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An Empirical Analysis of Work-life Balance on Work from Home during Covid-19 Pandemic: A Comparative Study on Men and Women
Abstract
Purpose:
The COVID-19 pandemic has brought tremendous changes and challenges to male and female employees. The idea of work-life balance means, that a human’s life outside of the job is equally important to their work life and that the amount of time spent working should be evenly divided by the amount of time spent doing things, such as occupied hours with friends and family, exercising, and other similar ventures. Amongst other challenges, attaining satisfaction and balance is a key challenge. Aim: The purpose of this study was to conduct a comparative analysis of men's and women's work-life balance during the COVID-19 pandemic lockdown, the theoretical framework of which is the work-life balance theory, which asserts that individuals should have an equitable distribution of time and energy between their work and personal life domains. The theory emphasizes the importance of maintaining a balance to promote overall well-being and satisfaction
Methodology:
The current study is descriptive, empirical, and quantitative. The data were collected through a questionnaire administered to 200 working men and women employees. The latest PLS method was also used to analyse the obtained data.
Results:
The findings reveal that women experience more workload than men because of their personal involvement in their jobs through the period of working from home. Notably, there were no gender variances in the connection between work interruptions and personal life. It was found that the organization could help to reduce work interference with personal life and that by doing so, employees’ work-life unevenness could be reduced to some level.
Practical and Social Implication:
Given the possibility of employees experiencing psychological stress, a company could consider arranging for a trained professional to provide online counselling. Such a strategic initiative by a company during stressful times could motivate employees. The environment may also aid employees in maintaining their psychological welfare
Conclusion:
Many prior studies have examined the nature of WLB and the psychological and behavioural disorders that employees face. This study aimed to investigate the work-life balance in which employees were mandated to work from home during the -19 pandemic.
1. INTRODUCTION
The COVID-19 pandemic is a worldwide epidemic of coronavirus (COVID-19), cognate by SARS Coronavirus type 2 (SARS – COV-2). This unique virus was recognized during an outburst in Wuhan, China, in December 2019. The country attempted to control the virus, but failed and allowed it to spread to other parts of the world. On 30th of January 30, 2020, the World Health Organization (WHO) announced a Public Health Emergency worldwide. The global pandemic, which began on March 11, 2020, caused over 6.37 million confirmed deaths and 563 million cases as of July 19, 2022, making it one of the most life-threatening diseases in history. Given the lack of a vaccine or medicine to treat the virus, social disconnection was suggested as a conceivable way to avoid infectious diseases. On March 24, 2020, the Indian Prime Minister announced a 21-day nationwide lockdown until April 3, 2020, which was later extended until 3rd May 2020 [1]. Some industries made employees comply with government mandates. After the proclamation of the worldwide lockdown in India to prevent the virus from spreading, the vast majority of businesses chose to work from home (WFH). The circumstances at home were quite different during the lockdown, as all family members were locked inside the house. On the other hand, quarantine offers an opportunity for time with the family, but it also makes managing responsibilities at home difficult. Outdoor movement restrictions altered people’s way of life. It took a lot of effort from everyone in the family to keep all family members committed and facilitate their psychological well-being. Felstead (2002) defined WLB as the relationship between organizational and societal work and non-work time and spaces in the community where revenue is primarily created and scattered through labour. Individuals, families, work and organisations, and the social environment are the major determinants of WLB shown in Fig. (1) Greenhaus (2002).
Most employees found it difficult to WFH during lockdown and had to participate in some household chores whether they were living alone or with family. Coordination between family and work demands during the lockdown was difficult [2]. Each employed person faced difficulties. Boundary theory states that individuals set up and maintain physical, chronological, and psychological boundary lines surrounding themselves to make their lives easier [3]. Amidst the lockdown, the inevitable challenge arose of work-life conflicts encroaching upon personal life or family dynamics affecting professional responsibilities. Emotional exhaustion may have ensued from the resultant conflicts between work and personal spheres during this period [4]. This research aims to explore the reported work-life balance (WLB) of employees working from home during the COVID-19 pandemic and examine variations in WLB experiences between men and women.
1.1. Positive Effects of Work from Home
Remote work offers increased flexibility in completing tasks. Individuals accustomed to daily laptop use often require a dedicated desk and chair. However, when working from home, employees have the freedom to choose their workspace, ranging from the living room to the bedroom or dining area. This flexibility allows them to evaluate and optimize their comfort levels during work. A key aspect of working from home is that employees enjoy autonomy in managing their daily tasks. An important benefit of remote work is the absence of a mandatory office presence. This eliminates the need for commuting expenses such as transportation or fuel costs. Working from home enables employees to efficiently complete their tasks, fostering job satisfaction. Increased job satisfaction is likely to boost both productivity and loyalty among remote workers. Additionally, the flexibility of a home environment allows employees to establish a secure, comfortable, and enjoyable workspace [5].
1.2. Negative Effects of Work from Home
A drawback associated with remote work is the potential decline in employee motivation. This can be attributed to various factors such as an unexpected or less conducive working environment at home, a disparity in the atmosphere compared to an office setting, and distractions from social media and other forms of entertainment. Employees who find themselves compelled to work in less-than-ideal conditions may experience a loss of motivation in their professional tasks. When working in an office, the institution is responsible for the cost of electricity and internet access. There will be no proper communication between employers and employees. The effectiveness of the productivity will not be as expected [5].

2. MATERIALS AND METHODS
2.1. Work-life Balance
WLB does not indicate dividing one's time into the middle of the job, family, and commitments. WLB is also emphasized as an idiosyncratic phenomenon that varies from person to person. In this regard, work-life balance should be viewed as appropriately allocating available resources such as time, thought, and labour among the elements of life. While some adhere to the philosophy of “working to live” and view work as the goal, others consider “living to work” and put work at the centre of life [2, 6] The study confirms thatwork–life imbalance has a negative impact on well-being and effective functioning. However, by examining work in isolation, employees can gain an incomplete understanding of its effects. A study discovered that acknowledgment is connected with WLB, which results in job satisfaction, and that the effects of incentives and appreciation for work contributions are reflected in their satisfaction [7]. Due to the difficulties faced by employees, the link between work responsibilities and WLB is positive. In this case, the worker's mistakes are turned into learning experiences in order for the worker to meet the mission and the company's objectives. This motivates workers to look forward to completing the additional tasks. WLB is commonly regarded as a personal concept, with balance explained as the apparent lack of disparity between employees' jobs and family roles [8]. As dual-career families have become more common and heavy workloads and long working hours have become the norm, WLB has become an important issue in all fields of work [9]. Employees' WLB was measured, and it was discovered that average hours of work and work-related stress, as well as occupation, age, and caring responsibilities, were very important determinants of employees' WLB. Conflicts over WLB have an impact on the health of working women, who report more stress, headaches, muscle pain, weight gain, and depression than their male equivalents. (Stankeviciute and Kunskaja (2022) revealed the significance of household responsibilities in influencing WLB, with higher family requirements indicating a lower WLB. Given that WLB benefits both employees and organizations in the long and short term, organizations are fortified to adopt HR practices that may contribute to higher WLB levels. A study revealed that work-family policies are an important but insufficient strategy for providing employees with an effective balance between work and family demands. Most employers concentrate on specific work-family policies to address work-family issues [11]. A Study investigated the links between home and work engagement, psychosocial factors, and employee engagement [12]. According to the findings, psychological empowerment and availability, as well as WLB, are considered a notable segment of the difference in employee engagement. A positive work-home connection was associated with feelings of psychological meaningfulness and availability at work, whereas a negative home-work connection had a negative impact on psychological availability. The authors investigated the origin of work-family role ambiguity and its implications for work-to-family disparity [13]. The power of this link depends on workers' access to and attention to specific job resources and demands. The link is stronger among employees who report stress intensity factors and poorer among those who have decision-making authority and schedule control [14]. Employers must have a broader view of work-life balance policy in order to include those who do not have traditional family responsibilities, which may require organizations to attempt to combat long-hours culture and increase the chance of flexible working for all employees. A study demonstrated that household contribution was more heavily associated with work-family disputes than overall contribution, showing that insight into work-family organizational support, both common and work-family specific, was related to work-family disputes [15, 16]. Work-life balance issues were not caused by increases in working time, and people complaining about time pressure are not impartially related to the time spent by the people at work. Shorter work days are undoubtedly appreciated by some workers and make it easier for many to accomplish a more enjoyable or less troubling work-life balance [17]. The existence of worker programs in organizations, such as managing pressure and malleable labour schedules, and the multifaceted nature of agony appear to have a negative influence on health and WLB [18]. Employers, as well as the family, all result in employee satisfaction with work-life balance and assist employees in dealing with the demands placed on them in various life domains [19]. Findings show that both men and women acknowledge a substantial portion of people’s work-life disputes regarding job-related issues are slightly compared to non-job-related issues. Particularly for women, the challenges, specifically related to their working hours and limited resources, have been a significant point of contention, furthermore, the demands of their work hours, as well as a shortage of resources, have been the source of contention. The essence of ideal employees in the workplace can explain managers' concerns as well as unjustifiable pay and leave entitlements. As a result, full-time working women require fair and equal WLB to direct their job and non-job roles in a flexible way. Enhancing women's capacity to manage dual roles requires not only supportive managers and flexible options but also heightened organizational sensitivity, particularly with supervisors being attuned to the socially constructed dilemmas they may face [20]. The work-family conflict had a beneficial and significant impact on workplace loneliness, but it could not mitigate the impact of spirituality at work on the choice to stay. However, the influence of spirituality in the workplace on female employees’ intention to stay was moderated by loneliness at work [21]. Overall, work-life balance is related to family support, which is shown in the work and adds to job happiness, which is effective in productivity.
2.2. Work from Home
WFH productivity has been practiced during the COVID-19 pandemic. According to the findings, the average work-from-home productivity compared to working in the usual workplace was around 60-70%, and it was relatively low for workers and companies that began practising work from home only after the COVID-19 pandemic spread. WFH efficiency was found to be slightly lower in highly educated and high-wage employees [22]. Working from home enhanced the psychological contract between employees, their managers, and the organization. Managers allowance decisions are also influenced by employee's trustworthiness [23]. Arntz et al. investigated the relationship between work arrangements and work hours, salary, and job satisfaction for various demographic groups [24]. The study discovered that WFH participants without a child worked an additional hour of overdue work per week and described high work contentment [1]. Organizational leaders must consider their workers' job satisfaction during WFH. It is irrefutable that WFH can disrupt employees' WLB and increase their work stress [5]. Work from Home can be done effectively if both parties are responsible. Even though they work in different locations, both parties must learn more about the conditions that arise to provide the best possible performance [25]. Unlike workplace flexibility, women and parents with school-aged children have greater access to work-at-home opportunities. Higher levels of education, such as flexible schedules, are associated with a greater likelihood of working from home [26]. Flexibility in work layout that allows people to integrate into the curriculum and non-work commitments, as well as a good opportunity option that may help organisations recruit and retain valuable human resources [27]. Face-to-face interactions are reduced by remote work. Consequently, increasing the number of home-based workers can help reduce the number of infections at a lower economic cost than many other isolation policies [28]. It was discovered that home demands, in particular for men, were related to job exhaustion. The significance is that the home side of the exponential function is underestimated in terms of how it affects individuals and their spouses’ work roles [29]. Work should be designed such that tasks can be completed within usual or contractually agreed-upon work hours, and employees' availability for work in their spare time should be minimized. Free time should be spent as such. The study [30] discovered that the standard organisational leadership styles have faded in relevance. Not only do the findings emphasize the significance of leadership styles, but they also demonstrate that employee motivation is an essential component of every successful firm [31]. Under this new normal, a remote working arrangement thrived. With the constant increase in jobs that allow for remote working, more individuals are working from home, giving them an easier way to manage work and family by lowering travel time, allowing for more flexibility in work hours, and achieving a better work-life balance.
2.3. Role of Gender
The gendered realism of WLB during COVID-19 focus on how variations in society replicate and influence the gender-based division of unpaid labour, such as housework and childcare errands (Hjalmsdottir & Bjarnadottir, 2021). A study [32, 33]. revealed public relations professionals' perceptions, challenges, and strategies in balancing work and life outside work. The study results lead to a new comprehension of WLB by implying that both women and men in public relations construct and navigate a work-personal continuum [34]. Men and women in professional or managerial roles want to devote more time to their families, particularly when their children are young, and this is stressful if it is difficult to achieve. Long-hour cultures, stress, and unhealthy habits, such as poor diet and increased consumption of alcohol, have all been conclusively linked [35]. New organizational practices and strongly gendered organizational and national cultures present work-life balance challenges. Working time can be reduced for both men and women, as well as help to rebalance the gender division of work. Coban (2022) revealed that, during the pandemic, responsibilities such as childcare, distance education, and domestic chores were primarily carried out by women. Telework has combined gender roles and raised the risk of offending women in the labour market [36, 37]. The COVID-19 crisis widened gender disparities in self-reported productivity and job satisfaction. An extensive survey initiated in the early stages of the pandemic revealed that women are inclined to psychological distress because they are less productive and engage in other negative behaviours [38]. It is irrefutable that working from home can disrupt the WLB among workers and increase work pressure. A study explored the possible disparities in men's and female's chances to enact their preferred boundary strategic plan in both work and personal life contexts and found that researching work requires easy accessibility and working time in relation to boundaries, that is, implemented assimilation, boundary impact on decision making, and perceived boundary control. Therefore, it is critical to achieve WLB. A study [39] shows how the COVID-19 lockdown has increased women's family responsibilities, leading to perpetual role conflict that has been worsened by the structural and interpersonal roles of women, particularly during the lockdown [40]. While simultaneously offering significant obstacles to role differences, women’s roles have become more crowded because of remote work. The study also discovered that the lockdown has allowed for the revelation of family values and deep connections [41]. For both men and women, having children in the home was connected with an absence of WLB, but for women, these struggles persisted for a long time and assumed very challenging forms. Women are expected to make seamless or ideally undetectable shifts between home and workplace throughout their lives. It is difficult to assess how self-employment affects work-life balance [42]. Particularly for women, space-time control and adaptability were crucial to work-life balancing experiences, although it was rarely discussed how much control they actually had over their working hours vs. how much was dictated by client and family demands.
The analysis of prior literature indicates a lack of clear distinction between work and personal life, underscoring the need for a comprehensive understanding of the evolving intersections of life and work domains. In the context of the COVID-19 pandemic, minimal research has been conducted in India on the correlation between family and job-related factors influencing work-life balance. Recognizing the significance of the work-life balance issue in India during the pandemic, the present study was undertaken with specific objectives.
2.4. Research Objectives
1. Examine the impact of the COVID-19 pandemic on work-life balance (WLB).
2. Evaluate the relationship between WLB and WFH.
3. Identify the factors influencing WLB in relation to gender (men and women).
4. Define the moderating influence of gender on the association between working from home (WFH) and work-life balance (WLB) (Fig. 2).

3. RESEARCH METHODOLOGY
This study employs a descriptive research design, utilizing a survey methodology for data collection. The data acquisition took place during the lockdown period and specifically targeted employees engaged in remote work from home.
3.1. Sampling Design
A convenient sampling method was used with a sample size of 200 for this study, and an adopted questionnaire was used to obtain data from the potential respondents online to obtain data.
3.2. Measurement
Work-from-home (WFH) measurements were adapted from [43] a 5-point Likert scale to 12 items comprising five indicator sub-scales (productivity, attitudinal factor, social factor, and situational factor based on resource and distraction). Work-life balance (WLB) was adapted from the work-life balance self-assessment scale [44], which consists of three factors: work interference with personal life (WIPL), personal life interference with work (PLIW), and a questionnaire with nine items on a 5-point Likert scale.
4. RESULTS AND DISCUSSION
4.1. Demographic Profiles of the Respondents
Data were collected from a total of 200 participants. It can be observed from Table 1 that the majority of the respondents were women 56.5% and 43.5% were male. It was also found that the age group between 21-25 years constituted 39% whereas 26-30 years constituted the most significant category at 40%, and 31-35 years constituted 14.5%, and 36 years and above constituted 6% only. The majority of the respondents were unmarried (67.5%) and 32.5% were married. The data shows that 74% of respondents had 1-5 years of experience, 18% had 6–10 years of working experience, and 8% had more than 10 years of experience. Most of the respondents were working in the private sector (73.5%), and 20.5% were from the public sector. 51% of respondents had an undergraduate degree, 40% had a postgraduate degree, 6% had a doctoral degree, and 3% had a diploma. The sociodemographic characteristics of the respondents are presented in Table 1.
Demographical Variables | Frequency | Percentage | |
---|---|---|---|
Gender | Male | 87 | 43.5% |
Female | 113 | 56.5% | |
Age | 21-25 years | 78 | 39.0% |
26-30 years | 81 | 40.0% | |
31-35 years | 29 | 14.5% | |
Above 35 years | 12 | 6.0% | |
Marital Status | Married | 65 | 32.5% |
Unmarried | 135 | 67.5% | |
Education | Diploma | 6 | 3.0% |
Bachelor’s Degree | 102 | 51.0% | |
Master’s Degree | 80 | 40.0% | |
Doctorate | 12 | 6.0% | |
Working Experience | 1-5 years | 148 | 74.0% |
6-10 years | 36 | 18.0% | |
More than 10 years | 16 | 8.0% | |
Current Employment | Private Sector | 147 | 73.5% |
Public Sector | 41 | 20.5% | |
Others | 12 | 6.0% |
4.2. Measurement Model
We used three measures to assess the research model: discriminant validity, composite reliability (CR), and convergent validity. All the tested items, the basic outer loading value was greater than 0.5, the composite reliability value was greater than 0.7, and all the variables were considered valid, as shown in Table 2.
4.3. Discriminant Validity
The test was carried out by differentiating √AVE from the variable correlation. If the outcome indicated that √AVE was higher than the correlation between the variables, the rule was valid. Table 2 shows that AVE was higher than the correlation value between the variables, indicating that it passed the discriminant validity test. The test results are listed in Table 3 and shown in Fig. (3).
Constructs | Items | Loading | Cronbach’s Alpha | CR |
---|---|---|---|---|
Work-life balance | WLB1 | -0.698 | .863 | .863 |
- | WLB2 | 0.803 | - | - |
- | WLB3 | 0.806 | - | - |
- | WLB4 | 0.746 | - | - |
- | WLB5 | 0.856 | - | - |
- | WLB6 | 0.824 | - | - |
- | WLB7 | 0.864 | - | - |
- | WLB8 | 0.796 | - | - |
- | WLB9 | 0.853 | - | - |
Work From Home | WFH1 | 0.800 | .965 | .966 |
- | WFH2 | 0.832 | - | - |
- | WFH3 | 0.854 | - | - |
- | WFH4 | 0.833 | - | - |
- | WFH5 | 0.858 | - | - |
- | WFH6 | 0.871 | - | - |
- | WFH7 | 0.863 | - | - |
- | WFH8 | 0.893 | - | - |
- | WFH9 | 0.897 | - | - |
- | WFH10 | 0.888 | - | - |
- | WFH11 | 0.842 | - | - |
- | WFH12 | 0.780 | - | - |
Variables | AVE | √AVE |
---|---|---|
WFH | 0.726 | 0.852 |
WLB | 0.651 | 0.806 |

4.4. Structural Model
The structural model was tested after meeting all estimated model standards for discriminant validity, composite reliability, and convergent validity. The goodness of fit can be seen with the structural model testing of PLS. Endogenous variable represented by the R2 value. For example, the endogenous variable, WFH, was (0.218) (21%). WLB and sex were found to affect WFH. The estimated significance Q2 value can be computed as follows:
Q2 = 1-(1-R12) (1-R22) (1-R32)
Q2 = 1-(1-0.218)
Q2 =1-(0.782)
Q2=0.218
4.5. Hypotheses Testing
The path coefficient of partial least squares (PLS) was used in hypothesis testing to show the amplitude of the impact of one endogenous variable on the exogenous variable. The path coefficient was calculated using Smart-PLS software and the bootstrap technique with 1000 subsamples. Furthermore, t > 1.96 and p 0.05 were the standard for a 95% significance level with a standard error of 5%. The results of the data analysis are presented in Table 4.
Table 4 shows the overall outcomes of the study, which indicate the connection between WLB and work from home. It shows that WLB has a significant impact on WFH, with a standardized coefficient (β (Beta) = 0.279), t = 2.264, >1.96, p<0.05). Hypothesis 1 confirms that WLB has a positive impact on WFH.
The above finding also shows that gender has a negative effect on WLB and WFH, with standardized coefficients (β (Beta) = -0.522, t=6.983 >1.96, p<0.05. Hypothesis 2 also supported that gender has a significant negative effect on working from home.
The formulated Hypothesis 3 is not confirmed from the obtained result that gender has a moderating role between WLB and WFH (β=0.155, t=1.237>0.261, p>0.05).
Hypothesis | Relationship | Path Co-efficient | t-value | p-value | Supported |
---|---|---|---|---|---|
H1 | WLB →WFH | 0.279 | 2.264 | 0.024* | Yes |
H2 | Gender →WFH | -0.522 | 6.983 | 0.000** | Yes |
H3 | Gender →WLB, WFH | 0.155 | 1.237 | 0.216 | No |
CONCLUSION
The global COVID-19 lockdown compelled a substantial number of employees to transition to remote work (WFH). Amidst this shift, concerns about work-life balance (WLB) arose, particularly as economic uncertainties led to fears of temporary layoffs. The challenge of balancing job responsibilities with family obligations became a significant source of emotional distress for employees during the lockdown. Notably, working women faced a dual burden, struggling to reconcile family and work roles exacerbated by prevailing gender norms in certain societies. In these exceptional circumstances, the support of family and friends proved crucial for working women, especially in managing overloaded family responsibilities. Public initiatives urging family members to actively participate in household tasks aimed to alleviate the challenges faced by women, fostering a more balanced distribution of responsibilities. The implementation of Work from Home (WFH) policies was perceived as a potential facilitator for improving work-life balance. The nationwide lockdown, driven by the COVID-19 pandemic, intensified the need for employees to adapt to remote work. Among the reported causes of emotional fatigue during this period was the ongoing effort to harmonize work and family obligations. Working women, grappling with societal gender roles, stood to gain significant support from family members in navigating family-related tasks during this extraordinary situation.
PRACTICAL IMPLICATIONS
The analysis confirms that there is no significant correlation between gender and work-life balance, and a negative impact is observed. The results highlight the necessity for organizational assistance in helping employees adapt to the evolving work environment. This finding aligns with prior research, emphasizing the challenge employees face in balancing personal and professional aspects due to inflexible working hours, particularly evident in a pandemic with numerous constraints. The organization is urged to support employees in navigating the challenges posed by static working hours, as this could facilitate a more effective adaptation to the new work situation. Establishing clear boundaries between family and work life is identified as a challenging aspect of achieving a favourable work-life balance, especially during a pandemic. Building on insights from previous studies, effective work-life balance methods are crucial when well-designed and implemented, with explicit support from management. This underscores the importance of strategic organizational efforts in facilitating a conducive work environment that fosters work-life balance for employees [1]. The consequences may impact the personal well-being of the employees. During a lockdown-induced WFH, the organisation can help an employee's psychological well-being. Given the possibility of employees experiencing psychological stress, a company could consider arranging for a trained professional to provide online counselling. Such a strategic initiative by a company during a stressful time. The environment may also aid employees in maintaining their psychological welfare [4]. The results additionally indicate a direct association between perceived work-life balance and spousal support, with no mediation by conflict perceptions. This observation is intriguing as it suggests that the relationship between spousal support and constructs like work-life balance (WLB), work-life dispute, or life-work dispute may vary in different organizational contexts or positions. Additionally, work-related factors can play a role in shaping individuals' beliefs regarding the extent of conflict between family and work roles.
LIMITATIONS
The study's limitations stem from a narrow scope of variables, potentially restricting the insights into work-life balance (WLB) achieved by employees working from home (WFH) during the lockdown. Data collection exclusively relied on online surveys within a brief timeframe, resulting in a limited sample size. A more extensive sample could have enhanced the reliability and utility of the findings. Furthermore, incorporating additional variables might have offered a more comprehensive understanding of the WLB experiences of individuals working from home during the lockdown. Comparative analyses involving diverse industries could have provided clearer insights into the relationship between WLB and the challenges faced by workers in different sectors. Expanding the scope to include data from various industries and conducting comparative analyses might have offered greater clarity on the connection between WLB and the emotional fatigue experienced by individuals across diverse professional domains.
LIST OF ABBREVIATIONS
WFH | = Work from Home |
WIPL | = Work Interference with Personal Life |
ETHICS APPROVAL AND CONSENT TO PARTICIPATE
The Ethical Committee of the Vellore Institute of Technology, (VIT University) Vellore, approved the study.
HUMAN AND ANIMAL RIGHTS
No animals were used in this research. All procedures performed in studies involving human participants were in accordance with the ethical standards of institutional and/or research committees and with the 1975 Declaration of Helsinki, as revised in 2013.
CONSENT FOR PUBLICATION
All human subjects gave their consent to participate in this study.
STANDARDS OF REPORTING
COREQ guidelines were followed.
AVAILABILITY OF DATA AND MATERIALS
The data and supportive information are available within the article.
FUNDING
This study was not a funded project.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
ACKNOWLEDGEMENTS
Declared none.