, with a higher incidence in resource-limited nations. Hospital-based patient records from different parts of Nepal suggest patients often use traditional eye medicine to treat MK. Traditional healers (TH) within the community are often the first point of care for MK management. Little is known of their practice, perceptions, and knowledge around MK management. We aimed to understand the role of traditional healers in the management of MK in south-eastern Nepal. A cross-sectional, mixed method, descriptive study was conducted in the Siraha district of Nepal. A total of 109 traditional healers consented to participate in a survey of knowledge, attitude, and practices. Some participants were also invited to participate in in-depth interviews and focus group discussions. Interviews and focus groups were conducted and recorded in the Maithili language by a native speaking interviewer and transcribed into English. Descriptive analysis was performed for the survey. Data saturation was considered the endpoint for qualitative data collection, and a thematic was analysis applied. Traditional healers believe that infection of the eye can be caused by trauma, conjunctivitis, or evil spirits. They were unclear about differentiating MK from other eye conditions. They provided various types of treatment. Some were confident that they could treat severe ulcers that had not responded to medical therapy, while others thought treating larger diameter ulcers would be difficult. Although there were mixed responses in referring patients with MK, the majority of TH were willing to refer. In a weak health system, traditional healers may help address barriers to healthcare access and reduce delays to definitive care, upon integration into the formal health system and referral pathway.

Validation of the Comprehensive and Brief International Classification of Functioning, Disability and Health Core Sets for Schizophrenia from the Perspective of Individuals Diagnosed with the Disorder: A Worldwide Study Using Focus Groups

The comprehensive and brief International Classification of Functioning, Disability and Health (ICF) core sets for schizophrenia, based on the World Health Organization (WHO) framework, aim to describe the functioning of individuals with schizophrenia. The objective of this study was to identify the most common problems faced by these individuals and validate the ICF core sets. Eight focus groups were conducted, recorded, and transcribed verbatim. The linking process involved two independent coders identifying meaningful units and linking agreed-upon concepts to the ICF categories. Data saturation was defined as the point at which no new categories emerged from additional focus groups. The 37 participants in this study represented the WHO regions of Africa, South-East Asia, the Western Pacific, and Europe. The focus groups confirmed the relevance of all ICF core set categories, with an additional 21 second-level categories being proposed in at least six of the eight focus groups. In this study, the ICF core sets for schizophrenia were validated from the perspective of individuals. However, several second-level categories not currently included in the ICF core sets also emerged. To ensure that the ICF core sets are truly international in scope, the potential relevance of these categories should be investigated further.

Organizational silence and hidden threats to patients' dignity with schizophrenia: A qualitative study.

Maintaining patients' dignity is a key ethical requirement in healthcare and is emphasized in nursing standards. This issue is particularly significant for patients with schizophrenia because they face unique challenges such as physical and psychological difficulties, dependence on others, and social isolation, making them more vulnerable. Organizational factors can either threaten or preserve their dignity. However, there is little knowledge in this domain within the sociocultural context of Iran. This study aimed to explore the role of the healthcare organization in the dignity of patients with schizophrenia, based on the opinions of patients, healthcare personnel, and family caregivers. This qualitative study was conducted with 26 participants (16 patients, 4 family caregivers, 2 nurses, 3 psychologists, and 1 service worker) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until data saturation was reached. The data were analyzed via Graneheim and Lundman's method. The study protocol was approved by the Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099). Based on data analysis, participants reported the three following challenges as organizational hidden threats to patients' dignity: "Lack of facilities," "premature management," and "ineffective communication." The study findings indicated that the healthcare organization does not support the dignity of patients. Management inefficiency and lack of facilities are evident in psychiatric hospitals, and healthcare centers are not monitored based on standard criteria. Limited interactions between healthcare personnel and patients were identified as the main reasons for the neglect of patients with schizophrenia and the violation of their dignity. The results of this study can help healthcare policymakers in designing and implementing effective programs to preserve the dignity of patients with schizophrenia.

Unsafe termination of pregnancy where abortion is illegal: A Botswana context-specific study

Unsafe pregnancy termination contributes to morbidity and mortality among women globally. Despite Botswana's restrictive abortion laws, women continue to use unsafe abortion methods. This study aimed to explore factors that contributes to unsafe termination of pregnancies in Ngami sub-district, Botswana. A qualitative descriptive and exploratory research approach, using a phenomenological design, was applied. Semi-structured in-depth interviews were conducted with women admitted to the gynecological ward from June to August 2021. Data saturation was reached with the 12th participant. Data was analyzed thematically. The study revealed two major themes: factors contributing to unsafe abortions, and interventions to reduce unsafe abortions. The study underscores the global issue of unsafe abortion that leads to high morbidity and mortality, and long-term complications. An overall recommendation is for Botswana to reconsider its abortion law and aim to prevent unsafe abortions and reduce healthcare costs.

Pengaruh Alam dan Budaya dalam Pembentukan Makanan Tradisional di Lembah Lenggong, Perak

Traditional food is a valuable asset inherited from one generation to another. The formation of this traditional food in a specific district or country is influenced by various factors such as natural environment, cultural intermingling, political boundaries and local genius. As a result, the background and characteristic of traditional food can reflect the community’s origin, culture and identity. Despite that, research on the formation of traditional food is seemingly limited, particularly in rural areas. This phenomenon is due to the lack of appreciation of traditional food among the community especially the young generation. Thus, this study aims to understand the formation of traditional food in Lenggong Valley based on the influence of nature and culture. A qualitative research design was used in this study. The data was collected through semi-structured interviews, and purposive sampling technique was employed by the researchers. A total of 10 informants were involved in this study comprising Lenggong traditional food experts and entrepreneurs. In addition, snowball sampling technique was used to achieve data saturation. To validate the findings from semi-structured interviews, participant observations were also executed by the researchers. Several places were visited such as traditional food restaurants, events and homestays to conduct the observations. Findings for this study have concluded into two themes namely, (1) Lenggong traditional food based on the availability of natural resources; and (2) the influence of culture diversity in the formation of Lenggong traditional food. This study explores the formation process of Lenggong traditional food that is influenced by the natural environment and cultural diversity, in which the influence of both explains the ingenuity of the past people in crafting various types of food which can still be tasted until today. Findings for this study encourage the current generation to preserve and sustain this intangible heritage for the next generations to come. Beside inheritance, the uniqueness and differences of Lenggong’s traditional food connote a potential that can also be benefited as a tourist attraction.