{"title":"Effects of single- and double-shift work on hand and cognitive functions in nurses.","authors":"Fadime Ulupinar, Sibel Meler","doi":"10.1111/inr.13057","DOIUrl":"10.1111/inr.13057","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to examine the influence of single and double-shift work schedules on hand function and cognitive capacities, specifically working memory, attention, and response time in nurses.</p><p><strong>Background: </strong>Shift work, particularly in extended formats, is known to affect various physical and cognitive functions critical to nursing duties. Understanding these impacts is vital for managing nurse schedules to minimize health risks and maximize performance.</p><p><strong>Introduction: </strong>With an increase in demands on healthcare systems, nurses often endure prolonged working hours, which may impair their cognitive and manual abilities, thereby affecting patient care quality.</p><p><strong>Methods: </strong>This study involved 45 nurses aged 20-40 years from shift-oriented units providing direct patient care. Hand function was assessed using the Nine-Hole Peg Test (9-HPT). Cognitive functions such as working memory, attention, and response time were evaluated using the digit span task and the Stroop test, respectively. Two-way analysis of variance (ANOVA) was used for statistical analysis, assessing the interactions of time and shift type, with a significance level set at p < 0.05.</p><p><strong>Results or findings: </strong>The results revealed significant changes in all tested variables between pre- and post-shift assessments and between single and double-shift conditions. Notably, the double-shift work significantly exacerbated declines in all measured functions.</p><p><strong>Discussion: </strong>These findings suggest that double shifts may intensify the deterioration of essential nursing skills, potentially compromising patient care.</p><p><strong>Conclusion and implications for nursing and/or health policy: </strong>This study underscores the detrimental effects of extended shift work on nurses' cognitive and manual functions. These insights should guide healthcare institutions in revising nurse scheduling practices to safeguard their well-being and maintain high standards of patient care.</p>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
İnci Mercan Annak, Birgül Erdoğan, Nihal Yıldız Emre
{"title":"Experiences of Turkish nurses volunteering in the disaster zone following the 2023 Türkiye-Syria earthquake.","authors":"İnci Mercan Annak, Birgül Erdoğan, Nihal Yıldız Emre","doi":"10.1111/inr.13056","DOIUrl":"https://doi.org/10.1111/inr.13056","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed to determine the experiences of Turkish nurses who volunteered in the disaster zone following the 2023 Türkiye-Syria earthquake.</p><p><strong>Background: </strong>The earthquake devastated 11 cities in Türkiye, which required a comprehensive humanitarian response. Despite the crucial role of nurses in crisis management, limited research exists on their experiences in earthquake zones.</p><p><strong>Introduction: </strong>Nurses experience difficulties in disaster areas, such as physical conditions, lack of disaster plans, and inadequate disaster training before being deployed to earthquake areas.</p><p><strong>Methods: </strong>This study used a qualitative research model and case study design. Data were collected through in-depth qualitative interviews. Nine participants who had worked in earthquake zones for at least 5 days were included in the study. The discussions were recorded, transcribed verbatim, and analyzed thematically. The purposive sampling method was used, and the Consolidated Criteria for Reporting Qualitative Research guidelines were followed.</p><p><strong>Results: </strong>As a result, 4 themes, namely physical conditions, psychosocial conditions, professional conditions, and organization, and their 14 subthemes were determined. This study revealed that nurses encountered difficulties related to physical conditions in earthquake zones. Moreover, the emotional burden expressed by the nurses highlighted the profound psychological impact of disaster response.</p><p><strong>Conclusion: </strong>This study determines that disaster preparedness and support for nurses should be enhanced to improve the arrangement of health services in future calamities.</p><p><strong>Implications for nursing policy: </strong>The results of this study can be used by nurse managers and healthcare policymakers to create nursing training programs that focus on disaster-related competencies.</p>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Facilitating acculturation of internationally educated nurses: A meta-synthesis of social integration strategies.","authors":"Huili Eugenia Foo, Yong Shian Goh","doi":"10.1111/inr.13058","DOIUrl":"https://doi.org/10.1111/inr.13058","url":null,"abstract":"<p><strong>Aim: </strong>To explore the social integration strategies adopted by internationally educated nurses during acculturation and to elucidate their role in facilitating successful adaptation to their host countries.</p><p><strong>Background: </strong>With their remarkable resilience, internationally educated nurses navigate numerous challenges in their acculturation process in the host country.</p><p><strong>Introduction: </strong>While the importance of effective social integration strategies in the acculturation and subsequent retention of internationally educated nurses is well known, the specific strategies adopted by these nurses have not been extensively explored. This study aims to fill this gap with its unique and significant focus on these strategies.</p><p><strong>Methods: </strong>Eight electronic databases were searched for English articles from inception to October 2023 to ensure a comprehensive review. The quality of the included studies was appraised using the Critical Appraisal Skills Program checklist. A meta-synthesis was performed using Sandelowski and Barroso's two-step approach, and a thematic analysis was performed according to Braun and Clarke's framework.</p><p><strong>Findings: </strong>This review included experiences of 258 internationally educated nurses across 16 primary studies and has yielded the overarching theme of 'fostering a sense of belonging'. The overarching theme is supported by three themes: (1) cultivating social capital, (2) employing effective communications, and (3) engaging with the community.</p><p><strong>Discussion: </strong>Internationally educated nurses' social integration is a complex process that leverages support networks, establishing connections and overcoming communication barriers. However, the most crucial element is the active involvement of the host community, which plays a significant role in internationally educated nurses' acculturation journey.</p><p><strong>Conclusion and implications for nursing practice: </strong>This review has highlighted the importance of social integration in internationally educated nurses' acculturation journey. Interventions such as having a supportive social network, providing a customised communication programme, organising engagement activities and granting overseas home leave are practical strategies that can enhance this journey.</p>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Being a nurse during an earthquake that affected ten provinces: A qualitative study on experiences and expectations.","authors":"Şenay Şermet Kaya, Eylül Gülnur Erdoğan","doi":"10.1111/inr.13051","DOIUrl":"https://doi.org/10.1111/inr.13051","url":null,"abstract":"<p><strong>Aim: </strong>This study was conducted to determine the professional experiences and future expectations of nurses working in the most damaged areas during the first two weeks of the 2023 Turkey earthquake.</p><p><strong>Background: </strong>The increase in the frequency and severity of disasters in recent years has strongly shown that nurses must be prepared to respond to all disasters. To prepare for disasters that require a multifaceted approach, the experiences of nurses serving in disasters should not be ignored.</p><p><strong>Methods: </strong>A hermeneutic phenomenological approach was used in this research. The study included 18 nurses who worked in the first two weeks of the disaster. Data were collected through semistructured in-depth interviews between April and May 2023.</p><p><strong>Results: </strong>Four themes were identified from the analysis of the data: (1) personal challenges, (2) organizational challenges, (3) nursing during the disaster, and (4) expectations.</p><p><strong>Conclusions: </strong>The results showed that nurses needed psychosocial support intervention skills in disasters and that their psychological preparation and knowledge levels for disasters were insufficient. In addition, the study revealed that organizational preparation was inadequate and that all these factors affected nursing care.</p><p><strong>Implications for nursing and health policy: </strong>The knowledge and skills that nurses need for professional disaster management can be provided by updating undergraduate education, in-service training procedures, and related policies. Considering that ideal disaster management is possible with a multidisciplinary team, it is recommended that national disaster policies be reviewed.</p>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ethical issues after the earthquake in Turkey: A qualitative study on nurses' perspectives.","authors":"Betül Ünsal, Esra Özbudak Arıca, Rukiye Höbek Akarsu","doi":"10.1111/inr.13048","DOIUrl":"https://doi.org/10.1111/inr.13048","url":null,"abstract":"<p><strong>Background: </strong>After natural disasters, the urgent need for survival and rescue operations for those trapped in the rubble results in a heightened demand for healthcare services. Nurses are pivotal in addressing the consequences of such calamities. Nurses operating in critical conditions encounter numerous challenges, including safety issues and ethical quandaries. The ethical considerations primarily revolve around the limitations, duties, and modified norms of care administered by nurses during disasters, presenting both significant and complex challenges.</p><p><strong>Aim: </strong>The study was designed to elucidate the nature and essence of nurses' care experiences and to offer an in-depth depiction of the ethical dilemmas while attending to individuals injured in the earthquake.</p><p><strong>Methods: </strong>A descriptive phenomenological design was used in this research. A total of 16 nurses who worked for at least 7 days in field hospitals in any of the earthquake regions after the 2023 earthquake in Turkey participated in the research. The research was conducted between March 13 and March 20, 2023. Data were collected by face-to-face interview method with a semistructured form. The steps of Colaizzi's phenomenological method were used to analyze the qualitative data.</p><p><strong>Results: </strong>The study involved a group of 16 Turkish nurses, aged between 20 and 36 years. Through data analysis, four primary themes, 14 subthemes, and 25 codes were identified. The principal themes derived from the interviews included \"humanitarian duties,\" \"non-adherence to ethical principles,\" \"respect for the injured,\" and \"medical errors.\"</p><p><strong>Conclusion: </strong>In this intricate process, it becomes paramount to enhance support for nurses in the domains of management, education, and psychosocial assistance, thereby nurturing their individual and professional acumen, commitment, and ethical sensitivity. Refining the guidelines and professional standards that encapsulate the principles to be adhered to by nurses in disaster scenarios, coupled with providing comprehensive training in both medical and ethical competencies, represents a significant avenue for advancement. Focused training on crisis management will enable nurses to render ethically informed decisions and bolster their professional proficiency.</p><p><strong>Implications for nursing policy: </strong>Natural disasters, including earthquakes, pose significant ethical challenges for healthcare professionals, especially nurses who play a pivotal role in delivering care during these emergencies. Issues such as resource allocation and triage, the duty of care and ensuring continuity of care, informed consent and communication, cultural sensitivity, and providing psychosocial support are critical ethical considerations for nursing policies in earthquake situations. Addressing these ethical issues in nursing policies related to earthquakes is crucial for maintaining","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of missed care on the nursing image perceived by patients and their trust relationships with nurses.","authors":"Behire Sancar, Ayse Buket Dogan Aktas","doi":"10.1111/inr.13053","DOIUrl":"https://doi.org/10.1111/inr.13053","url":null,"abstract":"<p><strong>Background: </strong>Missed care has negative consequences for patients, directly affecting the quality of nursing care and patient safety.</p><p><strong>Aim: </strong>This study investigated the effect of missed care on the nursing image perceived by patients and their trust relationships with nurses.</p><p><strong>Methods: </strong>This descriptive and correlational study was conducted in all inpatient wards of a hospital in southern Türkiye. The sample consisted of 200 patients. Data were collected using a patient information form, the MISSCARE Survey-Patient, the Nursing Image Scale (NIS), and the Trust in Nurses Scale (TNS). The data were analyzed using the Statistical Package for Social Sciences (for Windows 25.0). The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.</p><p><strong>Findings: </strong>Participants had a mean MISSCARE Survey-Patient, TNS, and NIS score of 2.09 ± 0.53, 23.48 ± 5.01, and 71.52 ± 6.75, respectively. There was a moderate negative correlation between MISSCARE Survey-Patient and TNS scores. There was a weak negative correlation between MISSCARE Survey-Patient and NIS scores. Moreover, there was a strong positive correlation between NIS and TNS scores.</p><p><strong>Discussion: </strong>MISSCARE Survey-Patient total scores vary due to the imbalance in the number of nurses and the complexity of their tasks. Poor quality of care and incomplete care undermine the image of nursing and negatively affect the trust relationship between patients and nurses.</p><p><strong>Conclusions: </strong>Nursing image and trust in nurses decreases as patient-nurse communication and basic care interventions are skipped.</p><p><strong>Implications for nursing policy: </strong>Inadequate care can have a detrimental effect on the nursing image and erode patient-nurse trust relationships. Therefore, there is a pressing need for ongoing review and enhancement of nursing education, policy, and practice to elevate the quality of care provided. Further research utilizing objective staff measures and outcome assessments, along with gathering primary data directly from patients, is essential to substantiate the assertion that missed care significantly influences patient outcomes.</p>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Organizational evidence-based practice culture, implementation leadership, and nurses: A bidirectional mediation model.","authors":"Shuang Hu, Siying Liu, Xianfeng Li, Junqiang Zhao, Jia Chen, Wenjun Chen, Jiale Hu","doi":"10.1111/inr.13054","DOIUrl":"https://doi.org/10.1111/inr.13054","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore 1) factors that influenced the evidence-based practice competencies and behaviors of clinical nurses and 2) the interaction between the organizational evidence-based practice culture, head nurses' implementation leadership, and nurses' evidence-based practice competencies and behaviors.</p><p><strong>Background: </strong>The significance of organizational evidence-based practice culture and head nurses' implementation leadership in enhancing nurses' evidence-based practice competencies and behavior is widely recognized in healthcare settings. However, there is limited knowledge of how these factors influence nurses' evidence-based practice competencies and behavior.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted at 10 hospitals in China. Data were collected via online questionnaires from October to December 2020, utilizing social characteristic questionnaires, the Evidence-Based Practice Questionnaire, the Organizational Culture and Readiness Scale for System-wide Implementation of Evidence-Based Practice, and the Implementation Leadership Scale. All data were imported into the IBM Statistical Program for the Social Sciences (SPSS) 27.0 and PROCESS version 4.1 macro on SPSS for statistical analysis. The design and reporting of our study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist.</p><p><strong>Results: </strong>We received 1047 (99.15%) valid questionnaires. The multiple linear regression analysis showed that significant factors were organizational evidence-based practice culture, implementation leadership, and years of experience in nursing. After controlling for the impact of the covariate (years of experience in nursing), it was found that organizational evidence-based practice culture partially mediated the relationship between head nurses' implementation leadership and nurses' evidence-based practice competencies and behaviors. Additionally, head nurses' implementation leadership partially mediated the relationship between organizational evidence-based practice culture and nurses' evidence-based practice competencies and behaviors.</p><p><strong>Conclusion: </strong>Organizational evidence-based practice culture, head nurses' implementation leadership, and years of experience in nursing significantly predict nurses' evidence-based practice competencies and behaviors. Organizational evidence-based practice culture and head nurses' implementation leadership mutually mediated their influence on nurses' implementation of evidence-based practice.</p><p><strong>Implications for nursing and policy: </strong>Head nurses should proactively seek opportunities to enhance their implementation leadership, such as participating in training programs (e.g., mentoring and coaching programs) and attending conferences, workshops, or seminars on implementation leadership. Policymakers should also consider providing more policy","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hong-Fei Ren, Chang-Qing Liu, Yan Jiang, Feng-Jiao Chen, Juan Lv, Rui-Xue Zhang, Li-Min Wen, You-Ping Li, Bo Gu
{"title":"Operational efficiency effect on nursing workload of tertiary hospital wards in China: A prospective observational study.","authors":"Hong-Fei Ren, Chang-Qing Liu, Yan Jiang, Feng-Jiao Chen, Juan Lv, Rui-Xue Zhang, Li-Min Wen, You-Ping Li, Bo Gu","doi":"10.1111/inr.13049","DOIUrl":"https://doi.org/10.1111/inr.13049","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the effect of ward operational efficiency on nursing workload and identify the factors that influence nursing workload.</p><p><strong>Background: </strong>It remains unclear how and to what extent ward operational efficiency can influence nursing workload.</p><p><strong>Methods: </strong>A prospective observational study was conducted from July 1, 2022 to June 30, 2023, in one tertiary general hospital in China. Purposive and convenience sampling was used, and 266 470 patients from 66 wards and 52 nurses from 13 wards were recruited. The relationships between operational efficiency and nursing workload and the predictors of nursing workload were analyzed. The STROBE guidelines were followed.</p><p><strong>Results: </strong>The operational characteristics vary by the type of wards. Nursing workloads were positively correlated with case mix index (CMI), rate of level 4 surgery, the number of patients transferred in and out, the number of deaths, total bed days, and the number of emergency admissions and critical illnesses (γ<sub>s</sub>: 0.35-0.56, p < 0.05). And the CMI, rate of level 4 surgery, average bed occupancy rate, number of critically ill patients, and total bed days were the predictors of nursing workload (R<sup>2 </sup>= 57.3%, p < 0.05).</p><p><strong>Discussion: </strong>This study is the first to discuss the relationship between operational efficiency and nursing workload on the ward level and offers valuable insights into the nursing workload.</p><p><strong>Conclusion: </strong>The operational efficiency of wards affects the nursing workload and needs to be considered both in the measurement of nursing activities and in the sizing of the nursing staff.</p><p><strong>Implications for nursing and nursing policy: </strong>The study findings provide a full understanding of the relationship between ward operation and nurse staffing, which is helpful for nursing managers to formulate scientific nurse staffing policies.</p>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nurses as UN champions: Increasing nursing presence and influence at the United Nations.","authors":"Kasey Bellegarde-Armstrong, Teddie Potter","doi":"10.1111/inr.13052","DOIUrl":"https://doi.org/10.1111/inr.13052","url":null,"abstract":"<p><strong>Background: </strong>Representing half of the global health workforce, nurses are critical to health promotion, disease prevention, and the economic and social needs of populations. However, nursing expertise is underutilized in the UN System, and nurses are underprepared for roles in policy to influence global health and sustainable development. Innovative education strategies are necessary to address the sidelining of nursing expertise in these spaces and build nursing literacy in shaping global policy.</p><p><strong>Aim: </strong>This quality improvement project aimed to develop and evaluate a model to build a USA-based school of nursing's literacy and engagement with the United Nations (UN) System.</p><p><strong>Methods: </strong>A Doctor of Nursing Practice (DNP) student developed an innovative educational model, the United Nations Essentials for Global Nursing Leadership, in partnership with a school of nursing (SON), to build faculty knowledge and skills on initiating and sustaining bidirectional engagement with the UN. In 2023, SON faculty piloted the model, and pre-/post-intervention survey data were utilized for improvement.</p><p><strong>Results: </strong>Participants reported increased knowledge, awareness, and confidence related to the UN System and their ability to engage as policy influencers, health diplomats, and global citizens. In total, 100% of participants volunteered to hold the role of UN champion for the SON.</p><p><strong>Discussion: </strong>This innovative model advances nursing knowledge and coherence in the UN System and key areas of policy, diplomacy, and global governance for meaningful UN engagement. CONCLUSION AND IMPLICATIONS FOR NURSING, HEALTH, AND SOCIAL POLICY: Models that invest in closing the global nursing leadership preparation gap can raise the profession's visible UN presence and strategic policy influence at a critical time for people and the planet.</p>","PeriodicalId":54931,"journal":{"name":"International Nursing Review","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}