Nursing Ethics最新文献

{"title":"Negotiating emotional and ethical tensions in hospital-based end-of-life cancer care.","authors":"Mirko Prosen, Sabina Ličen","doi":"10.1177/09697330261486764","DOIUrl":"https://doi.org/10.1177/09697330261486764","url":null,"abstract":"<p><p>BackgroundEnd-of-life cancer care is characterised by persistent tensions between curative and palliative approaches, creating emotional and ethical challenges for healthcare professionals.Research aimThis study aimed to explore how healthcare professionals experience and negotiate emotional and ethical tensions in end-of-life cancer care within hospital-based settings, and how these tensions are shaped by clinical, professional, and organisational contexts.Research designA qualitative study using an interpretative design and reflexive thematic analysis was conducted.Participants and research contextSemi-structured interviews were conducted with 25 healthcare professionals, including 15 nurses and 10 physicians, recruited from internal medicine, surgery, and intensive care departments across multiple hospitals in Slovenia. Participants had regular experience caring for patients with advanced cancer at the end-of-life.Ethical considerationsEthical approval was obtained from the Commission of the University of Primorska for Ethics in Human Subjects Research (Approval No: 4264-16-3/2022). Participation was voluntary, written informed consent was obtained from all participants, and confidentiality and anonymity were ensured throughout the study.Findings/resultsFour themes were generated: (1) negotiating the boundaries between life-prolongation and end-of-life care; (2) managing moral responsibility within team and hierarchical structures; (3) regulating emotional engagement to sustain professional functioning; and (4) working within structural constraints shaping care. While physicians primarily framed tensions through clinical decision-making and responsibility, nurses emphasised relational proximity to suffering and constrained professional agency. Emotional and ethical tensions were experienced as continuously produced through the interaction of uncertainty, hierarchy, emotional labour, and organisational conditions.OriginalityThis study provides an integrated interpretative account of how clinical uncertainty, professional hierarchy, emotional labour, and organisational constraints interact in shaping emotional and ethical tensions in hospital-based end-of-life cancer care. It further highlights how these tensions are experienced differently according to professional positioning, particularly the differing relationships between responsibility, relational proximity, and decision-making authority among nurses and physicians.ImpactThe findings indicate that emotional and ethical tensions in end-of-life cancer care cannot be addressed solely at the level of individual healthcare professionals. They highlight the need for stronger interdisciplinary collaboration, more inclusive involvement of nurses in decision-making, greater organisational support for emotional labour, and earlier integration of palliative care within acute hospital settings.ConclusionsEmotional and ethical tensions in end-of-life cancer care are embedded within broader instit","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330261486764"},"PeriodicalIF":3.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"mHealth use intensity and nurses' moral distress: The mediating role of perceived technical barriers to caring.","authors":"Peijun Wu, Maria Elizabeth Coronel Baua","doi":"10.1177/09697330261480340","DOIUrl":"https://doi.org/10.1177/09697330261480340","url":null,"abstract":"<p><p>BackgroundMobile health (mHealth) technologies have become increasingly integrated into nurses' workflows, enhancing efficiency while potentially disrupting the relational aspects of care. However, empirical evidence remains limited regarding how high-intensity mHealth use is associated with ethical strain among nurses.ObjectivesThis study examined the association between mHealth use intensity and nurses' moral distress and whether Perceived Technical Barriers to Caring (PTBC) statistically mediated this association.Research designA cross-sectional correlational design was used. An anonymous electronic questionnaire assessed mHealth use intensity, PTBC, and moral distress. Structural equation modeling with 5000 bootstrap resamples tested the hypothesized model.Participants and research contextA total of 331 registered nurses were recruited from three public general hospitals with established mHealth systems in Guizhou Province, Southwest China, between May and October 2025.Ethical considerationsThis study was undertaken during the author's doctoral studies in Nursing at St. Paul University Philippines. In accordance with the university's research ethics requirements, the study protocol was reviewed and approved by the Research Ethics Committee of St. Paul University Philippines. The study was conducted among registered nurses in public hospitals in Guizhou Province, China, and institutional permission was obtained from the participating hospitals before data collection.ResultsThe structural model demonstrated good fit (χ² = 195.02, df = 148, χ²/df = 1.32, CFI = 0.975, TLI = 0.972, RMSEA = 0.031, SRMR = 0.051). mHealth use intensity was significantly associated with PTBC (B = 0.31, β = 0.33, <i>p</i> < .001), and PTBC was significantly associated with moral distress (B = 1.58, β = 0.48, <i>p</i> < .001). The direct path from mHealth use intensity to moral distress was not significant (B = 0.57, β = 0.18, <i>p</i> = .157). A significant indirect association was observed through PTBC (unstandardized B = 0.49, bias-corrected 95% CI [0.22, 0.93]; standardized β = 0.16, 95% CI [0.06, 0.25]).ConclusionsmHealth use intensity was indirectly associated with moral distress through PTBC, but no significant direct association was observed. Care-sensitive digital implementation may help reduce technology-related ethical strain.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330261480340"},"PeriodicalIF":3.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical dimensions of living with one leg: A qualitative study.","authors":"Lisbeth Uhrenfeldt, Ane Simony, Bente Skovsby Toft, Inge Hansen Bruun","doi":"10.1177/09697330261483903","DOIUrl":"https://doi.org/10.1177/09697330261483903","url":null,"abstract":"<p><p>PurposeTo explore experiences of prosthetic leg provision, focusing on information, activities, and communication during hospitalization and after discharge.Material and methodsA hermeneutic analysis of unstructured dialogues with three adults aged 85+ living at home after leg amputation, pragmatically recruited by an outpatient surgeon.Ethical considerationsThe study is registered (j.nr. 26/2105) in the Danish regional research registry. Informed consent was obtained, stored, and handled in accordance with applicable regulations. The participants received oral invitations and information on the study's purpose. Moreover, they were assured of anonymity, confidentiality, and their right to withdraw at any time without consequence.ResultsFour themes emerged: (1) embodiment-the necessity of amputation; (2) lack of involvement in care decisions; (3) identity as physically active-to be maintained or re-established; and (4) altered everyday life and future. Living with one leg involves a complex and ethically charged transition, where suffering after major lower extremity amputation extends beyond physical loss to include autonomy, dignity, and identity.ConclusionPerson-centered care guided by meaningful dialogue, rather than rigid rehabilitation pathways, is essential to support older adults' informed decision-making and participation. Discretionary decisions about access to prosthetic rehabilitation and assistive devices may shape opportunities for mobility and inclusion, raising concerns about fairness and justice. These findings underscore the ethical importance of recognition, inclusion, and respectful communication, and highlight that high-quality rehabilitation requires a holistic and ethically grounded approach in which the person, not the procedure, remains central.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330261483903"},"PeriodicalIF":3.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultivating moral sensitivity and restraint-free practice in nurses and midwives.","authors":"Raffaella Dobrina, Alvisa Palese, Giulia Galvani, Alessandro Caldarola, Gaia Dussi, Silvana Schreiber, Luca Bertocchi","doi":"10.1177/09697330261476266","DOIUrl":"https://doi.org/10.1177/09697330261476266","url":null,"abstract":"<p><p>Nursing and midwifery students are frequently exposed to physical restraint during clinical training, often presented as necessary for patient safety. However, growing evidence challenges this assumption, highlighting the risks associated with restraint and the limited implementation of effective alternatives in practice. Studies show that alternatives are considered in only a minority of cases, while organisational and educational factors contribute to the persistence and normalisation of restraint. Although professional codes define restraint as an exceptional, last-resort measure, this principle is not consistently reflected in practice or education. Students may experience moral distress and cognitive dissonance when witnessing practices that conflict with core values such as patient autonomy and dignity. At the same time, hierarchical dynamics, obedience to authority, and the influence of the hidden curriculum and professional socialisation may inhibit critical reflection, foster passive compliance, and contribute to the normalisation of ethically problematic care. Despite these implications, nursing and midwifery curricula often provide limited opportunities to explicitly address restraint, its ethical complexity, and the development of moral sensitivity. This discussion paper explores how educational strategies can support students to critically engage with restraint practices encountered during clinical placements and to develop both moral sensitivity and ethical agency. It highlights the importance of cultivating moral sensitivity through reflection, simulation, and experiential and digital learning, enabling students to recognise ethical dilemmas, question routine practices, and advocate for patients. Educational approaches should also promote the application of evidence-based alternatives to restraint, including person-centred interventions such as pain management, environmental adaptations, de-escalation strategies, and the involvement of family members or volunteers. Ultimately, nursing and midwifery education should prepare future professionals to recognise when routine clinical practices have been normalised despite being ethically problematic, to question their legitimacy critically, and to advocate for humane, dignified, restraint-free care.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330261476266"},"PeriodicalIF":3.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An ethics of justice without an ethics of care: Why artificial intelligence ethics guidelines remain unimplementable in community care for older adults.","authors":"Claire Su-Yeon Park","doi":"10.1177/09697330261483594","DOIUrl":"https://doi.org/10.1177/09697330261483594","url":null,"abstract":"<p><p>Governments and international bodies have issued a great many artificial intelligence (AI) ethics guidelines over the past decade, yet evidence that they change how AI is built and deployed remains thin. This paper argues that the implementation gap in AI ethics is not only a shortfall of tools. In caring contexts, it is a consequence of moral form. Mainstream AI ethics operates, in its prevailing form, as an ethics of justice: principlist, calculative, and oriented toward what can be formalised. The claim is not that care is absent from its vocabulary. It is that the principles amenable to technical fixes, such as accountability, fairness and privacy, appear to be the ones that reach operational guidance, while dignity, relational autonomy and the prevention of suffering seem more often to be named than operationalised. Community-based care for older adults serves as a critical case. Assessed against established criteria for implementability and usability, the World Health Organization's guidance for health remains practicable in principle but not readily applicable at the point of care for this population, and the harms that matter most here, among them ageism, infantilisation, deception and social isolation, are barely registered. The paper does not call for abandoning principlism but for completing it. It sets out what a care-grounded reading changes in a single case, states what an ethics of care cannot do, and reframes implementation as ethical translation: the movement of a general commitment into the situation of a particular person. Nursing, situated where principle meets the particular patient, may hold a distinctive though not exclusive standpoint from which to contribute to that work. As a theoretical paper, this work involved no human or animal participants and required no ethical approval.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330261483594"},"PeriodicalIF":3.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caught between care and conviction: Primary health care nurses' moral distress during vaccine-hesitancy encounters in a culturally diverse context.","authors":"Ghada Elsaid Ali Elsayed, Osama Mohamed Elsayed Ramadan, Wargaa Hashim Taha, Abdullah Alotaibi, Fahad Rubayyi T Alshammari, Hamda Ahmed Mohamed Eldesoky","doi":"10.1177/09697330261483628","DOIUrl":"https://doi.org/10.1177/09697330261483628","url":null,"abstract":"<p><p>BackgroundVaccine hesitancy can generate moral distress when nurses' duty to protect children conflicts with parental decision-making authority, family dignity, and longitudinal trust.Research question/aim/objectivesTo interpret how primary health care nurses experience and negotiate moral distress during vaccine-hesitancy encounters with families in culturally diverse Saudi primary care.Research designA qualitative Interpretive Description study informed by moral distress theory. In-person semi-structured interviews were analysed using reflexive thematic analysis.Participantsand research context: Twenty-two registered nurses from 20 primary health care centres in one southern Saudi health cluster participated. Purposive recruitment lacked a fixed sampling frame or approach log; therefore, a conventional response rate was not calculable.Ethical considerationsNajran University Research Ethics Committee approved the study, and the health cluster granted permission. Written informed consent, confidentiality, and voluntary participation were maintained.Findings/resultsParticipants' retrospective accounts generated four themes: constrained action despite knowing what responsible practice required; moral agency negotiated through family, faith, and gendered authority; cumulative moral residue; and organisational ethical responsibility. Family decision hierarchy was the most consistently described cultural constraint, while religious interpretation and gendered credibility shaped particular encounters.ConclusionsWithin this single-cluster sample, nurses' moral distress was interpreted as a relationally and organisationally mediated ethical burden shaped by family hierarchy, religious reasoning, gendered credibility, and limited organisational support. Participant-informed ethics case forums, shared escalation pathways, and team-based support warrant local piloting and evaluation as potential strategies to support nurses' moral voice while preserving respectful dialogue and longitudinal trust.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330261483628"},"PeriodicalIF":3.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare professionals' compassion in caring for patients at the end of life - An integrative literature review.","authors":"Andrea Uhlman, Maria Rönnerhag, Margareta Karlsson","doi":"10.1177/09697330261483798","DOIUrl":"https://doi.org/10.1177/09697330261483798","url":null,"abstract":"<p><p>BackgroundIt is projected that the annual number of deaths will increase from 57 to 70 million between 2015 and 2030, placing increased demands on healthcare professionals in end-of-life care. Providing end-of-life care poses significant challenges for healthcare professionals, especially alleviating patients' suffering. Compassion, which is a foundational concept in caring science, is essential for easing suffering and can transform the caring experience for patients at the end of life and their families. According to the theory of caritative caring, compassion is the source of true caring.AimThe aim of this integrative review is to explore healthcare professionals' compassion in end-of-life care.DesignAn integrative review design was chosen. The literature searches were conducted in the CINAHL, Scopus and PubMed databases and 12 studies were included. As this was a review of published literature, ethical approval was not required.Quality appraisalThe Critical Skills Appraisal Programme (CASP) for qualitative research was used to evaluate the quality of the included studies.FindingsThe analysis revealed one overarching theme; <i>Embracing the patient at the end of life</i> and three categories; <i>Being with the patient in the present moment, Being in a caring communion</i> and <i>Being available and attuned to the patient</i>.ConclusionA healthcare professional's compassion can be key to achieving end-of-life care which unites evidence-based practice and the patient's voice as a human being. It is through compassion that healthcare professionals' caring can evolve at the end of life. This integrative review shows the importance and significance of a healthcare professional's compassion in caring for a patient at the end of life.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330261483798"},"PeriodicalIF":3.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical experiences of nursing students in inpatient psychiatric units: The autonomy-paternalism tension.","authors":"Sevgi Koroglu Gokbel, Gulgun Durat","doi":"10.1177/09697330261483572","DOIUrl":"https://doi.org/10.1177/09697330261483572","url":null,"abstract":"<p><p>BackgroundSymptoms of mental disorder that impair decision-making capacity in inpatient psychiatric units increase the ethical tension between patient autonomy and paternalistic responsibility. Practices such as involuntary admission, compulsory treatment, and physical restraint further intensify this tension, while nursing students are more vulnerable to these ethical dilemmas because of their limited clinical experience.AimThis study aimed to describe nursing students' ethical experiences regarding the autonomy-paternalism tension in inpatient psychiatric units.Research designA qualitative descriptive design was used. Data were collected through reflective journals kept during the clinical placement and semi-structured individual interviews conducted at the end of the placement. These data were analysed using thematic analysis.Participants and research contextThe study was conducted in the nursing department of a public university in Türkiye. Thirty nursing students undertaking clinical practice in inpatient psychiatric units kept reflective journals, and 17 of them participated in individual interviews.Ethical considerationsEthical approval was obtained from the Sakarya University Social and Human Sciences Ethics Committee, and written informed consent was obtained from all participants.FindingsThe findings showed that students experienced the ethical tension between patient autonomy and paternalistic practices both explicitly and implicitly. Three main themes were identified: <i>Experiencing Restrictions on Patient Autonomy</i>, <i>Ethical Silence in Response to Ethical Conflict</i>, and <i>Professional Ethical Development</i>. Students identified the lack of adequate information and insufficient consideration of patients' concerns as ethical problems that undermined patient autonomy. They also reported remaining silent, primarily because of hierarchical structures and their role as students.ConclusionsThe autonomy-paternalism dilemma in inpatient psychiatric units constitutes a multidimensional experiential field for nursing students, intertwined with ethical silence, emotional burden, and processes of professional ethical development.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"9697330261483572"},"PeriodicalIF":3.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence, nursing, and social justice.","authors":"Gülbu Tanrıverdi","doi":"10.1177/09697330261470503","DOIUrl":"10.1177/09697330261470503","url":null,"abstract":"","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1631-1633"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conscientious pause and harmony in nursing practice: A narrative analysis.","authors":"Maki Tanaka","doi":"10.1177/09697330261451367","DOIUrl":"10.1177/09697330261451367","url":null,"abstract":"<p><p>BackgroundContemporary nursing practice involves increasing complexity, time pressure, and organisational demands that require rapid judgement. Nurses are also expected to address the vulnerability of patients and families while maintaining dignity. Ethical tensions often occur when institutional expectations, professional responsibilities, and personal conscience do not fully align. Although conscience is recognised as an important ethical resource in nursing, little is known about how it is experienced in everyday clinical practice.AimThis study aimed to examine conscientious pauses experienced by nurses in Japanese nursing practice and to analyse how harmony is experienced and reconfigured during these ethical moments.Research designA thematic narrative analysis explored nurses' ethical experiences in everyday practice.Participants and research contextTwelve nurses working in healthcare institutions in Japan participated in the study.Ethical considerationsEthical approval was obtained from the relevant ethics committee, and all participants provided informed consent.FindingsConscientious pauses occurred in several ways: as deliberate hesitation to avoid premature judgement, as relationally sensitive actions to maintain harmony, as engagement with organisational and institutional tensions, and as ongoing processes of meaning-making over time. These pauses were not limited to specific clinical domains and often appeared as sensitivity to unspoken vulnerability rather than explicit ethical claims. Harmony was experienced not as a fixed value but as a relational condition negotiated and reconfigured through practice.ConclusionsConscientious pauses are relational and temporal ethical practices that enable nurses to address vulnerability in daily care. By viewing ethics as lived experience rather than solely as decision outcomes, this study emphasises the need to recognise and support conscientious pauses as shared ethical moments in nursing practice.</p>","PeriodicalId":49729,"journal":{"name":"Nursing Ethics","volume":" ","pages":"1892-1906"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148037136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}