International Journal of Mental Health Nursing最新文献

{"title":"Development of Priority Outcome Domains for Community Mental Health Research via Consensus Among Multiple Stakeholders: Online Delphi Study in Japan","authors":"Takuma Shiozawa,&nbsp;Sosei Yamaguchi,&nbsp;Momoka Igarashi,&nbsp;Makoto Ogawa,&nbsp;Makiko Abe,&nbsp;Naonori Yasuma,&nbsp;Takayuki Kawaguchi,&nbsp;Chiyo Fujii","doi":"10.1111/inm.70049","DOIUrl":"https://doi.org/10.1111/inm.70049","url":null,"abstract":"<p>Several core outcome sets (COS) have been developed in the field of mental health; however, the specific outcome domains that should be prioritised in community mental health research remain unclear. This study aimed to identify the key outcome domains for community mental health research in Japan, as determined by multiple stakeholders. First, a comprehensive list of outcome domains was compiled by scoping reviews, focus group interviews, and web-based questionnaire surveys. This was followed by two rounds of preliminary surveys with multiple stakeholders. Finally, three rounds of a web-based Delphi survey were conducted to determine the most important outcome domains of community mental health research in Japan. A total of 96 outcome domains were evaluated by 297 participants, with a response rate of 93.6%. This study identified 24 outcome domains that are essential for community mental health research in Japan. These 24 domains, which reached a consensus, included aspects related to comprehensive symptom assessment and personal recovery. Given that community care serves patients with diverse illnesses, identifying outcome domains that are broadly applicable across different community care settings rather than being limited to specific conditions is critical for future research. The study also highlights differences in perspectives among stakeholders regarding the importance of various outcomes. Despite these differences, several outcome domains have been recognised as being significantly important in the overall consensus.</p><p><b>Trial Registration:</b> University Hospital Medical Information Network (UMIN) Clinical Trials Registry: UMIN000044680.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Working With Patients Who Self-Injure: An Open Label Study of an Educational Intervention to Upskill Emergency Nurses on Non-Suicidal Self-Injury","authors":"Penelope Hasking,&nbsp;Amanda Aiyana,&nbsp;Jonathon Burcham,&nbsp;Samantha Carey,&nbsp;Joanne M. Dickson,&nbsp;Daniel Fatovich,&nbsp;Logan Hopkins,&nbsp;Eme John,&nbsp;Shirley McGough,&nbsp;Chloe McLean,&nbsp;Irene Ngune,&nbsp;Alex Wheeler","doi":"10.1111/inm.70064","DOIUrl":"https://doi.org/10.1111/inm.70064","url":null,"abstract":"<p>Non-suicidal self-injury (NSSI), deliberate damage to body tissue with no intent to die, is not engaged with suicidal intent but is the most reliable predictor of later suicidal behaviour. This makes efforts to reduce self-injury critical. Emergency departments can be the gateways to care for many people who have self-injured and optimal sites for interventions that promote recovery. However, emergency nurses have anecdotally reported that they lack training and feel ill-equipped to provide care for patients who self-injure. In this open label trial (where both participants and researchers were aware who received the intervention), all nurses in a metropolitan emergency department were invited to complete a multi-modal training programme designed to improve their knowledge, attitudes, confidence, and resilience, and reduce burnout related to caring for patients who self-injure. We also invited nurses to provide feedback in one-on-one interviews. Sixty nurses completed self-report measures at pre, post (immediately following training), and 1-month following training. Gains were seen immediately post-training in knowledge, empathy, self-compassion, and resilience, while reductions were seen in negative attitudes and burnout. In all cases these changes were maintained at 1-month follow-up. Eighteen nurses participated in interviews, who reported on the impact of the training on improving understanding of NSSI and confidence in working with patients who self-injure at both a personal and institutional level. They also identified barriers to implementing training, many of which require system-level changes within the health system. Findings suggest that training integrated within emergency settings can have a significant impact, not only on knowledge and confidence but on the wellbeing of emergency staff working with patients who self-injure.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognising the Value of Everyday Interactions in Inpatient CAMHS: Patient Thank-You Letters as Insights Into Nursing Impact","authors":"Sebastian Monteux,&nbsp;Fiona J. Stirling,&nbsp;Marcia Stoll,&nbsp;Lynne Thomas","doi":"10.1111/inm.70062","DOIUrl":"https://doi.org/10.1111/inm.70062","url":null,"abstract":"<p>This study explores patient feedback through unsolicited thank-you letters, asking: <i>What insights do these letters provide into impactful nursing practices in inpatient CAMHS?</i> Using an exploratory qualitative approach, data from two focus groups with mental health nurses (MHNs) and an online questionnaire were analysed through thematic analysis, identifying three key themes—‘<i>Being Present</i>,’ ‘<i>Being Skilful</i>,’ and ‘<i>Being Human</i>.’ Findings reveal that thank-you letters offer unique, spontaneous insights into the aspects of nursing care young people value most, highlighting everyday interactions over structured clinical interventions. However, these relational aspects of care are often undervalued in inpatient settings. To ensure they are recognised and sustained, inpatient CAMHS should integrate thank-you letters into staff training, reflective practice, and service development. This study underscores the need to reframe everyday nursing interactions as essential rather than incidental, recognising their critical role in therapeutic engagement and patient well-being.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Meaning of Collaboration in Rural Mental Healthcare Delivery From the Perspective of Mental Health Clinicians and Informal Carers of People Living With a Mental Health Illness—A Qualitative Study","authors":"Omolewa ‘Lola Erinle,&nbsp;Michael Olasoji,&nbsp;David Schmidt,&nbsp;Tracy Burrows,&nbsp;Kirsti Haracz","doi":"10.1111/inm.70066","DOIUrl":"https://doi.org/10.1111/inm.70066","url":null,"abstract":"<p>Mental health policies and practice guidelines emphasise the importance of collaboration with informal carers of people with mental illness, but this does not routinely occur in practice. Understanding the perspective of different parties regarding collaboration is a step towards ensuring an alignment between policy and routine clinical practice. This study explored the meaning of collaboration from the perspectives of informal carers and mental health clinicians in a rural Australian mental health service. This qualitative descriptive study used purposive sampling to recruit informal carers (<i>n</i> = 7) and mental health clinicians (<i>n</i> = 14) from an acute mental health inpatient facility. Data was generated from focus groups and semi-structured interviews and analysed using thematic analysis. Three overarching themes were identified: <i>three-way partnership, purposeful exchange and communication is everything.</i> Clinician and informal carer participants described collaboration as a respectful partnership that necessarily involves the consumer, their carers and clinicians. The purpose of the partnership was identified as providing holistic care <i>to the consumer,</i> which essentially includes support for their carer. Open and clear communication, as well as information sharing, were identified as important to collaboration. However, the experiences of informal carers did not reflect this description of collaboration. Adequate support for informal carers, recognition of their expertise and open and consistent communication are key to a collaborative process that delivers better outcomes for consumers and their carers. Proactive clinician training and a practical guide to inform the delivery of routine informal carer engagement in mental health services are required to achieve an effective three-way collaboration.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Treatment Orders in Australia in the Context of International Literature: A Narrative Review of Consumers, Families and Health Professionals' Perspectives","authors":"Madeleine Harvery,&nbsp;Rosamund Harrington,&nbsp;Matthew Morgan,&nbsp;Elisa Yule,&nbsp;Shelley Wright","doi":"10.1111/inm.70061","DOIUrl":"https://doi.org/10.1111/inm.70061","url":null,"abstract":"<p>A community treatment order (CTO) sets out legal conditions requiring a person experiencing mental illness to receive treatment and medication while living in the community. Although CTOs are used internationally in most high-income nations, CTO use in Australia is very high compared with world standards. CTOs are a contentious issue in mental health practice. While they aim to protect both consumers and society, they often interfere with personal freedom and trust between consumers and mental health professionals. International and Australian research is inconclusive about the effectiveness of CTOs in achieving their clinical aims. Australian research overwhelmingly reports consumers' experience with CTOs as coercive and distressing. Families generally support CTOs but are unhappy with certain aspects of the process. Consumers and families' feelings about CTOs often depend on how much they trust the mental health team, the support they receive, and the relationship between the consumer and mental health professional. Health professionals experience significant challenges balancing therapeutic care with their role carrying out CTOs. Local treatment culture, problems in the mental health system and staff attitudes also influence how CTOs are used. There is a lack of recent and high-quality guidance to inform CTO decision-making for mental health professionals. This perspective paper is presented as a narrative literature review, which proposes that if CTOs are used in clinical practice, close consideration towards how and why they are implemented is warranted.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights Into the Australian Stepped Care Model in Primary Mental Health Care: A Qualitative Study With Informal Carers","authors":"Shingai Mareya,&nbsp;Lin Zhao,&nbsp;Mimmie Claudine Watts,&nbsp;Michael Olasoji","doi":"10.1111/inm.70058","DOIUrl":"https://doi.org/10.1111/inm.70058","url":null,"abstract":"<p>Informal carers of people living with mental illness play a significant role in their overall care. This qualitative study investigates informal carers' vital yet often overlooked experiences supporting individuals with mental health conditions within the Australian stepped care model (SCM). Through semistructured interviews with seven carers, the research highlights their perceptions of the SCM's effectiveness and challenges in navigating mental health services. Key themes that emerged include (a) the toll of caring, (b) the hidden door to the SCM, (c) steps towards recovery, (d) carers included in the circle and (e) fine-tuning to elevate the SCM. These findings reveal that while the SCM provides a structured pathway for recovery, many carers encounter significant barriers, a lack of awareness about available services, insufficient support and difficulties accessing the appropriate level of care for their loved ones. The emotional and psychological toll of caregiving is emphasised as carers frequently experience stress, guilt and frustration. Many participants reported feeling overwhelmed by coordinating care and managing crises, adversely impacting their well-being. Moreover, the study underscores the necessity of including carers as active participants in the treatment process. Carers desired better communication with healthcare providers and greater involvement in decision making. Enhancing the visibility of services within the SCM and providing tailored support for carers are critical steps towards improving their overall experience. Addressing these issues can create a more inclusive and effective mental health care system, ultimately benefiting consumers and their caregivers. The findings offer valuable insights for mental health practitioners, policymakers and service providers, emphasising the need for a more integrated approach that recognises and supports the essential role of carers.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Restrictive Practice Review Meetings in an Acute Mental Health Unit: A Retrospective Before-and-After Study","authors":"Esario IV Daguman,&nbsp;Alison Taylor,&nbsp;Matthew Flowers,&nbsp;Richard Lakeman,&nbsp;Marie Hutchinson","doi":"10.1111/inm.70059","DOIUrl":"https://doi.org/10.1111/inm.70059","url":null,"abstract":"<p>A structured process of reviewing incidents of seclusion and physical restraint supports nurses in managing the emotional and relational impact of restrictive practices. However, these reviews are not a routine feature of everyday acute care provision, and have historically been influenced by practices that reflect a managerial or disciplinary focus. A retrospective before-and-after study was conducted in an adult acute mental health inpatient unit in regional New South Wales, Australia. The goal was to determine the impact of strengths-based restrictive practice review meetings from January 2019 to March 2020, with an equivalent timeframe before its implementation (October 2017–December 2018). The events of seclusion, physical restraint, and Code Blacks (emergency codes requiring security personnel in response to personal safety threats) were compared before and after the implementation of review meetings, with covariate balancing applied to enhance comparability. The reduction in the rate of seclusion was statistically significant post-implementation (incidence rate ratios [IRR] = 0.37, 95% CI [0.24, 0.57], <i>p</i> &lt; 0.001). At the same time, physical restraint showed a statistically insignificant reduction (IRR = 0.76, 95% CI [0.53, 1.09], <i>p</i> = 0.14). Code Black incidents remained stable (IRR = 1.02, 95% CI [0.70, 1.49], <i>p</i> = 0.91). These mixed results indicate that strengths-based reviews play a role in reducing coercion, although additional strategies may be needed to achieve significant reductions in restrictive practice outcomes. Intervention development requires broader service-level changes, with open and robust evaluations that enhance accountability and capture key influencing factors.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing Safewards Secure for Mental Health Prison Units Using a Nominal Group Technique","authors":"Tessa Maguire,&nbsp;Maicee Young,&nbsp;Monica Najda,&nbsp;Hannah Jackson,&nbsp;Jo Ryan,&nbsp;Trentham Furness,&nbsp;Brian McKenna","doi":"10.1111/inm.70036","DOIUrl":"https://doi.org/10.1111/inm.70036","url":null,"abstract":"<p>The introduction of Safewards has resulted in the reduction of conflict and containment in general mental health units, and an adaptation has been developed for secure hospitals in forensic mental health services. Forensic mental health nurses working in bed-based prison mental health units could benefit from having a model to assist conflict and containment reduction in their unique context. The aim of this study was to develop a version of Safewards for bed-based prison mental health nurses. A literature review was conducted to identify relevant features of bed-based prison mental health units including flashpoints, and staff and consumer modifiers. A summary of the review was presented to participants prior to a Nominal Group Technique (NGT) with nurses and other disciplines (working in bed-based prison mental health units) (<i>n</i> = 12). The NGT was used to elicit feedback about the proposed model and achieve agreement on several questions related to the proposed version. Data collected were analysed thematically. Two themes were interpreted: (1) ‘Square peg, round hole’: the stark difference between custodial and Forensic Mental Health staff values and aims; and (2) nothing can happen without custodial staff support. Consensus was reached on all suggested changes/additions to the model. Findings support the need for an adapted version of Safewards (Safewards Secure-Custodial Mental Health) to assist nurses working in this setting. However, modifiers for custodial staff require development and collaboration with Correctional services will also be essential for successful implementation in this setting.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Nurses' Enforcement of Involuntary Care in Inpatient Settings: A Meta-Ethnography","authors":"Luke Molloy,&nbsp;Paul Beckett,&nbsp;Sherphard Chidarikire,&nbsp;Natalie Cutler,&nbsp;Sophie Isobel,&nbsp;Gillian Murphy,&nbsp;Joel Zugai","doi":"10.1111/inm.70044","DOIUrl":"https://doi.org/10.1111/inm.70044","url":null,"abstract":"<p>Mental health nursing practices within inpatient care aim to empower consumers to lead their treatment and recovery. However, involuntary care may be justified for safety reasons. This practice can be traumatising and harmful. Our review explores the enforcement of involuntary care by mental health nurses in inpatient settings utilising meta-ethnography. Searches of articles published over a 10-year period (2014–2024) were conducted in Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE. The searches aimed to identify rich qualitative data on this area of mental health nursing practice. Six articles were selected for inclusion and a reciprocal translation synthesis was undertaken. Three key metaphors emerged: ‘a necessary evil’, ‘the dilemmas of enforcement’ and ‘perturbed practice’. These metaphors illustrate the complex and often conflicting emotions nurses experience when enforcing involuntary care. Nurses viewed the enforcement of involuntary care as a necessary but difficult practice, justified by the belief that it ultimately benefits the person's safety and well-being. Despite justifying involuntary care as necessary, nurses faced ethical dilemmas balancing patient autonomy, safety and dignity. Enforcing involuntary care caused significant emotional distress for nurses, who experienced discomfort, guilt and moral conflict, questioning their actions and the impact on their relationships with consumers. The findings highlight the importance of minimising restrictive practices and developing supportive frameworks that prioritise patient dignity and autonomy while ensuring safety.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Remote Appointments on the Outcomes of Community Mental Health Nurses in Primary Care Since the Covid Pandemic: A Retrospective Observational Cohort Study","authors":"Mark Kenwright,&nbsp;Paula Fairclough,&nbsp;Charlotte Graham","doi":"10.1111/inm.70051","DOIUrl":"https://doi.org/10.1111/inm.70051","url":null,"abstract":"<p>The move to remote working during the COVID-19 pandemic has remained an integral method of mental health service delivery. Yet there is a lack of evidence on the longer-term impact of this change, or on the comparative effectiveness of different remote formats. This retrospective observational cohort study examined the effect of the move to remote delivery on the effectiveness and practice of Community Mental Health Nurses in primary care. Data from 1634 referrals was examined across three cohorts: Those treated face-to-face pre-pandemic; those treated remotely during the pandemic restrictions; and those treated in a blended approach (remote and face-to-face) up to 16 months post-pandemic. Means, standard deviations and effect sizes for pre–post treatment change are reported for all clinical measures. Logistic regression examined predictors of reliable change. Despite increased severity in the mental health problems treated, effect sizes for remote treatment post-pandemic (0.5–0.8) were comparable to those for pre-pandemic face-to-face treatment (0.5–0.9). The blended use of online video appointments predicted better engagement and reliable improvement. The sole use of telephone appointments for complex problems predicted lower rates of engagement and improvement.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"34 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}