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Article History

Received: 22 October 2023

Accepted: 18 November 2024

First Online: 3 December 2024

Competing interests

: The authors declare no competing interests.

: This study is exempted in line with the ethical guidelines of Zhoukou Normal University, ensuring participant anonymity and avoiding sensitive topics. In line with the Declaration of Helsinki and our institution’s ethical guidelines, this study was designed to protect the rights, dignity, and welfare of all participants involved. Consequently, ethical approval for this study was waived during data collection period (February to April 2023), and no ethical approval number has been assigned. Informed consent was obtained during the data collection period of February to April 2023, detailing purpose, data use, and risks, emphasizing voluntary participation. This reflects our commitment to ethical standards, prioritizing participant rights and welfare.

: Written and oral consent was obtained from all individuals involved in this study from February to April 2023, during the data collection period.