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Article History

Received: 1 August 2024

Accepted: 26 May 2025

First Online: 31 May 2025

Declarations

:

: This study was reviewed and approved by the Research Ethics Committee of the University of Tartu (approval numbers 332/T-21, 21 December 2020 and 345/M-7, 14 June 2021), which is one of two officially recognized research ethics committees in Estonia. In accordance with national research policy, a single central ethics approval is sufficient for multi-center studies, provided that all participating institutions have granted formal permission to be included. All participating hospitals provided such permission prior to submission to the ethics committee. For Surveys I (1999) and II (2009), written or verbal consent was obtained from the institutions in accordance with the legal requirements of the time. In Survey III (2021), informed consent was obtained electronically: participants were presented with a clearly formulated introductory statement explaining the purpose, anonymity, and voluntary nature of the study. By proceeding to complete the questionnaire, participants explicitly confirmed their informed consent. All methods were carried out in accordance with the relevant guidelines and regulations, including the Declaration of Helsinki []. Participation was voluntary and based on informed consent.

: Not applicable.

: The authors declare no competing interests.