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Article History

Received: 14 July 2025

Accepted: 3 April 2026

First Online: 15 April 2026

Competing interests

: The author declares no competing interests.

: In accordance with ethical guidelines issued by the National Health Commission, Ministry of Education, Ministry of Science and Technology, and Administration of Traditional Chinese Medicine of China (see ), this study—though categorized under life-science research due to using sociological methods—does not involve medical procedures, biospecimens, health records, or sensitive personal data. Under Article 32 of the National Guidelines for Scientific Research Ethics Review, research based on anonymized, non-sensitive, non-medical data (with no risk to participants or commercial interests) is exempt from ethical review. Because the study used voluntary, fully anonymized questionnaires and collected only non-sensitive behavioral data, our study meets the criteria for exemption. Thus, this study is exempted in line with the author’s institution’s ethical guidelines as per the Declaration of Helsinki 1964, ensuring participant anonymity and avoiding sensitive topics. Informed consent was obtained during the data collection period of February to May 2023, detailing the purpose, data use, and risks, emphasizing voluntary participation. This reflects our commitment to ethical standards, prioritizing participant rights and welfare. Since the study was exempted from any procedures requiring ethical approval by an institutional review board, no specific ethical approval number was assigned.

: Written informed consent was obtained from all participants between February and May 2023. The consent form explained the study’s purpose, data usage, and voluntary nature, assuring participants of anonymity, confidentiality, and the right to withdraw at any time. As the research was non-interventional, no risks were involved.