Patient Education and Counseling最新文献

{"title":"Exploring the influence of privacy concerns, AI literacy, and perceived health stigma on AI chatbot use in healthcare: An uncertainty reduction approach","authors":"Zikun Liu ,&nbsp;Wenxue Zou ,&nbsp;Cong Lin","doi":"10.1016/j.pec.2025.109271","DOIUrl":"10.1016/j.pec.2025.109271","url":null,"abstract":"<div><h3>Objective</h3><div>Guided by Uncertainty Reduction Theory, this study aims to explore the influence of AI privacy concerns, AI literacy, and perceived health stigma on the preference for AI chatbots in Chinese healthcare contexts.</div></div><div><h3>Method</h3><div>We analyzed survey data from 1487 participants, employing frequency analyses to generate descriptive statistics and regression modeling to examine the relationships among key variables.</div></div><div><h3>Results</h3><div>The findings indicate that AI chatbots are most highly valued for their roles in health information dissemination and lifestyle guidance. Privacy concerns negatively affect perceptions of AI as a substitute for doctors, particularly regarding sensitive health issues. However, AI literacy mitigates these concerns across all functional domains. Additionally, perceived health stigma enhances the acceptance of AI chatbots as substitutes for doctors in sensitive areas and intensifies the adverse impact of privacy concerns on AI’s role in health information, decision-making, and lifestyle guidance.</div></div><div><h3>Conclusion</h3><div>The current study yields valuable insights into the role of AI chatbots in healthcare contexts, particularly in shaping users’ intentions to disclose personal information. It also advances the theoretical scope of Uncertainty Reduction Theory by extending its application to human-AI interactions.</div></div><div><h3>Practical Implications</h3><div>The findings underscore the need for healthcare providers, policymakers, and AI developers to prioritize privacy safeguards, promote AI literacy, and actively combat stigma. Such efforts are essential to fostering trust and encouraging meaningful patient engagement with AI-driven tools, especially in addressing sensitive health concerns.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"Article 109271"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704086","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":"An elaboration likelihood model approach to cancer patients’ decision-making: The role of social media use, provider discussion, and misinformation perceptions","authors":"Qiwei Luna Wu","doi":"10.1016/j.pec.2025.109270","DOIUrl":"10.1016/j.pec.2025.109270","url":null,"abstract":"<div><h3>Background</h3><div>While most cancer patients are willing to use social media (SM) to inform medical decisions, little is known about how provider’s communication may inform their decision process.</div></div><div><h3>Objective</h3><div>Based on the Elaboration Likelihood Model, this study explored how cancer patients’ health-related SM use may have effects on their decision-making through a central (clinical discussions) and a peripheral route (personal impression of the quality of SM information).</div></div><div><h3>Methods</h3><div>A sample of 813 adult cancer patients who went to a doctor in the past year and had used SM were selected from the nationally representative Health Information National Trends Survey (HINTS, Cycle 6). Path analysis was used to explore the research objective.</div></div><div><h3>Results</h3><div>About one in ten cancer patients make SM-based medical decisions (n = 82). Predictors of making SM-based decision include more discussions with providers (ß =.51, p &lt; .01), more health-related SM use (ß =.08, p = .03), and perceptions of SM information being not misleading (ß = −.14, p &lt; .01). Discussion with providers positively mediated the effect of SM use on making SM-based decisions. Discussion with providers was associated with lower SM misinformation perception, predicting more SM-based decisions.</div></div><div><h3>Conclusions</h3><div>Despite expert recommendations for cancer patients to discuss their online information searches with their providers, this study showed a potential confirmation bias among cancer patients who depend on SM for health information. Theoretical and practical implications are discussed.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"Article 109270"},"PeriodicalIF":2.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696488","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":"Qualitative study of Black and Latino (a/e) caregiver participation on family-centered rounds","authors":"Katie Margolis ,&nbsp;Kathryn I. Pollak ,&nbsp;Laura Fish ,&nbsp;Margaret Falkovic ,&nbsp;Pedro Gomez Altamirano ,&nbsp;Heather Parnell ,&nbsp;Victoria Parente","doi":"10.1016/j.pec.2025.109267","DOIUrl":"10.1016/j.pec.2025.109267","url":null,"abstract":"<div><h3>Background</h3><div>Family-centered rounds (FCR), multi-disciplinary rounds at bedside that involve the patient and family, has become the standard of care in pediatric hospitalizations. Caregiver participation on FCR improves shared-decision making and communication among providers, patients, and families. Evidence suggests Black and Latino (a/e) caregivers participate less during FCR than White caregivers, likely due to interpersonal and structural inequities, however contributing factors have not been adequately explored.</div></div><div><h3>Objective</h3><div>To better understand factors positively and negatively influencing Black and Latino (a/e) participation during FCR.</div></div><div><h3>Design/Methods</h3><div>We conducted a qualitative study of Black and Latino(a/e) caregivers and attending clinicians of hospitalized children admitted to a general pediatrics team at a tertiary care children’s hospital. We conducted virtual semi-structured interviews to assess factors that promoted and hindered caregiver participation on FCR. Clinician interviews addressed experiences encouraging caregiver participation on FCR with a focus on Black and Latino(a/e) caregivers. Investigators worked together to organize codes into common themes, select representative quotes, and create a conceptual framework.</div></div><div><h3>Results</h3><div>We conducted 21 interviews (14 caregivers, 7 clinicians) at an academic medical center. From our interviews, caregivers and their clinicians identified four major themes that influenced caregiver participation during rounds: 1) verbal and nonverbal interpersonal communication, 2) shared understanding and language, 3) structural factors (team size and time pressures), and 4) race, racism, and previous healthcare experiences.</div></div><div><h3>Conclusions</h3><div>Caregivers and their clinicians identified structural and modifiable clinician and health system factors that can promote Black and Latino (a/e) participation on FCR. Future research and interventions focused on these factors may improve not only racial inequities in clinician-caregiver communication, but also pediatric health outcomes.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"139 ","pages":"Article 109267"},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672656","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 perceived ethical appropriateness of messaging on breast cancer screening cessation among older women","authors":"Vivian V. Altiery De Jesus ,&nbsp;Mary Catherine Beach ,&nbsp;Susan M. Hannum ,&nbsp;Sarah E. Gollust ,&nbsp;Rebekah Nagler ,&nbsp;Mara A. Schonberg ,&nbsp;Cynthia Boyd ,&nbsp;Craig Evan Pollack ,&nbsp;Qian-Li Xue ,&nbsp;Nancy L. Schoenborn","doi":"10.1016/j.pec.2025.109263","DOIUrl":"10.1016/j.pec.2025.109263","url":null,"abstract":"<div><h3>Objective</h3><div>Messaging about breast cancer screening cessation may reduce over-screening by raising awareness of the harms of screening, but in a background of strongly positive beliefs about screening among the public, such messaging may be perceived negatively. We aimed to assess whether older women perceived it to be ethically appropriate for clinicians to share a message that encourages breast cancer screening cessation.</div></div><div><h3>Methods</h3><div>As part of a large national online survey experiment with women 65+ years, we presented a message (hereafter referred to as primary message) describing the rationales for stopping breast cancer screening (e.g., guideline recommendation, harms of screening) and assessed how ethical women thought it would be for doctors to share this information with patients. We assessed open-ended reactions. We also tested two variations of the primary message with different wordings of the recommendation to consider stopping screening.</div></div><div><h3>Results</h3><div>Of 683 participants, 75.9 % agreed that the primary message is ethically appropriate for doctors to share with patients., 13.2 % neither agree or disagree, and 10.9 % disagreed. Themes in open-ended responses suggested that the difference in participant response was partly attributed to whether participants perceived the message as informative or persuasive. Comparing across message variations, messages with stronger recommendations to stop screening were perceived to be less ethically appropriate than the primary message.</div></div><div><h3>Conclusions</h3><div>Most older women perceived that it was ethically appropriate for doctors to share messages aimed at reducing breast cancer over-screening with patients.</div></div><div><h3>Practice Implications</h3><div>Interventions should be developed to deliver messages to reduce over-screening among older women in practice settings, with evaluations to monitor their response.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"Article 109263"},"PeriodicalIF":2.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696374","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":"Measures to evaluate clinician communication in the intensive care unit: A systematic review of measurement properties","authors":"Claire R. Morton ,&nbsp;Lauren Raymond-King ,&nbsp;Alexandria Brackett ,&nbsp;Zara R. Cooper ,&nbsp;Jason B. Liu","doi":"10.1016/j.pec.2025.109266","DOIUrl":"10.1016/j.pec.2025.109266","url":null,"abstract":"<div><h3>Objectives</h3><div>Patients in the intensive care unit (ICU) face barriers to effective communication. Measures to evaluate communication quality remain limited. Patient and proxy reported outcome measures (PROMs and PrROMs) are increasingly being used to evaluate care in a patient-centered manner. We sought to identify validated PROMs and PrROMs for clinician communication quality in the ICU.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed according to COSMIN guidelines. The search strategy included text words and subject headings related to communication (construct), ICU patients (population), and questionnaires or surveys (instrument). Studies were included if they focused on the development or measurement properties of a PROM or PrROM for clinician communication in the ICU, included adult patients or proxies, and were published in English after 2000. The results were imported to Covidence, a literature review citation screening tool and manager.</div></div><div><h3>Results</h3><div>10258 studies were identified. After removal of duplicates, 6210 titles and abstracts were screened for inclusion. 29 full texts were assessed. Six manuscripts assessing three measures, the Family Satisfaction in the ICU (FS-ICU), Critical Care Family Satisfaction Survey (CCFSS), and the Family Inpatient Communication Survey (FICS), met criteria for inclusion. The only measure to have undergone an adequate design process, per COSMIN criteria, was the FICS. The FS-ICU and CCFSS demonstrated sufficient content validity. The FS-ICU demonstrated indeterminate content validity, insufficient structural validity, and sufficient construct validity. The FICS demonstrated sufficient structural validity, internal consistency, and construct validity. Other measurement properties were not reported.</div></div><div><h3>Conclusions</h3><div>None of the identified measures met criteria for recommendation based on the COSMIN framework. Furthermore, none of the measures exclusively or comprehensively assessed communication quality.</div></div><div><h3>Practice implications</h3><div>Proxy measures evaluating the quality of clinician communication in the ICU are limited. New measures or significant revision of current measures is necessary alongside developing multidimensional protocols for assessment.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"Article 109266"},"PeriodicalIF":2.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704085","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":"Equivocation in patients’ decisional preference about life-sustaining treatments","authors":"Anca-Cristina Sterie ,&nbsp;Gilles Merminod ,&nbsp;Eve Rubli Truchard ,&nbsp;Ralf J. Jox ,&nbsp;Paul Drew","doi":"10.1016/j.pec.2025.109265","DOIUrl":"10.1016/j.pec.2025.109265","url":null,"abstract":"<div><h3>Objective</h3><div>Communication is essential for achieving shared decision-making. We focus on how patients design decisional preferences to allow or decline life-sustaining treatments (LST). We examine “equivocation”, a practice through which patients refer to two preferences in response to the physician asking for only one.</div></div><div><h3>Methods</h3><div>Conversation analysis of 89 conversations with physicians in which patients allow or decline LST.</div></div><div><h3>Results</h3><div>We identified three types of decisional preference formats. In “unequivocal preferences”, patients express a clear-cut preference towards or against an intervention. In “implicitly equivocal preferences” patients express one preference accompanied by a conditional account, conveying an implicit caveat: if the condition is not fulfilled, the preference is not valid. In “explicitly equivocal preferences”, patients refer to two contrasting options.</div></div><div><h3>Conclusion</h3><div>These constructions reveal the complexity of decision-making and its granularity, as patients orient to particular scenarios that make relevant specific approaches, instead of confining decisional preferences to the polar request design employed by the physician.</div></div><div><h3>Practice Implications</h3><div>Equivocal answers are not always acknowledged by physicians, which means that the documentation of patients’ preferences might not adequately capture their wishes and expectations. This pattern of response also raises issues about what patients agree to and understand and, more generally, about patient literacy.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"Article 109265"},"PeriodicalIF":3.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724761","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":"Where is the problem to be solved? Problem defining and epistemic uncertainties in shared decision-making","authors":"Weiwei Lu","doi":"10.1016/j.pec.2025.109264","DOIUrl":"10.1016/j.pec.2025.109264","url":null,"abstract":"<div><h3>Background</h3><div>Physicians and patients apply different but overlapped knowledge in their contexts to define the divergent problems to solve during cancer treatment.</div></div><div><h3>Objectives</h3><div>This study aims to identify the knowledge sources of problem defining between physicians and patients in shared decision-making on cancer treatment.</div></div><div><h3>Methods</h3><div>This study adopted a divided narrative approach and interviewed 32 cancer patients and their paired 16 physicians from two top hospitals in northwestern China.</div></div><div><h3>Results</h3><div>Physicians defined problems by five types of knowledge sources structured in the social system and patients defined problems by five types of knowledge sources grounded in the individual system.</div></div><div><h3>Discussion and Conclusions</h3><div>Physicians and patients draw knowledge to define problems through asymmetric social mechanisms, which demonstrates the structural and cultural barriers to reaching mutual understanding and trust. However, a shared definition of the problem emerges from epistemic uncertainties in physician-patient interaction. Problem defining unfolds a chain of problems in shared decision-making, which can be potentially solved through narrative exchange at macro, meso, and micro levels.</div></div><div><h3>Practice implications</h3><div>This study suggests that, in shared decision-making, physicians can pay more attention to the cultural aspects of patients’ problem-defining narratives, while patients can be more aware of the social structural aspects of physicians’ problem-defining narratives.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"139 ","pages":"Article 109264"},"PeriodicalIF":2.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655833","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":"Corrigendum to “A theory-based educational intervention to increase mothers’ intention to vaccinate their daughters against human papillomavirus: A randomised controlled trial” [Patient Educ Couns 135 (2025) 108731]","authors":"Areej Alqethami ,&nbsp;Eman Alhalal","doi":"10.1016/j.pec.2025.109259","DOIUrl":"10.1016/j.pec.2025.109259","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"139 ","pages":"Article 109259"},"PeriodicalIF":2.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631593","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":"Risk communication of study drug side effects: An evaluation of informed consent forms from ClinicalTrials.gov","authors":"Chandler Coleman,&nbsp;Owen Jokinen,&nbsp;James Duhig,&nbsp;Andrea Best,&nbsp;Linda Scarazzini","doi":"10.1016/j.pec.2025.109261","DOIUrl":"10.1016/j.pec.2025.109261","url":null,"abstract":"<div><h3>Background</h3><div>Understandable safety language within informed consent forms (ICFs) is essential to informed clinical trial enrollment. Risk communication research has established that using the European Commission's (ECs) recommended verbal risk descriptors (‘very common, common, uncommon, rare, and very rare’) with a frequency band (e.g., ‘may affect more than 1 in 10 people’), absolute frequency (e.g., ‘5 out of 100 participants’), or percentage (e.g., ‘5 %’) is preferred, as it leads to improved comprehension of side effect susceptibility.</div></div><div><h3>Objectives</h3><div>We aimed to examine how ICFs present study drug side effect information, including the use of EC recommended verbal risk descriptors.</div></div><div><h3>Methods</h3><div>We systematically assessed ICFs from clinical studies within ClinicalTrials.gov, to determine how side effect frequency was described. We evaluated the method used to describe the likelihood of side effects and the information's presentation.</div></div><div><h3>Results</h3><div>547 English language ICFs were included in the analytic cohort. 104 ICFs (19 %) gave no indication of the frequency of study drug side effects occurring. 88 ICFs (16.1 %) used an EC recommended verbal descriptor with a frequency band, absolute frequency, or percentage, that displayed the incorrect probability of occurrence. Only 20 ICFs (3.6 %) used EC recommended verbal risk descriptors with their correct probability of occurrence. No ICFs utilized risk visualizations to display side effect frequency.</div></div><div><h3>Conclusions</h3><div>The communication of study drug side effects within ICFs varied widely and was often inadequate. The use of frequency bands, absolute frequencies, or percentages that incorrectly communicate the probability of occurrence associated with an EC verbal risk descriptor may exacerbate participant confusion on their susceptibility to risk.</div></div><div><h3>Practice implications</h3><div>This study highlights the need for standard guidance for side effect presentation within ICFs, which encourages the use of effective risk communication practices.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"140 ","pages":"Article 109261"},"PeriodicalIF":2.9,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704104","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":"Mobile app-based pain management education for ambulatory surgery patients in Denmark: A Legitimation Code Theory analysis","authors":"Anette Lykke Hindhede ,&nbsp;Tom Moeller ,&nbsp;Karsten Lomholt Lassen ,&nbsp;Bitten Dybdal ,&nbsp;Christina Ingeborg Andersen","doi":"10.1016/j.pec.2025.109262","DOIUrl":"10.1016/j.pec.2025.109262","url":null,"abstract":"<div><h3>Objectives</h3><div>This paper analyzes the educational content of the MinSmerte (MyPain) app, designed to educate patients on postoperative pain management after ambulatory surgery. It examines the complexity of instructional videos, investigating how these relate to the legitimacy claims constructed by educators – defined as assertions about the value of the information based on its relevance, authority, alignment with community norms. Patient feedback is explored to assess their perceptions of the app’s effectiveness in facilitating knowledge building.</div></div><div><h3>Methods</h3><div>The study involved an analysis of three instructional videos using the Semantics dimension of Legitimation Code Theory. Additionally, the Specialization dimension was used to analyse data from telephone interviews with 29 post-discharge patients, focusing on their perceptions of the app’s accessibility, comprehensibility, and usability, in relation to their everyday pain management practices. Interviews included specific questions to evaluate patients’ health literacy levels and how those influenced their perception of accessibility, comprehensibility, and usability.</div></div><div><h3>Results</h3><div>The instructional videos employed accessible language but varied in effectiveness. Some patients found the app beneficial for connecting with the hospital and tracking progress, while others faced challenges in navigation and clarity.</div></div><div><h3>Conclusion</h3><div>Mobile apps for patient education hold significant potential for postoperative pain management. The study highlights the importance of customizing both content and technical aspects of the app to align with patients’ health literacy and their perceptions of accessibility, comprehensibility, and usability for optimizing the educational impact.</div></div><div><h3>Practice implications</h3><div>Findings stress the importance of assessing health literacy in patient education apps to enhance patient experiences and promote knowledge building through a framework of socially just pedagogies. Legitimation Code Theory provides a valuable framework for understanding knowledge dynamics in app-based education, emphasizing the importance of patient involvement in the co-design process.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"139 ","pages":"Article 109262"},"PeriodicalIF":2.9,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631589","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}