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Parents’ experiences of their child’s best interests during a hospital stay in Australia 澳大利亚住院期间父母对子女最大利益的体验
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-04-03 DOI: 10.1177/13674935241243101
Angela Afua Quaye, Mandie Foster, Lisa Whitehead, Inger Kristensson Hallström
Determining the child’s best interests in a hospital setting will ideally involve the combined views of children, parents, and healthcare professionals. However, few studies have explored parents’ experiences of their child’s best interests when they engage with the healthcare system. Therefore, this study aimed to explore parents’ experiences of their child’s best interests during hospitalisation. A descriptive qualitative inductive design using face-to-face parent–child combined interviews, analysed by latent content analysis, was used. Sixteen parents recruited from a tertiary hospital in Western Australia were interviewed. Collaboration, development of trustworthy relationships, and effective communication were essential in shaping parents’ experiences of their child’s best interests during hospitalisation.
在医院环境中确定儿童的最大利益时,最好能综合儿童、家长和医疗保健专业人员的意见。然而,很少有研究探讨父母在与医疗系统接触时对其子女最大利益的体验。因此,本研究旨在探讨住院期间家长对其子女最大利益的体验。本研究采用描述性定性归纳设计,使用面对面亲子综合访谈法,并通过潜在内容分析法进行分析。从西澳大利亚州一家三甲医院招募的 16 名家长接受了访谈。合作、发展值得信赖的关系以及有效的沟通对于塑造家长在住院期间对孩子最佳利益的体验至关重要。
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引用次数: 0
Effect of vibratory device on the time of administration of vaccines and on patient satisfaction measures. 振动装置对疫苗接种时间和患者满意度的影响。
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-03-31 DOI: 10.1177/13674935241242156
Amanda Thompson, Minna Leydorf Rodrigo, Alia Roberts, Jaylyn Waddell, Rebecca Carter

Previous studies have demonstrated that Buzzy® is effective for pain reduction during vaccination. This study aimed to determine if Buzzy® would have an effect on either duration of vaccine administration and/or patient satisfaction. Pediatric patients aged birth to 18 years old receiving a vaccination were randomized to either a control group receiving no intervention, or the experimental group, utilizing Buzzy®. Time of administration was measured by the number of seconds required by nursing to administer vaccines. Patient satisfaction was measured with a survey given to guardians. Time required was reduced by almost 2 min when utilizing Buzzy®, with median time dropping to 190, 95% CI [26.99, 415.92] seconds from 333, 95% CI [51.35, 627.21] seconds. Patient satisfaction surveys showed positive impacts of using the device, with 100% that used the device reporting that it "made a difference in the pain level experienced," but did not demonstrate statistical significance. This study shows that use of Buzzy® increases efficiency of appointments with possible positive effect on patient satisfaction.

以往的研究表明,Buzzy® 能有效减轻疫苗接种过程中的疼痛。本研究旨在确定 Buzzy® 是否会对疫苗接种持续时间和/或患者满意度产生影响。年龄从出生到 18 岁、接受疫苗接种的小儿患者被随机分配到未接受干预的对照组或使用 Buzzy® 的实验组。接种时间以护理人员接种疫苗所需的秒数来衡量。病人满意度则通过向监护人发放调查问卷来衡量。使用 Buzzy® 所需的时间减少了近 2 分钟,中位时间从 333 秒(95% CI [51.35, 627.21])降至 190 秒(95% CI [26.99, 415.92])。患者满意度调查显示了使用该装置的积极影响,100% 的患者表示 "疼痛程度有所改善",但未显示统计学意义。这项研究表明,使用 Buzzy® 可以提高预约效率,并可能对患者满意度产生积极影响。
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引用次数: 0
Psychological wellbeing among parents of a child living with a serious chronic illness: A cross-sectional survey study. 患有严重慢性疾病儿童的父母的心理健康:一项横断面调查研究。
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-03-29 DOI: 10.1177/13674935241238485
Eden G Robertson, Lauren Kelada, Robert Ilin, Elizabeth Emma Palmer, Ann Bye, Adam Jaffe, Sean E Kennedy, Chee Y Ooi, Donna Drew, Claire E Wakefield

Parents of a child with a chronic illness can experience greater distress than the average population, yet little is understood about differences between illness groups. This cross-sectional survey study aimed to compare parents' psychological distress and perceived wellbeing across five chronic illnesses. Parents from one Australian pediatric hospital completed the Kessler Psychological Distress Scale and seven purpose-designed items about their wellbeing. Data from 106 parents (cancer = 48, cystic fibrosis [CF] = 27, kidney disease = 12, gastrointestinal condition/disorder = 9, developmental and epileptic encephalopathy [DEE] = 10) was analysed using bivariate Pearson's Correlation and linear mixed-effects models. Parents' distress scores differed between groups (F(4,80) = 2.50, p = .049), with the DEE group reporting higher distress than the CF group (mean difference = 6.76, 95% CI [0.11, 13.42]). Distress scores were moderately correlated to parents' perceptions of their child's health and their own wellbeing. Parents' self-reported coping with their child's condition/treatments differed (F(4,81) = 3.24, p = .016), with the DEE group rating their coping as poorer than the CF group (mean difference = -25.32, 95% CI [-46.52, 4.11]). Across all groups, parents reported unmet needs, particularly for psychosocial support and practical/financial assistance. Support interventions may be most effective if tailored to the child's illness, with greater support potentially needed for parents who have a child with DEE and/or severe comorbidities.

慢性病患儿的父母会比普通人经历更多的痛苦,但人们对不同疾病群体之间的差异却知之甚少。这项横断面调查研究旨在比较五种慢性病患儿家长的心理压力和幸福感。来自澳大利亚一家儿科医院的家长们填写了凯斯勒心理压力量表和七个专门设计的有关其幸福感的项目。使用双变量皮尔逊相关性和线性混合效应模型分析了来自 106 位家长(癌症 48 位、囊性纤维化 27 位、肾病 12 位、胃肠道疾病/紊乱 9 位、发育性和癫痫性脑病 10 位)的数据。各组家长的痛苦评分存在差异(F(4,80) = 2.50, p = .049),DEE 组的痛苦评分高于 CF 组(平均差异 = 6.76, 95% CI [0.11, 13.42])。困扰得分与家长对子女健康和自身幸福的看法呈中度相关。家长自我报告的应对孩子病情/治疗的情况存在差异(F(4,81) = 3.24, p = .016),DEE 组的应对情况比 CF 组差(平均差异 = -25.32,95% CI [-46.52, 4.11])。在所有组别中,家长都表示他们的需求未得到满足,尤其是对社会心理支持和实际/经济援助的需求。如果根据儿童的病情采取相应的支持干预措施,可能会取得最佳效果,而对于患有 DEE 和/或严重合并症的儿童,家长可能需要更多的支持。
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引用次数: 0
Adolescent and caregiver perceptions of addressing mental health in inflammatory bowel disease. 青少年和照顾者对解决炎症性肠病患者心理健康问题的看法。
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-03-26 DOI: 10.1177/13674935241241350
Catalina Berenblum Tobi, Maihan Vu, Maria E Díaz-González de Ferris, Sherritta Semerzier, Michael D Kappelman, Neal A deJong

Adolescents with inflammatory bowel disease (IBD) are at an increased risk of anxiety and depression compared to peers, but availability of mental health services in IBD clinics does not meet patients' needs, and use of primary care services for mental health screening and care is low. This study provides qualitative data regarding adolescent and caregiver perspectives on addressing mental health in IBD. Interviews were conducted with adolescents with IBD and caregivers of adolescents with IBD. Interview transcripts were coded and analyzed for prominent themes. Thirteen adolescents and fourteen caregivers were interviewed. Three primary themes emerged: mental health stigma makes discussing it more difficult, physician-adolescent trust makes conversations about mental health easier, and asking about mental health directly can help adolescents feel comfortable. Adolescents and caregivers highlighted the importance of considering each patient and their family individually when choosing how to discuss mental health. Fostering trust with adolescents with IBD is vital to addressing mental health. While encouraging standardized screening is important, the most patient-centered approach to mental health involves considering families individually to identify and address mental health challenges. Given the increased risk of anxiety and depression in pediatric patients with IBD, all providers encountering these patients should be equipped to discuss mental health non-judgmentally.

与同龄人相比,患有炎症性肠病(IBD)的青少年患焦虑症和抑郁症的风险更高,但 IBD 诊所提供的心理健康服务并不能满足患者的需求,而且利用初级保健服务进行心理健康筛查和护理的比例也很低。本研究提供了有关青少年和照护者对解决 IBD 患者心理健康问题看法的定性数据。研究人员对患有 IBD 的青少年和 IBD 青少年的照护者进行了访谈。我们对访谈记录进行了编码,并对突出主题进行了分析。共采访了 13 名青少年和 14 名照护者。访谈中出现了三个主要的主题:心理健康污名化使讨论心理健康问题变得更加困难;医生与青少年之间的信任使心理健康对话变得更加容易;直接询问心理健康问题能让青少年感觉舒适。青少年和护理人员强调,在选择如何讨论心理健康问题时,必须考虑到每位患者及其家庭的具体情况。与患有 IBD 的青少年建立信任对于解决心理健康问题至关重要。鼓励标准化筛查固然重要,但最以患者为中心的心理健康方法是单独考虑患者家庭,以识别和应对心理健康挑战。鉴于患有 IBD 的儿科患者罹患焦虑症和抑郁症的风险增加,所有遇到这些患者的医疗服务提供者都应具备不带偏见地讨论心理健康问题的能力。
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引用次数: 0
Consequences of the Coronavirus disease 2019 pandemic on child and adolescent mental, psychosocial, and physical health: A scoping review and interactive evidence map. 2019 年冠状病毒疾病大流行对儿童和青少年精神、社会心理和身体健康的影响:范围综述和互动证据图。
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-03-19 DOI: 10.1177/13674935241238794
Liza Bialy, Sarah A Elliott, Alison Melton, Samina Ali, Shannon D Scott, Lisa Knisley, Lisa Hartling

Effects of the Coronavirus disease 2019 (COVID-19) pandemic on children stem beyond immediate infectious and post-infectious risks. Our aim was to conduct a scoping review and produce an online Interactive Evidence Map (IEM) highlighting available literature around unintended effects of the pandemic on children's and adolescents' mental, psychosocial, and physical health. A search was run monthly in MEDLINE, PsycINFO, CENTRAL, and Cochrane COVID-19 Study Register from May 1st 2021 through April 30th 2022. All articles involving children and adolescents under 18 years of age relating to any unintended mental, psychosocial, and physical health consequences of the pandemic and resultant restrictions were included. Data were extracted and topics categorized, with corresponding data uploaded into EPPI-Reviewer and transferred to EPPI-Mapper for visualization. A total of 14,555 citations were screened and 826 (6%) articles included. Most articles reported on mental health outcomes, particularly anxiety (n = 309, 37%) and depression (n = 294, 36%). Psychosocial outcomes related to lockdowns such as loneliness (n = 120, 15%) and impact on adolescent relationships with others (n = 149, 18%) were also reported. Fewer articles examined physical consequences, but those that did mostly focused on child abuse (n = 73, 9%). Overall, currently mapped literature focuses on consequences related to mental health outcomes such as anxiety and depression.

2019 年冠状病毒病(COVID-19)大流行对儿童的影响不仅仅是直接的感染和感染后风险。我们的目的是进行一次范围界定审查,并制作一份在线互动证据图(IEM),重点介绍有关大流行对儿童和青少年心理、社会心理和身体健康的意外影响的现有文献。从 2021 年 5 月 1 日至 2022 年 4 月 30 日,每月在 MEDLINE、PsycINFO、CENTRAL 和 Cochrane COVID-19 研究注册中心进行一次检索。所有涉及 18 岁以下儿童和青少年的文章均被纳入其中,这些文章涉及大流行病和由此产生的限制所造成的任何意外的精神、社会心理和身体健康后果。对数据进行提取和主题分类,并将相应数据上传到 EPPI-Reviewer 和 EPPI-Mapper 以实现可视化。共筛选了 14,555 篇引文,收录了 826 篇(6%)文章。大多数文章报告了心理健康结果,尤其是焦虑(n = 309,37%)和抑郁(n = 294,36%)。还报道了与禁闭有关的社会心理后果,如孤独感(n = 120,15%)和对青少年与他人关系的影响(n = 149,18%)。研究身体后果的文章较少,但这些文章大多关注虐待儿童问题(n = 73,9%)。总体而言,目前所映射的文献主要集中在与焦虑和抑郁等心理健康后果相关的方面。
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引用次数: 0
Perspectives of healthcare workers on integrated management of childhood illness in Pakistan: A phenomenological approach. 巴基斯坦医护人员对儿童疾病综合管理的看法:现象学方法。
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-03-07 DOI: 10.1177/13674935241238474
Saidul Abrar, Asad Hafeez, Muhammad Naseem Khan, Muhammad Imran Marwat

In 2019, an estimated 5.2 million deaths were reported among children less than 5 years of age. At primary healthcare level, healthcare workers (HCWs) mostly rely on history and clinical findings and less on inadequate diagnostic facilities. To enhance case management skills of HCWs, World Health Organization devised an integrated management of childhood illnesses (IMCI) strategy in 1995, modified to distance learning IMCI in 2014. A qualitative phenomenological study was conducted to explore perceptions of HCWs about standard and distance IMCI. Four focus group discussions were conducted with purposively selected 26 HCWs (IMCI trained) from 26 basic health units of Abbottabad district in Pakistan. Gadamer's philosophical hermeneutics were adopted during the inductive thematic analysis. Five themes that emerged are inexorable health seeking behaviors, IMCI being a comprehensive algorithm for consultation, a tedious protocol, scaling up protocol to specialists and private practitioners, and administrative insufficiency by the department of health. Improvement in case management skills of HCWs was reported as a result of IMCI trainings. It needs administrative support, regulations to control poly-pharmacy and provision of drugs without prescription, and a curb on political and bureaucratic interference.

据报告,2019 年估计有 520 万 5 岁以下儿童死亡。在初级医疗保健层面,医护人员(HCWs)主要依靠病史和临床发现,较少依靠不完善的诊断设施。为提高医护人员的病例管理技能,世界卫生组织于 1995 年制定了儿童疾病综合管理(IMCI)战略,并于 2014 年将其修改为远程学习儿童疾病综合管理。我们开展了一项定性现象学研究,以探讨保健工作者对标准和远程儿童疾病综合管理的看法。研究人员从巴基斯坦阿伯塔巴德地区的 26 个基层医疗单位有目的地挑选了 26 名医护人员(接受过儿童疾病综合管理培训)进行了四次焦点小组讨论。在归纳式主题分析过程中采用了伽达默尔的哲学诠释学。出现的五个主题是:不可避免的求医行为、儿童疾病综合管理是一种全面的咨询算法、乏味的方案、将方案推广到专科医生和私人执业医师以及卫生部门的行政管理不足。据报告,儿童疾病综合管理培训提高了医护人员的病例管理技能。儿童疾病综合管理需要行政支持、控制多方用药和无处方提供药物的法规,以及遏制政治和官僚干预。
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引用次数: 0
Don't throw the baby out with the bathwater: Preserving children's undergraduate nurse education in the move towards genericism in nursing. 不要把孩子和洗澡水一起倒掉:在护理学走向通用化的过程中保护儿童本科护士教育。
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-03-01 Epub Date: 2024-01-30 DOI: 10.1177/13674935241231112
Michael J Tatterton, Matthew C Carey, Robin Hyde, Catherine Hewitt
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引用次数: 0
Experiences and expectations of parents when young people with congenital heart disease transfer from pediatric to adult care: A qualitative systematic review. 患有先天性心脏病的年轻人从儿科转入成人护理时,父母的经历和期望:定性系统回顾。
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-02-08 DOI: 10.1177/13674935241231024
Birgitte Lykkeberg, Marianne Wetendorff Noergaard, Merete Bjerrum

Parents encounter challenges when their child with congenital heart disease is transferred from pediatric to adult care. Until recently these parents' experiences and expectations of their child's transfer have received less attention. This systematic review aims to identify and synthesize qualitative evidence on parental experiences and expectations about their child's transfer from pediatric to adult care using a meta-aggregation approach. Six studies were included with 39 findings being aggregated into seven categories. Three syntheses were formed: Information is a prerequisite for supporting young people's transfer. The transition process should be well-prepared, individualized, and based on young people's maturity. Changing parental roles causes ambivalent feelings requiring support in the transfer process. Parents regard transfer from pediatric to adult care as a natural developmental step. However, some parents are anxious and worried while others found the transfer as feasible as other transitions in their child's life. Involving parents in the transition process enables them to facilitate their child's transfer. Parents worry their child is too young to take responsibility for their health. Parental roles from being a full caregiver to becoming a supportive person cause ambivalent feelings. These findings align with research on parents' experiences of young people with long-term conditions.

先天性心脏病患儿从儿科转入成人护理时,家长们会遇到各种挑战。直到最近,这些家长对孩子转院的经历和期望还很少受到关注。本系统性综述旨在采用元聚合法,识别并综合有关家长对孩子从儿科转入成人护理的经历和期望的定性证据。六项研究被纳入其中,39 项研究结果被归纳为七个类别。形成了三份综合报告:信息是支持青少年转院的先决条件。过渡过程应准备充分、因人而异,并以年轻人的成熟度为基础。父母角色的转变会产生矛盾情绪,需要在转学过程中提供支持。父母认为从儿科转到成人护理是一个自然的发展步骤。然而,有些家长会感到焦虑和担忧,而有些家长则认为转院与孩子生活中的其他过渡一样可行。让家长参与转院过程能让他们为孩子的转院提供便利。家长担心他们的孩子太小,不能为自己的健康负责。父母的角色从完全的照顾者转变为支持者,这让他们感到矛盾。这些发现与有关父母对患有长期疾病的年轻人的经历的研究结果一致。
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引用次数: 0
Characterizing research partnerships in child health research: A scoping review. 儿童健康研究中研究伙伴关系的特点:范围审查。
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-02-06 DOI: 10.1177/13674935241231346
Leah K Crockett, Shannon D Scott, S Michelle Driedger, Masood Khan, Devashree Prabhu, Nicole Askin, Dawn Steliga, Olivia Tefft, Ann Jansson, Sarah Turner, Kathryn M Sibley

Research partnerships between researchers and knowledge users (KUs) in child health are understudied. This study examined the scope of KU engagement reported in published child health research, inclusive of health research partnership approaches and KU groups. Search strategies were developed by a health research librarian. Studies had to be in English, published since 2007, and were not excluded based on design. A two-step, multiple-person hybrid screening approach was used for study inclusion. Data on study and engagement characteristics, barriers and facilitators, and effects were extracted by one reviewer, with 10% verified by a second reviewer. Three hundred fifteen articles were included, with 243 (77.1%) published between 2019 and 2021. Community-based participatory research was the most common approach used (n = 122, 38.3%). Most studies (n = 235, 74.6%) engaged multiple KU groups (range 1-11), with children/youth, healthcare professionals, and parents/families being most frequently engaged. Reporting of barriers and facilitators and effects were variable, reported in 170 (53.8%) and 197 (62.5%) studies, respectively. Publications have increased exponentially over time. There is ongoing need to optimize evaluation and reporting consistency to facilitate growth in the field. Additional studies are needed to further our understanding of research partnerships in child health.

对儿童健康领域研究人员与知识使用者(KUs)之间的研究合作关系研究不足。本研究考察了已发表的儿童健康研究中报告的知识用户参与范围,包括健康研究合作方式和知识用户群体。搜索策略由一名健康研究图书管理员制定。研究必须是英文的,自 2007 年以来发表,且不排除设计方面的原因。在纳入研究时采用了两步、多人混合筛选法。研究和参与特征、障碍和促进因素以及效果等方面的数据由一名审稿人提取,10% 的数据由第二名审稿人核实。共纳入 315 篇文章,其中 243 篇(77.1%)发表于 2019 年至 2021 年之间。基于社区的参与式研究是最常用的方法(n = 122,38.3%)。大多数研究(n = 235,占 74.6%)涉及多个 KU 群体(范围在 1-11 之间),其中儿童/青少年、医疗保健专业人员和父母/家庭参与最多。关于障碍、促进因素和效果的报告各不相同,分别有 170 项(53.8%)和 197 项(62.5%)研究进行了报告。随着时间的推移,发表的文章成倍增加。目前需要优化评估和报告的一致性,以促进该领域的发展。我们需要开展更多的研究,以进一步了解儿童健康研究伙伴关系。
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引用次数: 0
Evaluation of paediatric palliative care ambulance plans: A retrospective study. 评估儿科姑息关怀救护车计划:回顾性研究。
IF 1.9 4区 医学 Q3 NURSING Pub Date : 2024-01-23 DOI: 10.1177/13674935231225714
Julianna Wan, Angela Vaughan, Elizabeth Shepherd, Sandra Coombs, Susan Trethewie, Tiina Jaaniste

Paediatric Palliative Care Ambulance Plans ('Plans') are used by New South Wales Ambulance (Australia) to support the care needs of children with life-limiting conditions. We aimed to describe the population of children with Plans and provide details regarding Plan completion, paramedic responses during ambulance callouts, and correspondence between Plan recommendations and paramedic responses. Plans lodged in January 2017-December 2019 were retrospectively coded for demographic information, completeness and care preferences. Associated paramedic callout notes (January 2018-December 2019) were coded for paramedic responses. Of 141 Plans retrieved, 38 (41.3% of those providing suggested medications) suggested medication use outside general paramedic scope of practice. Of 199 associated ambulance callouts, reasons for callout included symptom management, planned transfer, death notification and end-of-life care. Over two-thirds of callouts (n = 135, 67.8%) occurred after-hours. Most paramedic callouts (n = 124, 62.3%), excluding planned transfers, resulted in children being transported. Paramedic interventions corresponded with interventions suggested in Plans. However, only 24 (25.3%) of paramedic callout notes documented Plans being sighted. This study provided detailed information about children with palliative care needs for whom Plans were being used, the nature of these Plans and associated paramedic callouts. However, it is not known how paramedics were influenced by Plans.

儿科姑息治疗救护车计划("计划")是澳大利亚新南威尔士州救护车为满足患有局限性疾病的儿童的护理需求而制定的。我们旨在描述拥有计划的儿童群体,并提供有关计划完成情况、救护车出诊期间护理人员的响应以及计划建议与护理人员响应之间的对应关系的详细信息。我们对2017年1月至2019年12月提交的计划进行了回顾性编码,以了解人口统计学信息、计划的完整性和护理偏好。对相关的辅助医务人员出诊记录(2018 年 1 月至 2019 年 12 月)进行了编码,以了解辅助医务人员的反应。在检索到的 141 份计划中,有 38 份(占提供建议用药者的 41.3%)建议在一般辅助医务人员执业范围之外用药。在 199 次相关的救护车出诊中,出诊原因包括症状处理、计划转院、死亡通知和临终关怀。超过三分之二的呼叫(n = 135,67.8%)发生在下班后。除计划转院外,大多数辅助医务人员出诊(124 人,占 62.3%)的结果都是将儿童送往医院。辅助医务人员的干预措施与计划中建议的干预措施一致。然而,只有 24 份(25.3%)辅助医务人员出诊记录记录了计划。这项研究提供了有关有姑息关怀需求的儿童的详细信息,包括计划的使用对象、这些计划的性质以及相关的辅助医务人员出诊情况。然而,目前尚不清楚护理人员是如何受到 "计划 "的影响的。
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引用次数: 0
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Journal of Child Health Care
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