Selective Coding Research Articles

P0083 Decisional needs among patients and physicians in Crohn's disease: A qualitative analysis

Abstract Background Shared decision-making (SDM) is a collaborative process between patients and healthcare professionals (HCPs) that is essential to align treatment choices with patient values. The increasing variety of treatment options for Crohn’s Disease (CD) challenges the assessment and communication of risks and benefits for both patients and HCPs. Patient decision aids (PDAs) have been shown to be effective in enhancing patient-centered care across various decision-making contexts. This study aims to identify the informational needs of both patients and HCPs to develop an effective PDA for CD. Methods Qualitative semi-structured interviews were conducted with 7 CD patient representatives and 5 HCPs. Purposive sampling was used for recruitment of respondents. An empirical phenomenological approach was taken in the interviews to describe similarities and differences of experiences, needs, and preferences of CD patients and HCPs. Interviews were conducted face-to-face or digitally, audio recorded, and transcribed verbatim. Transcripts were thematically analysed through consecutive open, axial, and selective coding. Results Preliminary results showed most patients were not actively involved but rather advised in their treatment decisions. Physicians typically preferred a particular treatment but regularly offered patients choices between similar medication options if they wanted more involvement. The primary concerns for patients were the reduction of medication related physical, mental, and social complaints that they often experienced from side effects, form of administration, and fear of surgery. This was reflected in the patients’ need for general disease information, treatment pros and cons, and patient experience stories. Physicians acknowledge that patients wish to be well-informed and believe they provide adequate information. However, many patients express feeling under-informed and frequently look for additional resources. Both groups find the idea of a PDA offering general and personalised information at varying stages in the treatment journey appealing, though physicians caution that personalised content may not be suitable for all patients. Conclusion This study highlights a barrier between the approach taken by physicians and patients’ desire for information and involvement in treatment. Providing a reliable and accessible source of information at key decision moments throughout the patient journey could help resolve this barrier. A well-designed PDA for CD patients with reliable information could empower them with confidence and support SDM. However, careful implementation is necessary to accommodate diverse patient needs and preferences.

Assessing the “Reach” of a Fire-Based Mobile Integrated Health Buprenorphine Induction Program through an Implementation Science Lens

ABSTRACT OBJECTIVES Medication for opioid use disorder (MOUD) reduces morbidity and mortality for patients with opioid use disorder (OUD). Recent administrative and legislative changes have made MOUD possible in the prehospital setting. We use an implementation science framework to outline the Reach of a fire department EMS-based Mobile Integrated Health (MIH) prehospital MOUD program. METHODS The West Allis Fire Department (WAFD) within the Milwaukee County EMS system operates an MIH program that allows for internal and external referrals for patients with OUD. Internal referrals originated from 9-1-1 dispatch via emergency medical dispatch code selection, self-dispatch, or a weekly summary of electronic patient care reports involving opioid-related encounters. External referrals came from emergency departments (ED) or community partners. Among all referral patients with OUD, the primary measures included Overall Reach (those who agreed to MIH services), Clinical Opiate Withdrawal Scale (COWS) Reach (those with a COWS score performed), Buprenorphine Reach (those who based on COWS were offered buprenorphine induction) and Induction Reach (those who accepted buprenorphine induction). RESULTS Between 5/24/2023 and 5/25/2024, the WAFD MIH program received 265 total potential OUD patient referrals, 135 internally and 130 externally. Internal referrals consisted of 48 MIH responses received from 9-1-1 dispatch, 5 self-dispatches, and 82 patients captured on a weekly report. In the external referral process, 8 originated from community partners and 122 from EDs. Among the combined 265 patient referrals, 128 (48.3%) patient contacts were made. The Overall Reach was 99/128 patients (77.3%), COWS Reach was 99/99 (100%), Buprenorphine Reach was 8/99 (8.1%) patients, and Induction Reach was 4/8 (50%). CONLUSIONS A fire department EMS-based MIH buprenorphine MOUD program is able to reach patients experiencing OUD. External partners make up a sizable proportion of patient referrals to increase a program’s reach. Challenges included obtaining real time assessment from designated MIH clinicians utilizing dispatch protocols, a high proportion of ineligible patients based on buprenorphine guidelines, and a relatively high proportion of patients declining induction. Results may assist other fire departments in assessing potential estimates of patient encounters and avenues for patient contact for similar programing.

A Qualitative Descriptive Study of Rural Primary Healthcare Professionals' Capacity for Disaster Health Management Before and During the COVID-19 Pandemic.

Rural areas face additional challenges in preventing, preparing for, responding to, and recovering from disasters. This study aimed to understand how rural primary healthcare professionals (PHCPs) perceive their roles, involvement, and capacity in disaster health management. For this qualitative descriptive research, semi-structured interviews were carried out with convenience and purposive samples of rural PHCPs before and during the COVID-19 pandemic. Open, axial, and selective coding were employed to analyse the data inductively. Five interviews were conducted before the pandemic, and ten interviews were conducted during the second and third waves of the COVID-19 pandemic in Australia. The themes identified were similar between the two periods. Rural PHCPs were underutilised due to a lack of awareness of their capacity and a lack of infrastructure and support for greater involvement. Rural PHCPs can be better integrated and supported in readiness for a whole-system response to future disasters. This study recommends empowering PHCPs in disaster management to promote the health and continuity of care in rural communities.

Understanding rangeland desertification through pastoralist perspectives using a grounded theory approach

Rangeland desertification risk has significantly increased due to the fragility of these ecosystems and the severity of degradation caused by climate instability and human activities over the last decade. This research focuses on identifying indicators of rangeland desertification risk using a qualitative grounded theory approach based on the perspectives of pastoralists in Kolijah and Qolaq-Borte, Golestan Province, Iran. The study population comprised regional pastoralists, with 15 experts selected through snowball sampling. Data collection was conducted through in-depth, semi-structured interviews, with thematic analysis carried out via open, axial, and selective coding. Results revealed three primary categories of desertification indicators: “vegetation,” “employment and income sources,” and “climate and natural hazards,” scoring 3.08, 3.00, and 2.80, respectively. Meanwhile, “water and water resources,” “animal health and diseases,” and “participation and social capital” were identified as less significant. Key findings emphasize the importance of vegetation decline, with reduced forage quality and increased prevalence of unpalatable plants serving as prominent signs of desertification. Additionally, socio-economic impacts, including increased animal husbandry costs and reduced livelihood resilience, highlight the multifaceted nature of desertification risk. The study underscores the critical need for targeted conservation policies, incorporating local knowledge to enhance restoration and sustainable management practices. By identifying the key indicators and their impacts, this research provides valuable insights for mitigating desertification and promoting the resilience of rangelands and pastoralist communities.

Nurses' Perceptions of Patients With Co-Occurring Psychiatric and Substance Use Disorders in Psychiatric Settings: A Grounded Theory Study.

To explore psychiatric and mental health nurses' perceptions of patients with co-occurring psychiatric and substance use disorders in psychiatric settings. An exploratory qualitative study design based on grounded theory, employing Straussian analytic procedures. Semi-structured interviews were conducted with 11 psychiatric and mental health nurses. Participants were recruited at a public psychiatric hospital located in the Paris metropolitan area of France. Face-to-face interviews took place between February 2024 and May 2024. Field notes and interview data were continuously analysed during open, axial and selective coding phases. The core category identified was 'waiting for a patient's will to change to emerge' when caring for patients with co-occurring substance use disorders. This active waiting period involved a balancing strategy between two discrete care objectives: stabilising the patient's clinical status and keeping the nurse-patient relationship intact. Identifying a patient's will to change provided an opportunity to reconcile these two aspects of psychiatric nursing through the addition of a collaborative component to the relationship. The substantive theory generated by our findings contributes to understanding the interactional and relational processes that occur between nurses and patients presenting with co-occurring substance use disorders in the context of psychiatric care. Implications of our study include the need for further emphasis on collaborative approaches that can be applied even in early or pre-contemplative stages of recovery. Organisational policies should systematically include training in the field of addiction care, given the high prevalence of co-occurring substance use disorders in psychiatric settings. Our findings can assist nurses in critically examining the challenges they experience when engaging with patients with co-occurring substance use disorders. This research adheres to the COREQ (COnsolidated criteria for REporting Qualitative research) Checklist. No patient or public contribution.

웰니스의 행복 개념에서 바라본 영유아의 수면과 영양의 의미: 아동건강교육 대학교재 내용 분석을 중심으로

Objectives The study aims to actively reflect in teacher government policies for teacher training in the future by highlighting the sleep and nuturion of childhood and toddlers pursued in the philosophy of wellness happyness through the analysis of the contents of the university textbooks for child health education for pre-service teachers. Methods To this end, 17 children’s health education textbooks published after the 2019 Nuri curriculum were analyzed by schematizing them from upper to lower areas using a classification system analysis method, and a frequency analysis using an Excel program was conducted. In addition, data were analyzed using selective coding and etic coding methods to analyze the meaning of sleep and nutrition. Results First, it appeared as the theoretical basis of child health education, child health education, child nutrition education, child safety education, institutional facilities and environmental management for child health education, and connection with families and communities. Second, the weight of the contents of each textbook was found to be different. Third, sleep appeared as understanding and support of sleep, and nutrition appeared as understanding and support of nutrition. Conclusions It is believed that it will contribute to the provision of basic data presented in government policies on sleep and nutrition in the university textbooks for children's health education of teacher training.

Intergenerational transmission or cultural loss? The continuity of ethnic identity among the Yao minority in China

PurposeThis study aims to examine the intergenerational transmission of ethnic culture among the Yao minority in China, focusing on how rapid societal changes and modernization impact cultural identity maintenance. The research seeks to understand the perspectives of different generations of Yao individuals regarding their traditional culture, external influences and ethnic identity. The study aims to identify factors that facilitate or hinder cultural transmission, assess the effectiveness of current cultural preservation efforts and uncover potential strategies for maintaining ethnic identity in a rapidly changing society. Additionally, the research investigates the role of traditional elements, such as ethnic clothing, in connecting younger generations to their cultural heritage.Design/methodology/approachThis study employed a qualitative approach using grounded theory methodology to explore the intergenerational transmission of Yao ethnic culture in China. In-depth, semi-structured interviews were conducted with 30 Yao individuals representing different generations. Participants were purposively selected from two Yao villages in southern China. Data collection also included researcher observations and memos. Interviews were conducted in Chinese, translated to English and analyzed using NVivo12 software. The analysis followed the grounded theory approach of open, axial and selective coding. Triangulation was achieved through discussions with participants' peers and family members. Ethical considerations included obtaining informed consent, ensuring participant anonymity and securing institutional review board approval.FindingsThe study revealed three distinct generational attitudes towards Yao culture: rejection among older generations, semi-openness in middle-aged groups and initiated closeness in younger generations. Despite government policies supporting population growth, ethnic identity is not effectively transmitted across generations. Economic disparities between Yao communities and external society significantly influence cultural preservation, with younger generations prioritizing economic opportunities over traditional practices. However, traditional Yao clothing emerged as a potential link between younger individuals and their cultural heritage, offering a promising avenue for cultural preservation. The research also highlighted the impact of education, technology and media on shaping attitudes towards traditional culture and external influences across different age groups.Originality/valueThis study provides insights into the cultural transmission within the Yao minority in China, a previously understudied ethnic group. It uniquely examines the interplay between economic development, government policies and intergenerational attitudes in shaping ethnic identity maintenance. The research reveals an unexpected potential for traditional clothing to serve as a bridge between younger generations and their cultural heritage, offering a fresh perspective on cultural preservation strategies. By identifying distinct generational attitudes towards cultural identity, this study contributes valuable knowledge to the fields of ethnic studies, cultural anthropology and social psychology, while also informing policymaking for minority cultural preservation in rapidly modernizing societies.

Synthesis of Dimensions, Indicators, and Components of Appropriate Educational Leadership for Blended Learning (In-Person and Virtual) in Elementary Education

Objective: The present study aimed to synthesize the dimensions, indicators, and components of appropriate educational leadership for blended learning (in-person and virtual) in elementary education. Methodology: The present study was qualitative and of the synthesis type. The statistical population of the research comprised existing studies from 2013 to 2023. In total, the number of articles and studies related to the keywords was 1,315 (69 Persian articles and 1,246 English articles). Out of this number, 26 studies (22 English studies and 4 Persian studies) were selected for final analysis based on exclusion criteria. The research data were analyzed using Roberts' six-step synthesis model, employing three-stage coding (open, axial, and selective). Findings: The data were identified in the form of 162 open codes, 24 axial codes, and 7 selective codes. The dimensions identified include competent leadership, organizational dimensions, technology, philosophical and epistemological systems, learning environment, learning outcomes, and evaluation systems. Conclusion: Identifying the dimensions, indicators, and components of appropriate educational leadership for blended learning in elementary education can play a significant role in designing an appropriate model for this stage.

Presentation of Administrative Standards Model for Educational Leaders in Third Millennium Schools

Objective: The present article aims to propose a model of administrative standards for educational leaders in third millennium schools. Methodology: This research employs a qualitative research methodology utilizing grounded theory. The statistical population consisted of educational leaders and experts from schools in Iraq, with purposive and snowball sampling methods applied until theoretical saturation was achieved. Data were collected through in-depth and exploratory interviews and analyzed using open, axial, and selective coding. Findings: The findings revealed that 133 different factors influence the development of administrative standards, which are categorized into five groups: causal, core, contextual, intervening, and consequences. The results indicated that causal, core, and intervening factors have a direct impact on the strategies and outcomes of standard development. These standards play a significant role in improving the quality of educational management, increasing staff and student satisfaction, and enhancing teaching-learning processes. Conclusion: This study emphasizes that educational leadership, as an independent domain, must align with the goals of education and play a key role in improving the quality and efficiency of the educational system. Additionally, the development of specific and efficient administrative standards for educational leaders is essential for effectively contributing to educational quality improvement. It is recommended that policymakers and educational planners consider these findings and take action to improve standards.

Analyzing the Lived Experiences of University Managers in Iraq in the Context of Knowledge Management Implementation to Propose a Model

Objective: The aim of this research was to analyze the lived experiences of university managers in Iraq regarding the implementation of knowledge management to propose a model. Methodology: The research methodology was qualitative-phenomenological. The research environment included all university managers in Iraq during the years 2023-2024. The sampling method was purposive and continued to the point of theoretical saturation until sufficient information was obtained, resulting in 21 university managers in Iraq. The research tools were in-depth and unstructured interviews. To determine the validity and reliability of the codes extracted from the interviews, the expert consensus method was used for confirmability. Data analysis was performed using open coding, axial coding, and selective coding. Findings: The results showed that the model for analyzing the lived experiences of university managers in Iraq regarding knowledge management implementation comprises eight dimensions: organizational structure reconstruction, organizational welfare, organizational technology, promotion of organizational leadership culture, organizational excellence, organizational knowledge processing, overcoming limitations, and enhancing stakeholder service quality. Conclusion: The findings of this study underscore the critical importance of various dimensions in the effective implementation of knowledge management in Iraqi universities. These dimensions include the reconstruction of organizational structure, enhancement of organizational welfare, utilization of organizational technology, promotion of organizational leadership culture, and processing of organizational knowledge. Additionally, addressing organizational constraints and improving stakeholder service quality are essential for fostering an environment conducive to knowledge management.

외모 단장 의례로서 헤어롤링: 의례의 확장과 공사 영역의 탈경계화

This study investigates the phenomenon of wearing hair rollers in public spaces and sharing photos of this practice on social media, particularly within contemporary Korean society. Rooted in the context of grooming routines, the study draws on existing research on ritualistic consumer experiences and the blurring of public and private spheres in modern society. A qualitative content analysis of Instagram posts—comprising captions, hashtags, and visual content (images/videos)—was conducted. The analysis followed grounded theory methodology, with three steps of coding: open, axial, and selective coding. The analysis revealed several key themes: the ordinariness of hair-rolling, the expansion of grooming rituals, the public display of a presentable appearance, and the blurring of boundaries between private and public spaces and times for hair-rolling. The findings are summarized as the hair-rolling phenomenon represents an expansion of traditional grooming rituals and a blurring of boundaries between public and private spheres. This shift reflects a broader trend of transitioning private grooming practices into the public realm, with these rituals becoming more intermittent throughout the day. Additionally, the practice of posting hair-rolling selfies expands the ritual script of grooming, which is posting selfies on social media. Ultimately, hair-rolling exemplifies the breakdown of public-private boundaries, with personal activities being publicly shared on social media, the merging of public and private spaces, and the intersection of public spaces with private time.

Transmission system with adaptive LDPC-Coded OFDM modulation implemented in GNU Radio

Real-time testing in wireless channel conditions of Forward Error Correction (FEC) coding techniques, Modulation and Coding Scheme (MCS) selection algorithms is a complex and challenging task. GNU Radio and Software Defined Radio (SDR) concept allow a wide range of practical and low-cost solutions to perform the testing operations mentioned above. The paper proposes a duplex transmission system with adaptive LDPC (Low Density Parity Check) coding and OFDM (Orthogonal Frequency Division Multiplexing) modulation implemented in GNU Radio. The frame structure, design principles, system architecture, and mechanisms controlling the transmission process are presented. The system’s modular architecture provides the framework for testing various LDPC coding and MCS selection techniques. The system’s design allows us to maximize the transmission’s efficiency, the encapsulation of various data structures, i.e., frame and transport block, using reduced overheads and the necessity of padding operations is minimized.

Artificial Intelligence (AI) and Men's Health Clinic Efficiency and Clinic Billing.

Artificial Intelligence (AI) has produced a significant impact across various industries, including healthcare. In the outpatient clinic setting, AI offers promising improvements in efficiency through Chatbots, streamlined medical documentation, and personalized patient education materials. On the billing side, AI technologies hold potential for optimizing the selection of appropriate billing codes, automating prior authorizations, and enhancing healthcare fraud detection. The purpose of this review is to explore the current applications of AI in men's health clinics, with a focus on enhancing clinic efficiency and billing practices. Current uses of AI, including AI-powered Chatbots, Large Language Models (LLM) and Natural Language Processing (NLP), are discussed with a focus on their application in men's health clinics. Additionally, the challenges associated with their implementation are highlighted.

Construction and Validation of a Secure-base Leadership Model in Educational Organizations: A Mixed-methods Exploratory Study

There is no doubt about the importance of leadership and attachment styles on individual behavior and organizational outcomes. However, researchers have neglected to apply and integrate attachment concepts in management and organizational studies for years. One of the basic concepts in attachment theory is the secure base. In 2010, Coombe considered the application of this concept in leadership, which resulted in representing the theory of secure base leadership. The present study aimed at constructing and validating a secure base leadership model. The research method is a mixed exploratory method composed of qualitative and quantitative measures including thematic analysis and survey, respectively. The participants of the qualitative section were 14 faculty members, specialists, and experts in the field of educational management and psychology selected using the purposive sampling method and snowball technique. Besides, the participants of the quantitative part included 441 administrative staff and teachers in Tehran were by cluster sampling. Open, axial, and selective coding was used to analyze interview data in the former part, while in the latter, structural equations were used. The results of the qualitative analysis indicated that secure base leadership includes three main aspects, namely security (accepting people (acceptance), support, providing security, mutual trust, independence, fairness, staying calm (controlling and adjusting emotions)), exploration (risk-taking, increasing individual capacities, being responsive and sensible, intellectual stimulation), and deep intellectual bond (positive attitude, high emotional capacity, transparency in relationships, compatibility, being a good listener). Also, the quantitative part of the research results showed validity and reliability as well as a good fit of the proposed model.

Lack of hospital resilience as the main challenge of hospital management during the COVID-19 pandemic: A grounded theory study.

Traditional hospital management responses during the coronavirus disease 2019 (COVID-19) pandemic proved ineffective, particularly considering the pre-existing challenges in healthcare systems. The study examines hospital management challenges during the COVID-19 pandemic, transforming their lived experiences into a conceptual approach to prevent repetition and benefit health planners and policymakers in future crises and normal times. This qualitative study utilized the grounded theory methodology, conducting in-depth interviews with 12 hospital administrators from seven major referral hospitals in Shiraz, Bushehr, and Tehran, focusing on COVID-19 patients' complex conditions. The participants had a mean age of 46.6 ± 8.8 years. Data analysis was conducted using the grounded theory (Straussian approach). A total of 98 subthemes and 25 themes were identified during the data analysis process. Using axial and selective coding, we found that in the presence of contextual and causal conditions, the lack of hospital resilience was recognized as the core theme in the final model. Intervening conditions, strategies to overcome the challenges of hospital management, and the outcomes were identified. Iranian hospital administrators dealing with COVID-19 recognize the lack of hospital resilience as their main management obstacle. Non-resilient hospitals' response to crises with new management strategies can fail due to insufficient documentation and information sharing, leading to persistent problems. Prioritizing evidence-based strategies and sharing successful approaches from other healthcare systems can improve resilience. Nationwide guidelines will ensure equitable patient treatment and reduce lawsuits against physicians for resource-efficient use. Hospital resilience implementation in real-world settings is widely sought for evidence.

The Role of Interpersonal Emotion Regulation in Couples' Relationships: Grounded Theory

Background: Interpersonal emotion regulation is a crucial skill that underpins the emotional dynamics in couples' relationships. In regulating interpersonal emotions, couples not only focus on their own emotions but also consider the emotions of their partner. Objectives: The study aimed to explore the role of interpersonal emotion regulation in couples' relationships. Methods: This qualitative study utilized a grounded theory strategy. Married women and men from Yazd (2021) who met the inclusion criteria participated in semi-structured interviews conducted through purposeful sampling until theoretical saturation was achieved. A total of 20 individuals (13 women and 7 men) were included in the study. Data were analyzed using MaxQDA 2020 software. Results: Collecting and coding the data with the Strauss and Corbin method, as open, axial, and selective coding, gave us 229 open codings, 32 axial codings, 7 selective codings, and one nuclear or core category under the title of safe attachment. The major categories included: Personal development, emotional safety, emotional self-awareness, empathic attunement, comprehensive support, comprehensive improvement of quality of life, and promotion of the spousal-safe base. A paradigm model was drawn from the components of the central phenomenon, causal conditions, contextual conditions, intervening conditions, strategies, and consequences. Conclusions: The specification of effective factors in the formation of interpersonal emotion regulation and the research paradigm model enables the accurate identification of strategies for interpersonal emotion regulation and their consequences in couple relationships, facilitating the progression of couples towards safe attachment. It is suggested that family counselors and therapists use these results to help couples.

Organizational capabilities for digital innovation: a systematic literature review

PurposeThe rapid advancement of digital technologies compels companies across all industries to develop new capabilities to foster innovation and sustain competitiveness. Consequently, scholarly debates have intensified regarding how these new capabilities contribute to companies’ innovation endeavors. This study addresses this imperative by exploring two primary research questions: first, identifying the essential organizational capabilities for digital innovation; and second, examining how these capabilities facilitate innovation. The objective is to develop a comprehensive conceptual framework that classifies digital innovation capability as a higher-order organizational capacity, offering valuable insights for both academic scholarship and practical applications in digital innovation management.Design/methodology/approachUsing a qualitative approach, this study combines a systematic literature review with grounded theory principles to analyze 38 empirical papers from Scopus and Web of Science databases. The rigorous multi-stage coding process – open, axial and selective coding – facilitated the identification and synthesis of valuable insights for digital innovation capabilities. This approach ensures a comprehensive yet focused review, supporting the development of a robust theoretical framework.FindingsFour critical capability clusters were identified to shape digital innovation capabilities: sensing, analytic-driven, digital platform and orchestration. Sensing capabilities enhance environmental awareness and enable organizations to detect market needs and opportunities, fostering customer-centric innovations. Analytic-driven capabilities leverage data for insightful decision-making and trend analysis. Digital platform capabilities highlight the strategic use of technological infrastructures to enable collaborative innovation, integrating diverse capabilities and objectives. Orchestration capabilities focus on effective coordination of resources and partnerships, ensuring sustained digital innovation by bridging capability gaps and reconfiguring resources. Collectively, these clusters offer a holistic framework for excelling in the dynamic digital innovation landscape.Originality/valueWhile previous literature has focused on the impact of individual capabilities on digital innovation, this study offers a novel and integrative framework that categorizes digital innovation capabilities into four distinct yet interconnected clusters: sensing, analytic-driven, digital platforms and orchestration. This framework delineates the unique roles each capability plays in the digital innovation process. By synthesizing empirical studies and constructing a robust theoretical framework, this research significantly contributes to both academic scholarship and practical applications, offering essential strategies for organizations to enhance their digital innovation efforts through sustainable capability development.

The Policy-Making Model Based on Conflict of Interest Management in Crisis Conditions in the Country's Health System (Case of Study: The Experience of COVID-19)

Background: Policy-making is one of the management functions in the health system, and according to the main goal of the health system, which is health promotion, health system approaches are advancing in the light of presenting a policy-making model based on conflict of interest management. Therefore, the purpose of this research is to present a policy-making model based on conflict of interest management in crisis conditions in the country's health system during the period of the COVID-19 crisis. Methods: This research is an applied research in terms of purpose, and has a qualitative approach, and the multi-grounded theory method was used as the research method. This study was conducted by collecting data, through library studies and semi-structured interviews with 12 experts of the country's health system through theoretical sampling until the saturation point was reached. The inclusion criteria were familiarity with the policy-making process in the health system and having at least a master's degree related to policy-making, and the exclusion criterion was lack of desire and motivation. Data analysis was done in three stages of open coding, axial coding, and selective coding using MaxQDA10 software. In order to obtain the reliability and validity of the data, 2 methods of reviewing the participants and Lincoln and Guba (1985) approach were used. Results: The findings showed that the policy-making model based on conflict of interest management includes 74 sub-categories in the form of 18 main categories of causal, contextual, intervening conditions, central phenomenon, consequences, and strategies. It indicates that selecting policy-maker, the personality characteristics of the policy-maker, the principles of health system policy-making, and medical resources and equipment are causal factors affecting policy-making based on conflict of interest management, which predicts consequences at the micro and macro levels. Conclusion: The policy-making model based on conflict of interest management comprehensively identifies factors such as the personality characteristics of policymakers and health system resources as influential factors. This model shows that considering these factors, consequences can be predicted at the micro and macro levels. Therefore, effective conflict of interest management requires attention to various conditions and factors, so that decisions can be made optimally and without conflict.

The Meaning of the Future for Adolescent Mothers: A Grounded Theory Study.

To describe the meaning that adolescent mothers give to their future. Qualitative study with a design based on grounded theory and the approach proposed by Corbin and Strauss. Forty-nine semistructured individual interviews were conducted with mothers between the ages of 16 and 19 living permanently with their child more than 40 days postpartum. The interviews were audio recorded. Field notes were made that were transcribed verbatim. Data analysis was carried out by means of open, axial and selective coding and theoretical sampling. Adolescent mothers' meaning of the future was encompassed by the core category of 'changing life, but not destroying it'. Five general categories emerged: changing life by being a mother; taking my child forward regardless of whether I expected it; changing my mind about motherhood; adjusting expectations about the child's father; performing family planning in search of a better future; each category is supported by subcategories that further adolescent mothers' meaning of the future. The meaning that an adolescent mother gives to her future arises from the interaction of the events in her past and her reaction to the present. In addition, this experience, together with her other circumstances, leads her to interpret reality in a specific way. This study provides obstetric nursing professionals with a theoretical proposal that describes the meaning of the future for adolescent mothers. It enables nursing practitioners to optimise care by aligning it with the realities faced by these mothers. Teen pregnancy is a public health priority. The theoretical approach in the study provides a distinct view to the field of nursing, health professionals and the school/government system on adolescent mothers. It demonstrates the vulnerability of mothers and their children and how they require an organised system that bypasses the inequity and stigmatisation to which they are subject. COREQ checklist was used. No patient or public contribution.

A Model of Death Preparedness in Patients With Advanced Cancer: A Grounded Theory Study.

Death preparedness in patients with advanced cancer is an important prerequisite for improving the quality of death. However, there are insufficient studies on death preparedness in patients with advanced cancer, and the level of death preparedness needs to be further improved. To develop a model of death preparedness in patients with advanced cancer. A qualitative approach with grounded theory was used. Data were collected between February 2024 and July 2024 in the oncology wards of the two general hospitals in Wuhan. We recruited 12 patients, 11 family members, 16 nurses and 4 doctors for semistructured interviews. Data analysis included open coding, axial coding and selective coding. The study is reported using the COREQ checklist. Death preparedness in patients with advanced cancer is a spiralling process whose core components include death awareness, emotional response, hospice programme and reflexive care, and multiple personal, interpersonal and social factors influence it. A model of death preparedness in advanced cancer patients was constructed through rooted theory, revealing its formation and change process. This model deepens the understanding of death preparedness and helps healthcare providers identify patients' preparedness status in advance to provide more targeted support and care. This personalised care enhances patients' quality of life and reduces the psychological burden on them and their families, achieving more comprehensive and humanised end-of-life care. To better understand patients' death preparedness, healthcare providers should focus on patients' cognitive, emotional, behavioural and social needs in the process of death preparation from a multifactorial perspective, and provide targeted support and assistance. No Patient or Public Contributions were included in this paper.