{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:59:59Z","timestamp":1781168399037,"version":"3.54.1"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Josef und Luise Kraft-Stiftung"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med"],"DOI":"10.1186\/s12916-026-04992-9","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T03:33:55Z","timestamp":1781148835000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Palliative care for the people without medical insurance in Germany: an empirical ethical approach"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6148-5748","authenticated-orcid":false,"given":"Matthias","family":"Zimmer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8354-3060","authenticated-orcid":false,"given":"Antonia","family":"Sahm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"4992_CR1","unstructured":"World Health Organization. Pallative Care, Key facts. 2020. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/palliative-care. Accessed 6 Nov 2024."},{"key":"4992_CR2","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.jpainsymman.2024.07.030","volume":"68","author":"JM Griffin","year":"2024","unstructured":"Griffin JM, Mandrekar JN, Vanderboom CE, Harmsen WS, Kaufman BG, Wild EM, et al. Transitional Palliative Care for Family Caregivers: Outcomes From a Randomized Controlled Trial. J Pain Symptom Manage. 2024;68:456\u201366. https:\/\/doi.org\/10.1016\/j.jpainsymman.2024.07.030.","journal-title":"J Pain Symptom Manage"},{"key":"4992_CR3","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s13010-019-0075-6","volume":"14","author":"J Boldt","year":"2019","unstructured":"Boldt J. The concept of vulnerability in medical ethics and philosophy. Philos Ethics Humanit Med. 2019;14:6. https:\/\/doi.org\/10.1186\/s13010-019-0075-6.","journal-title":"Philos Ethics Humanit Med"},{"key":"4992_CR4","unstructured":"Deutscher Hospiz- und Palliativverband e.V. Ambulante Hospizarbeit. https:\/\/www.dhpv.de\/themen_ambulante-hospizarbeit.html. Accessed 10 June 2024."},{"key":"4992_CR5","doi-asserted-by":"crossref","unstructured":"Dodds S. Dependence, care, and vulnerability. In: Mackenzie C, Rogers W, Dodds S, editors. Vulnerability: New essays in ethics and feminist philosophy. 2014. pp. 181\u2013203.","DOI":"10.1093\/acprof:oso\/9780199316649.003.0008"},{"key":"4992_CR6","doi-asserted-by":"crossref","unstructured":"Rogers W. Vulnerability and Bioethics. In: Mackenzie C, Rogers W, Dodds S, editors. Vulnerability: New essays in ethics and feminist philosophy. 2014. pp. 60\u201387.","DOI":"10.1093\/acprof:oso\/9780199316649.003.0003"},{"key":"4992_CR7","first-page":"139","volume":"1989","author":"K Crenshaw","year":"1989","unstructured":"Crenshaw K. Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics. U Chi Leg F. 1989;1989:139\u201367.","journal-title":"U Chi Leg F"},{"key":"4992_CR8","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1080\/15265161.2018.1557275","volume":"19","author":"Y Wilson","year":"2019","unstructured":"Wilson Y, White A, Jefferson A, Danis M. Intersectionality in Clinical Medicine: The Need for a Conceptual Framework. Am J Bioeth. 2019;19:8\u201319. https:\/\/doi.org\/10.1080\/15265161.2018.1557275.","journal-title":"Am J Bioeth"},{"key":"4992_CR9","volume-title":"Ver(un)sichert? Wie Ausgrenzung psychisch belastet. Krank und ohne Zugang zu Gesundheitsversorgung in Deutschland","author":"C Bader","year":"2022","unstructured":"Bader C, Gach J, Offe J. Ver(un)sichert? Wie Ausgrenzung psychisch belastet. Krank und ohne Zugang zu Gesundheitsversorgung in Deutschland. M\u00fcnchen: \u00c4rzte der Welt e.V.; 2022."},{"key":"4992_CR10","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/s12939-023-01930-6","volume":"22","author":"M St\u00f6tzler","year":"2023","unstructured":"St\u00f6tzler M, Kaifie A. Healthcare for individuals without health insurance in Germany \u2013 a mixed methods approach to assess the situation and current challenges. Int J Equity Health. 2023;22:117. https:\/\/doi.org\/10.1186\/s12939-023-01930-6.","journal-title":"Int J Equity Health"},{"key":"4992_CR11","first-page":"A","volume":"119","author":"C Kurz","year":"2022","unstructured":"Kurz C. Menschen ohne Krankenversicherung: Ein oft \u00fcbersehenes Problem. Dtsch Arztebl. 2022;119:A\u20131738.","journal-title":"Dtsch Arztebl"},{"key":"4992_CR12","first-page":"179","volume-title":"Jahrbuch Ethik in der Klinik 2022","author":"A Sahm","year":"2022","unstructured":"Sahm A, Zimmer M. Gute Versorgung \u00c4lterer parallel zur Klinik? Strukturelle H\u00fcrden in der Versorgung von Menschen ohne Krankenversicherung. In: Fewer A, Klotz S, M\u00fcller S, Sahm A, editors. Jahrbuch Ethik in der Klinik 2022. Erlangen: K\u00f6nigshausen & Neumann; 2022. pp. 179\u2013204."},{"key":"4992_CR13","volume-title":"Gesundheitsreport \u2013 Krank und ohne medizinische Versorgung in Deutschland","author":"\u00c4rzte der Welt e. V","year":"2024","unstructured":"\u00c4rzte der Welt e. V. Gesundheitsreport \u2013 Krank und ohne medizinische Versorgung in Deutschland. M\u00fcnchen: \u00c4rzte der Welt e. V; 2024."},{"key":"4992_CR14","doi-asserted-by":"publisher","DOI":"10.14361\/9783839434727","volume-title":"Die medizinische Versorgung von Menschen ohne Papiere in Deutschland: Studien zur Praxis in Gesundheits\u00e4mtern und Krankenh\u00e4usern","author":"M Mylius","year":"2016","unstructured":"Mylius M. Die medizinische Versorgung von Menschen ohne Papiere in Deutschland: Studien zur Praxis in Gesundheits\u00e4mtern und Krankenh\u00e4usern. 1st ed. Bielefeld: transcript; 2016.","edition":"1"},{"key":"4992_CR15","unstructured":"Trabert G, R\u00f6thig M. Armut und Gesundheit in Deutschland e.V. 2015. https:\/\/www.armut-gesundheit.de\/ Accessed 25 Feb 2022."},{"key":"4992_CR16","first-page":"211","volume-title":"Medizin f\u00fcr Menschen ohne Papiere: Menschenrechte und Ethik in der Praxis des Gesundheitssystems","author":"J Gather","year":"2011","unstructured":"Gather J, Windeln H, Schwienhorst E-M, Medinetz. Das Beispiel Mainz. In: Mylius M, editor. Medizin f\u00fcr Menschen ohne Papiere: Menschenrechte und Ethik in der Praxis des Gesundheitssystems. G\u00f6ttingen: V & R Uni; 2011. pp. 211\u201324."},{"key":"4992_CR17","first-page":"33","volume-title":"Medizin f\u00fcr Menschen ohne Papiere","author":"A Fisch","year":"2011","unstructured":"Fisch A. Menschenrechte von Sans Papiers verpflichten - wen? Ethische und politische Reflexionen zur medizinischen Grundversorgung. In: Mylius M, Bornschlegel W, Frewer A, editors. Medizin f\u00fcr Menschen ohne Papiere. G\u00f6ttingen: V&R uni; 2011. pp. 33\u201362."},{"key":"4992_CR18","unstructured":"Gemeinsamer Bundesauschuss. Richtlinie des Gemeinsamen Bundesausschusses \u00fcber Schutzimpfungen nach \u00a7 20i Absatz 1 SGB V. 2023."},{"key":"4992_CR19","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1080\/10510974.2018.1462224","volume":"69","author":"L Ramos Salazar","year":"2018","unstructured":"Ramos Salazar L. The Effect of Patient Self-Advocacy on Patient Satisfaction: Exploring Self-Compassion as a Mediator. Commun Stud. 2018;69:567\u201382. https:\/\/doi.org\/10.1080\/10510974.2018.1462224.","journal-title":"Commun Stud"},{"key":"4992_CR20","doi-asserted-by":"publisher","first-page":"2348","DOI":"10.1111\/jan.12084","volume":"69","author":"TL Hagan","year":"2013","unstructured":"Hagan TL, Donovan HS. Self-advocacy and cancer: a concept analysis. J Adv Nurs. 2013;69:2348\u201359. https:\/\/doi.org\/10.1111\/jan.12084.","journal-title":"J Adv Nurs"},{"key":"4992_CR21","doi-asserted-by":"publisher","DOI":"10.25646\/5872","author":"T Lampert","year":"2019","unstructured":"Lampert T, Hoebel J, Kroll LE. Social differences in mortality and life expectancy in Germany. Current situation and trends. J Health Monit. 2019. https:\/\/doi.org\/10.25646\/5872.","journal-title":"J Health Monit"},{"key":"4992_CR22","unstructured":"United Nations General. Assembly Resolution A\/RES\/217A, Universal Declaration of Human Rights. 1948."},{"key":"4992_CR23","unstructured":"Schwerdt JM. Palliativversorgung von Menschen ohne Krankenversicherung. Eine deutschlandweite Befragung in Versorgungs- und Beratungsstellen. Universit\u00e4t Bonn; 2023."},{"key":"4992_CR24","unstructured":"Deutscher Hospiz- und Palliativverband e.V. Zahlen zur Hospiz- und Palliativarbeit. 2024. https:\/\/www.dhpv.de\/zahlen_daten_fakten.html. Accessed 28 Nov 2024."},{"key":"4992_CR25","unstructured":"Kassen\u00e4rztliche Bundesvereinigung. Spezialisierte Ambulante Palliativversorgung. 2024. https:\/\/gesundheitsdaten.kbv.de\/cms\/html\/17063.php. Accessed 28 Nov 2024."},{"key":"4992_CR26","unstructured":"GKV-Spitzenverband. Rahmenvereinbarung nach \u00a7 39a Abs. 1 Satz 4 SGB V \u00fcber Art und Umfang sowie Sicherung der Qualit\u00e4t der station\u00e4ren Hospizversorgung vom 13.03.1998, i. d. F. vom 18.11.2024. 2024."},{"key":"4992_CR27","unstructured":"Book Five of the Social Code. - Article 1 of the Act of 20 December 1988 (Federal Law Gazette I, p. 2477, 2482), as last amended by Article 3 of the Act of 22 March 2024 (Federal Law Gazette 2024 I 102)."},{"key":"4992_CR28","unstructured":"GKV-Spitzenverband. Rahmenvereinbarung nach \u00a7 39a Abs. 2 Satz 8 SGB V zu den Voraussetzungen der F\u00f6rderung sowie zu Inhalt, Qualit\u00e4t und Umfang der ambulanten Hospizarbeit f\u00fcr Erwachsene vom 03.09.2002, i. d. F. vom 21.11.2022. 2022."},{"key":"4992_CR29","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s00481-021-00631-4","volume":"33","author":"M H\u00e4dicke","year":"2021","unstructured":"H\u00e4dicke M, Wiesemann C. Was kann das Konzept der Diskriminierung f\u00fcr die Medizinethik leisten? \u2013 Eine Analyse. Ethik Med. 2021;33:369\u201386. https:\/\/doi.org\/10.1007\/s00481-021-00631-4.","journal-title":"Ethik Med"},{"key":"4992_CR30","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1177\/02692163231164729","volume":"37","author":"K Stajduhar","year":"2023","unstructured":"Stajduhar K, Gott M. Closing the health equity gap in palliative care: The time for action is now. Palliat Med. 2023;37:424\u20135. https:\/\/doi.org\/10.1177\/02692163231164729.","journal-title":"Palliat Med"},{"key":"4992_CR31","unstructured":"Tolbert J, Drake P, Damico A. Key Facts about the Uninsured Population. 2023. https:\/\/www.kff.org\/uninsured\/issue-brief\/key-facts-about-the-uninsured-population\/. Accessed 29 Oct 2024."},{"key":"4992_CR32","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1093\/med\/9780199297368.003.0002","volume-title":"Empirical ethics in psychiatry","author":"J McMillan","year":"2008","unstructured":"McMillan J, Hope T. The possibility of empirical psychiatric ethics. In: Widdershoven G, editor. Empirical ethics in psychiatry. New York: Oxford University Press; 2008. pp. 9\u201322."},{"key":"4992_CR33","unstructured":"Schneider W, Dill H, Gm\u00fcr W, von Hayek J, Marek S, Schneider S et al. Sterben zuhause im Heim \u2013 Hospizkultur und Palliativkompetenz in der station\u00e4ren Langzeitpflege."},{"key":"4992_CR34","unstructured":"Porst R. Wie man die R\u00fccklaufquote bei postalischen Befragungen erh\u00f6ht. (GESIS-How-to, 9). 2001."},{"key":"4992_CR35","unstructured":"Kassen\u00e4rztliche Bundesvereinigung. Gesundheitsdaten - Spezialisierte ambulante Palliativversorgung (SAPV) - Ausgaben. 2024. https:\/\/gesundheitsdaten.kbv.de\/cms\/html\/17061.php. Accessed 28 Nov 2024."},{"key":"4992_CR36","doi-asserted-by":"publisher","first-page":"102095","DOI":"10.1016\/j.eclinm.2023.102095","volume":"62","author":"T Schiffler","year":"2023","unstructured":"Schiffler T, Carmichael C, Smith L, Do\u00f1ate-Mart\u00ednez A, Alhambra-Borr\u00e1s T, Varad\u00e9 MR, et al. Access to cancer preventive care and program considerations for people experiencing homelessness across four European countries: an exploratory qualitative study. eClinicalMedicine. 2023;62:102095. https:\/\/doi.org\/10.1016\/j.eclinm.2023.102095.","journal-title":"eClinicalMedicine"},{"key":"4992_CR37","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1007\/s10900-017-0316-9","volume":"42","author":"M Akinlotan","year":"2017","unstructured":"Akinlotan M, Bolin JN, Helduser J, Ojinnaka C, Lichorad A, McClellan D. Cervical Cancer Screening Barriers and Risk Factor Knowledge Among Uninsured Women. J Community Health. 2017;42:770\u20138. https:\/\/doi.org\/10.1007\/s10900-017-0316-9.","journal-title":"J Community Health"},{"key":"4992_CR38","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1634\/theoncologist.2016-0274","volume":"22","author":"D Pulte","year":"2017","unstructured":"Pulte D, Jansen L, Brenner H. Population-Level Differences in Rectal Cancer Survival in Uninsured Patients Are Partially Explained by Differences in Treatment. Oncologist. 2017;22:351\u20138. https:\/\/doi.org\/10.1634\/theoncologist.2016-0274.","journal-title":"Oncologist"},{"key":"4992_CR39","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1186\/s12913-023-09751-7","volume":"23","author":"D Gesell","year":"2023","unstructured":"Gesell D, Hodiamont F, Bausewein C, Koller D. Accessibility to specialist palliative care services in Germany: a geographical network analysis. BMC Health Serv Res. 2023;23:786. https:\/\/doi.org\/10.1186\/s12913-023-09751-7.","journal-title":"BMC Health Serv Res"},{"key":"4992_CR40","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/1472-6963-13-94","volume":"13","author":"C Grabovschi","year":"2013","unstructured":"Grabovschi C, Loignon C, Fortin M. Mapping the concept of vulnerability related to health care disparities: a scoping review. BMC Health Serv Res. 2013;13:94. https:\/\/doi.org\/10.1186\/1472-6963-13-94.","journal-title":"BMC Health Serv Res"},{"key":"4992_CR41","doi-asserted-by":"publisher","unstructured":"Fricker M. Epistemic Injustice. Oxford University Press; 2007. https:\/\/doi.org\/10.1093\/acprof:oso\/9780198237907.001.0001.","DOI":"10.1093\/acprof:oso\/9780198237907.001.0001"},{"key":"4992_CR42","unstructured":"Koordinierungsstelle f\u00fcr Hospiz. und Palliativversorgung in Deutschland. Charta zur Betreuung schwerstkranker und sterbender Menschen in Deutschland. 2010."},{"key":"4992_CR43","unstructured":"Di Cesare D. Philosophie der Migration. 2. Aufl. Berlin: Matthes & Seitz; 2022."},{"key":"4992_CR44","unstructured":"World Medical Association. Declaration of Lisbon on the Rights of the Patient: adopted by the 34th World Medical Assembly, last reaffirmed by the 200th WMA Council Session. 2015."},{"key":"4992_CR45","unstructured":"68th World Medical Assembly General Assembly. Declaration of Geneva: adopted by the 2th World Medical Assembly, last reaffirmed by the 68th WMA General Assembly. 2017."},{"key":"4992_CR46","unstructured":"Federal Medical Association. [Muster-]Berufsordnung f\u00fcr die in Deutschland t\u00e4tigen \u00c4rztinnen und \u00c4rzte: MBO-\u00c4 1997 in der Fassung des Beschlusses des 124. Deutschen \u00c4rztetages. 2021."},{"key":"4992_CR47","unstructured":"Hill Collins P, Bilge S, Intersectionality. Cambridge; Malden (MA): Polity Press; 2016."},{"key":"4992_CR48","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1017\/S1478951511000563","volume":"10","author":"D Stienstra","year":"2012","unstructured":"Stienstra D, Chochinov HM. Palliative care for vulnerable populations. Palliat Support Care. 2012;10:37\u201342. https:\/\/doi.org\/10.1017\/S1478951511000563.","journal-title":"Palliat Support Care"},{"key":"4992_CR49","doi-asserted-by":"publisher","unstructured":"Lang SA, Tinnemann P, Z\u00f6llner R. Wege in den Krankenversicherungsschutz \u2013 Das Pilotprojekt Clearingstelle 1.0 am Gesundheitsamt Frankfurt am Main. Gesundheitswesen. 2024;:a-2250-3670. https:\/\/doi.org\/10.1055\/a-2250-3670","DOI":"10.1055\/a-2250-3670"},{"key":"4992_CR50","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s00103-019-02972-4","volume":"62","author":"M Mylius","year":"2019","unstructured":"Mylius M, Dreesman J, Z\u00fchlke C, Mertens E. Reduce obstacles, promote health-healthcare access for undocumented migrants within a pilot project in Lower Saxony, Germany (2016\u20132018). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019;62:927\u201334. https:\/\/doi.org\/10.1007\/s00103-019-02972-4.","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"4992_CR51","unstructured":"Husson J-F, Klinger C. Projet de loi de finances pour 2021: Sant\u00e9. Rapport g\u00e9n\u00e9ral n\u00b0 138. 2020."},{"key":"4992_CR52","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1097\/00124784-200307000-00009","volume":"9","author":"SM Koroukian","year":"2003","unstructured":"Koroukian SM. Assessing the Effectiveness of Medicaid in Breast and Cervical Cancer Prevention. J Public Health Manag Pract. 2003;9:306\u201314. https:\/\/doi.org\/10.1097\/00124784-200307000-00009.","journal-title":"J Public Health Manag Pract"},{"key":"4992_CR53","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s12910-024-01059-3","volume":"25","author":"M Zimmer","year":"2024","unstructured":"Zimmer M. Refusal of patients: care for people without health insurance in German emergency departments. BMC Med Ethics. 2024;25:56. https:\/\/doi.org\/10.1186\/s12910-024-01059-3.","journal-title":"BMC Med Ethics"}],"container-title":["BMC Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12916-026-04992-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-026-04992-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-026-04992-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:33:52Z","timestamp":1781166832000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12916-026-04992-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4992"],"URL":"https:\/\/doi.org\/10.1186\/s12916-026-04992-9","relation":{},"ISSN":["1741-7015"],"issn-type":[{"value":"1741-7015","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"assertion":[{"value":"26 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. No personal data were collected, indicating that no ethics vote was required in accordance with the statutes of the Ethics Committee of the Hesse Medical Association, see Sect.\u00a0 15 Code of Professional Conduct for Physicians in Hesse. Therefore, a review by the ethics committee was not requested and no approval number was issued.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Participation in the descriptive study was entirely voluntary. Before beginning their participation, the participants were informed that the data collection was completely anonymous. After receiving this information, they actively agreed to participate.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}],"article-number":"353"}}