Applied Nursing Research最新文献

{"title":"Does confidence mirror competence? Outcomes following Stop the Bleed® training among lay community members","authors":"Allison R. Jones ,&nbsp;Rebekah D. Day ,&nbsp;Penni I. Watts","doi":"10.1016/j.apnr.2025.151928","DOIUrl":"10.1016/j.apnr.2025.151928","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate and compare pre- and post-STB training outcomes of bleeding control knowledge, willingness to act and confidence in doing so.</div></div><div><h3>Background</h3><div>Stop the Bleed® (STB) training improves trainees' willingness to intervene in pre-hospital bleeding emergencies and confidence in doing so, but few studies report associated knowledge-based outcomes.</div></div><div><h3>Methods</h3><div>A cross-sectional, observational study was performed using a pre-/post-test approach. Lay community members aged ≥18 who read and spoke English were included. On enrollment, participants completed the Stop the Bleed Training Survey (STB-TS) (five self-assessment and three knowledge-based items), and provided demographics and work history data; the STB-TS was completed again immediately after training. Descriptive statistics were used to characterize the sample. Paired <em>t</em>-tests were used to compare STB-TS self-assessment items. McNemar's Test was used to compare proportions of correct answers to STB-TS knowledge-based items.</div></div><div><h3>Results</h3><div>Trainees (<em>N</em> = 31) had a mean age of 33 ± 16 years, identified as mostly female (58.1 %) and people of color (54.8 %), and reported little experience with bleeding control emergencies. Total STB-TS scores increased from 14.4 ± 6.7 to 17.0 ± 10.8 (<em>p</em> = .26), indicating greater knowledge, confidence, and willingness to act. Correct response rates increased significantly from pre- to post-training (27.6 % vs 69.2 %, <em>p</em> = .003) on only one of the knowledge-based items: proper tourniquet application.</div></div><div><h3>Discussion</h3><div>Findings suggest a disconnect among trainees' willingness to act and confidence in doing so compared to their knowledge of bleeding control intervention. Incorporating use of high-fidelity simulation and standardized evaluation instruments may enhance content and skill mastery.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151928"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520592","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":"Work-family balance mediates self-efficacy and subjective well-being among nurses in Chinese intensive care units: A cross-sectional study","authors":"Lating Zhang ,&nbsp;Xianzhen Jin ,&nbsp;Na Cheng ,&nbsp;Ruhua Wang ,&nbsp;Xinhui Liang ,&nbsp;Haiyan Fan ,&nbsp;Xue Jiang","doi":"10.1016/j.apnr.2025.151932","DOIUrl":"10.1016/j.apnr.2025.151932","url":null,"abstract":"<div><h3>Background</h3><div>ICU nurses frequently confront lengthy working hours, elevated job intensity, heavy medical responsibilities, round-the-clock shifts, and a comparatively closed working environment. The high-risk, high-intensity, high-stress nature of the profession may prompt nurses to consider resignation, culminating in a significant shortage of nursing staff, adversely affecting the health and well-being of nurses. Necessitating a comprehensive investigation into the factors influencing their subjective well-being and the interrelations among these factors, thereby establishing a theoretical foundation for a more focused intervention program aimed at enhancing the subjective well-being of nurses.</div></div><div><h3>Methods</h3><div>This study employed a cross-sectional design in accordance with STROBE criteria. Two hundred forty-seven ICU nurses from four tertiary general hospitals were intentionally chosen to take an online survey. Metrics encompassed self-efficacy, work-family balance, and subjective well-being.</div></div><div><h3>Results</h3><div>The findings demonstrated that self-efficacy strongly influenced nurses' work-family balance and subjective well-being. The work-family balance served as a mediating factor in the association between self-efficacy and subjective well-being. Mediation analysis indicated a substantial overall influence of self-efficacy on subjective well-being (β = 0.758, p &lt; 0.01). In addition, self-efficacy had a direct effect on subjective well-being (β = 0.575, p &lt; 0. 01), on work-family balance (β = 0.458, p &lt; 0. 01), and work-family balance had a direct effect on subjective well-being (β = 0.399, p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>This study found that among nurses in ICU have moderate levels of self-efficacy and subjective well-being, which are positively correlated. This suggests that improving the self-efficacy and work-family balance of ICU nurses may help enhance their subjective well-being levels.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151932"},"PeriodicalIF":2.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-care in patients with a Left Ventricular Assist Device (LVAD): A systematic review","authors":"Federica Dellafiore ,&nbsp;Luca Guardamagna ,&nbsp;Morgana Milani ,&nbsp;Lorenzo Casole ,&nbsp;Gloria Modena ,&nbsp;Orejeta Diamanti ,&nbsp;Pierpaolo Servi ,&nbsp;Alessia Trenta ,&nbsp;Tiziana Nania","doi":"10.1016/j.apnr.2025.151929","DOIUrl":"10.1016/j.apnr.2025.151929","url":null,"abstract":"<div><h3>Background</h3><div>Self-care is essential for patient with chronic conditions such as heart failure. Self-care facilitates adaptation in patients with a Left Ventricular Assist Device (LVAD), improving their outcomes and preventing complications. Currently, no studies provide an overview of self-care in people with LVADs.</div></div><div><h3>Objective</h3><div>The present literature review aims to summarize the current scientific evidence relating to self-care behaviors in this population.</div></div><div><h3>Methods</h3><div>A systematic review with narrative synthesis was conducted. The databases consulted were Medline, Scopus, and CHINAL, and free research was performed on Google Scholar. The review included all the articles whose titles, abstracts, and text were considered relevant to the research purpose. The PRISMA flowchart was used to choose all the appropriate studies, and the final sample was deemed pertinent to the SPIDER methodology. Finally, the studies were subjected to a critical assessment of the methodological quality.</div></div><div><h3>Results</h3><div>Of the 487 studies initially identified, 15 met the inclusion criteria. This review provides a comprehensive overview of self-care behaviors in LVAD patients across all dimensions of self-care: self-care maintenance, self-care monitoring, self-care management, and self-care Confidence. Findings indicate that self-care positively influences LVAD patients by facilitating adaptation to the device and enhancing quality of life.</div></div><div><h3>Conclusions</h3><div>Self-care is crucial in LVAD patients, facilitating their adaptation and improving their outcomes. Health education focused on self-care appears particularly relevant in this population, but a more in-depth investigation is needed.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151929"},"PeriodicalIF":2.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510958","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":"Turnover intention, collaboration and competences of intensive care unit nurses: A descriptive correlational study","authors":"Miyase Avcı PhD ,&nbsp;Ahmet Avcı PhD","doi":"10.1016/j.apnr.2025.151930","DOIUrl":"10.1016/j.apnr.2025.151930","url":null,"abstract":"","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151930"},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509141","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":"Use of multimedia shared decision-making aids (EATING program) for improving advance care planning engagement among community-dwelling older adults with chronic diseases: A cluster randomized controlled trial","authors":"Lu-Yen Anny Chen PhD ,&nbsp;Chu-Ying Huang RN, MSc ,&nbsp;Yueh-Hsin Wang MD ,&nbsp;Po-Chin Yang MD ,&nbsp;Hsiao-Ting Chang MD, PhD ,&nbsp;Ming-Hwai Lin MD, PhD ,&nbsp;Tzu-Ting Huang PhD ,&nbsp;Cheng-Pei Lin PhD","doi":"10.1016/j.apnr.2025.151931","DOIUrl":"10.1016/j.apnr.2025.151931","url":null,"abstract":"<div><h3>Background</h3><div>Discussing advance care planning (ACP) preferences for nasogastric tube (NG) insertion remains challenging among older adults. Multimedia decision-making aids have demonstrated potential to enhance understanding and support informed decision-making.</div></div><div><h3>Aim</h3><div>To evaluate the effectiveness of the EATING program (multimedia decision-making aids + traditional educational module) compared to usual care (traditional educational module alone) in improving ACP readiness on NG insertion for community older adults with chronic illness.</div></div><div><h3>Methods</h3><div>A single blind, two-arm parallel cluster randomized controlled trial was conducted across four community villages in Northern Taiwan. Participants from two villages received the EATING program, while the other two villages received the usual care. Eligible criteria included community older adults aged ≥65 with at least one chronic disease who were able to provide informed consent. Exclusion criteria included hearing or visual impairments or a history of mental illness. Pre- and post-intervention outcomes, along with one-month follow-up data, were analyzed using descriptive statistics and generalized estimating equations.</div></div><div><h3>Results</h3><div>Both groups showed significant immediate improvements in knowledge (<em>p</em> &lt; 0.001), belief/behavior (p &lt; 0.001), decision confidence (<em>p</em> &lt; 0.001), and readiness for ACP (p &lt; 0.001). The experimental group showed greater improvement, particularly in emotional response and preferences (Z = -5.51, <em>p</em> &lt; 0.001), observed only in this group. Sustained effect on knowledge (B = 35.029, p &lt; 0.001), emotional response and preferences (B = 9.342, p &lt; 0.001), refusal NG tube insertion (Z = -2.770, <em>p</em> = 0.006), and likelihood of signing official documents (<em>p</em> = 0.035) were observed after one month.</div></div><div><h3>Conclusion</h3><div>The study highlights the potential of multimedia program to enhance NG insertion discussions among community older adults. Further qualitative investigations and cultural adaptation are recommended.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151931"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453243","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":"Longitudinal analysis of adolescents at high risk of depression: Prediction models","authors":"Jisu Park ,&nbsp;Eun Kyoung Choi ,&nbsp;Mona Choi","doi":"10.1016/j.apnr.2025.151927","DOIUrl":"10.1016/j.apnr.2025.151927","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to develop a machine-learning-based predictive model to identify adolescents at high risk of depression using longitudinal analysis to determine changes in risk factors over time.</div></div><div><h3>Methods</h3><div>This longitudinal study used 4 years of data from the Korea Child and Youth Panel Survey (2018–2021). The classification of high-risk depression was the outcome variable, with predictors categorized into general characteristics and personal, family, and school factors. The machine learning algorithms used in the analysis included logistic regression, support vector machine, decision tree, random forest, and extreme gradient boosting.</div></div><div><h3>Results</h3><div>Among the 1833 adolescents classified as having a low risk of depression during the initial survey year, 27.8 % were identified as being at a high risk of depression over the subsequent 3 years. The extreme gradient boosting algorithm yielded the best performance with an area under the curve of 0.9302. The key predictors identified included violent tendencies, self-esteem, sleep duration, gender, and coercive parenting style.</div></div><div><h3>Conclusion</h3><div>A machine-learning-based predictive model for identifying adolescents at high risk of depression was developed. These findings provide a foundation for early screening and the development of intervention programs and policies aimed at mitigating adolescent depression risk.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151927"},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474898","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":"Experiences and support of Australian nurses who identify as a second victim: A mixed methods study","authors":"Monica Peddle ,&nbsp;Madeline McPhillips ,&nbsp;Rachel Cross ,&nbsp;Lauren Zarb","doi":"10.1016/j.apnr.2025.151925","DOIUrl":"10.1016/j.apnr.2025.151925","url":null,"abstract":"<div><h3>Aims</h3><div>In this study, researchers investigated experiences and key elements of effective support programs that promote recovery in nurses who identify as second victims in Australia.</div></div><div><h3>Design</h3><div>Sequential explanatory mixed methods investigated experiences of nurses who identify as second victims, including support received and any educational and training included.</div></div><div><h3>Methods</h3><div>Data were collected using survey and in-depth interviews. Survey data were analysed using descriptive and non-parametric testing and thematic analysis was used to analyse qualitative data.</div></div><div><h3>Results</h3><div>Forty-three nurses indicated involvement in a patient safety incident in the previous five years with 27 nurses completing the survey. Thirty-seven percent reported experiencing psychological distress and 33% physical symptoms. Only 4% reported experiencing weak colleague support while 22% reported poor supervisor and 56% poor organisational support. Qualitative data from seven interviews revealed five themes identified included the Education and training; Environment surrounding the event; Burden of reporting; a ‘You’ve just got to get on with it’ culture; and Ways to action positive change.</div></div><div><h3>Conclusion</h3><div>Empathy and support from trained peer support colleagues were key elements to recovery of nurses who identified as second victims. The role of culture, and family values and beliefs in support of second victims need further investigation. Support programs need to address, not only psychological consequences of a patient safety event on the nurse, but also physical ramifications. Support of supervisors and organisations following a patient safety event may facilitate retention of nurses. The role of education and training in support programs requires further investigation.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151925"},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of gender role stress on psychological distress in pregnant women","authors":"Serap Açıkgöz ,&nbsp;Sakine Yılmaz ,&nbsp;Sevda Güvenç","doi":"10.1016/j.apnr.2025.151926","DOIUrl":"10.1016/j.apnr.2025.151926","url":null,"abstract":"<div><h3>Aim</h3><div>To examine the effect of gender role stress on psychological distress in pregnant women.</div></div><div><h3>Background</h3><div>Recognition and prevention of potential psychological as well as physiological adversities during pregnancy are critical in terms of reducing their impacts on mother and baby health and developing preventive health services.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted with 182 volunteer pregnant women in Türkiye. Data were collected using a Personal Information Form, an Obstetric Characteristics Information Form, the Feminine Gender Role Stress Scale (FGRSS), and the Kessler Psychological Distress Scale (K10-PDS). Data analysis included independent samples <em>t</em>-test, one-way analysis of variance, Duncan test, Pearson correlation coefficient, and linear regression analysis.</div></div><div><h3>Results</h3><div>The mean K10-PDS score of the pregnant women was 37.55 ± 8.87, which showed they were likely to have a severe mental disorder. There was a statistically significant difference between scale scores according to education level, perceived income, intervention of people outside the home, marital adjustment, and the presence of a health problem during the current pregnancy (<em>p</em> &lt; 0.05). It was determined that there was a weak negative relationship between the FGRSS and K10-PDS (<em>r</em> = −0.283; <em>p</em> &lt; 0.001) and that feminine gender role stress had an effect on psychological distress (F = 7332; p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The results of the study draw attention to pregnant women's need for psychological support. To reduce the adverse psychological effects of gender role stress on pregnant women in prenatal care services, studies on factors affecting adaptation to the pregnancy process can be planned.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151926"},"PeriodicalIF":2.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438208","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":"Nurses' competence and needs to assist advance directives for institutionalized people with dementia and their family","authors":"Hui-Chen Chao ,&nbsp;Yen-Lin Chen ,&nbsp;Hsiu-Ching Lin ,&nbsp;Jing-Jy Wang ,&nbsp;Ya-Ping Yang","doi":"10.1016/j.apnr.2025.151924","DOIUrl":"10.1016/j.apnr.2025.151924","url":null,"abstract":"<div><div>There is growing recognition of advance directives (AD) in dementia, however a gap remains between their perceived importance and actual implementation. This emphasizes the need to enhance healthcare professionals' support for people with dementia (PWD) with regards to making AD. This study aimed to investigate the competence, difficulties, and support needs of nurses in assisting institutionalized PWD to make AD. This mixed methods study included both quantitative and qualitative data analysis. Purposive sampling was used to recruit potential participants, and a self-developed questionnaire was used for data collection. Data were analyzed using descriptive statistics and <em>t</em>-test for quantitative information, and content analysis for qualitative information. A total of 188 questionnaires from 19 institutions were completed. The scores of knowledge, attitudes and skills in assisting PWD with making AD were 33.9, 39.4 and 39.5, respectively. The nurses stated that the difficulties in assisting PWD with making AD were a lack of relevant expertise, understanding the AD, and that they were unsure of how to handle conflicting viewpoints within the family. More in-service training and online courses on dementia and AD were required, as well as the creation of health education pamphlets and patient decision aids to help PWD and their families make decisions about AD. The results of this study can serve as a reference for understanding the competencies, improvements, needed support and in-service education of nurses in an institutional setting to assist PWD with making AD. We recommend the promotion of AD through related leading associations and their institutions.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151924"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378808","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":"Factors influencing digital health competence among healthcare professionals: A cross-sectional study","authors":"Goran ERFANI ,&nbsp;Jemma McCREADY ,&nbsp;Beckie GIBSON ,&nbsp;Bethany NICHOL ,&nbsp;John UNSWORTH ,&nbsp;Erika JARVA ,&nbsp;Kristina MIKKONEN ,&nbsp;Marco TOMIETTO","doi":"10.1016/j.apnr.2025.151922","DOIUrl":"10.1016/j.apnr.2025.151922","url":null,"abstract":"<div><h3>Background</h3><div>Improving healthcare professionals' digital health competence is critical to providing safer care. However, there is still a lack of empirical studies exploring the factors influencing healthcare professionals' digital health competence, even though significant investments have been made to advance digitalisation of healthcare globally.</div></div><div><h3>Aim</h3><div>This study aimed to identify the key characteristics influencing healthcare professionals' digital health competence.</div></div><div><h3>Methods</h3><div>Cross-sectional data was collected from 252 healthcare professionals using two instruments measuring the digital health competences and the associated educational and organisational factors in 2024 via an online and paper-based survey. Univariate and binary logistic regression analyses were performed to identify the key characteristics influencing digital health competence.</div></div><div><h3>Results</h3><div>Higher levels of education, working in a hospital, more professional experience, and increased use of digital solutions at work or during free time were associated with higher digital health competence. Higher qualifications were linked to greater digital health competence across several factors, with postgraduate degrees increasing health-related counselling competence and undergraduate degrees enhancing work-related attitudes and evaluating digital solutions. Professionals with university qualifications and those working in hospital settings showed higher ICT competence, while more years of professional experience increased ethical competence in using digital solutions.</div></div><div><h3>Conclusions</h3><div>Digital health competence development should prioritise healthcare professionals with lower educational levels. Additionally, such initiatives should include supporting those who work in non-hospital settings, have less professional experience, and use digital solutions less frequently at work or in their free time. Professional experience increases ethical competence in using digital solutions. Continuous professional development interventions and organisational policies should consider these factors to improve healthcare professionals' digital health competences.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151922"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}