Abstract
<title>Abstract</title> <p> <bold>Aim:</bold> To explore healthcare professionals’ experiences, perceived challenges, culturally adapted strategies, and support needs when recruiting women with recurrent pregnancy loss into nursing research. <bold>Design:</bold> Qualitative descriptive study. <bold>Methods:</bold> Semi-structured interviews were conducted with 22 healthcare professionals from a specialized obstetrics and gynecology institution in Xi’an, China. All participants had clinical or nursing experience related to miscarriage and had been involved in recruiting patients for miscarriage-related research. Data were analyzed using Braun and Clarke’s thematic analysis method. Study rigor was supported by Guba and Lincoln’s criteria for trustworthiness. <bold>Data Sources:</bold> Interview data were collected from January to March 2026.Interviews focused on perceived recruitment challenges, coping strategies, and support needs during the recruitment of patients with RPL. <bold>Results:</bold> Five themes and 15 subthemes were identified: (1) recruitment thresholds: patients’ concerns and multiple barriers to participation; (2) strategy exploration: culturally adapted recruitment practices; (3) invisible barriers: multidimensional obstacles to participation; (4) ethical dilemmas: moral conflicts and risks during recruitment; and (5) support needs: systemic support for effective recruitment. Healthcare professionals reported high refusal rates, mainly related to psychological trauma, self-isolation, privacy concerns, fear of social judgment, and the taboo surrounding miscarriage. When recruiting patients with recurrent miscarriage for a study, it is essential to establish clear boundaries between the initial introduction by clinical staff, the full disclosure provided by researchers, and the patient’s autonomous decision. However, this process also presents significant ethical challenges, including blurred role boundaries, implicit pressure, and the potential for secondary harm to patients. <bold>Conclusion:</bold> Recruiting patients with RPL into nursing research is culturally, psychologically, and ethically complex. The central challenge lies in balancing miscarriage-related taboo, patients’ privacy protection, and the need for nursing research. Culturally adapted recruitment guidelines are needed to support ethical and standardized research practice. <bold>Implications for the Nursing Profession:</bold> Recruitment involving vulnerable populations should go beyond standard protocols and consider trauma, privacy, and cultural context. Structured, ethical, and patient-centered strategies may improve participation in RPL nursing research. <bold>No Patient or Public Contribution:</bold> Patients, service users, caregivers, or members of the public were not involved in the design, conduct, data analysis, interpretation of the findings, or writing of this manuscript. This study focused on the experiences of healthcare professionals who had been directly involved in recruiting women with recurrent pregnancy loss into nursing research. Therefore, patient or public involvement was not included within the scope of the present study. Future studies should include patients with recurrent pregnancy loss and their family members to further validate and refine culturally appropriate recruitment strategies. </p>