{"title":"Posttraumatic growth in young adults with parents diagnosed with cancer: Application of the self-regulation model.","authors":"Shiri Shinan-Altman, Liat Becker","doi":"10.1017/S1478951524001433","DOIUrl":"https://doi.org/10.1017/S1478951524001433","url":null,"abstract":"<p><strong>Background: </strong>The rising incidence of cancer has led to an increased number of adult children impacted by parental cancer. Previous research primarily focused on younger individuals, leaving a gap in understanding the experiences of adult children aged 20-35.</p><p><strong>Objectives: </strong>To examine a model that integrates the interrelationships among the disease's characteristics (i.e., disease stage), illness representations, coping strategies, and posttraumatic growth (PTG) in young adults with parents diagnosed with cancer. In addition, we examined indirect relationships involving illness representations as independent variables, coping strategies as mediators, and PTG as the outcome variable.</p><p><strong>Purpose: </strong>The rising incidence of cancer has led to an increased number of adult children impacted by parental cancer. Previous research primarily focused on younger individuals, leaving a gap in understanding the experiences of adult children aged 20-35. This study examines a model that integrates the interrelationships among the disease's characteristics (i.e., disease stage), illness representations, coping strategies, and posttraumatic growth (PTG) in young adults with parents diagnosed with cancer. In addition, we examined indirect relationships involving illness representations as independent variables, coping strategies as mediators, and PTG as the outcome variable.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted with 109 adult children (ages 20-35) of cancer patients. Data were collected using the Posttraumatic Growth Inventory, the Brief Illness Perception Questionnaire, and the COPE questionnaire. Path analysis was performed to test the study's hypotheses.</p><p><strong>Results: </strong>The findings revealed that illness representations and coping strategies accounted for significant variance in PTG. Higher perceived severity of the parent's illness was associated with greater use of problem-focused and emotion-focused coping strategies, which were linked to higher PTG. Lower perceived control over the illness was associated with less use of problem-focused coping and subsequently lower PTG.</p><p><strong>Conclusions: </strong>This study underscores the importance of subjective perceptions and coping strategies in fostering PTG among young adults with parents diagnosed with cancer. The findings highlight the need for tailored psychosocial interventions to enhance adaptive illness representations and effective coping strategies, promoting resilience and growth in this unique demographic.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606896","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":"Compassion fatigue and palliative care in neonatal nurses.","authors":"Fatma Bozdag, Oznur Basdas, Neslihan Atlı","doi":"10.1017/S147895152400110X","DOIUrl":"https://doi.org/10.1017/S147895152400110X","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal intensive care units (NICUs) emerge as one of the areas where palliative care is most needed. This study was conducted to examine the attitudes and compassion fatigue levels of NICUs nurses working in Şanlıurfa, where the fertility rate and infant mortality are highest in Turkey, toward palliative care.</p><p><strong>Design: </strong>This study was conducted in descriptive type.</p><p><strong>Methods: </strong>The research was carried out with 204 (85%) nurses who agreed to participate in the research between October 2022 and February 2023, out of 240 neonatal intensive care nurses working in the NICU of 2 training and research hospitals and a university hospital in Şanlıurfa. The data of the study were collected using an Introductory Information Form, the Neonatal Palliative Care Attitude Scale, and the Compassion Fatigue Short Scale.</p><p><strong>Results: </strong>Nurses; compassion fatigue scale mean score was 61.46 ± 26.64, palliative care scale mean score was 3.13 ± 0.74 for organization subdimension, 2.85 ± 0.73 for resources subdimension, and 3.08 ± 0.89 for clinician subdimension. In the results of the study, 8 barriers (parents do not participate in decisions, there is not enough staff, lack of time to spend with the family, lack of policies/rules in institutions for palliative care, lack of education and communication, society's beliefs, nurses' personal attitudes toward death, and lack of appreciation of past experiences with palliative care) and 6 facilitators (Nurses' ability to express their perceptions, views and beliefs about palliative care, to participate and support palliative care, to inform parents, to provide counseling, adequate physical conditions) for palliative care were determined.</p><p><strong>Conclusion: </strong>While it was determined that nurses had a slightly below moderate level of compassion fatigue and a close attitude toward organization and resources toward palliative care, it was determined that ethical conflict toward palliative care was high in clinical subdimension scores.</p><p><strong>Objectives and significance of results: </strong>It is recommended that all nurses working in the NICU obtain certificates, improvements in resources such as personnel and equipment, improvements in the shift work system and development of policies/rules in institutions for palliative care.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606895","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":"Adaptation and validation of the Turkish version of the Bolton Compassion Strengths Indicators scale among nursing students: A psychometric analysis.","authors":"Feride Ercan, Merve Kızılırmak Tatu, Satı Demir","doi":"10.1017/S1478951524001469","DOIUrl":"https://doi.org/10.1017/S1478951524001469","url":null,"abstract":"<p><strong>Objectives: </strong>The study used a methodological design to adapt a Turkish translation and validate the Bolton Compassion Strengths Indicators scale.</p><p><strong>Methods: </strong>The sample of the study consisted of 500 nursing students. Partial least squares structural equation modelling was used to analyze the construct and internal validiy. The values of average variance explained were analyzed for convergent validity. Tukey's test of additivity examined the additivity, and Hotelling's T2 test examined the mean difference between items. Internal consistency and test-retest reliability were ensured for reliability. Test and retest scores were compared by applying the paired samples t-test and Wilcoxon test, and the fit was analyzed through the intra-class correlation coefficient.</p><p><strong>Results: </strong>The Turkish version of the scale consisted of 34 items and 8 subscales. The Cronbach's alpha coefficient of the overall scale was 0.954. The scale was highly reliable and displayed psychometric solid properties.</p><p><strong>Significance of results: </strong>It has been determined that the Turkish version of the Bolton Compassion Strengths Indicators scale is a comprehensive, easy-to-understand measurement tool with a broad perspective that can be safely applied to future nurse candidate students. The scale has been evaluated as a reliable measurement tool that can provide cross-cultural measurement.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606894","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":"Behavioral activation program for reducing depressive symptoms among the bereaved of cancer patients: A feasibility and preliminary effectiveness study in Japan.","authors":"Mariko Asai, Yuko Ogawa, Takatoshi Hirayama, Nozomi Sukigara, Eisho Yoshikawa, Sawako Furutani, Maiko Fujimori, Tatsuo Akechi, Shinichi Suzuki","doi":"10.1017/S1478951524001445","DOIUrl":"10.1017/S1478951524001445","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the feasibility and preliminary effectiveness of a behavioral activation (BA) program for the bereaved of cancer patients toward reducing depressive symptoms.</p><p><strong>Methods: </strong>The BA program for the bereaved was a partially modified version for cancer patients. This program encompassed a preinterview and seven 50-minute sessions every 1-2 weeks, using worksheets, with homework assignments each day. To examine feasibility, the completion rates of intervention and 3 months of follow-up were examined. To examine the preliminary effectiveness, psychological symptoms were assessed with the Patient Health Questionnaire (PHQ-9; primary outcome) and Beck Depression Inventory-II (BDI-II) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. These were evaluated 3 times: before, immediately after, and 3-month post-intervention. Non-parametric tests were used for comparison of scores at 3 time points and calculation of effect size.</p><p><strong>Results: </strong>Of the 42 bereaved who were contacted, 21 were eligible and 20 were participated, while 19 and 18 were in the completed intervention and completed 3-month post-intervention categories (intervention completion rate was 95% and follow-up completion rate was 90%). PHQ-9, BDI-II, and GAD-7 showed significant reductions immediately and 3 months after the intervention compared to pre-intervention, and the effect sizes were all large after 3 months, although they were less than immediately after (PHQ-9: 0.89, 0.71; BDI-II: 0.88, 0.67; GAD-7: 0.57, 0.53).</p><p><strong>Significance of results: </strong>This study indicated that the BA program for the bereaved of cancer patients was feasible and effective vis-à-vis reducing depressive symptoms.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591996","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":"The mediating role of COVID-19 anxiety on the relationship between quality of life and spiritual well-being, and hopelessness: A study on cancer patients.","authors":"Ebru Dığrak, Irfan Akkoç","doi":"10.1017/S1478951524001238","DOIUrl":"10.1017/S1478951524001238","url":null,"abstract":"<p><strong>Objectives: </strong>The coronavirus pandemic has caused concern in the community, especially in patients. Spirituality, hopelessness, and quality of life have an impact on the management of the process in cancer patients during these crisis periods. To investigate COVID-19 anxiety's mediating role in hopelessness' relationships with the quality of life and spiritual well-being among cancer patients.</p><p><strong>Methods: </strong>This study used a cross-sectional design to collect data from cancer patients using self-administered questionnaires. The study recruited 176 cancer patients receiving treatment at a university hospital. The participants completed measures of spiritual well-being, COVID-19 anxiety, hopelessness, and quality of life. Following preliminary analyses, a mediation model was analyzed using the PROCESS macro for SPSS, with the bootstrap method applied (model 4).</p><p><strong>Results: </strong>The results showed that spiritual well-being was negatively associated with COVID-19 anxiety and hopelessness, and positively associated with the quality of life. COVID-19 anxiety was associated positively with hopelessness, and negatively with the quality of life. Moreover, COVID-19 anxiety mediated the relationship between hopelessness, spiritual well-being, and quality of life.</p><p><strong>Significance of results: </strong>This study provides evidence for COVID-19 anxiety's mediating role in the relationship between spiritual well-being and quality of life and hopelessness among cancer patients. The findings suggest that interventions aimed at reducing COVID-19 anxiety may be effective in reducing hopelessness among cancer patients, by promoting higher levels of spiritual well-being and improving quality of life.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591998","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":"Validity and reliability of the Turkish version of the Information Concealment Scale for Caregivers of palliative care patients.","authors":"Gülşah Çamcı, Sıdıka Oğuz, Mehmet Ziya Özdemir","doi":"10.1017/S1478951524000853","DOIUrl":"10.1017/S1478951524000853","url":null,"abstract":"<p><strong>Objectives: </strong>This methodological study aimed to establish the validity and reliability of the Turkish version of the Information Concealment Scale for Caregivers of palliative care patients.</p><p><strong>Methods: </strong>The study was conducted between January and June 2023 with 155 caregivers who cared for patients hospitalized in the palliative care units of 2 hospitals in Istanbul, Turkey. Exploratory factor analysis and confirmatory factor analysis were performed for validity analysis. Cronbach's α, item-total correlation, intraclass correlation coefficient (ICC), and Pearson correlation analysis were used for reliability analysis.</p><p><strong>Results: </strong>Of the participants, 54.2% were female and 69% were married. The mean age was 37.96 ± 12.25 years. According to the exploratory factor analysis, the scale consisted of 3 subscales and 15 items. The first subscale of the scale was expressed as \"misrepresentation of the disease'; the second subscale was defined as \"concealment of information\"; the third subscale was defined as \"misrepresentation of the real situation.\" As a result of the modifications made in confirmatory factor analysis, the goodness-of-fit values were as follows: CMIN/DF(X<sup>2</sup>/Sd) = 175.16/815 = 2.16; GFI = 0.88; CFI = 0.91; RMSEA = 0.079; RMR = .070; NFI = 0.90. The Cronbach's α values of the subscale were between 0.79 and 0.87. ICC values were between 0.90 and 0.95 at a confidence interval of 95%. A positive correlation was determined between the subscales.</p><p><strong>Significance of results: </strong>It was determined that the Turkish version of the Information Concealment Scale was a valid and reliable tool for caregivers.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592002","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}
Fulvio Bergamo Trevizan, Carlos Eduardo Paiva, Laura Fiacadori de Almeida, Camila Zimmermann, Eduardo Bruera, Bianca Sakamoto Ribeiro Paiva
{"title":"Exploring patient awareness of palliative care - optimal timing and preferred approaches.","authors":"Fulvio Bergamo Trevizan, Carlos Eduardo Paiva, Laura Fiacadori de Almeida, Camila Zimmermann, Eduardo Bruera, Bianca Sakamoto Ribeiro Paiva","doi":"10.1017/S1478951524001081","DOIUrl":"https://doi.org/10.1017/S1478951524001081","url":null,"abstract":"<p><strong>Objectives: </strong>To explore patients' awareness levels of palliative care (PC) and how this awareness shapes their preferences regarding the timing and approach for discussing it.</p><p><strong>Methods: </strong>The study, conducted at a prominent institution specializing in oncology care, enrolled women aged 18-75 years who had been diagnosed with breast cancer. Patients completed guiding questions: Do you know what PC is?, When is the most appropriate time and the most appropriate way to discuss PC?. The interviews were conducted exclusively via video call and were recorded, transcribed, and then deleted.</p><p><strong>Results: </strong>The study involved 61 participants, averaging 49 years old. Almost half (47.5%) had completed high school. Qualitative data analysis revealed 9 thematic categories. Regarding the first question, 2 divergent categories emerged: care for life and threatening treatment. For the second question, opinions diverged into 4 categories: At an early stage, mid-course of the disease, as late as possible, and no time at all. For the third question, 3 categories emerged: communication and support, care setting and environment, and improving the PC experience.</p><p><strong>Significance of results: </strong>This study reveals diverse perspectives on patients' awareness and preferences for discussing PC, challenging the misconception that it's only for end-of-life (EOL) situations. Comprehending PC influences when and how patients discuss it. If tied solely to EOL scenarios, discussions may be delayed. Conversely, understanding its role in enhancing advance support encourages earlier conversations. Limited awareness might delay talks, while informed patients actively contribute to shared decision-making. Some patients prefered early involvement, others find mid-treatment discussions stress-relieving. Community support, quiet environments, and accessible resources, underscoring the importance of a calm, empathetic approach, emphasizing the importance of understanding its role in advance support and providing valuable implications for enhancing patient care practices, theories, and policies.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577144","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}
Loredana Dinapoli, Morena Caliandro, Silvia Chiesa, Elisa Marconi, Nikola Dino Capocchiano, Ciro Mazzarella, Francesco Beghella Bartoli, Serena Bracci, Mario Balducci, Daniela Pia Rosaria Chieffo, Alba Fiorentino, Vincenzo Valentini, Luca Tagliaferri, Maria Antonietta Gambacorta, Nicola Dinapoli
{"title":"Resilience and spiritual well-being as resources for coping with radiotherapy and surviving in patients with glioblastoma.","authors":"Loredana Dinapoli, Morena Caliandro, Silvia Chiesa, Elisa Marconi, Nikola Dino Capocchiano, Ciro Mazzarella, Francesco Beghella Bartoli, Serena Bracci, Mario Balducci, Daniela Pia Rosaria Chieffo, Alba Fiorentino, Vincenzo Valentini, Luca Tagliaferri, Maria Antonietta Gambacorta, Nicola Dinapoli","doi":"10.1017/S1478951524001111","DOIUrl":"https://doi.org/10.1017/S1478951524001111","url":null,"abstract":"<p><strong>Objectives: </strong>The primary aims of this multicenter, prospective observational study were to investigate spiritual well-being, resilience, and psychosocial distress in an Italian sample of glioblastoma patients undergoing radiochemotherapy. The secondary aim was to explore the influence of demographic, clinical, and psychological characteristics on survival.</p><p><strong>Methods: </strong>The assessment was conducted only once, within the first week of radiochemotherapy treatment. Spiritual well-being was evaluated by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp-12), and religious/spiritual beliefs and practices were evaluated by the System of Belief Inventory. Resilience was evaluated by the Connor-Davidson Resilience Scale (CD-RISC). Psychosocial distress was evaluated the by Distress Thermometer and Hospital Anxiety Depression Scale. We conducted an univariable analysis of overall survival (OS) using data from the most recent follow-up available, considering demographic and clinical variables that could influence survival. Follow-up was defined as either the time of death or the latest follow-up visit recorded.</p><p><strong>Results: </strong>We recruited 104 patients, and the median follow-up time was 18.3 months. \"Distressed\" patients had lower scores than \"not distressed\" patients on the FACIT-Sp-12 and CD-RISC. While OS was not significant according to the FACIT-Sp-12 threshold, the Kaplan-Meier log-rank test was 0.05 according to the CD-RISC threshold. Among demographic variables, age showed significant associations with OS (<i>p</i> = 0.011). Resilience showed significant associations with OS (<i>p</i> = 0.025).</p><p><strong>Significance of results: </strong>Data showed that high spiritual well-being was associated with high resilience and an absence of psychosocial distress in our sample of glioblastoma patients undergoing radiochemotherapy. Patients with greater resilience survived longer than those with lesser resilience. Profiling spiritual well-being and resilience in glioblastoma patients undergoing radiochemotherapy can be seen as a resource to identify novel characteristics to improve clinical take-in-charge of glioblastoma patients.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577148","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}
Lori Wiener, Parinita Nautiyal, Stacey McAdams, Mike Zoosman
{"title":"Making space for grief: The impact of remembrance programs for pediatric healthcare providers.","authors":"Lori Wiener, Parinita Nautiyal, Stacey McAdams, Mike Zoosman","doi":"10.1017/S1478951524001457","DOIUrl":"https://doi.org/10.1017/S1478951524001457","url":null,"abstract":"<p><strong>Objectives: </strong>While caring for seriously ill children is a rewarding experience, pediatric healthcare providers may experience sadness and emotional distress when their patient dies. These feelings, particularly when not addressed, can lead to negative health and occupational outcomes. Remembrance practices can provide a safe space for staff to process their grief. This study explored pediatric healthcare providers' perceptions of an annual Pediatric Remembrance Ceremony (PRC) and a quarterly program, Good Grief and Chocolate at Noon (GGCN), to learn what components of the programs were considered meaningful and the personal impact on those who attended. The programs pivoted to a virtual platform during the COVID-19 pandemic, and the study also assessed providers' perspectives of attending the programs virtually.</p><p><strong>Methods: </strong>A 19 multiple choice survey instrument was designed, reviewed, piloted, revised, and re-piloted by an interdisciplinary bereavement committee prior to administration. The survey included 2 open-ended questions, inviting additional insights into personal impact and future directions for remembrance programs. The survey was administered on an encrypted online platform.</p><p><strong>Results: </strong>Components of the PRC respondents most valued included the opportunity for staff to choose a name of a patient they cared for and to light a candle for that patient as their name is read. Those who participated in GGCN found story sharing helpful, along with having a speaker address a topic around loss and grief during the second half of the session. Both programs provided reflection, solidarity, and memorialization. Most respondents prefer having both in-person and virtual options.</p><p><strong>Significance of results: </strong>Healthcare providers are affected by the death of the children they care for and value opportunities provided to join colleagues in remembering their patients. The findings underscore the value of remembrance programs in supporting bereaved staff.</p>","PeriodicalId":47898,"journal":{"name":"Palliative & Supportive Care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577146","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}