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Before the interviews, the participants were verbally informed about the study\u2019s objectives and methods, how their data would be kept confidential, and their right to withdraw at any time without consequence. Each participant provided written informed consent. All study procedures adhered to the applicable guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The collected data were securely stored on the Iranian platform \u201cPorsline,\u201d designed for managing surveys in compliance with national data protection regulations. All the data were encrypted during transmission and storage to prevent unauthorized access, with raw data access restricted to designated research team members via password-protected systems. Participant anonymity was rigorously maintained by omitting personally identifiable information (e.g., names, contact details) and assigning unique numerical identifiers. The results were aggregated to eliminate individual traceability. In alignment with the Hamadan University Medical Sciences guidelines, raw data will be retained for five years postpublication to enable verification and secondary analysis, after which they will be permanently erased via specialized software compliant with ISO\/IEC 27001:2013 standards to ensure that no residual data remain. Informed consent was obtained electronically: participants received detailed study information upfront, including objectives, methodologies, risks, and rights, and confirmed voluntary participation by clicking an explicit agreement button. Among the 971 submitted questionnaires, 744 fully completed responses were included in the analysis, reflecting participants\u2019 autonomy to withdraw at any stage without consequence, as emphasized in the consent form. The questionnaires were distributed virtually by nursing supervisors and educational administrators, with assurances that participation decisions would not affect professional or academic standing. 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