Pub Date : 2025-10-17DOI: 10.1177/10598405251386068
Ali A Weinstein, Debora G Goldberg, Zill Shah, Megan E Warner, Erin D Maughan
BackgroundBurnout among school nurses is a growing concern as it may influence mental health and job performance.PurposeThis qualitative study investigates burnout-related factors among school nurses in the United States.MethodsA 2022 large multi-state survey of school nurses was conducted with 1,259 responses to an open-ended question regarding burnout. These were analyzed using content analysis to identify themes. The difference between those with and without burnout was examined on the identified themes.ResultsSymptoms of burnout reported were anxiety, stress, irritability and anger, loss of personal and social connectedness, sleep disturbances, depressive symptoms, and physical symptoms. The nurses reporting burnout also reported high workloads, job dissatisfaction, and intention to leave their current position.ConclusionsFindings suggest the potential importance of workload in reducing burnout, which would require structural reform and sustained administrative support.
{"title":"Burnout Among U.S. School Nurses After the COVID-19 Pandemic: Integrating Insights on Symptoms and Workplace Factors.","authors":"Ali A Weinstein, Debora G Goldberg, Zill Shah, Megan E Warner, Erin D Maughan","doi":"10.1177/10598405251386068","DOIUrl":"https://doi.org/10.1177/10598405251386068","url":null,"abstract":"<p><p>BackgroundBurnout among school nurses is a growing concern as it may influence mental health and job performance.PurposeThis qualitative study investigates burnout-related factors among school nurses in the United States.MethodsA 2022 large multi-state survey of school nurses was conducted with 1,259 responses to an open-ended question regarding burnout. These were analyzed using content analysis to identify themes. The difference between those with and without burnout was examined on the identified themes.ResultsSymptoms of burnout reported were anxiety, stress, irritability and anger, loss of personal and social connectedness, sleep disturbances, depressive symptoms, and physical symptoms. The nurses reporting burnout also reported high workloads, job dissatisfaction, and intention to leave their current position.ConclusionsFindings suggest the potential importance of workload in reducing burnout, which would require structural reform and sustained administrative support.</p>","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"10598405251386068"},"PeriodicalIF":1.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314039","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}
School nurses interact closely with parents of children with chronic health conditions. Understanding how they perceive and respond to parental health literacy (HL) is essential. In this study, we assessed the accuracy of school nurses' evaluations of parental HL by comparing their assessments with parents' objectively measured HL. A cross-sectional design was employed with a convenience sample of 52 parent-school nurse pairs. Parental HL was measured using the HLS-EU-Q16 and adapted items from previous studies. Data were analyzed using cross-tabulation, Kappa, intraclass correlation coefficient (ICC) and sensitivity-specificity metrics. The results demonstrated very low agreement between nurses' estimations and parents' actual HL (κ = 0.060, p = 0.547). Nurses frequently rated HL as 'Adequate', leading to misclassification of 'Problematic' and 'Inadequate' cases. Sensitivity in identifying inadequate HL was low, and ICC values confirmed poor reliability. Findings underscore the need for training school nurses to better identify and address parents' HL needs.
学校护士与患有慢性疾病儿童的家长密切互动。了解他们如何看待和应对父母健康素养(HL)至关重要。在本研究中,我们通过比较学校护士对家长HL的评估和家长客观测量的HL来评估学校护士对家长HL的评估的准确性。采用横断面设计,选取方便样本52对家长-学校护士。亲本HL测量采用HLS-EU-Q16和先前研究的改编项目。数据分析采用交叉表法、Kappa法、类内相关系数(ICC)和敏感性-特异性指标。结果显示,护士的估计与家长的实际HL之间的一致性非常低(κ = 0.060, p = 0.547)。护士经常将HL评为“适当”,导致“有问题”和“不适当”病例的错误分类。识别不充分HL的敏感性较低,ICC值证实可靠性较差。研究结果强调需要培训学校护士,以更好地识别和解决家长的HL需求。
{"title":"School Nurses' Assessment of Parental Health Literacy for Students with Chronic Health Conditions.","authors":"Areti Mamfreda, Athina Kalokairinou, Panayota Sourtzi, Venetia-Sofia Velonaki","doi":"10.1177/10598405251386064","DOIUrl":"https://doi.org/10.1177/10598405251386064","url":null,"abstract":"<p><p>School nurses interact closely with parents of children with chronic health conditions. Understanding how they perceive and respond to parental health literacy (HL) is essential. In this study, we assessed the accuracy of school nurses' evaluations of parental HL by comparing their assessments with parents' objectively measured HL. A cross-sectional design was employed with a convenience sample of 52 parent-school nurse pairs. Parental HL was measured using the HLS-EU-Q16 and adapted items from previous studies. Data were analyzed using cross-tabulation, Kappa, intraclass correlation coefficient (ICC) and sensitivity-specificity metrics. The results demonstrated very low agreement between nurses' estimations and parents' actual HL (κ = 0.060, p = 0.547). Nurses frequently rated HL as 'Adequate', leading to misclassification of 'Problematic' and 'Inadequate' cases. Sensitivity in identifying inadequate HL was low, and ICC values confirmed poor reliability. Findings underscore the need for training school nurses to better identify and address parents' HL needs.</p>","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"10598405251386064"},"PeriodicalIF":1.5,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304123","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}
Pub Date : 2025-10-01Epub Date: 2023-11-13DOI: 10.1177/10598405231212907
Camilla Perming, Eva-Lena Einberg, Sarah Bekaert, Pernilla Garmy
The purpose of this study was to describe experiences of pain among students at upper secondary schools (adolescents aged 16-19 years) in Sweden. Focus group (n = 9) interviews with 41 adolescents were conducted in southern Sweden in 2021. The interviews were analyzed by qualitative content analysis, which identified four categories encompassing the theme how pain expressed itself: (1) a warning bell-the body's way of saying that something is wrong; (2) school- and work-related pain; (3) interpersonal physical and emotional pain; and (4) heartache-a sign of humanity; and four categories describing the theme ways of dealing with pain: (1) turn your attention elsewhere; (2) "bite the bullet" and endure the pain; and (3) use painkillers or complementary treatments; and (4) ask for help from others. Findings are linked to the crucial role of school nurses in supporting students who experience pain.
{"title":"Adolescents' Experience of Pain: A Focus Group Study in Sweden.","authors":"Camilla Perming, Eva-Lena Einberg, Sarah Bekaert, Pernilla Garmy","doi":"10.1177/10598405231212907","DOIUrl":"10.1177/10598405231212907","url":null,"abstract":"<p><p>The purpose of this study was to describe experiences of pain among students at upper secondary schools (adolescents aged 16-19 years) in Sweden. Focus group (n = 9) interviews with 41 adolescents were conducted in southern Sweden in 2021. The interviews were analyzed by qualitative content analysis, which identified four categories encompassing the theme <i>how pain expressed itself</i>: (1) a warning bell-the body's way of saying that something is wrong; (2) school- and work-related pain; (3) interpersonal physical and emotional pain; and (4) heartache-a sign of humanity; and four categories describing the theme <i>ways of dealing with pain</i>: (1) turn your attention elsewhere; (2) \"bite the bullet\" and endure the pain; and (3) use painkillers or complementary treatments; and (4) ask for help from others. Findings are linked to the crucial role of school nurses in supporting students who experience pain.</p>","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"548-556"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92157143","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}
Pub Date : 2025-10-01Epub Date: 2023-12-10DOI: 10.1177/10598405231218287
Andrea Tanner, Jane von Gaudecker, Janice M Buelow, Wendy R Miller
Adolescents with functional (psychogenic nonepileptic) seizures experience school-related struggles. School nurses are positioned to address such struggles. However, school nurses report having little education or confidence in their role of managing or responding to this mental health condition. Little is known about adolescents' perceptions of school nurses' role in functional seizure care. This qualitative study used semi-structured interviews with 10 adolescents from across the United States with functional seizures to explore adolescents' perceptions of school nurses' roles in functional seizure care at school. Results revealed school nurses, when present, play a spectrum of roles according to adolescents' perceptions, ranging from negative (harmful and uninvolved) to positive (being present, expressing care, and actively doing tasks for the student). These perceived roles shed light upon school nurses' lack of functional seizure awareness and opportunities to incorporate mental health interventions for adolescents with functional seizures in the school setting.
{"title":"Adolescents' Perceptions of School Nurses' Role in Functional Seizures at School.","authors":"Andrea Tanner, Jane von Gaudecker, Janice M Buelow, Wendy R Miller","doi":"10.1177/10598405231218287","DOIUrl":"10.1177/10598405231218287","url":null,"abstract":"<p><p>Adolescents with functional (psychogenic nonepileptic) seizures experience school-related struggles. School nurses are positioned to address such struggles. However, school nurses report having little education or confidence in their role of managing or responding to this mental health condition. Little is known about adolescents' perceptions of school nurses' role in functional seizure care. This qualitative study used semi-structured interviews with 10 adolescents from across the United States with functional seizures to explore adolescents' perceptions of school nurses' roles in functional seizure care at school. Results revealed school nurses, when present, play a spectrum of roles according to adolescents' perceptions, ranging from negative (harmful and uninvolved) to positive (being present, expressing care, and actively doing tasks for the student). These perceived roles shed light upon school nurses' lack of functional seizure awareness and opportunities to incorporate mental health interventions for adolescents with functional seizures in the school setting.</p>","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"625-631"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810026","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}
Pub Date : 2025-10-01Epub Date: 2024-11-25DOI: 10.1177/10598405241293746
Kate Wachutka, Mercedes Echevarria, Jennifer Walsh
Background: School-aged children with unidentified mental illnesses experience poor health outcomes; managing this issue requires a collaborative community approach. Objectives: The objective was to implement an evidence-based mental health education and sustainment program within an underresourced school setting for staff and parents/guardians supervising children to optimize adult mental health literacy (MHL). Methods: The intervention included Youth Mental Health First Aid (YMHFA) training; measurements of pre- and post-MHL were completed with the Mental Health Literacy Scale (MHLS). Sustainment was achieved by developing a school-centered mental health toolkit and integrating a school champion. Results: There was a significant MHL score change from pretest to posttest. The toolkit bolstered sustainability by increasing the utilization of community resources. Conclusions: This mental health awareness initiative proved effective and can be expanded across similar underresourced schools to fill voids.
{"title":"Youth Mental Health First Aid (YMHFA): A Change Initiative in an Underresourced School.","authors":"Kate Wachutka, Mercedes Echevarria, Jennifer Walsh","doi":"10.1177/10598405241293746","DOIUrl":"10.1177/10598405241293746","url":null,"abstract":"<p><p><b>Background:</b> School-aged children with unidentified mental illnesses experience poor health outcomes; managing this issue requires a collaborative community approach. <b>Objectives:</b> The objective was to implement an evidence-based mental health education and sustainment program within an underresourced school setting for staff and parents/guardians supervising children to optimize adult mental health literacy (MHL). <b>Methods:</b> The intervention included Youth Mental Health First Aid (YMHFA) training; measurements of pre- and post-MHL were completed with the Mental Health Literacy Scale (MHLS). Sustainment was achieved by developing a school-centered mental health toolkit and integrating a school champion. <b>Results:</b> There was a significant MHL score change from pretest to posttest. The toolkit bolstered sustainability by increasing the utilization of community resources. <b>Conclusions:</b> This mental health awareness initiative proved effective and can be expanded across similar underresourced schools to fill voids.</p>","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"632-641"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711544","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}
Pub Date : 2025-10-01Epub Date: 2025-07-24DOI: 10.1177/10598405251360761
{"title":"National Association of School Nurses (NASN) Position Statement: School Nurse Workload-Essential Staffing for Safe and Equitable Student Care.","authors":"","doi":"10.1177/10598405251360761","DOIUrl":"10.1177/10598405251360761","url":null,"abstract":"","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"642-645"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700222","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}
Pub Date : 2025-10-01Epub Date: 2023-08-30DOI: 10.1177/10598405231198020
Ashley C Yaugher, Christina C Pay, Jenna Hawks, Cristian L Meier
There are effective prevention strategies to combat increasing rates of youth e-cigarette use. This study assessed the outcomes of an e-cigarette prevention program with teachers and parents/guardians across a three-county rural area. Researchers assessed teachers' and parent/guardians' increased knowledge and confidence in implementing vape prevention after receiving evidence-based trainings. Pre- and post-surveys demonstrated that teachers had a statistically significant increase in knowledge gain across all eight vape-specific domains assessed as expected. The parent/guardian pre- and post-survey results also show that knowledge and confidence increased significantly across seven domains. Findings suggest that multicomponent e-cigarette education and prevention programs better prepare teachers and parents/guardians to intervene with youth e-cigarette use and initiation, including being more likely to talk to youth about the risks of tobacco and vaping. Recommendations for school nurses are discussed and include educating youth, families, and staff for positive impacts.
{"title":"Evaluating a Multicomponent e-Cigarette Prevention Program in the Rural Northwest: Teacher and Parent/Guardian Program Outcomes.","authors":"Ashley C Yaugher, Christina C Pay, Jenna Hawks, Cristian L Meier","doi":"10.1177/10598405231198020","DOIUrl":"10.1177/10598405231198020","url":null,"abstract":"<p><p>There are effective prevention strategies to combat increasing rates of youth e-cigarette use. This study assessed the outcomes of an e-cigarette prevention program with teachers and parents/guardians across a three-county rural area. Researchers assessed teachers' and parent/guardians' increased knowledge and confidence in implementing vape prevention after receiving evidence-based trainings. Pre- and post-surveys demonstrated that teachers had a statistically significant increase in knowledge gain across all eight vape-specific domains assessed as expected. The parent/guardian pre- and post-survey results also show that knowledge and confidence increased significantly across seven domains. Findings suggest that multicomponent e-cigarette education and prevention programs better prepare teachers and parents/guardians to intervene with youth e-cigarette use and initiation, including being more likely to talk to youth about the risks of tobacco and vaping. Recommendations for school nurses are discussed and include educating youth, families, and staff for positive impacts.</p>","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"535-547"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10167666","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}
Pub Date : 2025-10-01Epub Date: 2023-11-29DOI: 10.1177/10598405231214981
Kimberly McNally, Ali Weinstein, Lisa Lindley, Robin Wallin, Amira Roess
School nurses improve public health through vaccine promotion and mandate compliance. Despite recommendations and support for comprehensive adolescent HPV vaccination from organizations like the National Association of School Nurses as of 2023 only Virginia, Washington DC, Rhode Island, and Hawaii mandate HPV vaccine in schools. Virginia's mandate allows caregivers to opt out of vaccination. It is important to consider how school-level vaccine compliance is associated with school and community factors. A multilevel analysis explored the association between school and county-level factors and HPV vaccination rates. This study shows schools that report higher rates of economically disadvantaged students had higher HPV vaccine coverage. HPV vaccine rates increased from 2019 to 2021 after the implementation of a gender-inclusive mandate. Virginia HPV rates still lag behind states with no mandate. The results suggest that school nursing practice related to HPV vaccine compliance may be impacted by community factors like economic status.
{"title":"A Multilevel Analysis of School-Level Human Papillomavirus Vaccination Coverage in Virginia.","authors":"Kimberly McNally, Ali Weinstein, Lisa Lindley, Robin Wallin, Amira Roess","doi":"10.1177/10598405231214981","DOIUrl":"10.1177/10598405231214981","url":null,"abstract":"<p><p>School nurses improve public health through vaccine promotion and mandate compliance. Despite recommendations and support for comprehensive adolescent HPV vaccination from organizations like the National Association of School Nurses as of 2023 only Virginia, Washington DC, Rhode Island, and Hawaii mandate HPV vaccine in schools. Virginia's mandate allows caregivers to opt out of vaccination. It is important to consider how school-level vaccine compliance is associated with school and community factors. A multilevel analysis explored the association between school and county-level factors and HPV vaccination rates. This study shows schools that report higher rates of economically disadvantaged students had higher HPV vaccine coverage. HPV vaccine rates increased from 2019 to 2021 after the implementation of a gender-inclusive mandate. Virginia HPV rates still lag behind states with no mandate. The results suggest that school nursing practice related to HPV vaccine compliance may be impacted by community factors like economic status.</p>","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"557-569"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464003","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}
Pub Date : 2025-10-01Epub Date: 2023-12-21DOI: 10.1177/10598405231221050
Caroline Skantze, Gerd Almqvist-Tangen, Maria Nyholm, Staffan Karlsson
This study aimed to describe parents' experiences of communication with school nurses concerning the growth data and weight development of their children aged 8 and 10 years old in Sweden. Eighteen interviews with parents were conducted and analyzed through qualitative content analysis. The result showed a need for improved dialogue where the parents viewed the health visit's purpose as unclear and lacked feedback. The parents desired access to their child's growth data and described the need for an improved channel for receiving information. The parents moreover experienced the lack of a child-centered perspective, described the child's context as not in focus, and desired collaboration around their child. This study shows the need for the development of evidence-based methods for communicating growth data and weight development between School Health Service (SHS) and parents, as well as the need for a reformed SHS perspective towards parents and children.
{"title":"Parents' Experiences of Communication With School Nurses About Their Child's Weight Development in Sweden.","authors":"Caroline Skantze, Gerd Almqvist-Tangen, Maria Nyholm, Staffan Karlsson","doi":"10.1177/10598405231221050","DOIUrl":"10.1177/10598405231221050","url":null,"abstract":"<p><p>This study aimed to describe parents' experiences of communication with school nurses concerning the growth data and weight development of their children aged 8 and 10 years old in Sweden. Eighteen interviews with parents were conducted and analyzed through qualitative content analysis. The result showed a need for improved dialogue where the parents viewed the health visit's purpose as unclear and lacked feedback<i>.</i> The parents desired access to their child's growth data and described the need for an improved channel for receiving information. The parents moreover experienced the lack of a child-centered perspective, described the child's context as not in focus, and desired collaboration around their child. This study shows the need for the development of evidence-based methods for communicating growth data and weight development between School Health Service (SHS) and parents, as well as the need for a reformed SHS perspective towards parents and children.</p>","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"570-578"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832735","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}
Pub Date : 2025-10-01Epub Date: 2025-07-24DOI: 10.1177/10598405251360760
{"title":"National Association of School Nurses (NASN) Position Statement: Gender and Sexual Diversity Support in Schools.","authors":"","doi":"10.1177/10598405251360760","DOIUrl":"10.1177/10598405251360760","url":null,"abstract":"","PeriodicalId":50058,"journal":{"name":"Journal of School Nursing","volume":" ","pages":"646-648"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700221","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}