Journal of Client-centered Nursing Care最新文献

{"title":"Investigating the Development and Psychometric Testing of the Information and Communication Technology Use Scale in Iranian Patients With Chronic Conditions","authors":"Fatemeh Sadat Izadi-Avanji, Tahere Esmaeli","doi":"10.32598/jccnc.10.1.280.6","DOIUrl":"https://doi.org/10.32598/jccnc.10.1.280.6","url":null,"abstract":"Background: The high prevalence and associated costs of chronic diseases have challenged global community health. The use of information and communication technology offers patients and healthcare providers the ability to respond to healthcare needs. This study develops an information and communication technology use scale for patients with chronic diseases and evaluates its psychometric properties. Methods: This exploratory sequential mixed-method study was conducted in Kashan City, Iran from September 2020 to July 2021. In the qualitative phase, 18 patients with chronic conditions were recruited via the purposeful sampling method. The initial pool of 33 items was extracted in this phase. Psychometric evaluation of the scale was examined through face, content, and construct validity. The internal consistency of the scale was assessed with the Cronbach α and its stability was examined by the test re-test. To evaluate the scale’s construct validity, a cross-sectional study was performed with 300 patients referring to hospital wards and private centers that provide services to patients with chronic diseases. A sequential sampling method was used to select the subjects. The exploratory factor analysis was performed using principal component analysis and the varimax rotation method in the SPSS software, version 16. Results: The initial version of the scale consisted of 33 items. A total of 6 items were removed in the face and content validity evaluation phase. Factor analysis with the removal of 4 items resulted in the extraction of 4 factors that explained 67.45% of the variance in the total scale score. The Cronbach α coefficient and intra-class correlation coefficient were estimated at 0.93 and 0.88, respectively. Conclusion: The scale developed in this study is a valid and reliable tool for measuring formation and communication technology use (including its dimensions) in patients with chronic diseases.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"51 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140519356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of A System Dynamics Model in Forecasting the Effect of Self-care Ability on the Quality of Life of Mildly Disabled Elderly in Nursing Homes","authors":"Maoqiang Xu, Asha Hasnimy Mohd Hashim, Zhiwei Chen","doi":"10.32598/jccnc.10.1.513","DOIUrl":"https://doi.org/10.32598/jccnc.10.1.513","url":null,"abstract":"Background: The large number of mildly disabled elderly people in China has resulted in the occupation of a large amount of public social resources. They have also imposed a serious social burden on the society. This study predicts that changes in the level coefficients of physical functioning, motor participation, and external environment are associated with quality of life (QoL) among the elderly with mild disabilities in nursing homes. Methods: A simulation model was created using the system dynamics method. Meanwhile, a 50-day simulation was used to predict the subsequent changes in the level of QoL of the elderly. This study was completed in the nursing homes of Chengdu, China, using random sampling and 85 elderly subjects participated to obtain the primary data. The data were analyzed using the Vensim software. Results: The results showed that the level of physical functioning (pain value of 0.241, autonomy of 0.163, and chronic disease of 0.192), the level of motor participation (education value of 0.186, and rehabilitation partner of 0.21), and the level of external environment (medical care value of 0.26, and rehabilitation environment value of 0.184) lead to subsequent changes in the level of QoL of mildly disabled elderly in nursing homes in 30 days. Conclusion: Considering the results of this simulation study, changes in the level of physical functioning, exercise participation, and external environment could forecast the QoL of mildly disabled elderly in the nursing homes of Chania, China. It is necessary to make the required changes in the nursing homes to promote the QoL of these groups.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140521580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Fear of Hypoglycemia and Treatment Satisfaction Among Patients With Diabetes Mellitus","authors":"Hamideh Hakimi, Pegah Afsaneh Abadi, Maryam Momeni","doi":"10.32598/jccnc.10.1.452.1","DOIUrl":"https://doi.org/10.32598/jccnc.10.1.452.1","url":null,"abstract":"Background: Treatment satisfaction is one of the main factors of assessing care quality in patients with chronic diseases. Some factors may influence treatment satisfaction and improve or impair clinical outcomes. This study aimed to determine the relationship between fear of hypoglycemia and satisfaction with treatment in patients with type 2 diabetes treated with oral antidiabetic drugs. Methods: This cross-sectional study was carried out in one of the hospitals of Qazvin Province, Iran, in 2021. The research sample was 390 patients with type 2 diabetes who used oral antidiabetic drugs, selected through convenience sampling. The data were collected using the hypoglycemic fear survey (HFS) and the diabetes medication satisfaction (DiabMedSat) questionnaire. Then, the obtained data were analyzed using the independent t-test, one-way analysis of variance, and multiple linear regression in SPSS software, version 26. Statistical significance was set at P<0.05. Results: Patients’ Mean±SD age was 53.4±11.49 years, and most (57.4%) were female. Treatment satisfaction score was lower in females (β=-0.12, P<0.007) and patients with diabetes complications (β=-0.138, P<0.005). Patients with college education had higher treatment satisfaction (β=0.173, P<0.001). Patients with very severe (β=-0.29, P<0.001) or severe hypoglycemia (β=-0.157, P<0.034) experienced lower treatment satisfaction than those with mild hypoglycemia. Low treatment satisfaction scores were associated with fear of hypoglycemia (β=-0.39, P<0.001). Conclusion: In this study, fear of hypoglycemia was associated with a decreased level of satisfaction with treatment. As a consequence, patients with type 2 diabetes must be assessed for hypoglycemia fears and their adverse effects. Also, to prevent complications caused by not taking antihyperglycemic drugs, nursing managers and clinical nurses are recommended to prepare appropriate programs to implement psychological interventions to reduce the fear of hypoglycemia.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140520096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Teaching Program on Knowledge, Practice, and Response Time of Nurses Regarding the Management of Upper Gastrointestinal Bleeding","authors":"Prakash Shashi, Verma Madhavi, S. M. Shasthry","doi":"10.32598/jccnc.10.1.583.1","DOIUrl":"https://doi.org/10.32598/jccnc.10.1.583.1","url":null,"abstract":"Background: Gastrointestinal bleeding is one of the emergencies that all therapeutic measures should be performed effectively and efficiently in a short time. This study aims to determine the effectiveness of an educational program on the improvement of nurses' knowledge, performance, and response time in the care of patients with upper gastrointestinal bleeding in the Emergency Department. Methods: This quasi-experimental study employed a single group pre-test and post-test design and was conducted at the Emergency Room of the Institute of Liver and Biliary Sciences (ILBS), New Delhi, India. A total of 20 nurses working in the Emergency Room were recruited through enumeration. Also, 35 events before and 35 events after the intervention were observed. The educational program was implemented through face-to-face lecture-cum discussion in six 30-minute sessions and groups of 3 to 4 nurses over three days. A researcher-made questionnaire was used to measure nurses’ knowledge regarding upper gastrointestinal bleeding, and their performance and response time were observed and calculated through a checklist. The data were described and analyzed using descriptive statistics, the paired t-test, the Kruskal-Wallis H test, and the Mann-Whitney U test in SPSS software, version 20. The significance level was set at P≤0.05. Results: A noticeable improvement in the scores of knowledge and performance and a significant decrease in the nurses’ response time were observed (P<0.001). Also, there was a significant relationship between the knowledge score and the work experience of nurses in the Emergency Department (P=0.018). Conclusion: Periodic evaluation of nurses’ performance in the care and treatment of upper gastrointestinal bleeding emergencies through observation and checklist is recommended. In-service training courses regarding managing upper gastrointestinal bleeding seem to be necessary.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"54 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140517507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Nurses’ Knowledge, Attitude, and Performance Regarding Pain Management of Non-verbal Critically-Ill Patients in Tanzania Intensive Care Units","authors":"Joel Abrahams Simbeye, F. Sharifi, Elham Navab, Fatemeh Bahramnezhad","doi":"10.32598/jccnc.10.1.433","DOIUrl":"https://doi.org/10.32598/jccnc.10.1.433","url":null,"abstract":"Background: Although patients› self-report is the gold standard for pain, many patients admitted to the intensive care units are unable to communicate and express their pain. Accordingly, the nurse must have special abilities to diagnose and manage pain in such conditions. This study assesses nurses’ knowledge, attitude, and performance regarding pain management of non-verbal critically ill adult patients in intensive care units. Methods: This cross-sectional descriptive study was conducted from February to May 2020 among nurses working in four national referral hospitals in Dar es Salaam, Tanzania. The study sample included 202 intensive care unit nurses who were recruited by the census. The data was collected using pre-validated questionnaires, including the knowledge and attitudes survey regarding pain tools, and a performance tool by Eunkyoung. The data were analyzed using the chi-square test, one sample t-test, and Spearman correlation coefficient in the SPSS software, version 20. The significance level was set at P<0.05. Results: The mean knowledge and attitude score was 13.26±2.75, indicating inadequate knowledge and negative attitude. The mean performance score was 2.08±0.16, indicating low performance. No significant relationship was detected between nurses’ knowledge and attitude and their performance according to the t-test (t=2.84, P=0.09) and the Spearman correlation coefficient (r=0.12, P=0.102). Meanwhile, no significant relationships were found between the nurses’ knowledge, attitude, and performance and their demographic characteristics. Conclusion: Planning to increase knowledge and improve the attitude and performance of ICU nurses for better pain management of non-verbal patients is necessary. It is recommended to evaluate the pain of these patients based on the observation of behavioral indicators of pain and choose the appropriate tool for pain assessment.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"70 3-4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140516482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Successful Experiences of Countries in Employing Nurse Practitioners to Provide Primary Health Care: Recommendations for Iran","authors":"Masoumeh Rostami, S. Navkhasi, Majid Barati, Mohammad Hosein Sattari","doi":"10.32598/jccnc.10.1.499","DOIUrl":"https://doi.org/10.32598/jccnc.10.1.499","url":null,"abstract":"Health systems are responsible for improving people’s health and protecting them against the financial costs of illness while respecting their dignity and status. In recent decades, the health systems of developing countries have put extensive reform programs on their agenda to meet the growing needs of patients.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140523924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Knowledge, Attitude, and Practice of Iraqi Intensive Care Nursing Staff Regarding Hand Hygiene","authors":"T. Najafi Ghezeljeh, Abdul Kareem Salman Khudhair, S. Haghani, Maha Muqdad Idan","doi":"10.32598/jccnc.10.1.464","DOIUrl":"https://doi.org/10.32598/jccnc.10.1.464","url":null,"abstract":"Background: Hospital-acquired infections are recognized as a major risk factor in healthcare settings. Hand hygiene as the first stage of infection control plays an important role in reducing these infections. This study assesses the knowledge, attitudes, and practice regarding hand hygiene among nurses in intensive care units (ICUs) of Basrah City and Dhi Qar City, Iraq. Methods: This descriptive cross-sectional study targeted 231 ICU nursing staff working in hospitals of Al-Basra and Dhi-Qar in Iraq in 2022. The subjects were recruited through the census. To assess the nurses’ hand hygiene knowledge, attitude, and practice, electronic questionnaires were administered via WhatsApp. The collected data were analyzed using descriptive statistics (absolute and relative frequency, Mean±SD) and inferential statistics (independent t-test, chi-square test, and Fisher test). The data analysis was performed using the SPSS software, version 22. Meanwhile, a significance level of <0.05 was considered for all statistical tests. Results: The mean scores (ranges) of nurses’ hand hygiene knowledge, attitude, and practice were 4.74±1.82 (1-10), 77.25±7.89 (55-95), and 49.80±12.23 (21-70), respectively. There was a significant relationship between hand hygiene knowledge and gender, with female nurses’ knowledge being higher compared to male nurses (P=0.03). Furthermore, nurses with less than 5 years of practical experience in the ICU had a higher mean score of attitudes toward hand hygiene compared to nurses with 5-10 years of practical experience (P=0.015). Additionally, nurses with less than 5 years of experience in the ICU showed a higher mean score of hand hygiene practice compared to nurses with more than 10 years of practical experience (P=0.028). Conclusion: According to the findings, the knowledge, attitude, and practice of ICU nurses about hand hygiene were inappropriate. It is necessary to implement educational programs to improve the knowledge, attitude, and practice of Iraqi ICU nurses in this area.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140516667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Health Literacy and Addiction Susceptibility in High School Adolescents","authors":"Marhamat Farahaninia, Zohreh Azarang, Mehri Bozorgnezhad, Hamid Haghani","doi":"10.32598/jccnc.10.1.93.21","DOIUrl":"https://doi.org/10.32598/jccnc.10.1.93.21","url":null,"abstract":"Background: Adolescence is a high-risk period. Teenagers experience risky behaviors in this period, including using abusive drugs and addiction. Meanwhile, sufficient awareness helps a person to interpret and analyze health-threatening factors. This study aimed to determine the relationship between health literacy and susceptibility to addiction in adolescents living in the western part of Tehran City, Iran. Methods: This descriptive-correlational study was performed on 265 senior high school students in the western part of Tehran in 2021. The subjects were recruited by cluster random sampling. The study data were collected online using the addiction susceptibility questionnaire and health literacy measure for adolescents. The obtained data were sorted by frequency distribution, Mean±SD and analyzed utilizing the Pearson correlation coefficient, independent t-test, and analysis of variance in SPSS software, version 16. The significance level was set at 0.05. Results: Most study subjects (56.4%) were female. Their Mean±SD score of health literacy was 65.31±21.15. Among the subscales of health literacy, “calculation”, with a Mean±SD score of 68.96±35.89, and “utilization”, with 61.29±25.05, had the highest and lowest mean scores, respectively. The Mean±SD score of addiction susceptibility was 25.3±30.05, and among its subscales, “showing off” with a mean score of 33.09±32.64 and “family dissatisfaction” with 19.75±35.47 had the highest and lowest mean scores, respectively. Health literacy and its dimensions had a negative correlation with addiction susceptibility (P<0.001). Conclusion: According to the findings, it is recommended to use appropriate strategies to increase adolescent health literacy by health service providers, school officials, school health nurses, and teachers. The results of this study can be used as a source for further research on addiction and health literacy in adolescents.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"28 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140518681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Music Intervention on Respiratory Comfort, Anxiety, and Depression During Noninvasive Mechanical Ventilation Among Patients With COVID-19","authors":"Reyhaneh Hassan Shahi, Fatemeh Hosseini, A. Akbari, Ahmadreza Reza Sayadi, Maryam Shahabi Nedjad","doi":"10.32598/jccnc.9.3.448","DOIUrl":"https://doi.org/10.32598/jccnc.9.3.448","url":null,"abstract":"Background: Hospitalized patients with COVID-19 may experience emotional problems and respiratory discomfort during mechanical ventilation. This study aimed to evaluate the effects of music therapy on respiratory comfort, anxiety, and depression among patients with COVID-19 under noninvasive mechanical ventilation. Methods: It was a randomized clinical trial. The study subjects were 64 patients requiring noninvasive mechanical ventilation (NIV) who were selected from the COVID-19 intensive care unit (ICU) of Ali ibn Abi Talib Hospital, Rafsanjan City, Iran. They were randomly allocated to the intervention (n=32) and control (n=32) groups. The intervention group received 30 minutes of daily light music by an MP3 player and a JBL headphone for 4 consecutive days, and the control group only used headphones. The data were collected by the hospital anxiety and depression scale and a visual analog scale before and 4 days after the intervention. The SPSS software, version 16 was employed for data analysis through the chi-square, independent sample, and paired-samples t-tests at a significance level P<0.05. Results: The groups did not significantly differ regarding the pre-test mean scores of respiratory comfort, anxiety, and depression before intervention (P>0.05). The mean scores of respiratory comfort, anxiety, and depression significantly changed in the intervention group (P<0.05), but no significant changes were seen in the control group (P>0.05). Between-group differences respecting the post-test mean scores of these variables were also significant (P<0.05). Conclusion: Thirty minutes of daily music therapy for 4 days is effective in reducing anxiety and depression and improving respiratory comfort among patients with COVID-19 under noninvasive mechanical ventilation.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126941368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysphagia Improvement Using Acupuncture Therapy: A Systematic Review","authors":"H. Siagian, Rusmimpong Rusmimpong, S. Sukurni, A. Arimaswati, La Ode Alifariki","doi":"10.32598/jccnc.9.3.455","DOIUrl":"https://doi.org/10.32598/jccnc.9.3.455","url":null,"abstract":"Background: Dysphagia is a common complication in patients with stroke. Although the research on acupuncture treatment of dysphagia has stepped up, the results are still inconsistent. In this review, we intend to answer the potential of acupuncture in treating dysphagia in stroke patients and which acupuncture points are the most promising for treating dysphagia. Methods: We used PRISMA (the preferred reporting items for systematic reviews and meta-analysis) 2020 guidelines in conducting this review. A literature search was performed in four databases (PubMed, ScienceDirect, Cochrane, and Willey online library) to find eligible randomized controlled studies that assessed the effect of acupuncture in post-stroke dysphagia. The search time is from 2010 to 2022. Study quality was assessed using the critical appraisal skills program (CASP), and the risk of bias was evaluated by the RoB software, version 2 (risk-of-bias tool). The data were analyzed thematically. Results: A systematic electronic search identified 1409 publications through forward and backward searching of relevant papers. The full-text screening was conducted on 777 articles. A total of 681 articles failed to meet eligibility criteria at this stage, and only 6 articles were finally eligible for further analysis. The results showed that compared with rehabilitation, acupuncture significantly improved dysphagia in post-stroke patients. Gallbladder (GB) 20 is often used as an acupoint. In addition, the frequency and duration of treatment also contributed to a more significant increase in dysphagia improvement. Conclusion: Acupuncture could effectively improve dysphagia in post-stroke patients, and acupuncture combined with rehabilitation has a better effect.","PeriodicalId":386609,"journal":{"name":"Journal of Client-centered Nursing Care","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126527385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}