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Approval was obtained from the Ethics Committee of Mashhad University of Medical Sciences under ethics code IR.MUMS.MEDICAL.REC.1403.226. Before the interviews, participants were informed about the objectives of the study, the voluntary nature of participation, and confidentiality procedures. Written informed consent was obtained prior to audio recording. Demographic and identifying data were stored securely under unique participant codes to ensure anonymity. To ensure confidentiality, all transcripts were pseudonymized by removing direct identifiers and assigning participant codes (e.g., P1, P2). Any potentially identifying information was omitted to prevent re-identification. Audio recordings were transferred immediately to a secure, password-protected computer accessible only to the research team. The recordings will be stored for five years in accordance with institutional policy and will then be permanently deleted.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"144"}}