Validation of an instrument in Latin America to measure fear perception of the consequences of a large-scale war (war-effect)

Christian R. Mejia; Renzo Felipe Carranza Esteban; Oscar Mamani-Benito; Luciana D Garlisi-Torales; Anthony Bautista-Pariona; Camilo Vega-Useche; Jamil Cedillo-Balcázar; Edilaine Braga-Souza; Carlos Jesus Iglesias Botello; Vanessa Ortiz; José Armada; Oriana Rivera-Lozada

doi:10.12688/f1000research.125170.1

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Research Article

Validation of an instrument in Latin America to measure fear perception of the consequences of a large-scale war (war-effect)

[version 1; peer review: 2 approved with reservations]

Christian R. Mejia¹, Renzo Felipe Carranza Esteban², Oscar Mamani-Benito³, [...] Luciana D Garlisi-Torales^4,5, Anthony Bautista-Pariona⁶, Camilo Vega-Useche⁷, Jamil Cedillo-Balcázar ^5,8, Edilaine Braga-Souza^5,9, Carlos Jesus Iglesias Botello^5,10, Vanessa Ortiz¹¹, José Armada¹², Oriana Rivera-Lozada¹³

Christian R. Mejia¹, Renzo Felipe Carranza Esteban², [...] Oscar Mamani-Benito³, Luciana D Garlisi-Torales^4,5, Anthony Bautista-Pariona⁶, Camilo Vega-Useche⁷, Jamil Cedillo-Balcázar ^5,8, Edilaine Braga-Souza^5,9, Carlos Jesus Iglesias Botello^5,10, Vanessa Ortiz¹¹, José Armada¹², Oriana Rivera-Lozada¹³

PUBLISHED 25 Nov 2022

Author details Author details

¹ Translational Medicine Research Centre. Universidad Norbert Wiener. Lima, Peru., Lima, Peru., Peru
² Grupo de Investigación Avances en Investigación Psicológica, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima, Peru., Peru
³ Universidad Señor de Sipan, Chiclayo, Juliaca, Peru
⁴ Universidad Nacional de Pilar. Pilar, Paraguay., Pilar, Paraguay., Paraguay
⁵ Federación Latinoamericana de Sociedades Científicas de Estudiantes de Medicina., Asunción, Paraguay., Paraguay
⁶ Department of Medicine, Universidad Nacional del Santa, Áncash, Peru., Peru
⁷ Universidad Pedagógica y Tecnológica de Colombia., Tunja, Colombia., Colombia
⁸ Carrera de Medicina, Facultad de Ciencias Médicas, Universidad Técnica Particular de Loja, Loja, Ecuador, Ecuador
⁹ Asociación Médica de Investigación y Servicios en Salud., Lima, Peru., Peru
¹⁰ Facultad de Ciencias de la Salud Dr. William C. Gorgas, Universidad Latina de Panamá., Ciudad de Panamá, Panamá., Panama
¹¹ Universidad Católica Nuestra Señora de la Asuncion, ,Asunción, Paraguay., Paraguay
¹² Universidad Continental., Huancayo, Peru., Peru
¹³ South American Center for Education and Research in Public Health, Universidad Norbert Wiener,, Lima, Peru., Peru

Christian R. Mejia
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Renzo Felipe Carranza Esteban
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Oscar Mamani-Benito
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Luciana D Garlisi-Torales
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Anthony Bautista-Pariona
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Camilo Vega-Useche
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Jamil Cedillo-Balcázar
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Edilaine Braga-Souza
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Carlos Jesus Iglesias Botello
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Vanessa Ortiz
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

José Armada
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Oriana Rivera-Lozada
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Background: The Russia-Ukraine war brought immediate and delayed socio-economic consequences. In general, the repercussions caused fear all over the world. This study aims to validate an instrument for measuring fear perception caused by the consequences of a large-scale war in Latin American citizens.
Methodology: An instrumental study in which 1705 residents of Bolivia, Colombia, Ecuador, Panama, Paraguay, Peru and other countries were surveyed through a virtual format. A literature search, expert judgment, preliminary (then exploratory and confirmatory) analysis, as well as reliability assessment were carried out.
Results: The skewness and kurtosis values of the 13 questions did not exceed the range ± 1.5 and showed significant correlations (>0.30). The Kaiser-Meyer-Olkin index (0.962) and Bartlett's test (19558.5; df=78; p=0.001) had good indicators. The parallel analysis suggested a single factor, which explained 75.59% of the total variance. The confirmatory factor analysis generated an instrument with six items (χ²=47.33, df=9, p=0.001; RMR=0.010; GFI=0.990; CFI=1.00; TLI=0.990; and RMSEA=0.050), with an overall Cronbach's Alpha=0.949 (95% CI=0.94–0.95).
Conclusion: A six-item instrument that measures the perception of fear caused by the consequences of a large-scale war was validated in half a dozen Latin American countries. This short and valid instrument can be administered to a broad population in Latin America.

Keywords

Latin America, War, Fear, Perception, Ukraine, Russian Federation.

Corresponding author: Jamil Cedillo-Balcázar

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2022 Mejia CR et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Mejia CR, Carranza Esteban RF, Mamani-Benito O et al. Validation of an instrument in Latin America to measure fear perception of the consequences of a large-scale war (war-effect) [version 1; peer review: 2 approved with reservations]. F1000Research 2022, 11:1387 (https://doi.org/10.12688/f1000research.125170.1) First published: 25 Nov 2022, 11:1387 (https://doi.org/10.12688/f1000research.125170.1) Latest published: 25 Nov 2022, 11:1387 (https://doi.org/10.12688/f1000research.125170.1)

Introduction

The coronavirus disease 2019 (COVID-19) pandemic is coming to an end, two years after it started in China and spread to practically all habitable territories in the world.¹^,² During this time, it has generated material and human costs for most families in different countries worldwide. No one can deny the great economic, social, mental and general health repercussions that various populations have suffered as a result of this pandemic.³^–⁹

This is the context in which another event that has had repercussions worldwide begun, the war between Russia and Ukraine. This conflict began to generate many repercussions at all levels in different countries.¹⁰ This is due to the possibility of an expansion of the war, especially due to the fact that the United States of America (USA) and its allies supported Ukraine, while China and its allies supported Russia.¹⁰^–¹² This led several people to think that there would be direct consequences generated by a war that would even reach far away regions, such as Latin America.¹³^,¹⁴

Subsequently, a series of consequences at the economic level started, since the USA and its allies imposed multiple sanctions on Russia. Russia did not want to be outdone and blocked all exports of oil, wheat and other products that they exported worldwide.¹⁵ This generated a series of repercussions for the economy, as there was an increase in prices in regard to oil and basic commodities, among many other items.¹⁶

In this panorama, many other repercussions have been foreseen, some acute, others that could last for several months.¹⁶ Therefore, it is important to measure the population's perception of the possible consequences of a war, not only in this context but also other possible war complications that may arise.¹⁰^,¹⁶ It is important to validate an instrument in Latin America because it is a very diverse region and is still in the context of the pandemic, which means that the repercussions of the war are mixed with those of COVID-19. Therefore, the objective of the research was to validate an instrument to measure fear perception caused by the consequences of a large-scale war in Latin American citizens.

Methodology

Design

Observational, analytical, instrumental and cross-sectional study.

Participants

Non-probabilistic sampling was used to recruit 1705 participants. The participants came most frequently from Peru, Paraguay, Panama, Ecuador, Colombia and Bolivia. Citizens over 18 years of age and residing in a Latin American country during the days of the survey (first three weeks of the conflict between Russia and Ukraine) were included. Those who did not agree to participate in the research and those with surveys that were incompletely answered (fewer than 150) were excluded.

Instrument

The questionnaire (war-effect) was administered. It was previously developed by the researchers and subjected to content and consistency evaluation procedures by experts. The initial instrument, which had 13 items, was administered to the participants virtually, using the most frequently used media (Facebook, WhatsApp and Instagram). It is worth mentioning that each of the questions had five response options formulated in accordance with the Likert format (from strongly disagree to strongly agree).

Procedure

After ethical approval, the war-effect questionnaire was analyzed and reviewed by the research team, before the evidence of content validity of the scale was analyzed. To this end, we requested the judgment of seven experts in different countries of Latin America (who were medical specialists, epidemiologists, teachers with master's or doctoral degrees, as well as some researchers with scientific publications). In this step, the relevance, representativeness and clarity of the items were analyzed.

Subsequently, from 5^th to 23^rd March 2022, the administration of the balance was carried out virtually through Google forms, thanks to the participation of multiple collaborators in all the countries involved in this research. Before filling in the instrument, the participants were informed of the objective of the research and were asked to give their consent to proceed to respond. The participation was completely voluntary and anonymous.

Data analysis

Descriptive analysis and exploratory factor analysis (EFA) were performed using the FACTOR Analysis program version 11.05. Thus, the mean, standard deviation, skewness and kurtosis of the 13 items of the scale were analyzed. Regarding the skewness and kurtosis coefficient, the value ± 2 was taken into account.¹⁷ For the EFA, the Kaiser-Meyer-Olkin coefficient (KMO) and Bartlett's test were considered. In addition, the estimation method we used was unweighted least squares with Promin rotation.¹⁸

In regard to the confirmatory factor analysis (CFA), the AMOS statistical program (version 21) was used, where structural equation modeling (SEM) was considered. The goodness-of-fit index (GFI), the Tucker-Lewis index (TLI) and the comparative fit index (CFI) were analyzed. Also, the parameters for the root mean square error of approximation (RMSEA) and the root mean square error index (RMR) were taken into account, following the criteria proposed by Hu & Bentler.¹⁹ These authors stated that the GFI, AGFI, TLI and CFI should be greater than 0.9 and the RMSEA lower than 0.08. Finally, the reliability of the scale was calculated using the SPSS statistical program (version 25.0) and its respective confidence intervals.²⁰

Results

Expert judgment

The expert judgment shows that the 13 items received a favorable evaluation by the experts in the great majority of results (V>0.7). Only the relevance and clarity of Item 9 had a value of 0.7. In addition, we can see that almost all the values of the lower limit (Ll) of the 95% CI are appropriate (Ll>0.59). Also, these values were lower in the case of the relevance and clarity of Item 9. Despite this, as they were in the appropriate threshold, they entered the second stage of validation. Thus, the war-effect scale in Latin America reports evidence of content-based validity (Table 1).

Table 1. Preliminary analysis of the items of the war-effect scale in Latin America.

Items	Relevance (N = 7)				Representativeness(N = 7)				Clarity (N = 7)
Items	M	SD	V	95% CI	M	SD	V	95% CI	M	SD	V	95% CI
Item 1	3.0	0.0	1.0	0.9–1.0	3.0	0.0	1.0	0.9–1.0	2.6	1.1	0.7	0.7–0.9
Item 2	3.0	0.0	1.0	0.9–1.0	3.0	0.0	1.0	0.9–1.0	2.7	0.8	0.9	0.8–1.0
Item 3	3.0	0.0	1.0	0.9–1.0	3.0	0.0	1.0	0.9–1.0	2.7	0.8	0.9	0.8–1.0
Item 4	2.9	0.4	1.0	0.8–1.0	3.0	0.0	1.0	0.9–1.0	2.7	0.8	0.9	0.8–1.0
Item 5	2.6	0.8	0.9	0.7–0.9	2.4	1.0	0.8	0.6–0.9	2.4	1.0	0.8	0.6–1.0
Item 6	2.7	0.8	0.9	0.8–1.0	2.7	0.8	0.9	0.8–1.0	2.7	0.8	0.9	0.8–1.0
Item 7	2.9	0.4	1.0	0.8–1.0	3.0	0.0	1.0	0.9–1.0	2.7	0.8	0.9	0.8–1.0
Item 8	2.7	0.8	0.9	0.8–1.0	2.7	0.8	0.9	0.8–1.0	2.6	0.8	0.9	0.7–0.9
Item 9	2.0	1.4	0.7	0.5–0.8	2.1	1.5	0.7	0.5–0.8	2.0	1.4	0.7	0.5–0.8
Item 10	2.4	1.1	0.8	0.6–0.9	2.6	1.1	0.9	0.7–0.9	2.4	1.1	0.8	0.6–0.9
Item 11	3.0	0.0	1.0	0.9–1.0	3.0	0.0	1.0	0.9–1.0	3.0	0.0	1.0	0.9–1.0
Item 12	3.0	0.0	1.0	0.9–1.0	3.0	0.0	1.0	0.9–1.0	2.9	0.4	1.0	0.8–1.0
Item 13	2.7	0.8	0.9	0.7–1.0	2.7	0.8	0.9	0.7–1.0	2.6	0.8	0.9	0.7–1.0

Preliminary analysis of the items

Table 2 shows the calculation of the mean, standard deviation, skewness and kurtosis (descriptive statistics) of the 13 items of the war-effect scale. It is observed that Item 1 had the highest mean score (M=3.66) and that Item 13 shows the highest variability (SD=1.07). The skewness and kurtosis values do not exceed the range ± 1.5.¹⁷ Moreover, the correlation between items were significant (all values>0.30).

Table 2. Preliminary analysis of the items of the war-effect scale in Latin America.

Item	M	SD	A	K	Inter-item correlation
Item	M	SD	A	K	Item 1	Item 2	Item 3	Item 4	Item 5	Item 6	Item 7	Item 8	Item 9	Item 10	Item 11	Item 12	Item 13
1	3.667	1.297	-0.926	-0.297	1
2	3.558	1.239	-0.773	-0.396	0.854	1
3	3.624	1.277	-0.873	-0.348	0.887	0.86	1
4	3.465	1.244	-0.674	-0.552	0.806	0.838	0.831	1
5	3.512	1.274	-0.726	-0.556	0.777	0.783	0.809	0.824	1
6	3.394	1.259	-0.582	-0.694	0.757	0.756	0.772	0.821	0.856	1
7	3.401	1.249	-0.550	-0.687	0.752	0.756	0.77	0.805	0.836	0.847	1
8	3.595	1.279	-0.778	-0.472	0.75	0.787	0.791	0.772	0.803	0.777	0.802	1
9	3.330	1.342	-0.459	-1.000	0.669	0.642	0.684	0.677	0.681	0.701	0.704	0.642	1
10	3.206	1.303	-0.364	-1.005	0.635	0.619	0.653	0.657	0.652	0.684	0.672	0.615	0.858	1
11	3.345	1.352	-0.473	-0.998	0.643	0.628	0.67	0.65	0.647	0.655	0.658	0.625	0.731	0.714	1
12	3.392	1.313	-0.556	-0.851	0.717	0.681	0.723	0.725	0.719	0.736	0.727	0.68	0.787	0.766	0.778	1
13	3.454	1.367	-0.597	-0.906	0.717	0.678	0.723	0.715	0.698	0.708	0.7	0.675	0.756	0.754	0.756	0.848	1

Exploratory factor analysis (EFA)

An EFA was performed after calculating the Kaiser-Meyer-Olkin index (KMO=0.962) and Bartlett's test (19558.5; df=78; p=0.001), both of which were good. The unweighted least squares with Promin oblique rotation method and the parallel analysis were used to determine the factors, which suggested the extraction of a single factor. The factor reached explains 75.59% of the total variance of the scale and its factor loadings range from 0.785 to 0.896 (Table 3).

Table 3. Exploratory factor analysis of the war-effect scale in Latin America.

N°	I’m afraid or worried that this war will have repercussions in terms of	F1	h2
1	Food shortages.	0.874	0.764
2	Not being able to import/export resources from the countries in conflict.	0.866	0.750
3	Other basic necessities being scarce because of the war.	0.896	0.803
4	Blocking all types of financial transactions with other countries.	0.891	0.794
5	The devaluation of my local currency or the dollar.	0.887	0.787
6	The devaluation of properties (houses, buildings, etc.).	0.885	0.784
7	The stock market crash.	0.881	0.775
8	The increase in prices of oil and other fuels due to the war.	0.849	0.720
9	Being called to enlist in the war.	0.824	0.679
10	Being asked for weapons and other resources to support the war.	0.798	0.636
11	Affecting my family/friends living near the war zone.	0.785	0.617
12	Restricting our free transit.	0.862	0.743
13	Not being able to study/work or do my daily duties due to this war.	0.845	0.714
Percentage of explained variance			75.59%

Confirmatory factor analysis (CFA)

A CFA was performed in order to analyze the evidence of validity, based on the internal structure of the war-effect scale. The results of the original model reported unsatisfactory goodness-of-fit indices. Therefore, through the index modification technique, two respecifications were performed. In the first one, Items 9, 10, 12 and 13 were eliminated, but a satisfactory fit was not achieved. In the second respecification, Items 1, 2 and 3 were eliminated and a satisfactory factor structure model was obtained (Table 4).

Table 4. Goodness-of-fit indices of the factor models of the war-effect scale in Latin America.

Goodness-of-fit index	Original	Model 1	Model 2
Goodness-of-fit index	(13 items)	(9 items)	(6 items)
CMIN	3805.10	1109.22	47.33
DF	65	27	9
P	0.000	0.000	0.000
CMIN/DF	58.54	41.08	5.26
RMR	0.100	0.040	0.010
GFI	0.670	0.840	0.990
CFI	0.860	0.940	1.000
TLI	0.840	0.920	0.990
RMSEA	0.180	0.150	0.050

The FI show that the six-item single-factor model is adequate (χ²=47.33, df=9, p=0.001; RMR=0.010; GFI=0.990; CFI=1.00; TLI=0.990; and RMSEA=0.050) (Figure 1).

Figure 1. Final model of the war-effect scale in Latin America.

Reliability

The scores of the war-effect scale are reliable (α=0.949; 95% CI=0.94–0.95). This instrument can be administered and we suggest, to determine those who have a greater perception of the repercussions of war, adding the scores (strongly disagree=1 point; disagreed=2 points; indifferent=3 points; agree=4 points; strongly agree=5 points). Having all the scores of the participants, those who are in the top tertile of the scores (33% of the best scores) should be considered those who perceive greater repercussions of a possible war (Figure 2).

Figure 2. Final draft of the war-effect scale in Latin America.

Discussion

In this study, 1705 responses were collected from Latin American residents to validate the “war-effect” scale. According to the values obtained in the statistical analysis of the scale and each of its items, we can conclude that the scale is a reliable method to measure and compare, the perception of war and the approach within Latin America. The analysis performed is similar to that proposed by Yuchun Zhou et al, in their work on how to develop and validate scales.²¹ Optimal results were obtained at all phases, and it was executed in a large population of multiple countries during the most critical weeks of the conflict between Russia and Ukraine; therefore, this scale can be used in multiple contexts and countries.

The instrument designed and validated in this research (war-effect) can be used and administered in the current context of the armed conflict between Russia and Ukraine. Moreover, it is designed to have a wide margin of action so it can be applied in different scenarios of armed conflicts, regardless of their scope. This instrument allows us to evaluate fear perception of consequences resulting from war in different war scenarios and situations, due to the intrinsic adaptability of the variables established in the war-effect questionnaire. On the other hand, this questionnaire could be used along with other instruments and scales that allow the evaluation of other components of the population’s mental health, as well as other changes influenced by the war context.²²^–²⁴

We have included questions that permit us to assess fear of the economic consequences of the conflict between Ukraine and Russia in the Latin American population. This is important because the economic and product exchange was stagnated between America and the conflict zone. This was not only due to the restrictions imposed, but also to the devaluation of the Russian currency, and the decrease in the supply of products, among others.²⁵ This will affect the economy of many countries in our region. For example, a decrease of up to 90% of bananas, flowers, and shrimps is expected in Ecuador. In addition, in Paraguay and Colombia, it has caused a limitation in meat export. Furthermore, within the framework of this conflict, the price of oil in Paraguay has increased by up to 70%.²⁶

These market changes are causing unemployment, strikes, and economic instability in Latin America. However, there could also be positive effects for some countries; for example, the limitation of fertilizer exports by Russia could benefit Bolivia by boosting its industry. In the case of Panama, this country remains neutral as long as the Panama Canal remains safe and open for the peaceful transit of ships of all nations on equal terms.²⁷^,²⁸ This shows us that there could be several, very varied consequences in the countries on this side of the world, but that they must be evaluated with instruments that have passed a rigorous validation process.

There are questions that measure the direct repercussion for family/friends living near the conflict, with which we can measure how it affects mental health. In addition, it is known that there are almost 100 thousand immigrants in Ukraine, coming from diverse countries, including Latinos, who now face not only the problems of discrimination, but challenges generated while trying to escape the war.²⁹^,³⁰ We can also mention the large group of migrants coming from Latin America, in recent years, not only because of the conflicts that have occurred in Venezuela, but also because of the poor situation in other countries such as Argentina and Peru. Therefore, it is necessary to have this type of instruments in order to determine whether there are relatives or people we know in that part of the world. In addition, this survey could be used for other wars or conflict, in general, occurring in other parts of the world.

The study’s limitation was the use of convenience sampling, which does not allow extrapolation of the results to the entire Latin American population or to the countries where it was administered. However, since it had a large population, this type of instrumental study does not require a random sampling; and more than 283 respondents were obtained for each of the six final questions. All in all, this research shows us an instrument that can be taken into account for different realities. Furthermore, it is the first instrument of its kind in the Latin American context. Additionally, it can be used for situations such as this Russian-Ukrainian war and in possible future warlike conflicts.

Taking into account all that was generated in the research, it is concluded that a short instrument was validated in half a dozen Latin American countries in the context of the war between Russia and Ukraine. All the validation stages were satisfactory and with very acceptable indicators. Recommendations for analysis are also provided, using the tertiles after the addition of the scores.

Data availability

Underlying data

DANS-EASY: Validation of an instrument in Latin America to measure fear perception of the consequences of a large-scale war (war-effect). https://doi.org/10.17026/dans-239-fyz5.³¹

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

Ethical approval

This research project was approved by the Ethics Committee of Universidad Norbert Wiener (Ethics Committee Resolution No. 1649-2022).

Informed consent

All respondents gave their written consent to participate in this study and fully answered the 13 initial questions of the previously created survey.

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