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Article History

Received: 9 October 2024

Accepted: 6 November 2025

First Online: 3 December 2025

Competing interests

: The authors declare no competing interests.

: This study received ethical approval from the Local Research Ethics Committee (LREC) at the University of Tabuk, Kingdom of Saudi Arabia (Approval No. UT-623-380-2023, granted October 25, 2023). The committee operates in compliance with the National Committee of Bioethics (NCBE) regulations (Registration No. HAP-07-TU-001) and the Declaration of Helsinki (1964) and its later amendments. The approved protocol covered all components of the study, including survey design, semi-structured interviews, participant recruitment, data protection, and privacy safeguards.

: All participants provided informed consent before taking part in this study. Ethical approval was granted by the University of Tabuk Local Research Ethics Committee (LREC) under approval number UT-623-380-2023, dated 25 October 2023, in accordance with the regulations of the National Committee of Bioethics (Registration No. HAP-07-TU-001). For the quantitative survey, electronic consent was obtained between 15 January and 20 March 2024 through an online Qualtrics form. Before accessing the questionnaire, each participant reviewed an information sheet explaining the study’s purpose, procedures, voluntary nature, and data-protection measures. Proceeding beyond this page and selecting “I agree to participate” served as documented consent. For the qualitative interviews, written consent was collected between 5 April and 10 June 2024. The principal investigator, Dr Mohammad O. Alhejaili, personally met each participant, providing a verbal explanation of the study’s objectives, interview process, confidentiality safeguards, and participants’ right to withdraw at any time without consequences. Each participant then signed a written consent form, with one copy retained by the participant and another securely archived by the research team. Consent covered participation, audio recording and transcription of interviews, the anonymised use of data for academic publication, and the secure storage of de-identified materials for five years following publication. Participants were explicitly informed that no names or identifying information would appear in any report and that all data would be stored in encrypted, access-restricted files. All participants were adults (18 years or older) residing in Saudi Arabia and capable of providing informed consent. No minors, patients, refugees, or other vulnerable groups were included. Participation was entirely voluntary, anonymity was guaranteed, and participants were advised that their data would be used solely for academic research purposes.