Pub Date : 2023-08-01DOI: 10.1177/10748407231164747
Sarah J Hoffman, Maria M Vukovich, Jayne Fulkerson, Abigail Gewirtz, Cheryl L Robertson, Windy M Fredkove, Joseph Gaugler
The direct exposure to physical or psychological trauma from torture or war leads to well-documented individual health consequences. Less understood are the inclusive and intergenerational effects of war trauma on family systems and youth adjustment. The purpose was to examine mechanisms in war-affected families that explained the significant emotional and behavioral consequences of intergenerational trauma in youth through the use of multiple methods. Quantitative assessments of maternal and paternal caregivers and youth characterized associations between parent torture, parent mental health distress, parent physical health problems, family functioning, and youth adjustment. Narrative statements further contextualized processes through which the trauma of a parent impacted youth and family systems. The research was conducted in partnership with local, refugee-serving community-based organizations. The study sample included parents and youth in 96 Karen families, originating from Burma in Southeast Asia, who had been resettled to the United States through the U.S. Refugee Admissions Program. Path analysis results indicated that parent torture (β = -0.173) had statistically significant negative direct effects on youth adjustment. Parent torture had a negative indirect effect on youth adjustment through the mental health (β = -0.345) and physical health problems of parents (β = -0.305), and youth gender (β = 0.126) and trauma exposure of youth (β = -0.048). Family functioning type demonstrated a positive direct effect on youth adjustment (β = 0.449). Family type had an indirect effect on youth adjustment through youth gender (β = 0.142), youth trauma exposure (β = -0.165), parent physical health problems (β = -0.202), and parent mental health (β = 0.509). The current study developed and tested the first model of intergenerational trauma's effects on the adjustment of Karen refugee youth. Results emphasize that individual recovery from torture must be accompanied by adjunct interventions focused on family systems and youth adjustment, to holistically address intergenerational sequala of trauma.
{"title":"The Impact of Parent Torture and Family Functioning on Youth Adjustment in War-Affected Families: A Path Analysis Describing Intergenerational Trauma and the Family System.","authors":"Sarah J Hoffman, Maria M Vukovich, Jayne Fulkerson, Abigail Gewirtz, Cheryl L Robertson, Windy M Fredkove, Joseph Gaugler","doi":"10.1177/10748407231164747","DOIUrl":"https://doi.org/10.1177/10748407231164747","url":null,"abstract":"<p><p>The direct exposure to physical or psychological trauma from torture or war leads to well-documented individual health consequences. Less understood are the inclusive and intergenerational effects of war trauma on family systems and youth adjustment. The purpose was to examine mechanisms in war-affected families that explained the significant emotional and behavioral consequences of intergenerational trauma in youth through the use of multiple methods. Quantitative assessments of maternal and paternal caregivers and youth characterized associations between parent torture, parent mental health distress, parent physical health problems, family functioning, and youth adjustment. Narrative statements further contextualized processes through which the trauma of a parent impacted youth and family systems. The research was conducted in partnership with local, refugee-serving community-based organizations. The study sample included parents and youth in 96 Karen families, originating from Burma in Southeast Asia, who had been resettled to the United States through the U.S. Refugee Admissions Program. Path analysis results indicated that parent torture (β = -0.173) had statistically significant negative direct effects on youth adjustment. Parent torture had a negative indirect effect on youth adjustment through the mental health (β = -0.345) and physical health problems of parents (β = -0.305), and youth gender (β = 0.126) and trauma exposure of youth (β = -0.048). Family functioning type demonstrated a positive direct effect on youth adjustment (β = 0.449). Family type had an indirect effect on youth adjustment through youth gender (β = 0.142), youth trauma exposure (β = -0.165), parent physical health problems (β = -0.202), and parent mental health (β = 0.509). The current study developed and tested the first model of intergenerational trauma's effects on the adjustment of Karen refugee youth. Results emphasize that individual recovery from torture must be accompanied by adjunct interventions focused on family systems and youth adjustment, to holistically address intergenerational sequala of trauma.</p>","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 3","pages":"288-300"},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9790834","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}
Pub Date : 2023-08-01DOI: 10.1177/10748407231163588
Mallory Lucier-Greer, Catherine Walker O'Neal, Jay A Mancini
Accessing two independent samples of adolescents in military families in the United States who recently experienced parental separation (N = 573; N = 186), this study sought to identify adolescent mental health profiles indexed on multiple indicators. In other words, we asked how military adolescents fare after parental separation in terms of mental health indicators. Proximal family processes (family cohesion, conflict, and marital adjustment) were also examined in relation to mental health profiles as well as core adolescent outcomes, self-rated health, and school enjoyment. In both samples, three profiles emerged identifying similar structures of mental health profiles. Two-thirds of adolescents were in the lowest risk mental health group. Poor family cohesion and greater conflict were associated with the moderate and highest risk groups. The lowest risk group reported better health and greater school enjoyment. Family nurses and other health care professionals are encouraged to inquire about military connectedness, structural changes occurring within the family system, and family processes in relation to adolescent well-being.
{"title":"Identifying Mental Health Profiles Among Adolescents Who Experienced a Recent Parental Deployment or Military-Related Family Separation.","authors":"Mallory Lucier-Greer, Catherine Walker O'Neal, Jay A Mancini","doi":"10.1177/10748407231163588","DOIUrl":"https://doi.org/10.1177/10748407231163588","url":null,"abstract":"<p><p>Accessing two independent samples of adolescents in military families in the United States who recently experienced parental separation (<i>N</i> = 573; <i>N</i> = 186), this study sought to identify adolescent mental health profiles indexed on multiple indicators. In other words, we asked how military adolescents fare after parental separation in terms of mental health indicators. Proximal family processes (family cohesion, conflict, and marital adjustment) were also examined in relation to mental health profiles as well as core adolescent outcomes, self-rated health, and school enjoyment. In both samples, three profiles emerged identifying similar structures of mental health profiles. Two-thirds of adolescents were in the lowest risk mental health group. Poor family cohesion and greater conflict were associated with the moderate and highest risk groups. The lowest risk group reported better health and greater school enjoyment. Family nurses and other health care professionals are encouraged to inquire about military connectedness, structural changes occurring within the family system, and family processes in relation to adolescent well-being.</p>","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 3","pages":"301-312"},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166776","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}
Pub Date : 2023-08-01DOI: 10.1177/10748407231167874
Erika Sana Moraes, Ana Márcia Chiaradia Mendes-Castillo
Video calling emerged as an important resource during coronavirus disease 2019 (COVID-19) to reconnect child and family, bringing the possibility of communication even during isolation. The objective of this study was to understand the experiences of families who communicated with their children through video calls during isolation by COVID-19 in the pediatric intensive care unit (PICU). This was a qualitative study employing the theory of symbolic interactionism and the research method of grounded theory, with 14 families of children in PICU who used video calling as a communication resource. The data were collected through semi-structured interviews. The analysis revealed the main category of "Connecting to (re)connect: Video calling as a resource to unite families and children in PICU in the COVID-19 era," from which a theoretical model explaining the experience was built. Video calling is an important resource to mitigate the effects of family-child separation during hospitalization, and its use is encouraged in other contexts.
{"title":"Connecting to (Re)connect: Video Calling as a Resource to Unite Families and Children in a Pediatric Intensive Care Unit During the COVID-19 Era.","authors":"Erika Sana Moraes, Ana Márcia Chiaradia Mendes-Castillo","doi":"10.1177/10748407231167874","DOIUrl":"https://doi.org/10.1177/10748407231167874","url":null,"abstract":"<p><p>Video calling emerged as an important resource during coronavirus disease 2019 (COVID-19) to reconnect child and family, bringing the possibility of communication even during isolation. The objective of this study was to understand the experiences of families who communicated with their children through video calls during isolation by COVID-19 in the pediatric intensive care unit (PICU). This was a qualitative study employing the theory of symbolic interactionism and the research method of grounded theory, with 14 families of children in PICU who used video calling as a communication resource. The data were collected through semi-structured interviews. The analysis revealed the main category of \"Connecting to (re)connect: Video calling as a resource to unite families and children in PICU in the COVID-19 era,\" from which a theoretical model explaining the experience was built. Video calling is an important resource to mitigate the effects of family-child separation during hospitalization, and its use is encouraged in other contexts.</p>","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 3","pages":"263-274"},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196685/pdf/10.1177_10748407231167874.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10152258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01Epub Date: 2023-05-16DOI: 10.1177/10748407231167545
Jacquelyn J Benson, Karla T Washington, Olivia J Landon, Daphne E Chakurian, George Demiris, Debra Parker Oliver
The difficulties of caring for a family member with advanced cancer are well documented. Support from a caregiver's social network-especially other family-is vital to reducing caregiver burden and psychological distress. However, the family environment is not always supportive as reports of family conflict and dissatisfaction with support are common. Despite knowing that family relationships are complex, little is known about the types of family stress that caregivers of advanced cancer patients face in their daily lives. To address this gap, researchers applied concepts from the double ABCX model to conduct a reflexive thematic analysis of interviews with 63 caregivers of cancer patients receiving outpatient palliative care. Four themes of family stress were identified: failed support, relational tensions, denial, and additional care work. Findings inform clinical assessment and caregiver intervention development by revealing the importance of measuring the mundane machinations of family life for caregivers of adult cancer patients.
{"title":"When Family Life Contributes to Cancer Caregiver Burden in Palliative Care.","authors":"Jacquelyn J Benson, Karla T Washington, Olivia J Landon, Daphne E Chakurian, George Demiris, Debra Parker Oliver","doi":"10.1177/10748407231167545","DOIUrl":"10.1177/10748407231167545","url":null,"abstract":"<p><p>The difficulties of caring for a family member with advanced cancer are well documented. Support from a caregiver's social network-especially other family-is vital to reducing caregiver burden and psychological distress. However, the family environment is not always supportive as reports of family conflict and dissatisfaction with support are common. Despite knowing that family relationships are complex, little is known about the types of family stress that caregivers of advanced cancer patients face in their daily lives. To address this gap, researchers applied concepts from the double ABCX model to conduct a reflexive thematic analysis of interviews with 63 caregivers of cancer patients receiving outpatient palliative care. Four themes of family stress were identified: <i>failed support, relational tensions, denial</i>, and <i>additional care work</i>. Findings inform clinical assessment and caregiver intervention development by revealing the importance of measuring the mundane machinations of family life for caregivers of adult cancer patients.</p>","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 3","pages":"275-287"},"PeriodicalIF":2.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10330805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10169317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.1177/10748407231167438
Marta Domingo-Osle, Virginia La Rosa-Salas, Cristina García-Vivar
A randomized pilot study was conducted involving 69 third-year nursing students (ClinicalTrials.gov ID: NCT05270252). Students were randomly assigned to the CG (n = 34) or the intervention group (n = 35), using computer-generated randomization. The CG completed the third-year nursing, and the intervention group received in addition the Learning & Care educational intervention. The aim of this study was to determine the effectiveness, feasibility, and acceptability of the Learning & Care for students to acquire the knowledge, skills, and attitudes necessary to care for survivors and their families. The intervention group significantly improved in knowledge (p = .004; -1.15, 95% confidence interval [CI] [-1.94, -0.37]), skills (p ≤ .0001; -13.51, 95% CI [-15.19, -11.83]), and attitudes (p = .006; -5.61, 95% CI [-8.81, -2.42]). The students' satisfaction was found to be high (93.75%). Offering a family nursing approach improves students' competence to care for long-term cancer survivors and their families.
{"title":"Educational Intervention for Family Nursing Students in Long-Term Cancer Survivorship: A Randomized Pilot Trial.","authors":"Marta Domingo-Osle, Virginia La Rosa-Salas, Cristina García-Vivar","doi":"10.1177/10748407231167438","DOIUrl":"https://doi.org/10.1177/10748407231167438","url":null,"abstract":"<p><p>A randomized pilot study was conducted involving 69 third-year nursing students (ClinicalTrials.gov ID: NCT05270252). Students were randomly assigned to the CG (<i>n</i> = 34) or the intervention group (<i>n</i> = 35), using computer-generated randomization. The CG completed the third-year nursing, and the intervention group received in addition the Learning & Care educational intervention. The aim of this study was to determine the effectiveness, feasibility, and acceptability of the Learning & Care for students to acquire the knowledge, skills, and attitudes necessary to care for survivors and their families. The intervention group significantly improved in knowledge (<i>p</i> = .004; -1.15, 95% confidence interval [CI] [-1.94, -0.37]), skills (<i>p</i> ≤ .0001; -13.51, 95% CI [-15.19, -11.83]), and attitudes (<i>p</i> = .006; -5.61, 95% CI [-8.81, -2.42]). The students' satisfaction was found to be high (93.75%). Offering a family nursing approach improves students' competence to care for long-term cancer survivors and their families.</p>","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 3","pages":"248-262"},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9796811","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}
Pub Date : 2023-08-01DOI: 10.1177/10748407231184545
{"title":"Calendar.","authors":"","doi":"10.1177/10748407231184545","DOIUrl":"https://doi.org/10.1177/10748407231184545","url":null,"abstract":"","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 3","pages":"313"},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10136087","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}
Pub Date : 2023-08-01DOI: 10.1177/10748407231184546
{"title":"Family Nursing Network.","authors":"","doi":"10.1177/10748407231184546","DOIUrl":"https://doi.org/10.1177/10748407231184546","url":null,"abstract":"","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 3","pages":"314"},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10165120","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}
Pub Date : 2023-05-01DOI: 10.1177/10748407231174088
{"title":"Family Nursing Network.","authors":"","doi":"10.1177/10748407231174088","DOIUrl":"https://doi.org/10.1177/10748407231174088","url":null,"abstract":"","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 2","pages":"224"},"PeriodicalIF":3.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9402120","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}
Pub Date : 2023-05-01DOI: 10.1177/10748407221145963
Pernille Friis Rønne, Bente Appel Esbensen, Anne Brødsgaard, Stine Maria Rosenstrøm, Barbara Voltelen, Carrinna Aviaja Hansen
This mixed-methods research examined the translation of a family nursing conversation intervention to the multidisciplinary treatment of patients experiencing chronic noncancer pain. The intervention required educating nurses who offered family nursing interventions to these families. The research uncovered barriers and facilitators influencing the nurses' perceived self-efficacy related to the process of incorporating family nursing conversations in their nursing care. A qualitative, descriptive, longitudinal design with three focus group interviews was implemented. A template analysis, using a priori themes based on Bandura's self-efficacy theory, illuminated a process initially predominated by barriers. Learning how to offer family nursing conversations was initially overwhelming for nurses because they were concerned about harming the family. Over time, the nurses came to understand the usefulness of the therapeutic conversation with families. Significant facilitators were the project manager's role, a strong nursing community, and the positive influence of the family intervention on the nurses' professional identity.
{"title":"Barriers and Facilitators Influencing Nurses' Confidence in Managing Family Nursing Conversations in the Treatment of Chronic Noncancer Pain: A Longitudinal Qualitative Study.","authors":"Pernille Friis Rønne, Bente Appel Esbensen, Anne Brødsgaard, Stine Maria Rosenstrøm, Barbara Voltelen, Carrinna Aviaja Hansen","doi":"10.1177/10748407221145963","DOIUrl":"https://doi.org/10.1177/10748407221145963","url":null,"abstract":"<p><p>This mixed-methods research examined the translation of a family nursing conversation intervention to the multidisciplinary treatment of patients experiencing chronic noncancer pain. The intervention required educating nurses who offered family nursing interventions to these families. The research uncovered barriers and facilitators influencing the nurses' perceived self-efficacy related to the process of incorporating family nursing conversations in their nursing care. A qualitative, descriptive, longitudinal design with three focus group interviews was implemented. A template analysis, using <i>a priori</i> themes based on Bandura's self-efficacy theory, illuminated a process initially predominated by barriers. Learning how to offer family nursing conversations was initially overwhelming for nurses because they were concerned about harming the family. Over time, the nurses came to understand the usefulness of the therapeutic conversation with families. Significant facilitators were the project manager's role, a strong nursing community, and the positive influence of the family intervention on the nurses' professional identity.</p>","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 2","pages":"166-178"},"PeriodicalIF":3.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9632000","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}
Pub Date : 2023-05-01DOI: 10.1177/10748407221148083
Cristina Alfaro-Díaz, Nuria Esandi, María Pueyo-Garrigues, Navidad Canga-Armayor, Maria João Forjaz, Carmen Rodriguez-Blazquez, Ana Canga-Armayor
Nurses' attitudes toward families play an important role in improving relationships with patients' families. It is essential to have valid and reliable instruments to assess nurses' attitudes toward involving families. The aim of this study was to analyze the psychometric properties of the refined Spanish version of the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) according to classical test theory and the Rasch model (N = 263). Cronbach's alpha values were .73 to .87 and intraclass correlation coefficients ranged from .72 to .86. Rasch analysis results suggested that it was a multidimensional scale with four dimensions and a simpler response scheme than the original scale. Except for one item, the scale was free from bias regarding age and experience time. The FINC-NA is a reliable and valid measure showing a good fit to the Rasch model and is ready to map nurses' attitudes and measure the effectiveness of family nursing educational interventions.
{"title":"Psychometric Evaluation of the Spanish Families Importance in Nursing Care: Nurses' Attitudes Scale Through Classical Test Theory and Rasch Analysis.","authors":"Cristina Alfaro-Díaz, Nuria Esandi, María Pueyo-Garrigues, Navidad Canga-Armayor, Maria João Forjaz, Carmen Rodriguez-Blazquez, Ana Canga-Armayor","doi":"10.1177/10748407221148083","DOIUrl":"https://doi.org/10.1177/10748407221148083","url":null,"abstract":"<p><p>Nurses' attitudes toward families play an important role in improving relationships with patients' families. It is essential to have valid and reliable instruments to assess nurses' attitudes toward involving families. The aim of this study was to analyze the psychometric properties of the refined Spanish version of the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) according to classical test theory and the Rasch model (<i>N</i> = 263). Cronbach's alpha values were .73 to .87 and intraclass correlation coefficients ranged from .72 to .86. Rasch analysis results suggested that it was a multidimensional scale with four dimensions and a simpler response scheme than the original scale. Except for one item, the scale was free from bias regarding age and experience time. The FINC-NA is a reliable and valid measure showing a good fit to the Rasch model and is ready to map nurses' attitudes and measure the effectiveness of family nursing educational interventions.</p>","PeriodicalId":50193,"journal":{"name":"Journal of Family Nursing","volume":"29 2","pages":"179-191"},"PeriodicalIF":3.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9626163","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}