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="color:#2980b9;"><b>Background:</b></span> 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 still high.<br> <span style="color:#2980b9;"><b>Objectives:</b></span> This study aimed to explore the factors influencing the acceptance or refusal of organ donation among families of brain-dead patients.<br> <span style="color:#2980b9;"><b>Method:</b></span> This descriptive qualitative study was conducted on 21 family members of brain-dead patients registered in the Organ Procurement Unit database of Yazd University of Medical Sciences, Iran, from <span style="border: 1pt windowtext; padding: 0in;"><span style="color:#1f1f1f">April 2020 and May 2022. </span></span>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. Data analysis was performed simultaneously with data collection, using the conventional content analysis method proposed by Graneheim and Lundman in MAXQDA v.10 software.<br> <span style="color:#2980b9;"><b>Result:</b></span> Data analysis resulted in the extraction of 520 initial conceptual codes, which were grouped into 12 categories and four main themes, including &quot; how families understood and interpreted brain death and organ donation &quot;, &quot; how contextual factors shaped the family&rsquo;s decision about organ donation &quot;, &quot; how family interactions shaped the decision about organ donation &quot;, &quot;influential insights and beliefs&quot;.<br> <span style="color:#2980b9;"><b>Conclusion:</b></span> 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></span><br> &nbsp;</div> Qualitative study, Content analysis, Brain death, Organ transplantation, Organ donation 0 0 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-1082-3&slc_lang=en&sid=1 Mehdi barzegar mehdibarzegar1024@gmail.com 100319475328460014622 100319475328460014622 Yes MSc, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran mostafa javadi javadinurse@gmail.com 100319475328460014623 100319475328460014623 No Associate professor, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran SEYEDEH ESMAT HOSSEINI esmat.hosseini_110@yahoo.com 100319475328460014624 100319475328460014624 No Assistant professor, Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran