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Article History

Received: 19 May 2025

Accepted: 8 September 2026

First Online: 30 September 2026

Declarations

Competing interests: The authors declare no competing interests.

Ethics approval and consent to participate: This study received ethical approval from Ankang University (approval number: S2024-020-01; approval date: 11 December 2023). The research was conducted in accordance with the Declaration of Helsinki. Participants’ names, identification documents, addresses, and other personal information were not collected. Anonymity and confidentiality were maintained throughout the study. All participants were fully informed of the study aims and procedures and provided informed consent before taking part. Consent to publish: Participant recruitment and data collection were conducted in three waves between March and May 2024. Informed consent was obtained by email on 25 March 2024, 21 April 2024, and 20 May 2024, immediately prior to each wave of the survey. All responses were collected anonymously after consent had been provided. No personally identifiable information is presented in this article. Participants were informed that only anonymized, aggregated findings would be used for academic publication; separate consent to publish identifiable individual data was therefore not applicable.