Media accountability and journalists: to whom do Spanish professionals feel responsible?

1 This is an Accepted Manuscript of the published article: Chaparro Domínguez MA, Suárez Villegas JC, Rodríguez Martínez R. Media accountability and journalists: to whom do Spanish professionals feel responsible? Journalism Practice. 2019 Aug 20. DOI: 10.1080/17512786.2019.1655470 MEDIA ACCOUNTABILITY AND JOURNALISTS To whom do Spanish Professionals feel Responsible? This paper analyses to whom Spanish journalists feel responsible. To achieve this objective, we sent out a survey to Spanish journalists to ascertain their opinion on this question. The journalists’ point of view was then compared with that of the general public though six focus groups consisting of Spanish citizens from six cities in Spain (Barcelona, Castellón, Madrid, Sevilla, Mondragón and Santiago de Compostela). Lastly, five in-depth interviews were conducted with journalism experts (e.g. directors of professional journalist associations). The main results show that the journalists feel particularly responsible to their conscience, the journalism code of ethics and their sources. The citizens, in contrast, believe that journalists should be responsible to the audience. We contextualised the Spanish finding in the European context by comparing our results with those derived from a study among European journalists. KEYWORDS: citizens; conscience; journalists; media accountability; responsibility; Spain. Introduction Media accountability is a fundamental aspect of any democracy (Bertrand 2000; Mauri- Ríos and Ramón-Vegas 2015; Ramón-Vegas and Rojas-Torrijos 2017). The current hybrid media system, in which traditional media and new media exist side by side with their respective practices and contents (Chadwick 2013), has simultaneously witnessed a decline in public confidence and a growing concern over the ethical standards that should characterise the journalists’ day-to-day work (Van der Wurff and Schönbach 2014; Plaisance 2013). Media professionals need a "moral compass" (Kovach and Rosenstiel 2001, 181), a set of ethical standards, both the service of the public interest and of the quality of information (Frost 2011; Rodríguez-Martínez et al. 2017). According to the analysis of a survey of 1,762 taken of journalists from the United Kingdom, Finland, the Netherlands, Germany, Austria, Switzerland, France, Italy, Spain, Tunisia and Jordan, the MediaAcT research project showed that these journalists considered both the traditional accountability instruments and the newer online instruments inadequate to guarantee the quality of information (Fengler et al. 2015). The journalists who took this survey also rejected state intervention as a system of media regulation, since it would sanction political abuse. On the other hand, the audiences demand media transparency, accountability and a more professional form of self-regulation to improve the quality of published news (Van der Wurff and Schönbach 2014). Therefore, it is observed how the media 2 accountability is an issue that worries both journalists and their audiences. Thus, the social responsibility of the media is a central topic in democratic societies around the world from the Second World War until today (Christians and Nordenstreng 2009; Schauster, Ferrucci and Neill 2016). Yet to whom do journalists feel responsible and to whom should they be held accountable? The present study addresses these two questions by taking into account the two key actors in the journalistic process: the journalist and the citizen. It is framed in the Spanish context, where no studies have been conducted on this subject. In recent years a number of investigations involving Spanish journalists have been carried out into journalism practice, such as how content published on social media is corroborated (Brandtzaeg, Følstad, and Chaparro-Domínguez 2018) or how journalists work in the field of data journalism (Appelgren and Salaverría 2018; La-Rosa and Sandoval-Martín 2016). The research by the aforementioned MediaAcT project allowed us to determine, through its survey of 123 Spanish journalists their opinion of how journalists voice and receive professional criticism (Rodríguez-Martínez, Mauri-De los Ríos, and Fedele 2017). The results showed that journalists tend to include criticism, both expressed and received, in their daily routines, and that they pay special heed to criticism from the audience. The present research, carried out through an online survey focuses on Spanish journalists' perceptions of to whom they feel they should be held accountable in their daily work. To obtain a more complete picture of the Spanish scenario, views of citizens on the subject were analysed in six focus groups held across Spain. The opinions of the journalists and the citizens were supplemented by interviews with journalism experts. Media Accountability Media Accountability refers to media organisations’ commitment to provide an account of their activities to society (Pritchard 2000; Harro-Loit 2015). This concept tends to be related to the media's recognition of certain responsibilities, functions and objectives (Christians et al. 2009) “as a requirement of the media in return for the freedom and privileges (access to information, tax reductions, etc.) that they receive” (Lauk, Harro- Loit, and Väliverronen 2014, 83). Such accountability means in practice that authors of information, in a wide sense (journalists, sources, gatekeepers, etc.), are accountable for the quality and consequences of their copy, which is aimed at the citizens and others involved, and which should therefore respond to their expectations and those of society in general (McQuail 2003). Hence, Media accountability implies both the journalist’s awareness of responsibility and the willingness of organisations to accept criticism and engage in a dialogue with citizens about news production (Porlezza and Splendore 2016). In short, the concept of Media Accountability concerns the principles of information transparency, public participation and the willingness to improve its professional selfregulation (Puppis 2009). Media organisations are held accountable through Media Accountability Instruments (MAI) (Rodríguez-Martínez, Mauri-De los Ríos, and Fedele 2017; Fengler et al. 2015), consisting of offline and online instruments developed by the media and audiences. This is an informal body “which intends to monitor, comment on and criticize journalism and seeks to expose and debate problems of journalism at the individual, media routines, organizational and extra-media levels” (Eberwein et al. 2011, 20). 3 Traditional MAIs, such as letters to the editor, ethical standards or offline newspaper ombudsmen, have little impact on professional practice, as they are rarely used by society (Alsius and Salgado 2010). In contrast, new MAIs related to news transparency and quality, developed in the online environment, include readers’ comments, report-an-error or complaint notification buttons as well as audience participation through Facebook and Twitter, have expanded rapidly, allowing citizens to comment on journalism practice in a simple way (Loosen and Schmidt 2012; Craft, Vos, and Wolfgang 2015; Suárez-Villegas et al. 2017). Agents and frameworks of Media Accountability In the same way accountability agents (Moore 2014), such as citizens, civil society groups and the media (Ojala, Pantti, and Laaksonen 2018), are the actors to whom governments are held accountable, media accountability agents oversee the journalistic process. They are the ethics councils of journalism (Suárez-Villegas 2015), the courts, the citizens, journalists working in other media and journalism experts (Van der Wurff and Schönbach 2014). This study focuses on these last three groups. Having considered all the above-mentioned agents, the social responsibility of the media can be called to account from two frameworks or stances (McQuail 1997): the answerability model or the liability model. The first involves the media’s willingness to resolve differences with social actors through dialogue and negotiation. The issues discussed concern the quality of journalistic projects and their social implications as well as the journalistic values they transmit. In contrast to this framework of ongoing dialogue with the audience, the liability model focuses on the freedom of journalists and media proprietors to conduct their work. This freedom is limited when it clashes with and infringe on the freedom of other social actors, such as the audience, in cases such as invasion of privacy. The limits for the media and journalists are, therefore, the laws in force, which define their respective responsibilities. In this case, the courts take centre stage. There is another framework, the professional model, which falls halfway between the two previous ones (Singer 2003). According to the professional model, the audience and other social actors can register complaints against journalists and the media, but unlike the answerability model, they cannot engage in a dialogue with them about journalistic quality. Moreover, these complaints are not settled in court, as in the liability model. In the professional model, journalism bodies, composed of experts in the field (such as complaint commissions or press councils, for example), are tasked with dealing with and resolving readers' complaints. These three frameworks underpin the study cited on Dutch society by Van der Wurff and Schönbach (2014), which concludes that citizens are interested in news but not in the way journalism works, which explains why they rejected the dialogue-based model (answerability model) and opted for the other two, which entail less audience involvement. The Spanish Media Context This study examines the opinions of Spanish journalists, citizens and journalism experts. Southern European countries, including Spain, are characterised by deeply politicised media systems (Mazzoleni and Sfardini 2009). According to Hallin and Mancini (2004), Spain, along with other southern European Mediterranean countries 4 such as Greece, Italy, Portugal and France (in part), belongs to the Polarised Pluralist Model, as opposed to the Corporate Democratic Model of central and northern Europe and the Liberal Model of the North Atlantic. These three models are defined according to the relations established between the media and the political systems of each country. The Polarized Pluralist Model is characterised by strong state interventionism, a very limited newspaper circulation, weak professionalisation and a predominance of opinion to the detriment of information (Media Landscapes 2017). According to Media Pluralism Monitor Report 2017, by The Centre for Media Pluralism and Media Freedom, the risks for media pluralism and the safety of journalists are increasing across Europe. In Spain, the report indicates an overall medium risk to media pluralism in the four major areas encompassed: political independence, market plurality, social inclusiveness and basic protection. However, the indicators for market plurality show one high risk level (75%) regarding the “Crossmedia concentration of ownership and competition enforcement” (Masip, Ruiz, and Suau 2018). On the other hand, Iin Spain, criticism of the media is rare, which indicates a lower level of transparency compared to other more advanced countries in this sphere area, such as the United Kingdom, Finland, the Netherlands, Germany and Switzerland (Fengler et al. 2014). According to the previous theoretical background, the following research questions asked were explored: RQ1: To whom (or what) do Spanish journalists feel responsible in their profession? RQ2: Do Spanish journalists feel answerable in their profession to the same bodies or people as do European journalists? RQ3: Do demographic and/or professional factors influence the choice of actors to whom Spanish journalists feel responsible in their profession? RQ4: To whom are journalists answerable from the point of view of Spanish citizens? Methodology This research applied three types of methodologies: 1) to ascertain journalists' opinions, a quantitative approach was conducted via an online survey. The survey, which focused on aspects of media accountability, was sent to journalists across Spain. 2) To know the public's opinion on the ethical aspects of professional journalism, a qualitative methodology, based on the focus group technique, was used. 3) To gauge opinion on the ethical aspects previously consulted with the journalists and the citizens, in-depth interviews were conducted with five experts in media ethics and media accountability. Thus, we made a methodological triangulation, ‘across method’ type, because our study combines qualitative and quantitative data collection techniques (Boyd 2001). The methodological triangulation allows to use two or more research methods in order to decrease the weaknesses of one method, strengthen the results of the study and to ensure completeness of data, using quantitative and qualitative approaches to identify any similarities and differences (Sharif and Armitage, 2004; Bekhet and Zauszniewski, 2012). In this way, the qualitative data (focus group to the public and in-depth 5 interviews with experts) complement and clarify the quantiative results (survey to the journalists). The methodological triangulation allows us to answer the four research questions posed on this research. A total of 228 journalists completed the survey sent out to them. The survey consisted of 29 questions related to various ethical aspects of the profession such as the relationship with external and internal regulatory instruments and the relationship with political or economic power. The questions were based on a ten-point Likert scale. To guarantee operability, dichotomous, multiple-choice and rating scale questions were combined (Wimmer and Dominick 2011). The respondents were also able to add notes and other relevant comments and observations on the issues addressed. The survey was administered online through the SurveyMonkey platform and was open for three months (17 October 2017 - 17 January 2018). During this period, the responses entered were monitored on a weekly basis. Once the material was collected, a descriptive monovariate and bivariate statistical analysis was carried out using the specialised program IBM Statistical Package for the Social Sciences (SPSS). The resulting data were then triangulated with the qualitative information gathered from the citizen discussion groups. This paper presents the results of the analysis of response number 20 of the survey: “To whom do you feel responsible as a journalist?” The journalists were asked to rate on a 0 to 10 scale the extent to which they felt responsible for the various options shown in the question, where 0 signified ‘no responsibility’ and 10 signified ‘very responsible’. The items the citizens assessed were as follows: [Table 1 near here] In addition, the results from the focus groups of citizens are presented. The aim of the focus groups was to ascertain the social perception of the effectiveness of the different accountability instruments promoted internally and externally to the media in the different autonomous communities under study. The citizens’ perspective was included, since it was considered necessary to determine the awareness and impact of these instruments on society as a whole. The six focus groups were focused on the following subjects: - General assessment of ethics in current journalism. - Instruments to ensure media ethics. - Journalists’ ethics. One focus group was conducted in each of the following cities: Barcelona, Castellón, Madrid, Sevilla, Mondragón and Santiago de Compostela. To ensure that the media context was as similar as possible, the period in which focus groups were run did not exceed a month and a half. Thus, the first focus group held in Barcelona took place on 12 April and the last, held in Santiago de Compostela, was held on 31 May. Finally, five in-depth interviews were carried out to obtain a more exhaustive knowledge of the opinions of academics, journalists and members of regulatory or selfregulatory bodies from different parts of Spain. The in-depth interview was a qualitative methodology that, based on a pre-defined questionnaire adapted to the interviewee's profile, allowed the respondent to answer spontaneously to the questions posed (Alsius 2010). The questionnaire design for the in-depth interviews, based on the survey questionnaire, as well as the questions used in the focus groups, was adapted to a face- 6 to-face interview, for which the number of questions was set at 12 per interview. Sample Description. Survey for Journalists In accordance with the criteria outlined by Weischenberg, Malik, and Scholl (2006), respondents had to fulfil the following conditions: (1) work for a journalism media outlet (public relations professionals tasks were excluded); (2) undertake journalism practice (professionals involved in technical or organizational tasks in the media industry were excluded); and (3) be employed as a full-time journalist or earn 50 percent or more of their income from professional journalism (freelancers earning 50 percent or more of their income from journalism activities were also included). The same characteristics were also used in the European research MediaAcT project, in which some of the members of the MediaACES project participated. Accordingly, some of the results from this research were compared with those obtained at European level. Spain, in contrast to countries such as France, Germany, Finland or Switzerland, has no official data on the demographics of journalism professionals, nor does it have a directory or census of the profession (Fengler et al. 2015; Rodríguez-Martínez, Mauri- De los Ríos and Fedele 2017). In view of this structural limitation, in the framework of the MediaAcT project three criteria – the number of journalists who are members of professional associations, the different types of media and the approximate number of journalists per region – were used to establish that the estimated population of journalists in Spain stood 25,000 professionals. Therefore, to ensure a reliable representation of Spanish journalists, a subsample of 123 journalists was deemed valid (Fengler et al. 2015; Eberwein et al. 2014). A total of 228 (N=228) responses were yielded for the present research. This number of responses allowed us to obtain data of relevance to understand the perception of accountability among Spanish journalists, thus updating and extending the data procured in the MediaAcT project. More specifically, 52.2% (n=119) of the respondents were women and 47.8% (n=109) were men. The majority of the interviewees (71.1%) held university degrees in journalism. In addition, 53.1% belonged to an association or professional college of journalists. Sample Description. Focus Groups with Citizens A total of 38 participants (22 women and 16 men) took part in six focus groups. The age of the participants was balanced, with 42% middle-aged participants, and the rest distributed almost equally between those under 30 and those over 60. The participants with the highest level of education held PhDs and Degrees, some of them in the field of audio-visual communication or journalism. The focus group members with medium or low educational backgrounds mostly performed administrative or commercial tasks. The vast majority of the participants consumed online press, while traditional print newspapers were rarely mentioned. Few of the participants read the international or specialised press, and when this type of newspaper or magazine was mentioned, it was for professional reasons or because the participants were born abroad. The participants usually accessed news online via Twitter or, secondly, Facebook. In other words, they did not read the news until a story was pointed out or referred to them. When this happened, they usually went directly to the referred link to read the news in the newspaper itself. In any case, the participants also actively consulted the online press. To a lesser extent, some followed certain journalists directly on social media sites. 7 Sample Description. In-Depth Interviews In accordance with the selection criteria, all of the participants belonged to one of these five professional categories: - Journalists' associations/professional colleges. - Media boards. - Self-regulatory bodies. - Regulatory bodies. - Academics and researchers in the field of journalism. Thus, Nemesio Rodríguez is first vice-president for Professional Affairs of the Press Association of Madrid and currently president of the Federation of the Association of Journalists of Spain; Salvador Alsius is a media ethics researcher and member of Audiovisual Board of Catalonia; Xose Manuel Pereiro is a former dean of Professional College of Journalists of Galicia and currently vice-dean of the same organisation; Arturo Maneiro is the president of the Journalists Association of Galicia and member of the Board of Management of the Galician Radio and Television Company, and finally, Luis Menéndez is the president of Association of Journalists of Santiago de Compostela and Spanish representative of the European Federation of Journalists. All interviews were conducted in person (or exceptionally by telephone) by members of the research team in order to guarantee the same performance criteria. To establish a methodological coherence between the different analysis techniques, the interviews were carried out after designing and testing the survey and the focus groups, both in the same period between April and June 2018. Results The Accountability of Journalists Perceived by Themselves (RQ1, RQ2 and RQ3) The question discussed in this paper (“To whom do you feel responsible as a journalist?”) provided an insight into the various aspects that journalists take into account when faced with a key ethical issue such as the concept of responsibility. To this question, unlike the others in which the responses only referred to ethical aspects, items were included that were not specifically related to ethics. Hence, “God”, “religious values” or “democratic values” were also included as possible responses. Of all the possible responses (14) to the question at hand, seven yielded an above-average positive rating on the Likert rating scale of 1 to 10, that is, a mean and/or median/mode value of >5, as shown in Table 2. In fact, one aspect was the striking difference between the response “Our advertisers”, which attained the highest rating below the average and the response “My direct superior”, which obtained the lowest rating above the average. Also noteworthy was the difference between the item “God” or “My religious values”, which received a lower score, and “My conscience”, which received a higher score. [Table 2 near here] Spain in the European Context 8 In order to contextualise the results of the survey of the Spanish journalists, we compared them with the response given by the 1,762 journalists to the same question in the survey conducted by the European MediaAcT project, in which a 1 to 5 rating scale was used. [Table 3 near here] The comparison between the tables obtained from the survey of the Spanish journalists and those from the European journalists survey showed that “My conscience” was the most highly rated item in both cases, with an average of 9.4 among the Spanish journalists (based on a ten-point Likert scale) and an average of 4.78 among European journalists (based on a five-point Likert scale). Similar results were found for the items rated the highest in the second and third options. Thus, both the Spanish and the European journalists rated the professional ethical codes second, with an average of 9 among the Spanish journalists (based on a ten-point Likert scale) and an average of 4.49 among the European journalists (based on a five-point Likert scale). Similarly, Sources was third highest rated item, with an average of 8.9 among the Spanish journalists (based on a ten-point Likert scale) and an average of 4.53 among the European journalists (based on a five-point Likert scale). The greater difference was observed in the response that received a lower rating, where the Spanish journalists chose God and their religious values as the least important item (x=1.1 based on a ten-point Likert scale), while the European journalists indicated they felt less answerable to political parties (x=1.49 based on a five-point Likert scale). As regards the results for “My conscience” among the European countries analysed, Spain yielded a score slightly below the European average. [Table 4 near here] Type of Media In terms of the type of media in which the journalists work, conscience continued to be one of the most highly rated items, although professional ethical codes and sources no longer yielded the most salient responses. For example, the online newspaper journalists gave conscience a lower rating (8.5), while private television journalists rated democratic values over conscience (8.9). It is also worth noting that the journalists working for private radio, online newspapers, news agencies, as well as the freelancers, attached importance to the audience. Online newspaper journalists and news agency reporters rated this item equal to sources, but private radio journalists rated the audience even higher than sources (9- 8.9). The journalists working for weekly publications (9.8), public radio (9.2) and private television (9) rated “Democratic values” above the “Professional ethical codes” and “My sources”. The freelance journalists ranked sources (9.1) and audience (8.9) above professional ethical codes. [Table 5 near here] The Age of the Journalists The age variable had no effect in changing the high score obtained for “My 9 conscience”, since all the age ranges rated it highest. However, it should be noted that the age group that gave this item the lowest rating was among the journalists aged 19- 24, with a score of 8.7. The most significant differences were found in the responses to “Professional code of ethics”. Both the younger journalists (19-24) and the older ones (55-64) attached greater importance to “democratic values”, with 8.2 and 9.1 respectively. The middle-aged journalists (25-34) and (45-54) did not rate “Professional code of ethics” as the second most important item either, choosing instead “Sources” with 9.2 and 9.3 respectively. [Table 6 near here] The Accountability of Journalists Perceived by Citizens (RQ4) Having analysed the results of the survey of journalists on their sense of responsibility, we compared these attitudes and behaviours with the citizenry’s opinion of the reporter's sense of responsibility. For this purpose, the focus group participants were given a list of possible responses from which they were allowed to choose three: 1. The citizenry/ public. 2. Conscience. 3. Code of ethics. 4. Information sources. 5. Democratic values. 6. My editorial office colleagues and other profession colleagues. 7. My boss or superior. 8. The advertisers. 9. Government, political parties. 10. God or religious values. From the different items presented, the participants of the focus groups chose, in first place, the audience/public; conscience, in second place, and code of ethics, in third. The Audience/Public The comments in this section refer to the importance of the right to truthful information and to the responsibility towards the audience or the public. The citizens feel that journalists should be answerable, above all, to them, the citizens (the audience). This was borne out by 76% of the total number of participants who chose this option (77% and 75% of the total number of women and men respectively). The respondents’ main argument was that without truthful, independent information in the public interest, the very essence of democracy is called into question. Although they acknowledged the current vulnerabilities of journalism, its precarious economic situation, the competition with interactive means of communication undermining the demands of professional information and the pressures of political and economic interests, the citizens agreed that journalists owed their raison d'être to the people they serve. To that effect, they understood there must be a system in place to ensure a sense of responsibility towards the audience. 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TABLES My conscience Professional code of ethics My sources The audience/ public Democratic values My professional editorial colleagues My direct superior Our advertisers The government of the Autonomous Community where I work Others The Spanish government Political parties 18 Religious authorities/ religious groups God or my religious values Table 1. Items included for the question “To whom do you feel responsible as a journalist?” Responses given Mean score(0-10) My conscience 9.4 Professional code of ethics 9.0 My sources 8.9 The audience/ public 8.7 Democratic values 8.6 My professional editorial colleagues 7.6 My direct superior 7.3 Our advertisers 3.8 The government of the Autonomous Community where I work 2.7 Others 2.5 The Spanish government 2.1 Political parties 2.1 Religious authorities/ religious groups 1.4 God or my religious values 1.1 Table 2. Results of the journalists to the question “To whom do you feel responsible as a journalist?” (N=228) Responses given Mean score(1-5) My conscience 4.78 Professional code of ethics 4.49 My sources 4.53 The audience/ public 4.12 Democratic values 4.23 My professional editorial colleagues 3.72 My direct superior 3.28 Our advertisers 1.92 The Spanish government 1.58 Political parties 1.49 Religious authorities/ religious groups 1.62 19 God or my religious values 1.93 Table 3. Results of the European journalists for project MediaAcT to the question “To whom do you feel responsible as a journalist?” (N=1762) My conscience Mean score(1-5) Germany 4.80 Switzerland 4.82 Finland 4.70 Jordan 4.79 Austria 4.75 Romania 4.89 Italy 4.87 The Netherlands 4.68 Poland 4.80 Estonia 4.74 Tunisia 4.78 Spain 4.75 UK 4.82 France 4.78 Table 4. Results by country to the question “To whom do you feel responsible as a journalist?” (N=1762) Type of medium My conscience My direct superior My professional editorial colleagues Profession al code of ethics My source s The audience/ public Democratic values Our advertisers Daily 9.5 8.2 8.2 9.2 9.2 8.8 8.2 4.5 Weekly 10 7.8 8.2 9.6 9.2 8.2 9.8 6.2 Magazine 9.6 7.4 6 9.3 8.9 8.4 7 4.1 Public Radio 9.7 7.2 7.7 9.1 9 8.8 9.2 3.8 Private Radio 9.4 7.7 8.5 9.2 8.9 9 8.8 5.4 Public TV 9.5 6.5 6.6 9 8.9 8.5 8.9 2.4 Private TV 8.9 7.8 8 8.2 8.9 7.7 9 3.8 Online Daily 8.5 6.6 7.3 8.2 8.2 8.2 7.5 3 News Agency 9.5 8.4 8 9.2 9.1 9.1 9 3.6 20 Freelance 9.1 6.2 6.3 8.8 9.1 8.9 7.8 3.2 Table 5. Results (average score from 0 to10) of the survey to the question “To whom do you feel responsible as a journalist?” according to the type of medium in which the participants worked (N=228). *Note: only the responses with a maximum score of more than 5 points were included. Age range (in years) My conscience My direct superior My professional editorial colleagues Professional code of ethics My sources The audience/ public Democratic values 19-24 8.7 6.4 7 8.1 7.4 7.7 8.2 25-34 9.6 8.2 7.6 9.1 9.2 8.5 8.2 35-44 9.3 7.5 7.8 9 8.9 8.7 8.5 45-54 9.4 7 7.5 9.2 9.3 9 8.8 55-64 9.4 6.1 7.1 8.7 8.4 8.9 9.1 Table 6. Results (by average score from 0 to 10) of the survey to the question “To whom do you feel responsible as a journalist?” according to the age range of the journalists (N=228). *Note: only responses with a maximum score of more than 5 points were included. In addition, the over 65-age group gave only 2 responses. For this reason, give its very low number, this age group was omitted from the table.