Pain Management Nursing最新文献

{"title":"A Conceptual Analysis of Opioid Use Disorder in Chronic Noncancer Pain Using Rodger's Evolutionary Approach","authors":"","doi":"10.1016/j.pmn.2024.03.017","DOIUrl":"10.1016/j.pmn.2024.03.017","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to examine the complex nature of opioid use disorder (OUD) in chronic noncancer pain (CNCP) by exploring its antecedents, attributes, consequences, and interrelated concepts.</p></div><div><h3>Design</h3><p>A systematic literature review was conducted to gather relevant studies published between 2015 and 2022, utilizing the CINAHL, MEDLINE, PsycINFO, and PubMed databases.</p></div><div><h3>Data Sources</h3><p>The selected databases provided a comprehensive range of articles related to OUD in CNCP, ensuring a comprehensive topic analysis.</p></div><div><h3>Methods</h3><p>Twenty-two articles meeting the inclusion criteria were included in the analysis. These articles were critically reviewed and analyzed to identify key themes and concepts related to OUD in CNCP.</p></div><div><h3>Results</h3><p>The findings of this study shed light on the multifaceted aspects of OUD in CNCP, including its antecedents, such as goals of physical function improvement, prescription of opioids for CNCP, social influences, and mental health dynamics. The attributes of OUD in CNCP were identified as chronic pain, noncancer pain, opioid use, misuse, and abuse. OUD's consequences in CNCP include impaired functioning, increased health risks, psychological distress, social challenges, and economic burden.</p></div><div><h3>Conclusion</h3><p>Understanding the complexity of OUD in CNCP is crucial for improving patient outcomes. Collaborative efforts among healthcare systems, regulatory bodies, and professional organizations are needed to develop policies promoting safe and effective pain management while mitigating risks associated with opioid use in CNCP.</p></div><div><h3>Implications for Practice</h3><p>Implementing policy recommendations derived from this study enhances care and outcomes for individuals with CNCP. By addressing complex issues of OUD in CNCP and adopting evidence-based practices, healthcare providers can optimize pain management and promote well-being in CNCP patients.</p></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus Guidelines for Assessment and Comprehensive Outcomes Evaluation in Rural Pain Clinics","authors":"","doi":"10.1016/j.pmn.2024.03.006","DOIUrl":"10.1016/j.pmn.2024.03.006","url":null,"abstract":"<div><p><span>Recent advancements in nurse anesthesiology<span><span><span><span> fellowship training programs have helped to establish advanced pain management services for rural communities. Consensus guidelines to direct the rural provider toward the most valid and reliable measures for pain assessment and functional outcomes evaluation are not presently available. The primary aim of this initiative was to establish consensus guidelines for a comprehensive outcome </span>evaluation program with specific time intervals for assessments that can be utilized by all rural pain clinics. The American Association of Nurse Anesthesiology Nonsurgical Pain Management </span>Advisory Panel<span><span> members provided formative and expert feedback for this initiative. The Delphi model was utilized to achieve consensus through multiple rounds of surveys. Items achieving &gt;70% agree/strongly agree were kept; items with &gt;70% disagree/strongly disagree were rejected; items meeting neither advanced to the following round for evaluation until consensus was met. During round I, consensus was reached for: (1) the use of the Numerical Rating Scale for </span>pain severity; and (2) timing of pain severity &amp; functional pain outcomes on each </span></span>office visit and before/after each intervention. Round II, consensus was achieved for: (1) the use of Wong-Baker FACES Pain Rating Scale as a suitable instrument when literacy or communication pose a barrier but not as a primary assessment; and (2) the use of the Brief Pain Index-Short Form for functional outcome measures. During round III, consensus was reached for: (1) the use of the </span></span>Oswestry Disability Index as a functional outcome measure; and (2) pain reassessment being performed within 14 days of intervention. This initiative provides rural pain clinics with a comprehensive outcome evaluation program with specific time intervals for assessments.</p></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering Cancer Patients with Self-Care and Pain Management Skills: A Quasi-Experimental Study","authors":"","doi":"10.1016/j.pmn.2024.03.001","DOIUrl":"10.1016/j.pmn.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><p>Cancer patients experience distress as a result of their health condition, which, in turn, contributes to the progression of the disease. Moreover, their daily activities, well-being, and health status are significantly impacted by pain and other symptoms. In this context, empowering these patients with self-care and pain management skills can greatly contribute to effective symptom control.</p></div><div><h3>Aim</h3><p>To develop and implement an educational approach focused on empowering family caregivers and patients with advanced cancer in effectively managing pain at home.</p></div><div><h3>Method</h3><p>An educational program, PECP/C-Pain Management, was developed to empower family caregivers and cancer patients to manage pain at home. A quasi-experimental study involving 52 participants with advanced cancer was conducted to test the program. Participants’ skills, behaviors, and knowledge related to self-care and pain management were assessed before and after the intervention using an appropriate instrument, the Pain Management Knowledge and Behavior Scale.</p></div><div><h3>Results</h3><p>Pain was reported as the primary symptom, and following the educational program, participants were able to monitor pain and other symptoms and effectively self-manage their treatment.</p></div><div><h3>Conclusions</h3><p>The findings suggest that the PECP/C-Pain Management intervention was effective in improving participants’ knowledge and skills in managing pain, leading to better symptom control. In addition, the Pain Management Knowledge and Behavior Scale is a reliable tool for measuring the outcomes of this intervention.</p></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1524904224000997/pdfft?md5=02872517f547c55cb81e1b9a933fd748&pid=1-s2.0-S1524904224000997-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Teach-Back Education Program on Perioperative Pain in Patients With Lung Cancer: An Intervention Study Using Behavior Change Wheel","authors":"","doi":"10.1016/j.pmn.2024.03.011","DOIUrl":"10.1016/j.pmn.2024.03.011","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the effect of a teach-back educational intervention using Behavior Change Wheel (BCW) framework on perioperative pain among patients with lung cancer.</p></div><div><h3>Methods</h3><p>A prospective quasi-experimental study was conducted in 88 patients with lung cancer from a tertiary hospital in China. According to the order of admission, they were allocated to either control group or intervention group, with 44 patients in each group. Patients in the control group received routine nursing care, while patients in the intervention group were given a teach-back education program based on BCW framework. The visual analog scale (VAS) was adopted to evaluate patients’ pain on the day of surgery (T0), 1 (T1), 2 (T2), and 3 (T3) days after surgery. We also recorded the use of patient-controlled analgesia (PCA), the length of hospital stay, and the degree of patients’ satisfaction.</p></div><div><h3>Results</h3><p>Rest pain, pain when coughing, and pain during activity that patients in the intervention group experienced were significantly less severe than those in the control group on T0 and T1. The pain when coughing in the intervention group was also significantly milder on T2 and T3. In addition, the number of self-control time, use duration, and total dose of PCA were significantly lower in the intervention group. Moreover, patients’ satisfaction of nursing service was significantly higher in the intervention group.</p></div><div><h3>Conclusion</h3><p>A teach-back education program based on BCW framework was effective in pain management among the perioperative patients with lung cancer. This study demonstrates the application of teach-back method and the BCW in the development of patient education intervention to mitigate perioperative pain.</p></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1524904224001097/pdfft?md5=addfb22cc56c3db59061948e5b8f4c63&pid=1-s2.0-S1524904224001097-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S1524-9042(24)00206-6","DOIUrl":"10.1016/S1524-9042(24)00206-6","url":null,"abstract":"","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1524904224002066/pdfft?md5=4e1ad2640eb07f3b5242c355717fcf78&pid=1-s2.0-S1524904224002066-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Nurses Regarding Opioid Administration: A cross-sectional study","authors":"","doi":"10.1016/j.pmn.2024.02.013","DOIUrl":"10.1016/j.pmn.2024.02.013","url":null,"abstract":"<div><h3>Background</h3><p>Opioids are important drugs used in pain management due to their strong analgesic effects. However, there is limited research on nurses' perceptions of administering opioids.</p></div><div><h3>Purpose</h3><p>This study aims to determine nurses' perceptions of administering opioids.</p></div><div><h3>Design</h3><p>This study used a descriptive cross-sectional design.</p></div><div><h3>Settings</h3><p>A university hospital located in the south of Turkey.</p></div><div><h3>Methods</h3><p>A self-reporting survey was provided to a convenience sample of 190 nurses. The data were collected with the “Introductory Information Form,” and the “Nurses’ Perceptions on Opioid Medications Administration Questionnaire.” Descriptive statistics were applied for data analysis.</p></div><div><h3>Results</h3><p>The mean age of the nurses was 33.11 ± 7.82 and 86.3% were female. The majority of the nurses did not receive any training on opioid administration other than their undergraduate education. Among the nursing staff, 90.0% expressed the importance of having trust in the prescribing doctor for their comfort in administering opioids. Of the nurses, 30% were undecided about “Nurses associate opioids with drug abuse.” and 78.9% disagreed with the statement \"Nurses often associate giving opioids with helping patients to die.”</p></div><div><h3>Conclusions</h3><p>The results of this study provided further insight into nurses’ perceptions of administering opioids that potentially contribute to pain management. Nurses had information needs and some prejudices regarding opioid administration. Also, relying on the prescribing doctor was important, and problems with prescribing were an obstacle to pain control.</p></div><div><h3>Clinical Implications</h3><p>Determining the knowledge and needs of nurses regarding opioid administration and providing in-service training on this subject would positively affect their approach to opioids.</p></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Associated Factors of Postoperative Acute Pain for Mothers Who Gave Birth With Cesarean Section: A Systematic Review and Meta-Analysis.","authors":"Basazinew Chekol Demilew, Negesse Zurbachew, Nega Getachew, Getachew Mekete, Diriba Teshome Lema","doi":"10.1016/j.pmn.2024.05.010","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.05.010","url":null,"abstract":"<p><strong>Background: </strong>Cesarean section frequently is associated with different undesirable postoperative outcomes. Acute postoperative pain is one of the most frequently experienced adverse outcomes that occurs as the result of actual tissue damage. Previous studies have shown inconsistent results regarding the prevalence and predictors of acute postoperative pain. Therefore, this study aimed to assess the pooled prevalence and associated factors of postoperative pain after cesarean section.</p><p><strong>Methods: </strong>This is a systematic review and meta-analysis study that was performed on the basis of studies published within the last 10 years on the prevalence and associated factors of postoperative pain after cesarean section. After PubMed, Google Scholar, HINAR, Scopus, Web of Sciences, Cochrane, EMBASE, and gray literature extensive search for primary studies, their quality was assessed and data was extracted. STATA^MP, version 17.0, was used for all possible analyses of the study.</p><p><strong>Results: </strong>Twenty-eight studies were included in this systematic review and meta-analysis. The pooled prevalence of postoperative pain was 58% (95% confidence interval [CI] 48%, 67%) with heterogeneity (I² 99.33%). Incision length >10 centimeters (odds ratio [OR] 2.34 [95% CI 1.71, 2.97]); spinal anesthesia without adjuvant (OR 3.45 [95% CI 1.56, 5.33]); general type of anesthesia (OR 3.54 [95% CI 2.61, 4.48]); presence of preoperative anxiety (OR-1.73, 95% CI 1.12-2.35); and no peripheral nerve block (OR 3.23 [95% CI, 2.27-4.18]) were associated with the prevalence of postoperative pain significantly.</p><p><strong>Conclusions: </strong>The pooled prevalence of acute postoperative pain after cesarean section was high (58%), which needs more strategies for pain management. Incision length >10 centimeters, spinal anesthesia without adjuvants, general type of anesthesia, preoperative anxiety, and no peripheral nerve block were significantly associated with this prevalence.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Providers’ Utilization of Nonpharmacological Methods in Managing Labor Pain: An Integrative Review","authors":"","doi":"10.1016/j.pmn.2024.06.010","DOIUrl":"10.1016/j.pmn.2024.06.010","url":null,"abstract":"<div><h3>Background</h3><p>The management of labor pain is a critical aspect of maternal care, with implications for the well-being of both the mother and the newborn. Nonpharmacological pain management (NPPM) offers a safe and more accessible option to labor pain management in African healthcare settings.</p></div><div><h3>Objective</h3><p>This review aims to determine the facilitators of and barriers to using NPPM during labor among healthcare professionals (HCPs) in Africa.</p></div><div><h3>Methods</h3><p>This integrative review was done using articles that focused on NPPM and published between 2013 and 2023. Databases searched include PubMed, CINAHL, SCOPUS, and EMBASE. Content analysis was done independently by two reviewers using inductive coding to generate categories.</p></div><div><h3>Findings</h3><p>Three main themes emerged: Perceived barriers to the utilization of NPPM among HCPs, categories that emerged under this theme include lack of training, resource limitation, lack of priority, cultural norms and beliefs, and lack of awareness. The second theme is potential facilitators to the utilization of NPPM among HCP, the categories generated include healthcare provider’ knowledge, positive attitude of healthcare providers, family support, infrastructure/working environment, experiences of HCPs, and client preferences. The third theme that emerged is the most utilized methods of NPPM among HCPs, with back massage and psychological support being the most used, whereas music and exercise were the least NPPM methods used by HCPs.</p></div><div><h3>Recommendations and implications for care</h3><p>The findings from this study show that the attitudes and knowledge of HCPs about NPPM can either be a facilitator or a barrier in its utilization. In the clinical setting, HCPs need to be sensitized on the benefits of using these methods of pain management during labor to encourage use. Interventions designed based on the findings from this study can promote a more holistic approach to labor pain management in African healthcare settings.</p></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1524904224001966/pdfft?md5=9ae8c59dbda3aa9482cda0892fa6ca29&pid=1-s2.0-S1524904224001966-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Evaluation of Patient-Controlled Analgesia for Pain Crises in Sickle Cell Disease.","authors":"Şebnem Rumeli, Selin Azizoğlu, Mustafa Azizoğlu","doi":"10.1016/j.pmn.2024.06.011","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.06.011","url":null,"abstract":"<p><strong>Background: </strong>Vaso-occlusive crisis causing severe pain can be seen in patients with sickle cell anemia and potent opioids should be used in this process. Although sickle cell disease (SCD) patients use patient-controlled analgesia (PCA), we encountered no study evaluating this method from the participants' perspective.</p><p><strong>Aim: </strong>This descriptive study aimed to evaluate the use and effectiveness of PCA administered using the Mersin Algology Protocol (MAP) during painful episodes of SCD based on participants reports.</p><p><strong>Methods: </strong>After obtaining approval from the local ethics committee, 109 SCD participants using PCA as per the MAP between 2018 and 2020 were recruited for the study. The participants answered a 28-item questionnaire regarding their annual number of pain crises, sites of pain, knowledge about PCA, the number of times they used PCA, and the positive and negative aspects of the PCA method.</p><p><strong>Results: </strong>The mean age of the participants was 28.80 ± 11.5 years. Ninety-nine (90.8%) of the participants considered PCA superior to other pain management methods they had used previously. The 53 participants (48.6%) who waited for their pain to worsen before administering the demand dose expressed fear of taking high doses of medication. As the number of times a participant used PCA increased, NRS scores for pain at the time of demand dosing decreased from 7-10 to 4-6 (p = .013). Eighty-five (78%) of the participants reported having no problems related to the device or drug while using PCA.</p><p><strong>Conclusion: </strong>We found that PCA was used more correctly by participants with more experience using the device. Participants who delay demand dosing do so because of anxiety about developing dependence and to avoid high doses.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Teaching and Learning Pediatric Pain Management in Ghana","authors":"","doi":"10.1016/j.pmn.2024.05.004","DOIUrl":"10.1016/j.pmn.2024.05.004","url":null,"abstract":"<div><h3>Background</h3><p>The literature has revealed gaps in knowledge and attitudes regarding pediatric pain management among Ghanaian nurses and nursing students that can be attributed to inadequate education in the area. Consequently, nursing tutors teaching pain management might not have the appropriate knowledge to transfer to their students.</p></div><div><h3>Purpose</h3><p>To explore nursing tutors’ experiences of teaching pediatric pain management as well as their students’ learning experiences before and after the tutors’ training workshop.</p></div><div><h3>Design</h3><p>A descriptive qualitative design was employed for the conduct of the study.</p></div><div><h3>Methods</h3><p>Data were collected via focus groups from 32 tutors and 24 students before and after an educational workshop. Data analysis drew on Braun and Clarke's thematic analysis.</p></div><div><h3>Findings</h3><p>Pre-workshop themes revealed knowledge deficits regarding pediatric pain management in both tutors and students due to learning having occurred in bits and pieces. Furthermore, lack of accessibility to books and pain scales perpetuated this bits-and-pieces approach to learning. Post-workshop findings revealed gains in tutors’ knowledge and skills. Consequently, students gained new insights into pediatric pain management.</p></div><div><h3>Conclusion</h3><p>Tutors and student nurses had a knowledge deficit regarding pediatric pain management. The educational workshop and the provision of learning materials resulted in enhanced knowledge and attitudes that subsequently improved tutors’ ability to effectively teach the topic to their students, with a clear implication for improvements in clinical practice.</p></div><div><h3>Clinical Implication</h3><p>Educating nursing tutors about pediatric pain is imperative to enable students and thus future nurses to be equipped with the necessary evidence-based knowledge of how to manage pediatric pain.</p></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}