{"title":"Validation of the Japanese version of Algoplus® for the assessment of acute postoperative pain in older patients with cancer","authors":"Masumi Mori, Eri Ikeda, Kimie Fujita","doi":"10.1111/jjns.12623","DOIUrl":"https://doi.org/10.1111/jjns.12623","url":null,"abstract":"AimThis study aimed to validate a Japanese version of the Algoplus® tool by assessing postoperative pain in older Japanese patients with cancer and examining the scale's psychometric properties.MethodsAfter translating Algoplus® into Japanese, we conducted a cross‐sectional study of patients aged 65 years or older who underwent surgery to remove malignant tumors. Two registered nurse‐certified investigators used the Numerical Rating Scale, the Japanese version of Algoplus®, and the Japanese version of the Abbey Pain Scale before and after analgesic use on postoperative days 3 and 5 to evaluate response to pharmacologic therapy. Validity was tested by a correlation analysis between the Japanese version of Algoplus®, two pain scales, and nine hypotheses related to demographic variables and surgical invasions. The Kuder–Richardson‐20 test and Cohen's Kappa coefficient were used for internal consistency and inter‐rater reliability, respectively.ResultsThe total score of the Japanese version of Algoplus® showed strong to moderate correlations with the two pain scales. Demographic characteristics were not associated with the total score of the Japanese version, but significant correlations with operative time and postoperative analgesia administration existed. The scale demonstrated good internal consistency (Kuder–Richardson‐20 <jats:italic>α</jats:italic>: .70) and inter‐rater reliability (Kappa coefficient .72). The total score of the Japanese version decreased significantly after analgesic use in both postoperative assessments.ConclusionsThe Japanese version of Algoplus® is a reliable and valid instrument for nurses to easily assess acute postoperative pain in older Japanese patients with cancer and shows good responsiveness for detecting the change in pain status.","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of positive psychological capital on burnout in public hospital nurses: Mediating effect of compassion fatigue is greater than compassion satisfaction","authors":"Sin Ah Kim, Sung Reul Kim, Hye Young Kim","doi":"10.1111/jjns.12627","DOIUrl":"https://doi.org/10.1111/jjns.12627","url":null,"abstract":"AimAlthough relationships among positive psychological capital (PsyCap), compassion fatigue, compassion satisfaction, and burnout have been reported, causal relationships among these variables have not been identified. This study examined the influence of positive PsyCap on burnout and confirmed the mediating effects of compassion fatigue and satisfaction among public hospital nurses.MethodsThis study adopted a correlational cross‐sectional design. We recruited 237 nurses working at a public hospital, using convenience sampling.ResultsThe fit of the hypothetical model was adequate. Positive PsyCap directly affected compassion fatigue and satisfaction, and burnout. It had an indirect effect on burnout. Compassion fatigue and satisfaction directly affect burnout. This finding indicates that compassion fatigue and satisfaction partially mediate between positive PsyCap and burnout. In addition, the mediating effect of compassion fatigue was greater than that of compassion satisfaction on the relationship between positive PsyCap and burnout. Finally, positive PsyCap, compassion fatigue, and compassion satisfaction explained 70.4% of the total variance in burnout scores. The effect size (<jats:italic>f</jats:italic><jats:sup>2</jats:sup>) was 2.38 (large effect size).ConclusionsBurnout should be assessed with positive PsyCap, compassion fatigue, and compassion satisfaction among public hospital nurses. Given that the mediating effect of compassion fatigue was greater than that of compassion satisfaction, interventions for compassion fatigue may be a strategy to reduce burnout, especially among public hospital nurses with low levels of positive PsyCap.","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mayumi Makino, Mayumi Kato, Sanae Naruse, Yukari Yoshie, Koji Eda
{"title":"Organizational factors associated with less use of restraints in older adults with dementia in acute care hospitals: A scoping review","authors":"Mayumi Makino, Mayumi Kato, Sanae Naruse, Yukari Yoshie, Koji Eda","doi":"10.1111/jjns.12620","DOIUrl":"https://doi.org/10.1111/jjns.12620","url":null,"abstract":"ObjectiveDementia affects more than 55 million people worldwide. Use of restraints for hospitalized older adults with dementia is a social issue that should be addressed systematically and should not depend on the characteristics of nurses. This study reviewed the literature on organizational factors associated with reducing use of restraints in older adults with dementia admitted to acute care hospitals.MethodsA scoping review was performed. Three databases were searched for papers that met our eligibility criteria. Factors related to restraint reduction were extracted, and results were deduced. Through inductive analysis, subthemes were categorized according to similarities and differences, which were then integrated into broader themes.ResultsSixteen studies were eligible for inclusion. The prevalence of restraints ranged from 5.1% to 80.0% depending on how the meaning of restraint was interpreted. The most common indications for restraints were history of falls and fall risk. Interdisciplinary screening for restraints was associated with reduced prevalence of restraints, with a 0.18‐fold (confidence interval [CI]: 0.12–0.24) reduction through use of a restraint decision flowchart and a 0.76‐fold (CI: 0.63–0.92) reduction through consultation with a psychiatrist. Interdisciplinary members included nurses, physicians, clinical psychologists, pharmacists, respiratory therapists, and therapists.ConclusionsResearch is needed to introduce and develop an interdisciplinary restraint decision‐making system and to test its effectiveness. Important factors in implementing alternatives to restraints are the harmful effects of restraints, expertise in dementia, regular education on alternative methods, an inpatient environment that ensures patient safety, and the development of human resources.","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Barriers and facilitators to bridging the healthcare digital divide for the older adults: A qualitative research from patients in China","authors":"Fei Liu, Xiaobing Yin, Yuting Huang, Xiaoping Zhu","doi":"10.1111/jjns.12626","DOIUrl":"https://doi.org/10.1111/jjns.12626","url":null,"abstract":"AimThe aim of this study was to explore the barriers and facilitators underlying the healthcare digital divide by using qualitative methodologies, integrated with the Capabilities, Opportunities, Motivations, and Behaviors (COM‐B) as well as the Behavior Change Wheel (BCW) theoretical frameworks.MethodsTo conduct a thorough analysis, semi‐structured,in‐depth interviews were orchestrated among a cohort of older patients who had experiences with digital healthcare systems. Data were meticulously analyzed via Colaizzi's seven‐step methodological procedure.ResultsNine barriers were elucidated, including physical limitation, inadequate training and support, self‐imposed denial, failure to rebuild the digital healthcare environment, equipment constraints, deficits in communication and feedback, skepticism regarding data accuracy and validity, sense of social deprivation, and network information boycott. Conversely, eleven facilitators were identified, encompassing peer modeling, availability of training and support, reconstructive efforts toward the digital healthcare environment, mandatory usage, familial influence, media impact, scientific publicity and education, enhancement of self‐efficacy, sense of social participation, perceived convenience, and access to healthful information.ConclusionBased on the COM‐B and BCW models, healthcare organizations may be able to improve their digital healthcare support systems (capabilities), technical design, network speed, and equipment configuration (opportunities), as well as focus on “human‐computer integration,” the parallel existence of digital technology and humanistic care, and taking into account the issues of information security, accuracy, and human rights equality (motivation) while benefiting the patients, in order to bridge the healthcare digital divide for the older adults.","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of hand-bathing on noise-induced vasoconstriction: A randomized controlled trial.","authors":"Keita Sugawara, Eriko Takeno, Takahito Mabuchi, Ayano Sukeda, Sana Ohashi, Norikazu Ohnishi","doi":"10.1111/jjns.12625","DOIUrl":"https://doi.org/10.1111/jjns.12625","url":null,"abstract":"<p><strong>Aim: </strong>This study assessed the effects of hand-bathing on sympathetic nervous activity exacerbated by psychological stress. Participants immersed one hand in warm water for 2 min while exposed to noise, and changes in blood flow and skin temperature of the non-immersed hand were observed.</p><p><strong>Methods: </strong>Twenty-nine healthy university students aged 20 years or older were randomly assigned to either the hand-bathing group (n = 14) or the control group (n = 15). After a brief rest in a quiet environment, participants were exposed to noise for 6 min. Those in the hand-bathing group submerged their left hand in a 40°C thermostatic bath for 2 min, starting 2 min into the noise exposure. The tympanic temperature, blood flow, and skin temperature of the non-immersed hand were continuously measured, along with blood pressure and subjective evaluations before and after the noise exposure.</p><p><strong>Results: </strong>Both groups experienced a decrease in fingertip skin temperature at the start of the noise exposure, persisting longer in the control group. Conversely, the hand-bathing group showed increased fingertip skin temperature after 150 s, significantly higher after the noise exposure than the control group (p = .04). Participants in the hand-bathing group reported significantly increased overall body warmth, thermal comfort, and relaxation during hand-bathing (p = .007, p = .01, p < .001).</p><p><strong>Conclusions: </strong>The 2-min hand-bathing intervention reversed the pronounced vasoconstrictive response induced by noise exposure and elicited heightened sensations of overall body warmth, thermal comfort, and relaxation. Hand-bathing may mitigate heightened sympathetic nervous activity associated with psychological stress induced by noise exposure.</p>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sense of coherence on the relationship between COVID-19-related stress and sleep quality among nurses.","authors":"Mami Ishitsuka, Kei Muroi, Tomoko Hachisuka, Itsuka Shibata, Daisuke Hori, Shotaro Doki, Tsukasa Takahashi, Shinichiro Sasahara, Ichiyo Matsuzaki","doi":"10.1111/jjns.12618","DOIUrl":"https://doi.org/10.1111/jjns.12618","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to examine the mediating effects of the Sense of Coherence (SOC) on the relationship between stress and sleep in nurses during the coronavirus disease 2019 (COVID-19) pandemic.</p><p><strong>Methods: </strong>A cross-sectional survey targeting nurses in Chiba and Tokyo during the summer of 2021 was conducted using Google Forms. Responses were obtained using the Pittsburgh Sleep Quality Index (PSQI), the 13-item version of the SOC scale (SOC-13), and questions regarding COVID-19-related stress. Structural equation modeling (SEM) was performed to investigate relevant relationships.</p><p><strong>Results: </strong>A total of 181 valid responses were obtained from 400 surveyed nurses. SEM analysis showed that COVID-19 stress was indirectly related to PSQI via its effect on SOC-13, with higher SOC-13 negatively correlated with PSQI.</p><p><strong>Conclusions: </strong>Our findings suggest the need for interventions designed to promote SOC for nurses working under stressful conditions.</p>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of a scale to assess nurses' difficulties in collaborating with physicians in responding to clinical deterioration during night shifts.","authors":"Soichiro Hotta, Kaoru Ashida, Makoto Tanaka","doi":"10.1111/jjns.12622","DOIUrl":"https://doi.org/10.1111/jjns.12622","url":null,"abstract":"<p><strong>Aims: </strong>To develop a scale to assess difficulties that nurses experience when collaborating with physicians in responding to clinical deterioration during night shifts and identify factors associated with scoring using the developed scale.</p><p><strong>Methods: </strong>A web-based questionnaire with a draft scale, the Nighttime Collaboration Difficulties between Nurses and Physicians for Nurses (NCDNP-N), was distributed to nurses working night shifts in acute-care hospitals across Japan. Data were collected between July and October 2023. Of 435 responses, 405 were examined for the NCDNP-N's psychometric validation, including structural validity, criterion-related validity, and reliability assessments. Multiple linear regression analysis was performed for 385 responses excluded by listwise methods to identify factors associated with NCDNP-N scores.</p><p><strong>Results: </strong>The NCDNP-N has 10 items and three domains: Domain 1, dissatisfaction with physicians' actions; Domain 2, burden of working with night-shift physicians; and Domain 3, barriers to reporting during night shifts. Estimated reliability coefficients exceeded the recommended values. Multiple regression analyses demonstrated that more years of experience in the current ward and frequency of calling the covering physician at night were markedly associated with higher scores, whereas more nursing experience was associated with lower scores.</p><p><strong>Conclusion: </strong>We developed the NCDNP-N and confirmed its validity and reliability. The study results suggest that the responsibilities and competence of nurses working night shifts and communication with the night-covering physician are associated with difficulties in nighttime collaboration. The NCDNP-N may help identify challenges in clinical settings as well as can be utilized in the evaluation study for improving nighttime collaboration.</p>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adjusting to living with chronic liver disease among patients who continue regular healthcare visits for hepatocellular carcinoma surveillance: A grounded theory study.","authors":"Keiko Hatanaka, Yoshiko Sasaki, Makoto Tanaka","doi":"10.1111/jjns.12619","DOIUrl":"https://doi.org/10.1111/jjns.12619","url":null,"abstract":"<p><strong>Aim: </strong>To explore patients' process of living with chronic liver disease while continuing regular healthcare visits for hepatocellular carcinoma surveillance.</p><p><strong>Methods: </strong>Semistructured interviews and participant observations were conducted in this qualitative constructivist grounded theory study. The participants included 11 patients undergoing regular hepatocellular carcinoma surveillance every 1-6 months for 2-30 years. Data were analyzed using coding, memo-writing, theoretical sampling, and constant comparison.</p><p><strong>Results: </strong>The participants incorporated regular healthcare visits into their living cycle. The cycle's core comprised two categories (\"inferring my liver condition\" and \"desiring status quo\"). The cycle underwent a transition described by three phases (\"seeking ways to live with my chronic liver disease,\" \"being overwhelmed by living with my chronic liver disease,\" and \"reconstructing my life to live with my chronic liver disease\"). This transition involved adjusting to living with chronic liver disease while continuing regular healthcare visits. The relative importance of the cycle's core progressively shifted from \"inferring my liver condition\" to \"desiring status quo.\"</p><p><strong>Conclusions: </strong>This study revealed the transition phases of patients' living cycles in adjusting to living with chronic liver disease while continuing regular healthcare visits. Understanding the different phases in which patients are and the psychological impact of healthcare visits can help them look forward to recuperative actions. Furthermore, patients who have a sense of ownership experience loneliness because of regular healthcare visits. A support system including nurses as part of regular hepatocellular carcinoma surveillance should be established to help ease patients' sense of loneliness by utilizing their sense of ownership.</p>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relationship between maternal postpartum depression, fatigue, sleep quality and infant growth: A cross-sectional study.","authors":"Mingbo Wang, Ting Bai, Jie Zhang, Huahua Liu, Lingling Wu, Feng Zhang","doi":"10.1111/jjns.12614","DOIUrl":"https://doi.org/10.1111/jjns.12614","url":null,"abstract":"<p><strong>Background: </strong>Current research separately analyzed the connection between postpartum depression, fatigue, sleep and infant development. However, depression, fatigue and sleep quality often coexisted as adverse symptoms in postpartum women and influenced infant development together. This study explored the maternal postpartum symptoms on infant growth.</p><p><strong>Methods: </strong>Our study included 224 pairs of singleton full-term mothers and their infants who underwent routine pediatric outpatient clinics. Latent profile analysis was applied to identify the latent classes based on mothers' postpartum depression, fatigue and sleep profile characteristics. We evaluated the maternal adverse symptoms and infant development using multivariable logistic regressions.</p><p><strong>Results: </strong>Totally, 224 pairs of eligible mothers (28.85 ± 4.43 years) and infants (30.93 ± 3.26 days) participated in this study. Latent profile analysis identified 3 latent groups: mild (58.04%), moderate (34.37%), and severe (7.59%) postpartum adverse symptoms. Postpartum adverse symptoms were associated with delayed development in the baby's motor level (χ<sup>2</sup> = 6.572, p = .037) and weight-for-length (χ<sup>2</sup> = 9.652, p = .008). After controlling for mother and infant related factors, postpartum adverse symptoms remained a risk factor for infant motor level (odds ratio [OR]: 4.35; 95% confidence interval [CI]: 1.25-15.08) and weight-for-length (OR: 5.53; 95% CI: 1.55-19.74).</p><p><strong>Conclusions: </strong>Maternal postpartum depression, fatigue and sleep quality are associated with infant development. Clinically, mothers with these symptoms should be intervened timely to avoid the aggravation of maternal symptoms, which affect baby's development.</p>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The relationships among factors affecting compassion fatigue, compassion satisfaction, and burnout in Japanese nurses: A cross-sectional study.","authors":"Kumiko Kishimoto, Kenichi Asano","doi":"10.1111/jjns.12617","DOIUrl":"https://doi.org/10.1111/jjns.12617","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the relationships among factors affecting compassion fatigue/secondary traumatic stress, burnout, and compassion satisfaction in Japanese nurses, focusing on self-compassion, fears of compassion, and attachment styles.</p><p><strong>Methods: </strong>This cross-sectional observational study enrolled 400 clinical nurses (aged ≥20 years) in Japan, registered with an online survey company, from June 6 to June 26, 2021. The subjects completed a web-based questionnaire that assessed compassion fatigue/secondary traumatic stress, burnout, compassion satisfaction, self-compassion, fears of compassion for self, anxiety, and avoidance. Additionally, descriptive statistics, correlation analysis, multiple regression analysis and path analysis were performed to examine the relationships among the influencing factors.</p><p><strong>Results: </strong>Compassion fatigue/secondary traumatic stress was influenced by anxiety and fears of compassion for self (R<sup>2</sup> = .31). Burnout was affected by compassion fatigue/secondary traumatic stress, compassion satisfaction, self-compassion, anxiety, and avoidance (R<sup>2</sup> = .63). Compassion satisfaction was impacted by self-compassion, anxiety, and fears of compassion for self (R<sup>2</sup> = .31). Additionally, self-compassion (R<sup>2</sup> = .28) and fears of compassion for self (R<sup>2</sup> = .55) were influenced by anxiety and avoidance.</p><p><strong>Conclusions: </strong>Compassion fatigue/secondary traumatic stress leads to burnout, whereas compassion satisfaction moderates burnout. Furthermore, there were associations among the factors leading to compassion fatigue/secondary traumatic stress and burnout and compassion satisfaction. Therefore, an approach that enhances self-compassion and promotes the development of a stable attachment style could mitigate compassion fatigue/secondary traumatic stress and fears of compassion for self while moderately maintaining and improving compassion satisfaction.</p>","PeriodicalId":50265,"journal":{"name":"Japan Journal of Nursing Science","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}