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Article History

Received: 7 February 2025

Accepted: 20 April 2026

First Online: 11 May 2026

Competing interests

: The authors declare no competing interests.

: At the time this study was conducted, our institution, Tribhuvan University, Kathmandu, Nepal, did not have an established ethical review board to approve research and as a result, there was no formal ethical approval body readily available to grant ethical clearance. However, we have received approval letter from Research Management Cell (RMC) of Birendra Multiple Campus, Tribhuvan University. We followed the guidelines provided RMC (Ref no: RMC/2022-09 ) to ensure and maintain standard ethical practices, including obtaining informed consent, ensuring voluntary participation, and maintaining the confidentiality of all data. Furthermore, we prioritized authenticity throughout the research process to ensure the integrity and validity of the study’s findings.

: Before collecting data, we obtained oral informed consent from all participants. We informed participants about the research topic, its objectives, the intended use of the data, and our data storage procedures. We told them they had the right to withdraw at any time. We also informed participants that the survey questionnaire didn’t collect any personal identification information. We assured them of the confidentiality and anonymity of their data, which we would use solely for research purposes. After participants provided their oral consent, we distributed questionnaires to them. We collected data from July 2023 to December 2023.