Journal of Occupational Rehabilitation最新文献

{"title":"Inability to Work Fulltime and the Association with Paid Employment One Year After the Work Disability Assessment: A Longitudinal Register-Based Cohort Study.","authors":"Henk-Jan Boersema, Tialda Hoekstra, Raun van Ooijen, Sander K R van Zon, Femke I Abma, Sandra Brouwer","doi":"10.1007/s10926-024-10212-z","DOIUrl":"https://doi.org/10.1007/s10926-024-10212-z","url":null,"abstract":"<p><strong>Objectives: </strong>Disability benefit applicants with residual work capacity are often not able to work fulltime. In Dutch work disability benefit assessments, the inability to work fulltime is an important outcome, indicating the number of hours the applicant can sustain working activities per day. This study aims to gain insight into the association between inability to work fulltime and having paid employment 1 year after the assessment.</p><p><strong>Methods: </strong>The study is a longitudinal register-based cohort study of work disability applicants who were granted a partial disability benefit (n = 8300). Multivariable logistic regression analyses were conducted to study the association between inability to work fulltime and having paid employment 1 year after the assessment, separately for working and non-working applicants.</p><p><strong>Results: </strong>For disability benefit applicants, whether working (31.9%) or not working (68.1%) at the time of the disability assessment, there was generally no association between inability to work fulltime and having paid employment 1 year later. However, for working applicants diagnosed with a musculoskeletal disease or cancer, inability to work fulltime was positively and negatively associated with having paid employment, respectively. For non-working applicants with a respiratory disease or with multimorbidity, inability to work fulltime was negatively associated with paid employment.</p><p><strong>Conclusions: </strong>Inability to work fulltime has limited association with paid employment 1 year after the disability benefit assessment, regardless of the working status at the time of assessment. However, within certain disease groups, inability to work fulltime can either increase or decrease the odds of having paid employment after the assessment.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Physiotherapy Continuity of Care with Duration of Time Loss Among Compensated Australian Workers with Low Back Pain.","authors":"Shannon E Gray, Benedict Tudtud, Luke R Sheehan, Michael Di Donato","doi":"10.1007/s10926-024-10209-8","DOIUrl":"https://doi.org/10.1007/s10926-024-10209-8","url":null,"abstract":"<p><strong>Purpose: </strong>The aims of this study are to determine how continuous the care provided by physiotherapists to compensated workers with low back pain is, what factors are associated with physiotherapy continuity of care (CoC; treatment by the same provider), and what the association between physiotherapy CoC and duration of working time loss is.</p><p><strong>Methods: </strong>Workers' compensation claims and payments data from Victoria and South Australia were analysed. Continuity of care was measured with the usual provider continuity metric. Binary logistic regression examined factors associated with CoC. Cox regression models examined the association between working time loss and CoC.</p><p><strong>Results: </strong>Thirty-six percent of workers experienced complete CoC, 25.8% high CoC, 26.1% moderate CoC, and 11.7% low CoC. Odds of complete CoC decreased with increased service volume. With decreasing CoC, there was significantly longer duration of compensated time loss.</p><p><strong>Conclusion: </strong>Higher CoC with a physiotherapist is associated with shorter compensated working time loss duration for Australian workers with low back pain.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Struggling with Fitting in: Clients Mixed Experiences of Receiving Job Support and Getting a Job When Participating in Individual Placement and Support in Norway.","authors":"Liv Grethe Kinn, Larry Davidson, Ketil Joachim Oedegaard, Eva Langeland","doi":"10.1007/s10926-024-10206-x","DOIUrl":"https://doi.org/10.1007/s10926-024-10206-x","url":null,"abstract":"<p><strong>Purpose: </strong>To explore clients' experiences of receiving job support from employment specialists (ESs) working with individual placement and support (IPS) in Norway. IPS is developed to help people with severe mental illness (SMI) into competitive employment as an integral component of mental health services.</p><p><strong>Methods: </strong>Using a hermeneutic phenomenological methodology, this study comprises individual semi-structured interviews with ten participants engaged in IPS at two districts psychiatric centers. Data analysis was conducted according to systematic text condensation.</p><p><strong>Results: </strong>Three themes emerged: (1) ES-a door opener? (2) Striving to sidestep a \"spider web\" of triggers at and away from work; and (3) Calling for a safer route.</p><p><strong>Conclusion: </strong>This study highlights the importance of ESs offering IPS clients' opportunities to try out diverse jobs and focusing more on assessing the work environment in the jobs they place people into. Our findings imply that ESs should spend more time on building a good working alliance with both clients and employers, and pay more attention on understanding individuals' vocational capacities and support needs at the worksite. The ES training should focus not simply on the technical processes of job development and placement, but more directly on empowering clients to stay focused on their vocational ambitions and prospects. The salutogenic model of health can help ESs to analyze whether clients experience workplaces as meaningful, manageable, and comprehensible.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainable Employability of People with Limited Capability for Work: The Participatory Development and Validation of a Questionnaire.","authors":"S R Hiemstra, B P I Fleuren, A de Jonge, J Naaldenberg, L Vaandrager","doi":"10.1007/s10926-024-10191-1","DOIUrl":"https://doi.org/10.1007/s10926-024-10191-1","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding sustainable employability (SE) of people with limited capability for work (LCW) due to physical or mental disability is crucial for the sustainable participation of this target group. Therefore, adequate measurement instruments for SE are needed. This study aims to validate a questionnaire to measure SE among people with LCW using a participatory approach, including person-job fit (PJ fit) and work-related sense of coherence (Work-SoC).</p><p><strong>Methods: </strong>Existing scales for the main concepts were tested and adapted for face validity via cognitive interviews (n = 6), with the involvement of a co-researcher with LCW in the research team. Next, the questionnaire was administered among people with LCW (n = 248) to assess its factor structure (Confirmatory Factor Analysis) and reliability (Cronbach's alpha).</p><p><strong>Results: </strong>Analysis of the cognitive interviews identified problems with clarity and readability of items, instructions and response categories of used (existing) scales. The main adjustments concerned the shortening of text length, the usage of familiar language and examples, and the addition of an introduction game. Most of the adapted SE indicator scales showed an overall good fit and acceptable-to-good internal reliability. The overall SE model had an overall good fit, and excluding 'internal employability' further improved this fit. PJ fit and Work-SoC had an acceptable/good model fit and internal consistency.</p><p><strong>Conclusion: </strong>The participatory validation process resulted in a validated and comprehensive questionnaire to measure SE, PJ fit and Work-SoC among people with LCW, which enables research into the development of their SE. This questionnaire can be utilised to contribute to a more inclusive labour market.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Much Physiotherapy, Chiropractic, and Osteopathy Care Do Compensated Australian Workers with Low Back Pain Receive? A Retrospective Cohort Study.","authors":"Michael Di Donato, Shannon Gray, Luke R Sheehan, Rachelle Buchbinder, Ross Iles, Alex Collie","doi":"10.1007/s10926-024-10202-1","DOIUrl":"https://doi.org/10.1007/s10926-024-10202-1","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the prevalence and frequency of physiotherapy, chiropractic, and/or osteopathy care in Australians with workers' compensation claims for low back pain (LBP).</p><p><strong>Methods: </strong>We included workers with accepted workers' compensation claims longer than 2 weeks from the Australian states of Victoria, Queensland, South Australia, and Western Australia. Workers were grouped by whether they attended physiotherapy, chiropractic, and/or osteopathy in the first 2 years of their claim. Descriptive statistics and logistic regression were used to describe differences between groups. Descriptive statistics and negative binomial regression were used to describe differences in the number of attendances in each group.</p><p><strong>Results: </strong>Most workers had at least one physical therapy attendance during the period of their claim (n = 23,619, 82.0%). Worker state, socioeconomic status, and remoteness were the largest contributing factors to likelihood of physical therapy attendance. Most workers only attended physiotherapy (n = 21,035, 89.1%, median of 13 times). Far fewer only attended chiropractic (n = 528, 2.2%, median of 8 times) or only osteopathy (n = 296, 1.3%, median of 10 times), while 1,750 (7.5%) attended for care with more than one type of physical therapy (median of 31 times).</p><p><strong>Conclusion: </strong>Most Australian workers with workers' compensation time loss claims for LBP attend physiotherapy at least once during their claims. State of claim is the strongest predictor of which physical therapy profession they attend, possibly due to regional availability. Workers who see a physiotherapist have significantly more attendances. Future research should explore the relationship between these patterns of care and claimant outcomes, including work disability duration.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factors and Models for Predicting Work Absence in Adults with Musculoskeletal Conditions Consulting a Healthcare Practitioner: A Systematic Review.","authors":"Gwenllian Wynne-Jones, Elaine Wainwright, Nicola Goodson, Joanne L Jordan, Amardeep Legha, Millie Parchment, Ross Wilkie, George Peat","doi":"10.1007/s10926-024-10205-y","DOIUrl":"https://doi.org/10.1007/s10926-024-10205-y","url":null,"abstract":"<p><strong>Purpose: </strong>It is difficult to predict which employees, in particular those with musculoskeletal pain, will return to work quickly without additional vocational advice and support, which employees will require this support and what levels of support are most appropriate. Consequently, there is no way of ensuring the right individuals are directed towards the right services to support their occupational health needs. The aim of this review will be to identify prognostic factors for duration of work absence in those already absent and examine the utility of prognostic models for work absence.</p><p><strong>Methods: </strong>Eight databases were search using a combination of subject headings and key words focusing on work absence, musculoskeletal pain and prognosis. Two authors independently assessed the eligibility of studies, extracted data from all eligible studies and assessed risk of bias using the QUIPS or PROBAST tools, an adapted GRADE was used to assess the strength of the evidence. To make sense of the data prognostic variables were grouped according to categories from the Disability Prevention Framework and the SWiM framework was utilised to synthesise findings.</p><p><strong>Results: </strong>A total of 23 studies were included in the review, including 13 prognostic models and a total of 110 individual prognostic factors. Overall, the evidence for all prognostic factors was weak, although there was some evidence that older age and better recovery expectations were protective of future absence and that previous absence was likely to predict future absences. There was weak evidence for any of the prognostic models in determining future sickness absence.</p><p><strong>Conclusion: </strong>Analysis was difficult due to the wide range of measures of both prognostic factors and outcome and the differing timescales for follow-up. Future research should ensure that consistent measures are employed and where possible these should be in-line with those suggested by Ravinskaya et al. (2023).</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Work Ability in Employees with Pain and Stress-Related Ill-Health: An Explorative Network Analysis of Individual Characteristics and Psychosocial Work Environment.","authors":"Hedvig Zetterberg, Xiang Zhao, Sofia Bergbom, Nadezhda Golovchanova, Ida Flink, Katja Boersma","doi":"10.1007/s10926-024-10200-3","DOIUrl":"https://doi.org/10.1007/s10926-024-10200-3","url":null,"abstract":"<p><strong>Purpose: </strong>There is a wide range of individual and work environment factors that influence work ability among workers with pain and stress-related ill-health. The multiple interactions and overlap between these factors are insufficiently understood, and a network approach could mitigate limitations of previous research. This pilot study aimed to explore interactions between individual characteristics and psychosocial work environment and potential links to long-term work ability.</p><p><strong>Methods: </strong>Prospective data from a prevention project was used. Individuals (N = 147) with pain and/or stress-related ill-health (95% women) at public sector workplaces filled out baseline questionnaires about a collection of individual and work environment factors, which were used for constructing undirected networks. The model was run in three subsamples of workplaces. Finally, a separate model was established with work ability at 6-month follow-up as outcome variable. A shortest pathway analysis was calculated to identify mediators of work ability.</p><p><strong>Results: </strong>Symptom catastrophizing and perceived stress were the most influential factors in all network models. Symptom catastrophizing and pain-disability risk were found to mediate the relation between perceived stress and long-term work ability. Further, demand-control-support factors were interrelated, and patterns of interaction differed between different types of workplaces.</p><p><strong>Conclusion: </strong>The findings support the importance of individual factors, specifically symptom catastrophizing in an individual's coping with pain or stress-problems and its influence on long-term work ability. Catastrophizing might play a role in stress-related disorders which should be further investigated. Individual and work environment factors interact and vary across context, which needs to be taken into consideration to prevent pain and stress-related ill-health at work.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generalizability of a Musculoskeletal Therapist Electronic Health Record for Modelling Outcomes to Work-Related Musculoskeletal Disorders.","authors":"M Wassell, A Vitiello, K Butler-Henderson, K Verspoor, H Pollard","doi":"10.1007/s10926-024-10196-w","DOIUrl":"https://doi.org/10.1007/s10926-024-10196-w","url":null,"abstract":"<p><strong>Purpose: </strong>Electronic Health Records (EHRs) can contain vast amounts of clinical information that could be reused in modelling outcomes of work-related musculoskeletal disorders (WMSDs). Determining the generalizability of an EHR dataset is an important step in determining the appropriateness of its reuse. The study aims to describe the EHR dataset used by occupational musculoskeletal therapists and determine whether the EHR dataset is generalizable to the Australian workers' population and injury characteristics seen in workers' compensation claims.</p><p><strong>Methods: </strong>Variables were considered if they were associated with outcomes of WMSDs and variables data were available. Completeness and external validity assessment analysed frequency distributions, percentage of records and confidence intervals.</p><p><strong>Results: </strong>There were 48,434 patient care plans across 10 industries from 2014 to 2021. The EHR collects information related to clinical interventions, health and psychosocial factors, job demands, work accommodations as well as workplace culture, which have all been shown to be valuable variables in determining outcomes to WMSDs. Distributions of age, duration of employment, gender and region of birth were mostly similar to the Australian workforce. Upper limb WMSDs were higher in the EHR compared to workers' compensation claims and diagnoses were similar.</p><p><strong>Conclusion: </strong>The study shows the EHR has strong potential to be used for further research into WMSDs as it has a similar population to the Australian workforce, manufacturing industry and workers' compensation claims. It contains many variables that may be relevant in modelling outcomes to WMSDs that are not typically available in existing datasets.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Strategic Human Resource Management Practices and the Employment of Vulnerable Workers: A Two-Wave Study Among Employers.","authors":"Amber Kersten, Marianne van Woerkom, Goedele A Geuskens, Roland W B Blonk","doi":"10.1007/s10926-024-10197-9","DOIUrl":"https://doi.org/10.1007/s10926-024-10197-9","url":null,"abstract":"<p><strong>Purpose: </strong>To improve the inclusion of vulnerable workers in the labor market, employer behavior is key. However, little is known about the effectiveness of strategic Human Resource Management (HRM) practices that employers use to employ vulnerable workers. Therefore, this exploratory study investigates the association between strategic HRM practices (based on social legitimacy, economic rationality and employee well-being) and the actual and intended employment of vulnerable workers in the future.</p><p><strong>Methods: </strong>In total, 438 organizations included in the Netherlands Employers Work Survey participated in a two-wave study with a nine-month follow-up period. Logistic regression models were used to estimate the relationship between strategic HRM practices (T0) with the employment of vulnerable workers (T1) and intentions to hire vulnerable workers (T1), while controlling for organizational size, sector, and employment of vulnerable workers at baseline.</p><p><strong>Results: </strong>Employers who applied strategic HRM practices based on social legitimacy (e.g., inclusive mission statement or inclusive recruitment) or economic rationality (e.g., making use of reimbursements, trial placements, or subsidies) at T0 were more likely to employ vulnerable workers and to intend to hire additional vulnerable workers at T1. No significant results were found for practices related to employee well-being.</p><p><strong>Conclusion: </strong>Since different types of strategic HRM practices contribute to the inclusion of vulnerable workers, employers can build on their strategic priorities and strengths to create inclusive HRM approaches. Future research is needed to study whether these strategic HRM domains also relate to sustainable employment of vulnerable workers.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Job Burnout, Work Health Management Interference, and Organizational Health Climate Among Employees with Varied Levels of Work Ability","authors":"Julie M. Slowiak, Mariah McDonough","doi":"10.1007/s10926-024-10198-8","DOIUrl":"https://doi.org/10.1007/s10926-024-10198-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The presence of chronic health conditions (CHCs), without sufficient personal and job resources, can impede one’s ability to effectively perform work tasks and manage job demands. The aim of this study was to evaluate the level of job burnout and perceptions of work health management interference (WHMI) and organizational health climate (OHC) among employees with varied levels of work ability (WA). We also examined relationships among these variables and with sociodemographic and job-related variables (e.g., age, number of physician-diagnosed conditions).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A convenience sample of 878 adults living and working in the United States who responded to a recruitment message via professional listservs/email lists and social media participated in a non-experimental, cross-sectional online survey. Participants reported sociodemographic and job-related items, as well as measures to evaluate WA, burnout, WHMI, and OHC.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Statistically significant differences in burnout, WHMI, and OHC were observed across WA groups. Workers with poor WA reported the highest levels of overall burnout, WMHI, and the least supportive OHC. A more supportive OHC was associated with lower burnout. A strong inverse relationship between WA and the number of physician-diagnosed conditions was observed; weak relationships between WA and age, as well as WA and managerial status, were found.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Employees with lower levels of WA tended to report higher levels of burnout and WHMI and lower levels of OHC. Findings provide a foundation for future research to examine causal relationships among these variables and to inform actions to both preserve WA and support worker well-being.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140840140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}