en Nursing Orginal research <div style="text-align: justify;"><span style="line-height:2;"><span style="font-family:Times New Roman;"><span style="font-size:14px;"><span style="unicode-bidi:embed"><b><span style="color:#2980b9;">Background:</span><span style="color:#2f5496"> </span></b><span style="color:black">The issue of organ donation in brain-dead patients is a challenging topic. In most countries, the organ donation process depends on the decision of the deceased&#39;s family. Currently, the number of families who are unwilling to consent to organ donation is remains high.</span><span dir="RTL" lang="AR-SA"><span style="color:black"></span></span></span><br> <span style="unicode-bidi:embed"><span style="color:#2980b9;"><b>Objectives:</b></span> <span style="color:black">This study aimed to explore the factors influencing the acceptance or refusal of organ donation among families of brain-dead patients.</span></span><br> <span style="unicode-bidi:embed"><span style="color:#2980b9;"><b>Methods:</b></span> <span style="color:black">This descriptive</span> <span style="color:black">qualitative study was conducted among 21 family members of brain-dead patients registered in the Organ Procurement Unit database of Yazd University of Medical Sciences, Iran, from April 2020 to May 2022. Participants were selected using purposive sampling. Data were collected through semi-structured interviews with 15 family members who consented to organ donation and 6 who did not, until data saturation was reached.</span> <span style="color:black">Data analysis was performed simultaneously with data collection, using the conventional content analysis method proposed by Graneheim and Lundman in MAXQDA version 10.</span></span><br> <span style="unicode-bidi:embed"><span style="color:#2980b9;"><b>Results:</b></span> <span style="color:black">Data analysis resulted in the extraction of 520 initial conceptual codes, which were grouped into 12 categories and four main themes, including </span><span dir="RTL" lang="AR-SA"><span style="color:black">&quot;</span></span> <span style="color:black">How families understood and interpreted brain death and organ donation </span><span dir="RTL" lang="AR-SA"><span style="color:black">&quot;</span></span><span style="color:black">, </span><span dir="RTL" lang="AR-SA"><span style="color:black">&quot;</span></span> <span style="color:black">How contextual factors shaped the family&rsquo;s decision about organ donation </span><span dir="RTL" lang="AR-SA"><span style="color:black">&quot;</span></span><span style="color:black">, </span><span dir="RTL" lang="AR-SA"><span style="color:black">&quot;</span></span> <span style="color:black">How family interactions shaped the decision about organ donation </span><span dir="RTL" lang="AR-SA"><span style="color:black">&quot;</span></span><span style="color:black">, </span><span dir="RTL" lang="AR-SA"><span style="color:black">&quot;</span></span><span style="color:black">Influential insights and beliefs</span><span dir="RTL" lang="AR-SA"><span style="color:black">&quot;</span></span><span style="color:black">.</span></span><br> <span style="unicode-bidi:embed"><span style="color:#2980b9;"><b>Conclusion:</b></span> <span style="color:black">Understanding families&rsquo; perceptions of brain death and the contextual, emotional, and cultural factors influencing decisions can guide nurses in providing preventive, family-centered care, improving communication, reducing misconceptions, and supporting informed organ donation decisions. </span><span dir="RTL" lang="AR-SA"><span style="color:black"></span></span></span></span></span></span><br> &nbsp;</div> Qualitative study, Content analysis, Brain death, Organ transplantation, Organ donation 37 48 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-1082-3&slc_lang=en&sid=1 Mehdi barzegar mehdibarzegar1024@gmail.com 100319475328460015652 100319475328460015652 No Organ Procurement Unit, Shahid Sadoughi University of Medical Sciences, Yazd, Iran mostafa javadi javadinurse@gmail.com 100319475328460015653 100319475328460015653 No Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Seyedeh Esmat Hosseini esmat.hosseini_110@yahoo.com 100319475328460015654 100319475328460015654 Yes Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran