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Authors
Huang, Bingying
Tang, Jiaying
Guo, Zhiting
Chen, Ying
Zhou, Lili
Zhang, Fengying
Zhao, Qiaomei
Zhao, Hua
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Article History
Received: 25 July 2024
Accepted: 29 May 2026
First Online: 16 June 2026
Declarations
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: This study was conducted in accordance with the tenets of the Declaration of Helsinki and in strict compliance with local laws. Informed consent was obtained from all participants before enrollment. The study protocol was approved by the Institutional Review Board of the Second Affiliated Hospital of Zhejiang University (approval number 2023 − 0664). Data confidentiality was strictly maintained throughout the study period to ensure the privacy and rights of all participants. Permission for the translation of the Chronic Disease Helplessness Survey (CDHS) and for the use of instruments requiring authorization (such as the LHS-18) was obtained from their respective original developers prior to the study. Other instruments used in this study (such as the GAD-7 and PHQ-9) are freely available in the public domain.
: Not applicable.
: The authors declare no competing interests.
