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Article History

Received: 24 January 2025

Accepted: 20 April 2026

First Online: 19 May 2026

Competing interests

: The authors declare no competing interests.

: This study was reviewed and approved for exemption by the Institutional Review Board (IRB) of Southwest University. The IRB determined that the study qualified for exemption according to the Ethical Review Measures for Biomedical Research Involving Humans issued by the National Health Commission of the People’s Republic of China. The specific basis for exemption is that the research involved the collection and analysis of completely anonymous data through an online questionnaire, where all identifying information was removed prior to data analysis, and the study posed no more than minimal risk to participants. Date of exemption: 2023.12.23

: Informed consent was obtained from all participants. Given the minimal risk nature of the research and the fact that data were collected and stored in a fully anonymous manner (with no personal identifiers collected or linked to the responses), the IRB granted a waiver of written (signed) documentation of informed consent. Instead, oral informed consent was deemed appropriate and was obtained from all participants prior to their enrollment in the study. The consent procedure was as follows: Before participating, all potential participants recruited via WeChat received a comprehensive verbal explanation detailing the study’s purpose, procedures, their right to withdraw at any time without penalty, the anonymous nature of data handling, and the potential uses of the research findings. Participants indicated their consent to proceed with the study by clicking on the questionnaire link and submitting their responses after hearing this explanation.