Patient Education and Counseling最新文献

{"title":"Improving value of care for renal cell carcinoma patients; development of a decision aid for metastatic clear-cell renal cell carcinoma","authors":"Cato C. Bresser ,&nbsp;Harm H.E. van Melick ,&nbsp;Regina The ,&nbsp;Paul B. van der Nat ,&nbsp;Mirjam M. Garvelink","doi":"10.1016/j.pec.2025.108800","DOIUrl":"10.1016/j.pec.2025.108800","url":null,"abstract":"<div><h3>Objective</h3><div>Patient decision aids (PtDAs) can support shared decision-making (SDM) by providing information about options, pros and cons and eliciting personal preferences. The aim of this study was to develop and test the acceptability and usability of a PtDA for patients with metastatic clear-cell renal cell carcinoma (RCC), the most common type of metastatic kidney cancer.</div></div><div><h3>Methods</h3><div>User-centered mixed methods design. Co-creation process with stakeholders guided by the International Patient Decision Aids Standards (IPDAS) criteria, consisting of three main elements: (a) a needs assessment; (b) acceptability and usability testing; and (c) compatibility assessment with IPDAS criteria.</div></div><div><h3>Results</h3><div>Thirteen RCC patients and 29 healthcare professionals (HCP) participated in this study. Co-creation sessions were held with nine HCPs and a patient representative. Needs assessment (a) showed that patients lacked real treatment choices and wanted information on all treatment options, including life expectancy, side effects, psychological, and lifestyle advice. HCPs expect a PtDA to improve information delivery and patient engagement. A three-component PtDA was developed and tested (b), with positive feedback from both patients and professionals. The tool meets all 12 IPDAS criteria (c).</div></div><div><h3>Conclusions</h3><div>The web-based PtDA was developed and adapted to address unmet needs and found to be acceptable and usable by patients and HCPs.</div></div><div><h3>Practice implications</h3><div>The use of this tool could contribute to high quality, patient-centered and appropriate care for metastatic clear cell RCC patients in the Netherlands.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108800"},"PeriodicalIF":2.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding young persons' experiences through healthcare transition. A qualitative study","authors":"Natwarin Janssens ,&nbsp;Lisa Van Wilder ,&nbsp;Karsten Vanden Wyngaert ,&nbsp;Ann Van Hecke ,&nbsp;Kim Van Hoorenbeeck ,&nbsp;Elianne Van Loock ,&nbsp;Ellen Dupont ,&nbsp;Delphine De Smedt ,&nbsp;Eva Goossens","doi":"10.1016/j.pec.2025.108798","DOIUrl":"10.1016/j.pec.2025.108798","url":null,"abstract":"<div><h3>Purpose</h3><div>During adolescence, the care for adolescents and young adults (AYAs) with chronic conditions is expected to transfer from a pediatric to adult setting. Up to 40 % of AYAs experience a disruption in medical care access after their transfer. To mitigate this, a gradual implementation of interventions focusing on positive health behaviors is desirable. Currently, the majority of such interventions are designed for complex disease-specific chronic conditions, focusing primarily on pre-transfer intervention strategies. This study aims to provide an in-depth understanding of AYAs with mild chronic conditions’ experiences throughout the stages of healthcare transition.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted using semi-structured interviews, complemented by photovoice. Study participants were AYAs, 15–21 years old, diagnosed with asthma, type 1 diabetes, and/or obesity, and were either facing the upcoming transfer or had already experienced the transfer to adult care. Interview and image data were thematically analyzed using NVivo.</div></div><div><h3>Results</h3><div>A total of 18 AYAs (M_age=18 years) participated and a total of 39 photographs were acquired. Five themes were identified, with transition being an individual process as the overarching theme. Additional themes were: setting the expectations, wanting a voice in transition, trust is key and the importance of a support system.</div></div><div><h3>Conclusion</h3><div>Healthcare transition experiences are overarching across different chronic conditions. The current study highlights the need for continuity of care in healthcare transition, by providing an overview of insights pre-, peri- and post-transfer. Complementary, photovoice was applied as a participatory method. Overall, healthcare transition cannot be approached as a one size fits all, with AYAs advocating for an individualized transition program, tailored to their needs.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108798"},"PeriodicalIF":2.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The difficult inpatient, prevalence and characteristics","authors":"Jeffrey L. Jackson ,&nbsp;Mary G. Murphy ,&nbsp;Kathlyn E. Fletcher","doi":"10.1016/j.pec.2025.108785","DOIUrl":"10.1016/j.pec.2025.108785","url":null,"abstract":"<div><h3>Background</h3><div>Up to 18 % of ambulatory clinic patients are considered difficult by their primary care providers. Two qualitative studies suggest that inpatient medicine providers also commonly experience hospitalized patients as difficult. There have been no quantitative studies of how often hospitalized patients on medicine services are perceived as difficult. Our study purpose was to assess the prevalence and characteristics of difficulty.</div></div><div><h3>Methods</h3><div>Hospitalized patients were randomly selected and their inpatient providers (hospitalist, non-hospitalist medicine faculty, medicine resident and interns) completed surveys on experiencing patients as difficult. Difficulty was rated on a dichotomous (yes/no) and continuous (0−10) scale. Characteristics extracted from the chart included patient demographics, cognitive status, Charlson comorbidity index, length of stay, and whether the patient had a chart diagnosis of depression, anxiety, PTSD, chronic pain, somatization disorders or personality disorders.</div></div><div><h3>Results</h3><div>There were 322 surveys completed on 202 unique inpatients; 24.5 % were considered difficult. Age, mental health comorbidities (depression, anxiety), and medical complexity were not associated with being perceived as difficult. On multivariate analysis, personality disorders (OR: 5.4, 95 % CI: 2.6–10.9) and chronic pain (OR: 2.1, 95 % CI: 1.2–3.8) were the only characteristics independently associated with increased difficulty ratings.</div></div><div><h3>Limitations</h3><div>Single site, VA patients, potential response bias.</div></div><div><h3>Conclusion</h3><div>Medicine inpatients are commonly experienced as difficult by their providers. Chronic pain and personality disorders increased the likelihood of being experienced as difficult.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108785"},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of an ICU peer support group for ICU survivors and caregivers post-discharge from a quaternary hospital (ICU Peer Support Study)","authors":"Krishnaswamy Sundararajan ,&nbsp;Simone Dafoe ,&nbsp;Kristin Hayres ,&nbsp;Andre Koronis ,&nbsp;Sarah Doherty ,&nbsp;Shaad Manchanda ,&nbsp;Caroline Phelan ,&nbsp;Mohammad Afzal Mahmood","doi":"10.1016/j.pec.2025.108795","DOIUrl":"10.1016/j.pec.2025.108795","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to explore ICU survivors' and caregivers' (i.e., consumers') perspectives on the utility of an ICU peer support groups (PSG).</div></div><div><h3>Methods</h3><div>A qualitative study using focus group discussions (FGDs) of former patients (i.e., Survivors) and caregivers (i.e., adult mixed medical-surgical intensive care unit (ICU) in a quaternary referral centre in Adelaide, South Australia. Purposive sampling was conducted to identify participants. The semi-structured guide was utilised to facilitate discussion with group members. Four focus group discussions were conducted with former ICU patients (i.e., survivors) and caregivers. Thematic analysis identified themes and subthemes that informed us about the utility of the ICU peer support group and identified system-level areas for improvement. ICU survivors and their caregivers were recruited via the hospital-run ICU peer support group.</div></div><div><h3>Results</h3><div>Thirteen survivors (five females, mean age 56, and nine caregivers (seven females, mean age 39 (SD 33.6)) consented to participate in the focus group discussions. The study identified six themes relevant to the utility of the peer support group: (1) Dealing with the impact of ICU, (2) Information on peer support groups and post-intensive care syndrome whilst in ICU, (3) Information provided during peer support group meetings (4) Leadership (5) Managing challenging situations and expectations of caregivers and (6) Opportunities for organisational improvement.</div></div><div><h3>Conclusion</h3><div>ICU survivors and their caregivers value the ICU peer support model of care and can identify unit and system-level improvement opportunities to meet consumers' unmet needs.</div></div><div><h3>Practice implications</h3><div>ICU survivors and their caregivers' perspectives and viewpoints regarding this ICU peer support group identifies themes on the utility of peer support and survivorship. This is beneficial in further defining a peer support program and offering a platform for structuring and operationalising ICUs by partnering with consumers.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108795"},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking internet health information seeking to psychological distress among Chinese adults with a family cancer history: The attenuating role of patient–clinician communication of internet searches","authors":"Yuyuan Kylie Lai ,&nbsp;Jizhou Francis Ye ,&nbsp;Changhao Yan ,&nbsp;Xinshu Zhao","doi":"10.1016/j.pec.2025.108799","DOIUrl":"10.1016/j.pec.2025.108799","url":null,"abstract":"<div><h3>Objective</h3><div>The psychological distress faced by individuals with a family cancer history (FCH) has emerged as a significant concern. This study examined the relationship between Internet health information seeking (IHIS) and psychological distress, focusing on the mediating roles of cancer information overload and cancer worry and the moderating role of patient–clinician communication of Internet searches.</div></div><div><h3>Methods</h3><div>In 2023, a nationally representative online survey was conducted. This research encompassed a cohort of 580 Chinese adults with FCH and no personal cancer history. Moderated mediation analysis was employed.</div></div><div><h3>Results</h3><div>IHIS was not directly associated with psychological distress. However, it increased cancer information overload and cancer worry, which in turn exacerbated psychological distress. In addition, among people who discussed their online searches with healthcare providers, the positive association between IHIS and cancer information overload became nonsignificant.</div></div><div><h3>Conclusion</h3><div>The current study elucidates a mediation mechanism of cancer information overload and cancer worry in understanding the association between IHIS and psychological distress among individuals with FCH. Patient–clinician communication serves a prophylactic role by attenuating these adverse effects.</div></div><div><h3>Practical implications</h3><div>Encouraging patient–clinician dialogues about Internet health information may be promising in curbing cancer information overload. Healthcare providers should proactively engage in such discussions to support patients’ psychological health.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108799"},"PeriodicalIF":2.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The stone of Persia: A lesson in compassion","authors":"Antonio Yaghy","doi":"10.1016/j.pec.2025.108791","DOIUrl":"10.1016/j.pec.2025.108791","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108791"},"PeriodicalIF":2.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to lifestyle intervention activities in the SINgapore GERiatric to reduce cognitive decline and physical frailty (SINGER) study: A one-year preliminary analysis of process evaluation","authors":"Kwong Hsia Yap ,&nbsp;April Ka Sin Phua ,&nbsp;Richelle Santiano ,&nbsp;Melmar Folloso ,&nbsp;Eddie J.Y. Chong ,&nbsp;Xin Xu ,&nbsp;Christiani Jeyakumar Henry ,&nbsp;Effie Chew ,&nbsp;Andrea B. Maier ,&nbsp;Nagaendran Kandiah ,&nbsp;Christopher Philip Li-Hsian Chen","doi":"10.1016/j.pec.2025.108797","DOIUrl":"10.1016/j.pec.2025.108797","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate adherence to lifestyle intervention activities in the SINgapore GERiatric Intervention Study to Reduce Cognitive Decline and Physical Frailty (SINGER) study's intensive intervention arm over one year, as part of ongoing process evaluation. The analysis identifies sociodemographic, psychosocial, and vascular risk factors associated with adherence to optimize intervention strategies and improve participant engagement.</div></div><div><h3>Methods</h3><div>Adherence was categorised as non-adherent, low, moderate and high adherence based on participants' attendance. Total adherence was assessed in two ways, i) a composite of all attendance and ii) Latent Class Analysis (LCA) to identify distinct participant subgroups based on adherence to the SINGER study activities. Regression models assessed associations between individual factors with adherence to each type of intervention component and adherence profiles derived from LCA.</div></div><div><h3>Results</h3><div>More than 70 % of participants achieving moderate to high adherence. LCA identified three distinct adherence profiles: Low, Moderate and High adherence. Participants showed higher adherence to vascular and diet components, followed by exercise components, and lower adherence to cognitive components. Factors such as being female and having higher education were associated with higher adherence while living alone was associated with lower adherence. Participants with hypertension had higher overall adherence but lower adherence to vascular management sessions. The complexity, delivery mode and frequency of the activities influenced adherence, with more complex and frequent activities showing lower adherence.</div></div><div><h3>Conclusion</h3><div>The intensive intervention arm showed satisfactory adherence. A comprehensive analysis highlighted the relationship between adherence, sociodemographic factors, and vascular risks, emphasizing the need for targeted strategies to support subgroups with lower adherence and optimize engagement.</div></div><div><h3>Practice implications</h3><div>The study team should enhance participant engagement by simplifying complex activities and tailoring strategies for subgroups with lower adherence. Ongoing monitoring of adherence patterns and participant feedback will be crucial for making timely adjustments to the intervention.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108797"},"PeriodicalIF":2.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communicating with children in healthcare: How can we make it better?","authors":"Imelda Coyne ,&nbsp;Siyang Yuan","doi":"10.1016/j.pec.2025.108796","DOIUrl":"10.1016/j.pec.2025.108796","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108796"},"PeriodicalIF":2.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-determination theory interventions in self-care of cardiovascular disease: A systematic review","authors":"Yasser Saeedian ,&nbsp;Anjali Agarwal ,&nbsp;Paul Jansons ,&nbsp;Matthew Fuller-Tyszkiewicz ,&nbsp;Ralph Maddison","doi":"10.1016/j.pec.2025.108794","DOIUrl":"10.1016/j.pec.2025.108794","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) is a leading cause of death and disability worldwide. Effective self-care behaviours are critical for the secondary prevention of CVD, however many individuals fail to engage in these self-care activities in the long-term. Self-determination theory (SDT) offers a robust theoretical framework for understanding motivations for engaging in self-care. SDT-based interventions may improve self-care in people with CVD but has yet to be systematically reviewed.</div></div><div><h3>Objectives</h3><div>A systematic review was conducted to determine the effectiveness of SDT-based interventions on global measures of self-care of CVD, as well as specific self-care activities.</div></div><div><h3>Methods</h3><div>A literature search was conducted in August 2024 using MEDLINE, CINAHL, Embase, Global Health, APA PsycINFO, and SocINDEX. The inclusion criteria involved randomised controlled trials and cluster randomised trials that tested the effect of SDT-based interventions on self-care activities among adults with CVD.</div></div><div><h3>Results</h3><div>A total of 251 publications were screened and 7 studies included in the review. Results revealed inconsistent application of SDT principles across the included studies. While some incorporated all psychological needs according to SDT, others focused on only selected needs. Nevertheless, supporting people’s autonomy emerged as a consistent core component across all interventions. Three studies reported improvements in global self-care, two found improvements in physical activity, while one found no significant effect on physical activity, and another found no significant effect on dietary habits and smoking behaviours. There was considerable variation in the measurement of self-care with some studies focussed on global measures, while others targeted specific aspects of self-care such as diet or exercise, which prohibited meta-analysis.</div></div><div><h3>Conclusions</h3><div>Findings from this systematic review showed that SDT-based intervention demonstrated potential for enhancing self-care in individuals with CVD. However, the limited number of eligible studies and methodological heterogeneity preclude definitive conclusions about their effectiveness for improving self-care<strong>.</strong></div></div><div><h3>Practice implications</h3><div>Healthcare professionals should foster competence, relatedness, and autonomy support while adopting a holistic approach to self-care. Combining group and one-to-one interventions and integrating health education and goal-setting can promote maintained self-care adherence.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108794"},"PeriodicalIF":2.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an eLearning course for patients on osteoarthritis knowledge and pain self-efficacy in people with hip and/or knee osteoarthritis: A randomised controlled trial","authors":"Rachel K. Nelligan ,&nbsp;Rana S. Hinman ,&nbsp;Fiona McManus ,&nbsp;Anurika P. De Silva ,&nbsp;Maya Gregory ,&nbsp;Neil Bidgood ,&nbsp;Kim L. Bennell","doi":"10.1016/j.pec.2025.108792","DOIUrl":"10.1016/j.pec.2025.108792","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate a knee/hip osteoarthritis eLearning course for patients.</div></div><div><h3>Methods</h3><div>Randomised controlled trial. 124 community volunteers with knee/hip osteoarthritis were randomised to either i) a 4-week self-directed eLearning or ii) an electronic osteoarthritis pamphlet (control). Primary outcomes: change in knowledge (Osteoarthritis Knowledge Scale (OAKS)) and pain self-efficacy (Arthritis Self-Efficacy Scale (ASES pain subscale)) over 5 weeks. Secondary outcomes: fear of movement, exercise self-efficacy, osteoarthritis illness perceptions, physical activity levels, and use of physical activity/exercise, weight loss, pain medication, and health professional care seeking to manage joint symptoms.</div></div><div><h3>Results</h3><div>117(94 %) participants (mean (SD) age, 67.1(8.8) years; 91(77.8 %) female) provided 5-week primary outcomes. At 5-weeks, eLearning group showed greater improvements in osteoarthritis knowledge (mean difference 5.3(95 % CI 2.5,8.2), &lt; 0.001), which was sustained at 13-weeks (4.6(2.1,7.0), &lt; 0.001). There were no between-group differences in pain self-efficacy. Between-group differences for exercise self-efficacy and osteoarthritis illness perceptions at 5-weeks, and fear of movement and use of weight loss to manage joint symptoms at 13-weeks, favoured eLearning group.</div></div><div><h3>Conclusions</h3><div>eLearning produced immediate and sustained improvements in osteoarthritis knowledge but not pain self-efficacy compared to a typical osteoarthritis education intervention (information pamphlet).</div></div><div><h3>Practice implications</h3><div>Self-directed interactive eLearning is an effective method to educate patients about hip/knee osteoarthritis and its management.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"137 ","pages":"Article 108792"},"PeriodicalIF":2.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}