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Article History

Received: 30 October 2023

Accepted: 18 March 2026

First Online: 2 April 2026

Competing interests

: The authors declare no competing interests.

: The study was reviewed and approved by the Commission of Investigation and Ethical Protocol of Shanghai Jiao Tong University on October 14, 2020 (Approval Number: H2020043I). This approval, granted prior to the commencement of any research activities, covered all aspects of the study, including participant recruitment, informed consent, and data collection methods (survey). All research adhered strictly to the ethical standards of the approving institution and the 1964 Helsinki Declaration and its subsequent amendments.

: All participants were fully informed of the study’s aims and procedures, and their consent was obtained. Assurances of data confidentiality were provided, given that all instruments were anonymous. Furthermore, participants were explicitly informed of their right to withdraw from the study at any time without penalty. Prior to the commencement of the questionnaire measurement, the principal investigator read the detailed informed consent form to the invited participants. This form covered: (1) the objectives of this study, (2) who were invited to participate in this study, (3) the risks of participating in this study, (4) the benefits of participating in this study, (5) participants have the right not to take part in this study and to withdraw from this study at any time, (6) confidentiality of the information and data (7) contact details of the principal subject and the Ethics Committee. Verbal consent was obtained after this briefing (witnessed by the class teacher) before the questionnaire was administered. Participants retained the right to withdraw at any stage, even after commencing the survey.