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Article History

Received: 9 July 2024

Accepted: 20 January 2026

First Online: 28 January 2026

Competing interests

: The authors declare no competing interests.

: The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Medical Ethics Committee of Macau University of Science and Technology (Approval number: MUST-20240603001; approved on February 3, 2024; valid until December 31, 2026).

: Written and oral informed consent regarding the voluntary nature of the study were obtained from all participants. For the semi-structured interviews conducted between February and March 2024, written consent was signed by participants prior to commencement. For the questionnaire surveys conducted between March and April 2024, oral consent was obtained and recorded by researchers via a confirmation box on the questionnaire. Researchers obtained consent from respondents covering the scope of participation, data use, and permission for publication. Respondents were informed of the voluntary nature of participation, potential risks (none foreseeable), study objectives, the protection of anonymity, and the anonymized use of data. The study protocol was approved by the Medical Ethics Committee of Macau University of Science and Technology (February 3, 2024).