International Journal of Integrated Care最新文献_第5页

Inter-Organizational Coordination to Improve Patient Outcomes in Multimorbid Older Patients Following Hospital Discharge - a Systematic Review. 组织间协调以改善出院后多病老年患者的预后——一项系统综述。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-05-12 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.9018

Wilhelm Linder, Richard Ssegonja, Inna Feldman, Robert Sarkadi Kristiansson, Jamile Marchi, Ulrika Winblad

{"title":"Inter-Organizational Coordination to Improve Patient Outcomes in Multimorbid Older Patients Following Hospital Discharge - a Systematic Review.","authors":"Wilhelm Linder, Richard Ssegonja, Inna Feldman, Robert Sarkadi Kristiansson, Jamile Marchi, Ulrika Winblad","doi":"10.5334/ijic.9018","DOIUrl":"10.5334/ijic.9018","url":null,"abstract":"Introduction: Health and social care systems are constantly undergoing major reforms to meet the rising demands of an increasing proportion of older patients, with many such reforms aiming to improve integration and coordination. The aim of this systematic review was to synthesize the evidence on inter-organizational coordination interventions between hospitals and outpatient (health- and social care) providers for older patients with complex needs during- and after hospital discharge.Methods: A systematic search of four databases was performed to identify interventions of inter-organizational coordination at hospital discharge for older patients with complex needs. The retrieved literature was analyzed using a narrative synthesis.Results: Twelve studies were included (seven randomized controlled trials and five non-randomized intervention studies). The most common intervention components were; needs assessments, dedicated care coordinators and multi-professional teams. Findings show that inter-organizational coordination could decrease- or even increase readmission rates, with similar findings for hospital length of stay and mortality. Furthermore, inter-organizational coordination seemed to have a positive impact on quality of life and activities of daily living.Conclusion: Inter-organizational coordination could potentially reduce health-care utilization and improve quality of life for older patients with complex needs. However, the findings remain uncertain and further research is warranted.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 2","pages":"12"},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Infinity Loop of Healthcare Innovation: Development of an Integrated Rehabilitation Pathway for Lumbar Fusion Surgery Through Design Thinking. 医疗创新的无限循环：通过设计思维开发腰椎融合手术的综合康复途径。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-05-12 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.7765

Liedewij Bogaert, Bart Depreitere, Sanne Peters, Tinne Thys, Simon Brumagne, Sebastiaan Schelfaut, Koen Peers, Lieven Moke, Wim Dankaerts, Peter Van Wambeke, Ann Spriet, Thijs Willem Swinnen, Lotte Janssens

{"title":"The Infinity Loop of Healthcare Innovation: Development of an Integrated Rehabilitation Pathway for Lumbar Fusion Surgery Through Design Thinking.","authors":"Liedewij Bogaert, Bart Depreitere, Sanne Peters, Tinne Thys, Simon Brumagne, Sebastiaan Schelfaut, Koen Peers, Lieven Moke, Wim Dankaerts, Peter Van Wambeke, Ann Spriet, Thijs Willem Swinnen, Lotte Janssens","doi":"10.5334/ijic.7765","DOIUrl":"10.5334/ijic.7765","url":null,"abstract":"Introduction: Integrated care pathways may help to bridge evidence-practice gaps. To overcome the limitations of traditional researcher-centred and linear pathway development frameworks, a more user-centred approach is needed. In this study, we propose design thinking as a framework for developing integrated care pathways, specifically targeting rehabilitation of patients undergoing lumbar fusion surgery.Description: From 2017 to 2022, we utilized the design thinking infinity loop to create an evidence-based rehabilitation pathway for patients undergoing lumbar fusion surgery. This approach consisted of five phases: (1) empathizing with user needs, (2) defining problem statements, (3) ideating through meta-analysis, expert consensus, and brainstorming, (4) prototyping the pathway, and (5) testing its effectiveness and implementability.Discussion: Through the proposed design thinking phases, innovative elements such as prehabilitation, early mobilization, and consistent communication emerged as the building blocks of the new rehabilitation pathway, addressing the needs of both patients and healthcare providers. These results serve as a practical guide for applying design thinking in developing integrated care pathways.Conclusion: Design thinking, represented by the infinity loop, presents a user-centred framework for developing integrated care pathways, and has the potential to effectively bridge the gap between evidence and clinical practice.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 2","pages":"11"},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of the Relationship Between Organizational Learning and Healthcare Integration. 组织学习与医疗一体化的关系分析。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-05-09 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.9681

Roberto Nuño-Solinís

引用次数: 0

Development of a Person-Centred Coordinated Care Pathway in Swedish Healthcare for Low Back Pain. 发展以人为中心的协调护理途径在瑞典医疗保健下背部疼痛。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-05-09 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.8940

Allan Abbott, Malin Forsbrand, Thomas Torstensson, Ann-Charlotte Lindström, Gudrun Greim, Sammy Klaff, Åsa Niper, Marc Karlsson, Christian Simonsberg, Mimmi Engström, Tommy Olsson, Annelie Petersson, Per Ekman, Peter Försth, Gösta Ullmark, Steven J Linton

{"title":"Development of a Person-Centred Coordinated Care Pathway in Swedish Healthcare for Low Back Pain.","authors":"Allan Abbott, Malin Forsbrand, Thomas Torstensson, Ann-Charlotte Lindström, Gudrun Greim, Sammy Klaff, Åsa Niper, Marc Karlsson, Christian Simonsberg, Mimmi Engström, Tommy Olsson, Annelie Petersson, Per Ekman, Peter Försth, Gösta Ullmark, Steven J Linton","doi":"10.5334/ijic.8940","DOIUrl":"https://doi.org/10.5334/ijic.8940","url":null,"abstract":"Introduction: This project aimed to develop a Person-Centred Co-ordinated Care (P3C) pathway for low back pain (LBP).Description: A national working group was formed consisting of representatives from all regional healthcare organisations in Sweden and included all relevant healthcare professions, academia, and patient organisations. A mixed method iterative design and consensus approach was applied in the development of the P3C pathway.Discussion: As a foundation, patient interviews along with a review of literature were conducted investigating the evidence base for healthcare interventions, earlier regional care programs/pathways and guidelines in Sweden as well as patient experiences and challenges with healthcare for LBP. Updated evidence-based clinical recommendations, tools supporting the practical use of the national P3C pathway and national healthcare data registry-based quality outcome indicators were then developed. Thereafter, an open consultation period provided review and feedback for final revisions and consensus.Conclusions: Essential factors for integrating best praxis according to scientific evidence and patient and healthcare professional perspectives were identified to establish a Swedish national P3C pathway for LBP. This provides a novel and innovative example of feasible methodology applicable in the international context. Future research will evaluate potential improvements in healthcare quality outcomes and effectiveness of dissemination and implementation strategies.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 2","pages":"8"},"PeriodicalIF":2.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Testing the TEC-MED-Integrated Transcultural Social-Ethical-Care Model for Older People in the Mediterranean Basin: A Mixed-Method Quasiexperimental Study Protocol. 地中海盆地老年人tec - med -整合跨文化社会-伦理护理模式的检验：一种混合方法准实验研究方案。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-05-09 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.9017

Marta Lima-Serrano, Regina Allande-Cussó, Ana Magdalena Vargas-Martínez, Georges Karam, Lea El-Korh, Ana María Porcel-Gálvez

{"title":"Testing the TEC-MED-Integrated Transcultural Social-Ethical-Care Model for Older People in the Mediterranean Basin: A Mixed-Method Quasiexperimental Study Protocol.","authors":"Marta Lima-Serrano, Regina Allande-Cussó, Ana Magdalena Vargas-Martínez, Georges Karam, Lea El-Korh, Ana María Porcel-Gálvez","doi":"10.5334/ijic.9017","DOIUrl":"https://doi.org/10.5334/ijic.9017","url":null,"abstract":"Background: The global shift toward aging populations, driven by advancements in the economy, healthcare, and society, has transformed once-lethal diseases into chronic conditions. Complex patient management scenarios emerge through this trend, coupled with demographic changes, given that multiple chronic diseases coexist within an individual. The TEC-MED project, which spans multiple countries, aims to evaluate whether the TEC-MED model can improve the quality of life and reduce care dependency among older adults in the Mediterranean region.Methods: This study employs a mixed-method approach including a longitudinal analytical quasiexperimental design, economic evaluation, and qualitative techniques such as interviews and focus groups. The sample includes at least 20,000 older adults and their caregivers from the Mediterranean basin countries. Quantitative data analysis encompasses descriptive and bivariate statistical analyses, regression models, and economic evaluation, whereas qualitative analysis involves discourse analysis and thematic categorization.Discussion: The TEC-MED project's focus on integrating social and health care is expected to improve health outcomes and quality of life for older people and their caregivers. The anticipated outcomes will contribute valuable insights into the TEC-MED model's effectiveness in promoting person-centered care and addressing global challenges posed by aging populations.Trial registration: NCT06184178 (ClinicalTrials.gov).Date of registration: 27/12/2023.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 2","pages":"9"},"PeriodicalIF":2.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementation of Goal-Oriented Care in Belgium: Experiences From 25 Primary Care Organisations. 目标导向护理在比利时的实施：来自25个初级保健组织的经验。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-05-02 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.8983

Lotte Vanneste, Isabelle Heymans, Jean-Luc Belche, Ine Huybrechts, Dominique Van de Velde, Patricia De Vriendt, Reini Haverals, Dagje Boeykens, Sibyl Anthierens, Pauline Boeckxstaens

{"title":"Implementation of Goal-Oriented Care in Belgium: Experiences From 25 Primary Care Organisations.","authors":"Lotte Vanneste, Isabelle Heymans, Jean-Luc Belche, Ine Huybrechts, Dominique Van de Velde, Patricia De Vriendt, Reini Haverals, Dagje Boeykens, Sibyl Anthierens, Pauline Boeckxstaens","doi":"10.5334/ijic.8983","DOIUrl":"https://doi.org/10.5334/ijic.8983","url":null,"abstract":"Introduction: Goal oriented care (GOC) and its readiness for implementation has been described in scientific literature, but research on GOC implementation in primary care organisations is limited. This study aims to capture the experiences of primary care organisations in implementing GOC in their context.Method: A qualitative study, with data triangulation, was conducted. Primary care organisations that experimented with the implementation of GOC in their context were followed. Data were analysed using inductive thematic analysis.Results: Seven themes supporting GOC implementation were identified. Project leaders from the primary care organisations experienced that related concepts can serve as a foundation for initiating the implementation of GOC. The implementation process is an iterative and reflective process, with resistance viewed as an integral part of the process, offering opportunities for reflection. Collaborating with partners, especially the active participation of patients, was seen as a facilitator. Furthermore, having a clear vision for GOC is necessary. Projects invested in adapting tools and processes to align with GOC and provided relevant training.Discussion and conclusion: The findings led to recommendations that can guide the implementation of future GOC projects. Effective implementation extends beyond the development and adaptation of tools; it requires translating theoretical concepts into practical application and creating a shared vision on GOC.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 2","pages":"7"},"PeriodicalIF":2.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Integrated Specialised Care Approach for Families with Multiple, Severe, and Enduring Problems: A Qualitative Evaluation. 对多重、严重和持久问题家庭的综合专门护理方法：一项定性评价。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-04-30 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.8576

Anne Marie Barnhoorn-Bos, Eline Heek, Eva A Mulder, Robert R J M Vermeiren, Sarah Soenen, Inge Simons, Laura A Nooteboom

{"title":"An Integrated Specialised Care Approach for Families with Multiple, Severe, and Enduring Problems: A Qualitative Evaluation.","authors":"Anne Marie Barnhoorn-Bos, Eline Heek, Eva A Mulder, Robert R J M Vermeiren, Sarah Soenen, Inge Simons, Laura A Nooteboom","doi":"10.5334/ijic.8576","DOIUrl":"https://doi.org/10.5334/ijic.8576","url":null,"abstract":"Introduction: To realize an integrated specialised care approach for families with multiple, severe, and enduring problems, specialised teams providing integrated care are emerging. In this qualitative evaluation, we aimed to gain insight into the key elements promoting an integrated specialised care approach at the level of professionals by studying five Specialist Integrated care Teams (SITs).Methods: Perspectives of families, professionals, managers, and policymakers were gathered by conducting 52 semi-structured interviews. Additionally, 40 observations of case meetings were conducted. A theory-driven framework method was applied to analyse the transcripts both deductively and inductively.Results: Five key elements promoting an integrated specialised care approach were identified: i) a broad view on families, ii) an integration of specialised perspectives, iii) providing specialised care flexible and timely, iv) working from families' preferences and needs, and v) organising a well-structured care process and multidisciplinary evaluations.Discussion: When providing integrated specialised care, a family-centred focus, flexibility to tailor care within a well-structured care process, and investing in collaborative relationships with families are key.Conclusion: Although SITs are a promising form of an integrated specialised care approach, ensuring integrated care is the responsibility of every professional and (specialised) care service involved in families' care.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 2","pages":"6"},"PeriodicalIF":2.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Community-Based Interventions to Support HIV and AIDS Orphans and Vulnerable Children (OVC) in Africa: A Systematic Review. 以社区为基础的干预措施支持非洲艾滋病毒和艾滋病孤儿和弱势儿童（OVC）：系统回顾。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-04-29 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.8920

Livhuwani Precious Matshepete, Lufuno Makhado, Ntsieni Stella Mashau

{"title":"Community-Based Interventions to Support HIV and AIDS Orphans and Vulnerable Children (OVC) in Africa: A Systematic Review.","authors":"Livhuwani Precious Matshepete, Lufuno Makhado, Ntsieni Stella Mashau","doi":"10.5334/ijic.8920","DOIUrl":"https://doi.org/10.5334/ijic.8920","url":null,"abstract":"Introduction: Community-based interventions to support orphans and vulnerable children were the basis for this systematic review, which was undertaken using the available literature based on different studies that outlined community-based interventions.Methodology: A systematic literature searches for quantitative, mixed methods, and qualitative studies describing the community-based intervention to support HIV and AIDS orphans and vulnerable children in Africa was performed in the following databases: Google Scholar, PubMed, EBSCOhost and Science Direct. The search utilized keywords, Boolean operators, and search engine filters, guided by inclusion and exclusion criteria as part of the search strategy. The keywords used included: community-based interventions, support (psychosocial, economic, material, and social), OVC, and Africa. A thematic approach was used to analyze common emerging themes in the community-based interventions to support HIV and AIDS orphans and vulnerable children in Africa.Results: In total, 16 studies met the inclusion criteria, documenting a range of community-based interventions to support OVC in Africa. These included food and/or food parcels, child protection, healthcare services, as well as educational, legal and psychosocial support.Conclusion: Community-based intervention support plays a crucial role in enhancing the lives of orphans and vulnerable children in Africa. Community-based intervention support needs to be integrated into a wider social service system. Further research focusing on the cost of community-based intervention support and successful programs for mainstreaming community-based intervention into a wider social system is needed.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 2","pages":"5"},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementation of Integrated Care of Patients with Non-Cancer Chronic Pain in Chile: Advances and Challenges. 智利非癌症慢性疼痛患者综合护理的实施：进展与挑战。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-04-28 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.8970

Paula Zamorano, Teresita Varela, Isidora Salvatierra, Leonardo Silva, Víctor Lucero, Denisse Figueroa, Sheila Salazar, Pia Casas, Nidia Castro, Pablo Montecinos, Francisco Salinas

引用次数: 0

Navigating Complexity: Lessons Learned from Co-Designing a Care Transition Intervention for People with Stroke. 导航复杂性：共同设计卒中患者护理过渡干预的经验教训。

IF 2.6 3区医学

International Journal of Integrated Care Pub Date : 2025-04-24 eCollection Date: 2025-04-01 DOI: 10.5334/ijic.8943

Sebastian Lindblom, Charlotte Ytterberg, Ann Charlotte Laska, Malin Tistad, Marie Elf, Lena von Koch, Maria Flink

{"title":"Navigating Complexity: Lessons Learned from Co-Designing a Care Transition Intervention for People with Stroke.","authors":"Sebastian Lindblom, Charlotte Ytterberg, Ann Charlotte Laska, Malin Tistad, Marie Elf, Lena von Koch, Maria Flink","doi":"10.5334/ijic.8943","DOIUrl":"https://doi.org/10.5334/ijic.8943","url":null,"abstract":"Introduction: Participatory, emergent, and reflective approaches are needed in research on person-centred integrated care. This paper describes and explores the process of developing a complex care transition intervention for stroke survivors, along with the lessons learned.Description: This study concerns the Missing Link project, which aimed to develop and evaluate a care transition intervention from hospital to home. The care transition was developed according to the Medical Research Council (MRC) Framework and included studies on context, co-design workshops, and prototype development.Discussion: The development process faced challenges relating to understanding the emergence within the studied context and the complex adaptive systems. We failed to have a continuous and sustained involvement of healthcare professionals, patients, and significant others during the different phases of the project. Hence, a lack of shared understanding is conceivable as the emergence might have been interpreted and understood differently by the actors.Conclusion: Challenges in achieving shared understanding throughout the project underline the importance of investing in relationship building, meaningful interaction, and continuous feedback loops. While the MRC framework provides guidance for developing complex interventions, the phased approach may only partially capture the emergence and self-organisation within complex adaptive systems.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"25 2","pages":"3"},"PeriodicalIF":2.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0