To identify and explain the challenges of effective pain management in patients with cancer in Iran.

A convergent mixed-methods study.

Oncology departments and palliative care units across multiple healthcare institutions in Iran.

Quantitative phase: 320 healthcare providers, including anaesthesiologists, general practitioners, oncologists, nurses and pharmacists, selected via convenience sampling. Qualitative phase: 10 stakeholders, including patients, caregivers, policy makers and clinicians.

Quantitative data were collected using a psychometrically validated 23-item questionnaire assessing knowledge, attitudes and perceived barriers to cancer pain management. Qualitative data were obtained through semistructured interviews and analysed using Graneheim and Lundman’s content analysis method with MaxQDA software. Integration was performed using a side-by-side approach.

Quantitative data showed that over 65% of providers did not routinely assess pain, and only 29.1% believed pharmacological treatments were effective. Qualitative analysis identified 13 barriers across three domains—professional, patient and organisational—spanning physical, psychological, social and spiritual dimensions. Integrated findings revealed consistent patterns of underassessment, legal and cultural resistance and lack of interdisciplinary collaboration. These converging challenges highlight the need for holistic, system-level reform.

The convergence of quantitative and qualitative data reveals a multilayered system of barriers, professional, patient-related and organisational—rooted in physical, psychological, social and spiritual dimensions. These interlinked challenges contribute to fragmented pain management and limited interdisciplinary coordination. Addressing them requires a holistic reform strategy that integrates structural, cultural and clinical solutions.

Autoimmune disease can greatly affect pregnancy outcomes, leading to increased health risks for both mothers and fetuses. Vitiligo is a common chronic skin condition characterised by the loss of pigment. However, there is controversy regarding adverse pregnancy outcomes (APOs) associated with this condition. Our scoping review aims to explore and summarise the existing literature on pregnancy outcomes in patients with vitiligo.

This scoping review will follow the five-stage methodological framework introduced by Arksey and O’Malley. This stages approach encompasses the following stages: (a) identifying the research questions, (b) identifying relevant research studies, (c) selecting studies, (d) extracting and charting the data and (e) summarising, analysing and reporting the results. We will search two databases, PubMed and Scopus, for published literature up to January 2025 using keywords related to pregnancy outcomes and vitiligo. All retrieved articles will be organised using EndNote software. Two trained reviewers will complete title and abstract screening, full-text screening and data charting. The data will be presented using different strategies, including tables and graphs, to map pregnancy outcomes in patients with vitiligo.

The scoping review will not involve direct contact with humans or patients; therefore, ethical approval is not required for this protocol. The data analysis will focus on exploring APOs in patients with vitiligo. The results of this study will be published in peer-reviewed journals.