Patient Education and Counseling最新文献

{"title":"Timing of advance care planning in patients with advanced cancer: Analysis of ACTION data","authors":"Tingting Zhu ,&nbsp;Judith AC Rietjens ,&nbsp;Johannes J.M. van Delden ,&nbsp;Luc Deliens ,&nbsp;Agnes van der Heide ,&nbsp;Anna Thit Johnsen ,&nbsp;Francesca Ingravallo ,&nbsp;Urška Lunder ,&nbsp;Nancy J. Preston ,&nbsp;Jane Seymour ,&nbsp;Ida J. Korfage","doi":"10.1016/j.pec.2025.108761","DOIUrl":"10.1016/j.pec.2025.108761","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the experiences of patients with advanced cancer regarding the timing of ACP.</div></div><div><h3>Methods</h3><div>This secondary analysis used data from the ACTION cluster-randomized clinical trial. 288 patients with advanced lung or colorectal cancer, WHO performance status 0–3, and with a minimum life expectancy of 3 months were included in this analysis.</div></div><div><h3>Results</h3><div>The mean time between patients’ cancer diagnosis and the first ACP conversation was 15.3 months (SD:19.4). The average duration from current cancer stage diagnosis to the first conversation was 8.9 months (SD:10.7). The timing of the conversation was perceived as “just right” by 217 (75.3 %) of the patients. Patients who perceived the timing as “too early” were more recently diagnosed with cancer (9.1 months) or with their current cancer stage (5.7 months) than those who did not. Patients perceiving the timing as “too late” had shorter estimated survival times.</div></div><div><h3>Conclusion</h3><div>Patients with advanced cancer may benefit from earlier ACP than what is currently typically initiated in clinical practice.</div></div><div><h3>Practice implications</h3><div>When initiating ACP conversations, several aspects should be considered, including patients’ gender, their socio-cultural environment, and their ability to perform daily activities, with or without limitations.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108761"},"PeriodicalIF":2.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-design and feasibility testing of the heart failure carer support programme (HELP): A convergent, mixed-method study","authors":"Lorna Cassidy ,&nbsp;Gareth Thompson ,&nbsp;Loreena Hill ,&nbsp;Jennifer McGaughey ,&nbsp;Martin Dempster ,&nbsp;Eunice Greene ,&nbsp;Patrick Donnelly ,&nbsp;Lana Dixon ,&nbsp;Patricia Campbell ,&nbsp;Donna Fitzsimons","doi":"10.1016/j.pec.2025.108760","DOIUrl":"10.1016/j.pec.2025.108760","url":null,"abstract":"<div><h3>Objectives</h3><div>This study co-designed and feasibility tested a novel psychoeducational intervention delivered online to carers of patients with heart failure (HF) and examined the potential impact on carer-related outcomes.</div></div><div><h3>Methods</h3><div>The HEart faiLure carer support Programme (HELP) was co-designed with carers and healthcare professionals at a large University hospital. This intervention comprises an information booklet and six psychoeducational support group sessions delivered online by a multidisciplinary team. A convergent mixed-method design examined the feasibility, acceptability, and potential impact of HELP. Carers of patients with HF were recruited in the United Kingdom (UK) via clinical teams along with printed and online advertisements. Quantitative measurements included carer-related outcomes (carer burden, carer preparedness, quality of life, anxiety, depression, stress, and social support) and feasibility assessments (recruitment rates, attrition, and intervention usefulness). Focus groups conducted post-intervention qualitatively investigated the acceptability of HELP. Data was collected at baseline, 6 weeks post-intervention, and 3 months post-intervention. Quantitative and qualitative data were analyzed with descriptive and thematic analysis, respectively. The results were integrated to generate a holistic understanding of the findings.</div></div><div><h3>Results</h3><div>51 carers were eligible and 22 (43 %) provided consent. Of those 22, 18 (89 %) participated and 12 (67 %) completed all intervention sessions. Participants highly rated the usefulness of the intervention via a feedback questionnaire (4.7 ± 0.59 out of 5, overall) and positive changes were found across the following carer-related outcomes: anxiety, depression, caregiver burden, stress, preparedness, and social support. Data integration generated three key findings: (1) Improved carer preparedness and knowledge, (2) Support from group environment, and (3) Emotional support and personal wellbeing.</div></div><div><h3>Conclusions</h3><div>HELP delivery to carers of patients with HF is feasible and potentially provides emotional support and empowerment in their caring role.</div></div><div><h3>Practice implications</h3><div>HELP will advance to implementation testing across the UK to inform large-scale adoption in routine clinical practice.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108760"},"PeriodicalIF":2.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of metaphor in provider-patient communication in medical settings: A systematic review","authors":"Xingbing Liu","doi":"10.1016/j.pec.2025.108751","DOIUrl":"10.1016/j.pec.2025.108751","url":null,"abstract":"<div><h3>Background</h3><div>Metaphors are extensively utilized by those studying and practicing medicine. Those metaphors employed in provider-patient communication in medical settings are particularly significant due to their dynamic and interactive nature, and their direct contribution to the completion of core medical tasks and the quality of provider-patient interaction and relationship.</div></div><div><h3>Objective</h3><div>We aim to: (1) to identify and summarize existing literature on the use of metaphors in patient-provider communication in medical settings; (2) discuss the implications of these studies for medical research and practice; and (3) provide recommendations for future research in this area.</div></div><div><h3>Methods</h3><div>The Chinese National Knowledge Infrastructure and the Web of Science Core Collections were systematically searched, and the obtained literature was combined with the online resource \"Metaphor in Health Discourse and Communication\". The resultant literature was then screened according to preset inclusion and exclusion criteria.</div></div><div><h3>Results</h3><div>Of 265 articles identified, 16 studies were found to completely meet our purpose and inclusion criteria. Analysis revealed 7 major themes, including the metaphor’s facilitating functions, harmful effects, differences between providers and patients etc. Metaphors were found to enhance provider-patient relationship and communication and promote shared understanding and decision-making.</div></div><div><h3>Conclusion</h3><div>Metaphors play a significant role in provider-patient communication in medical settings, offering both benefits and challenges. Future research can further explore other aspects of metaphor use in medical settings, and update the research methodology and approaches by collecting larger, balanced samples of metaphor, conducting quantitative analyses of metaphor efficacy, and doing multimodal analysis of metaphor use.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108751"},"PeriodicalIF":2.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684718","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":"Patients’ requests and physicians’ prescribing behavior. A systematic review","authors":"Aline Rinaldi ,&nbsp;Anna Bullo ,&nbsp;Peter Johannes Schulz","doi":"10.1016/j.pec.2025.108747","DOIUrl":"10.1016/j.pec.2025.108747","url":null,"abstract":"<div><h3>Background</h3><div>Patients' requests is a frequently cited factor in the literature affecting doctors’ prescribing decisions. This systematic review aims to consolidate quantitative findings, shedding light on the relationship between patient requests and the actions taken by general practitioners. A broader perspective was adopted by not limiting our investigation to specific medication categories. Instead, we treat the act of requesting as a communicative behavior, separate from the pharmacological context.</div></div><div><h3>Method</h3><div>A comprehensive search across various online databases was performed. Two authors independently contributed the screening phase. The selection of articles and the data extraction were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart.</div></div><div><h3>Results</h3><div>Patient’s request demonstrated to be a driving factor for physician’s prescribing behavior not only when antibiotics are involved, but as a more generalized trend.</div></div><div><h3>Conclusions</h3><div>The study acknowledges the complexity of patient-provider communication, emphasizing the asymmetry in roles and the tension between patient empowerment and medical expertise. By uncovering the underlying mechanisms shaping doctors' responses to patient requests, this systematic review enhances our understanding of communication in healthcare settings.</div></div><div><h3>Practice implications</h3><div>Understanding the impact of patient requests on prescribing decisions highlights the importance of training healthcare providers in effective communication strategies that balance patient autonomy with clinical judgment. These insights can inform guidelines and interventions aimed at managing patient expectations, supporting more evidence-based prescribing practices and fostering better doctor-patient relationships.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108747"},"PeriodicalIF":2.9,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing virtual patients for empathy training in healthcare: A scoping review","authors":"Xiaobei Chen ,&nbsp;Zixiao Yang","doi":"10.1016/j.pec.2025.108752","DOIUrl":"10.1016/j.pec.2025.108752","url":null,"abstract":"<div><h3>Objective</h3><div>A growing body of virtual patients (VPs) generated by computers has been incorporated into medical education that includes empathy training. We sought to uncover the validity and effectiveness of VPs in empathy training.</div></div><div><h3>Method</h3><div>The authors carried out a comprehensive search of all articles published between 1991 and 2023 in the seven databases of literature in the areas of health science and education. In total, 2170 abstracts were reviewed, and ultimately, the final corpus consisted of 44 articles.</div></div><div><h3>Results</h3><div>Guided by the Computer-as-social-actor framework, this study identified four types of primary social cues presented in current literature to arouse trainees’ social responses. Overall, the social cues used across the included studies were similar. However, the efficacy and effectiveness of VPs varied, and we identified four factors that may influence these outcomes. First, technology matters. VPs for VR systems were found to be effective in clinical empathy training, but limited empirical evidence supported web-or-mobile-based VPs. Second, improvement was only observed in the cognitive empathy dimension. Third, studies that have longer interaction duration (over 30 minutes). Last, using self-report measurements were more likely to observe significant improvements. Qualitative findings revealed that VPs for VR systems can create an immersive experience that allows users to understand the needs of patients and put themselves in patients’ shoes, while web-or-mobile-based VPs are more convenient for trainees.</div></div><div><h3>Practical implications</h3><div>This review displays evidence supporting the efficacy and effectiveness of VPs in future medical empathy training. Mechanisms and future research agendas were discussed.</div></div><div><h3>Conclusion</h3><div>VPs are promising tools for future empathy training.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108752"},"PeriodicalIF":2.9,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671497","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":"Older patients’ experiences and needs regarding pharmacotherapeutic care in-hospital and after discharge","authors":"Eline M.C. Engelen ,&nbsp;Wilma Knol ,&nbsp;Stephanie C.M. Wuyts ,&nbsp;Darshana A. Theunissen ,&nbsp;Ariel M. Vondeling ,&nbsp;Sjacky Cooijmans ,&nbsp;Noortje van Herwaarden ,&nbsp;Cornelis Kramers ,&nbsp;Patricia M.L.A. van den Bemt ,&nbsp;Michiel A. van Agtmael ,&nbsp;Marcel L. Bouvy","doi":"10.1016/j.pec.2025.108754","DOIUrl":"10.1016/j.pec.2025.108754","url":null,"abstract":"<div><h3>Objective</h3><div>This qualitative study explores the experiences and needs of older patients with polypharmacy regarding transitional pharmacotherapeutic care during hospital admission and following discharge, identifying areas for improvement.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted using semi-structured interviews with patients discharged from two Dutch hospitals (academic and non-academic). Patients were asked about their experiences and needs related to medication management, information provision, attitude towards medication changes, decision-making, interactions with healthcare providers and involvement of professional and non-professional support networks. Interviews were transcribed verbatim and analyzed thematically using the Framework approach.</div></div><div><h3>Results</h3><div>Thirteen interviews were conducted. Patients reported diverse experiences and needs regarding transitional pharmacotherapeutic care. Three key themes emerged: patient context, trust in the healthcare system and collaborative decision-making. Participants showed a high level of trust in the organization of healthcare and varying awareness of the benefits of extensive collaboration between healthcare professionals across healthcare settings.</div></div><div><h3>Conclusions</h3><div>Patients’ experiences with pharmacotherapeutic care during hospital admission and following discharge were partly influenced by a high level of trust in the healthcare system. However, shortcomings were noted in adapting care to individual informational needs, patient contexts, and involvement in decision-making about medication changes.</div></div><div><h3>Practice implications</h3><div>To optimize patients’ experiences in pharmacotherapeutic transitional care, it is essential to balance patient autonomy with professional guidance in the development of new patient-centered medication optimization interventions. Healthcare professionals should ask and document patient preferences in communication and support regarding medication decisions. Clear communication about the role of each healthcare professional may enhance patient awareness of potential medication errors, as some patients now put their trust in the organization of healthcare.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108754"},"PeriodicalIF":2.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Promoting interactional health equity through (Complementary and Integrative Health) talk during clinical encounters” [Patient Educ Couns 134 (2025) 108651]","authors":"Evelyn Y. Ho ,&nbsp;Christopher J. Koenig","doi":"10.1016/j.pec.2025.108739","DOIUrl":"10.1016/j.pec.2025.108739","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"135 ","pages":"Article 108739"},"PeriodicalIF":2.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of GROVE: A Guideline for RepOrting Vignette Experiments conducted in a healthcare context","authors":"Marij A. Hillen ,&nbsp;Leonie N.C. Visser ,&nbsp;Nanon H.M. Labrie ,&nbsp;Liesbeth M. van Vliet ,&nbsp;Som Saha ,&nbsp;Danielle Blanch-Hartigan ,&nbsp;Ellen M.A. Smets ,&nbsp;On behalf of the GROVE Working group","doi":"10.1016/j.pec.2025.108750","DOIUrl":"10.1016/j.pec.2025.108750","url":null,"abstract":"<div><h3>Objective</h3><div>Experimental studies using vignettes investigate the impact of healthcare professional or patient/client characteristics, communication, and/or other behaviors on outcomes. To ensure methodological rigor and quality, guidance is needed for systematic reporting of such studies. We describe the development of the Guideline for RepOrting of Vignette Experiments (GROVE).</div></div><div><h3>Methods</h3><div>A steering group comprising experts in vignette research oversaw guideline development using an iterative and expert-driven approach. The development process included reviewing relevant literature, developing draft reporting criteria, soliciting feedback from a working group of international experts, applying the draft criteria to completed or planned vignette studies, and iteratively revising criteria until final group consensus was reached. GROVE was registered with the EQUATOR network repository of reporting guidelines.</div></div><div><h3>Results</h3><div>The final guideline encompasses the following criteria: 1. Rationale for a vignette design; 2. Vignette content; 3. Outcomes; 4. Vignette validity &amp; realism; 5. Participants; and 6. Accessibility. Criterion 2 is further divided into five sub-criteria: 2.1. Healthcare scenario; 2.2. Manipulation &amp; standardization; 2.3. Mode of delivery; 2.4. Expert involvement; and 2.5. Pilot testing.</div></div><div><h3>Conclusion</h3><div>GROVE offers authors guidance in reporting experimental vignette studies.</div></div><div><h3>Practice implications</h3><div>Transparent reporting of vignette studies will help readers evaluate the reliability and validity of study findings, replicate studies, and extract relevant information for reviews.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108750"},"PeriodicalIF":2.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications in human-centered design: Shared-Decision Making for mental health treatment in primary care","authors":"Katie Tirtanadi ,&nbsp;Kathryn A. Johnson ,&nbsp;Amee J. Epler ,&nbsp;Jessica A. Chen","doi":"10.1016/j.pec.2025.108745","DOIUrl":"10.1016/j.pec.2025.108745","url":null,"abstract":"<div><h3>Objective</h3><div>Shared Decision Making (SDM) is heralded as a standard for patient-centered care, but implementation of SDM in routine mental health practice has proven difficult to achieve. Human-centered design (HCD) may hold promise for improving SDM implementation in busy clinical settings. This study describes applying HCD to develop an SDM documentation support tool intended to encourage successful use of SDM by mental health clinicians.</div></div><div><h3>Methods</h3><div>This descriptive, proof-of-concept study utilized the Discover-Design-Build-Test HCD framework to simplify a comprehensive SDM protocol for mental health decision making. Implementation was piloted within multiple primary care clinics. The study consisted of three phases: information gathering (interviewing clinicians), solution generation and prototyping, and testing a final prototype in routine care settings.</div></div><div><h3>Results</h3><div>Our project proceeded through eight cycles of user design and feedback. Clinicians pilot tested the final product, a documentation note template incorporating SDM prompts and explanations. It is currently available for clinical use.</div></div><div><h3>Conclusions</h3><div>Clinicians were able to use the HCD-redesigned SDM documentation note template intuitively, i.e., without explicit instruction. Leveraging buy-in from users throughout the entirety of the process (from problem investigation to solution discussions) created opportunities to tailor implementation strategies and may support ownership of the end-product by primary stakeholders.</div></div><div><h3>Practice implications</h3><div>HCD may be a promising methodology for streamlining the adoption of complex clinical tasks like SDM.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108745"},"PeriodicalIF":2.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684724","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":"Pictorial art for gaining informed consent in low-literacy settings","authors":"Swapnil.G. Ghotane ,&nbsp;Clarice. Holt ,&nbsp;Stephen.J. Challacombe ,&nbsp;Patric. Don-Davis ,&nbsp;David. Kamara ,&nbsp;Jennifer.E. Gallagher","doi":"10.1016/j.pec.2025.108749","DOIUrl":"10.1016/j.pec.2025.108749","url":null,"abstract":"<div><h3>Objective</h3><div>Gaining informed consent for research in low-literacy setting is challenging. This study explores the creation and use of pictorial art in information and consent form in Sierra Leone (SL).</div></div><div><h3>Methods</h3><div>A pictorial ‘information and consent’ (PIC) sheet was developed with an illustrator (co-author) and local colleagues for a national oral health survey involving school children in SL. Evaluation included 500 participants (children and parents) who received a feedback form to assess their satisfaction with pictures and also their effectiveness in aiding understanding of the research process, using a visual five-point Likert scale. Data were descriptively analysed using STATA v.18.</div></div><div><h3>Results</h3><div>Feedback was received from 360 children (aged 12 and 15 years) and 14 parents of 6-year-olds. The average rating, out of five, for the question about liking pictures on the PIC sheet was 4.83 (S.D. = 0.62), while rating for how well pictures helped them understand the survey was 4.87 (S.D. = 0.54). Although most feedback was positive, a small minority expressed negative views.</div></div><div><h3>Conclusion</h3><div>Overall, participants appreciated that the pictorial aids had helped in understanding the research process.</div></div><div><h3>Practical implications</h3><div>Pictorial aids show potential to improve comprehension and informed consent in low-literacy settings, indicating a promising approach for future research in similar contexts.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"136 ","pages":"Article 108749"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}