{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T02:46:34Z","timestamp":1791859594300,"version":"4.3.4"},"reference-count":59,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T00:00:00Z","timestamp":1660608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Central Norway Regional Health Authority","award":["90327500\/2018"],"award-info":[{"award-number":["90327500\/2018"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Nurses\u2019 well-being has been increasingly recognised due to the ongoing pandemic. However, no validation scales measuring nurses\u2019 well-being currently exist. Thus, we aimed to validate the WHO-5 Well-Being Index (WHO-5) in a sample of nurses. A cross-sectional multinational study was conducted, and a total of 678 nurses who worked during the COVID-19 pandemic in Spain (36.9%), Chile (40.0%) and Norway (23.1%) participated in this study. The nurses completed the WHO-5, the Patient Health Questionnaire-2 (PHQ-2), the Generalized Anxiety Disorder-2 (GAD-2) and three questions about the quality of life (QoL). The WHO-5 demonstrated good reliability and validity in the three countries. Cronbach\u2019s alphas ranged from 0.81 to 0.90. High correlations were found between the WHO-5 and the psychological well-being dimension of QoL, and negative correlations between the WHO-5 and PHQ-2. The unidimensional scale structure was confirmed in all the countries, explaining more than 68% of the variance. The item response theory likelihood ratio model did not show discernible differences in the WHO-5 across the countries. To conclude, the WHO-5 is a psychometrically sound scale for measuring nurses\u2019 well-being during a pandemic. The scale showed strong construct validity for cross-cultural comparisons; however, more research is required with larger sample sizes.<\/jats:p>","DOI":"10.3390\/ijerph191610106","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T23:44:25Z","timestamp":1660693465000},"page":"10106","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Psychometric Properties of the WHO-5 Well-Being Index among Nurses during the COVID-19 Pandemic: A Cross-Sectional Study in Three Countries"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7342-9049","authenticated-orcid":false,"given":"Mariela","family":"Lara-Cabrera","sequence":"first","affiliation":[{"name":"Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7091 Trondheim, Norway"},{"name":"Nidelv Community Mental Health Centre, Division of Psychiatry, St Olavs Hospital Trondheim University Hospital, 7006 Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7790-8557","authenticated-orcid":false,"given":"Mois\u00e9s","family":"Betancort","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, Psychobiology and Methodology, Universidad de La Laguna, 38200 San Crist\u00f3bal de La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9953-9054","authenticated-orcid":false,"given":"Amparo","family":"Mu\u00f1oz-Rubilar","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Universidad Central de Chile, Santiago 8370178, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7492-5063","authenticated-orcid":false,"given":"Natalia","family":"Rodr\u00edguez-Novo","sequence":"additional","affiliation":[{"name":"Departament of Nursing, Universidad de La Laguna, 38200 San Crist\u00f3bal de La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ottar","family":"Bjerkeset","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Health Sciences, Nord University, Levanger Campus, 8026 Levanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5742-905X","authenticated-orcid":false,"given":"Carlos","family":"De las Cuevas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna, 38200 San Crist\u00f3bal de La Laguna, Spain"},{"name":"Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, 38200 San Crist\u00f3bal de La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jpsychores.2009.07.002","article-title":"Measures of self-perceived well-being","volume":"69","author":"McDowell","year":"2010","journal-title":"J. Psychosom. Res."},{"key":"ref_2","first-page":"30","article-title":"The Well-Being Index WHO-5: Hedonistic foundation and practical limitations","volume":"30","author":"Kusier","year":"2019","journal-title":"Med. Humanit."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e010641","DOI":"10.1136\/bmjopen-2015-010641","article-title":"Review of 99 self-report measures for assessing well-being in adults: Exploring dimensions of well-being and developments over time","volume":"6","author":"Linton","year":"2016","journal-title":"BMJ Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1093\/eurpub\/cku193","article-title":"Well-being measurement and the WHO health policy Health 2010: Systematic review of measurement scales","volume":"25","author":"Lindert","year":"2015","journal-title":"Eur. J. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"De Kock, J.H., Latham, H.A., Leslie, S.J., Grindle, M., Munoz, S.A., Ellis, L., Polson, R., and O\u2019Malley, C.M. (2021). A rapid review of the impact of COVID-19 on the mental health of healthcare workers: Implications for supporting psychological well-being. BMC Public Health, 21.","DOI":"10.1186\/s12889-020-10070-3"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2426","DOI":"10.1111\/jan.14445","article-title":"Psychometric properties of the Five-item World Health Organization Well-being Index used in mental health services: Protocol for a systematic review","volume":"76","author":"Bjorkly","year":"2020","journal-title":"J. Adv. Nurs."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000376585","article-title":"The WHO-5 Well-Being Index: A systematic review of the literature","volume":"84","author":"Topp","year":"2015","journal-title":"Psychother. Psychosom."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Blasco-Belled, A., Tejada-Gallardo, C., Fatsini-Prats, M., and Alsinet, C. (2022). Mental health among the general population and healthcare workers during the COVID-19 pandemic: A meta-analysis of well-being and psychological distress prevalence. Curr. Psychol., 1\u201312.","DOI":"10.1007\/s12144-022-02913-6"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Hall, L.H., Johnson, J., Watt, I., Tsipa, A., and O\u2019Connor, D.B. (2016). Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0159015"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"103637","DOI":"10.1016\/j.ijnurstu.2020.103637","article-title":"Implications for COVID-19: A systematic review of nurses\u2019 experiences of working in acute care hospital settings during a respiratory pandemic","volume":"111","author":"Fernandez","year":"2020","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"104272","DOI":"10.1016\/j.ijnurstu.2022.104272","article-title":"Impact of the COVID-19 pandemic on the mental health of hospital staff: An umbrella review of 44 meta-analyses","volume":"131","author":"Dragioti","year":"2022","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"103809","DOI":"10.1016\/j.ijnurstu.2020.103809","article-title":"Prevalence and associated factors of depression and anxiety among nurses during the outbreak of COVID-19 in China: A cross-sectional study","volume":"114","author":"Zheng","year":"2021","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Slusarska, B., Nowicki, G.J., Niedorys-Karczmarczyk, B., and Chrzan-Rodak, A. (2022). Prevalence of Depression and Anxiety in Nurses during the First Eleven Months of the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031154"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Huerta-Gonzalez, S., Selva-Medrano, D., Lopez-Espuela, F., Caro-Alonso, P.A., Novo, A., and Rodriguez-Martin, B. (2021). The Psychological Impact of COVID-19 on Front Line Nurses: A Synthesis of Qualitative Evidence. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182412975"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Lara-Cabrera, M.L., Betancort, M., Mu\u00f1oz-Rubilar, C.A., Rodr\u00edguez Novo, N., and De las Cuevas, C. (2021). The Mediating Role of Resilience in the Relationship between Perceived Stress and Mental Health. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18189762"},{"key":"ref_16","unstructured":"World Health Organization (1998). Use of well-being measures in primary health care-the DepCare project health for all. Target, 12, E60246."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bech, P. (2012). Clinical Psychometrics, John Wiley & Sons.","DOI":"10.1002\/9781118511800"},{"key":"ref_18","unstructured":"World Health Organization (1998). Wellbeing Measures in Primary Health care\/The DepCare Project: Report on a WHO Meeting: Stockholm, Sweden, 12\u201313 February 1998, World Health Organization Regional Office for Europe."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jad.2009.06.005","article-title":"Monitoring treatment response and outcomes using the World Health Organization\u2019s Wellbeing Index in psychiatric care","volume":"122","author":"Newnham","year":"2010","journal-title":"J. Affect. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jad.2022.05.111","article-title":"Cross-cultural validity of the WHO-5 Well-Being Index and Euthymia Scale: A clinimetric analysis","volume":"311","author":"Carrozzino","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"149","DOI":"10.3389\/fpubh.2018.00149","article-title":"Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer","volume":"6","author":"Boateng","year":"2018","journal-title":"Front. Public Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"60","DOI":"10.5502\/ijw.v5i4.437","article-title":"Positive cross-cultural psychology: Exploring similarity and difference in constructions and experiences of wellbeing","volume":"5","author":"Lomas","year":"2015","journal-title":"Int. J. Wellbeing"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100020","DOI":"10.1016\/j.jadr.2020.100020","article-title":"The WHO-5 well-being index\u2013validation based on item response theory and the analysis of measurement invariance across 35 countries","volume":"1","author":"Sischka","year":"2020","journal-title":"J. Affect. Disord. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1177\/0011000016633507","article-title":"Measuring Well-Being:A Review of Instruments","volume":"44","author":"Cooke","year":"2016","journal-title":"Couns. Psychol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1177\/0022022117749042","article-title":"On detecting systematic measurement error in cross-cultural research: A review and critical reflection on equivalence and invariance tests","volume":"49","author":"Boer","year":"2018","journal-title":"J. Cross-Cult. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.invent.2014.10.002","article-title":"Workplace mental health promotion online to enhance well-being of nurses and allied health professionals: A cluster-randomized controlled trial","volume":"1","author":"Bolier","year":"2014","journal-title":"Internet Interv."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"638006","DOI":"10.3389\/fpsyg.2021.638006","article-title":"Assessment of the Quality of Life in Parents of Children With ADHD: Validation of the Multicultural Quality of Life Index in Norwegian Pediatric Mental Health Settings","volume":"12","author":"Mundal","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e63","DOI":"10.1111\/dme.12040","article-title":"Psychometric and screening properties of the WHO-5 well-being index in adult outpatients with Type 1 or Type 2 diabetes mellitus","volume":"30","author":"Hajos","year":"2013","journal-title":"Diabet. Med."},{"key":"ref_29","first-page":"234","article-title":"The Four-item Patient Health Questionnaire for Anxiety and Depression: A Validation Study in Infertile Patients","volume":"14","author":"Ghaheri","year":"2020","journal-title":"Int. J. Fertil. Steril."},{"key":"ref_30","first-page":"1171","article-title":"COSMIN methodology for systematic reviews of patient-reported outcome measures (PROMs)","volume":"27","author":"Mokkink","year":"2018","journal-title":"User Man."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"113268","DOI":"10.1016\/j.psychres.2020.113268","article-title":"Patient-reported well-being: Psychometric properties of the world health organization well-being index in specialised community mental health settings","volume":"291","author":"Mundal","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1093\/fampra\/cmv011","article-title":"Diagnosis of depressed young people--Criterion validity of WHO-5 and HSCL-6 in Denmark and Norway","volume":"32","author":"Christensen","year":"2015","journal-title":"Fam. Pract."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1111\/j.1365-2753.2010.01609.x","article-title":"The Multicultural Quality of Life Index: Presentation and validation","volume":"17","author":"Mezzich","year":"2011","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"317","DOI":"10.7326\/0003-4819-146-5-200703060-00004","article-title":"Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection","volume":"146","author":"Kroenke","year":"2007","journal-title":"Ann. Intern Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1097\/01.MLR.0000093487.78664.3C","article-title":"The Patient Health Questionnaire-2: Validity of a two-item depression screener","volume":"41","author":"Kroenke","year":"2003","journal-title":"Med. Care"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1037\/cou0000182","article-title":"Development of an abbreviated Career Indecision Profile-65 using item response theory: The CIP-Short","volume":"64","author":"Xu","year":"2017","journal-title":"J. Couns. Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/109442810031002","article-title":"A Review and Synthesis of the Measurement Invariance Literature: Suggestions, Practices, and Recommendations for Organizational Research","volume":"3","author":"Vandenberg","year":"2000","journal-title":"Organ. Res. Methods"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1027\/1015-5759\/a000487","article-title":"Still comparing apples with oranges? Some thoughts on the principles and practices of measurement invariance testing","volume":"34","author":"Greiff","year":"2018","journal-title":"Eur. J. Psychol. Assess."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v039.i08","article-title":"lordif: An R Package for Detecting Differential Item Functioning Using Iterative Hybrid Ordinal Logistic Regression\/Item Response Theory and Monte Carlo Simulations","volume":"39","author":"Choi","year":"2011","journal-title":"J. Stat. Softw."},{"key":"ref_40","first-page":"356","article-title":"Evaluaci\u00f3n progresiva de la invarianza factorial entre las versiones original y adaptada de una escala de autoconcepto","volume":"17","author":"Elosua","year":"2005","journal-title":"Psicothema"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/BF02296192","article-title":"A scaled difference chi-square test statistic for moment structure analysis","volume":"66","author":"Satorra","year":"2001","journal-title":"Psychometrika"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1017\/gmh.2021.26","article-title":"Validation of the Bangla WHO-5 Well-being Index","volume":"8","author":"Faruk","year":"2021","journal-title":"Glob. Ment. Health (Camb)"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2044635","DOI":"10.1080\/10872981.2022.2044635","article-title":"Validation of the World Health Organization Well-Being Index (WHO-5) among medical educators in Hong Kong: A confirmatory factor analysis","volume":"27","author":"Chan","year":"2022","journal-title":"Med. Educ. Online"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1186\/s12955-018-1001-0","article-title":"Test-retest reliability and measurement error of the Danish WHO-5 Well-being Index in outpatients with epilepsy","volume":"16","author":"Schougaard","year":"2018","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s41256-018-0081-z","article-title":"Validation of a Swahili version of the World Health Organization 5-item well-being index among adults living with HIV and epilepsy in rural coastal Kenya","volume":"3","author":"Chongwo","year":"2018","journal-title":"Glob. Health Res. Policy"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"872436","DOI":"10.3389\/fpubh.2022.872436","article-title":"Validity and Psychometric Evaluation of the Chinese Version of the 5-Item WHO Well-Being Index","volume":"10","author":"Fung","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1002\/nop2.1207","article-title":"Psychological impact of the COVID-19 pandemic on nursing students in the first wave: A cross-sectional survey","volume":"9","author":"Bande","year":"2022","journal-title":"Nurs. Open"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1186\/s12955-020-01532-8","article-title":"Assessing mental well-being in a Sinhala speaking Sri Lankan population: Validation of the WHO-5 well-being index","volume":"18","author":"Perera","year":"2020","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_49","first-page":"2058","article-title":"The WHO-5 Well-Being Index: A Validation Study in People with Infertility","volume":"48","author":"Maroufizadeh","year":"2019","journal-title":"Iran. J. Public Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"107970","DOI":"10.1016\/j.diabres.2019.107970","article-title":"Validation of the Polish version of WHO-5 as a screening instrument for depression in adults with diabetes","volume":"159","author":"Cichon","year":"2019","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Kwon, M., and Kim, H. (2020). Psychological Well-Being of Female-Headed Households Based on Age Stratification: A Nationwide Cross-Sectional Study in South Korea. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17186445"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Suhaimi, A.F., Makki, S.M., Tan, K.A., Silim, U.A., and Ibrahim, N. (2022). Translation and Validation of the Malay Version of the WHO-5 Well-Being Index: Reliability and Validity Evidence from a Sample of Type 2 Diabetes Mellitus Patients. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19074415"},{"key":"ref_53","first-page":"1007","article-title":"Statistical Power Analysis For The Behavioral Sciences (rev ed.). Hillsdale, NJ: Erlbaum, 1988","volume":"67","author":"Cohen","year":"1988","journal-title":"Percept. Mot. Ski."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s11205-020-02441-5","article-title":"Mental Well-being Among Workers: A Cross-national Analysis of Job Insecurity Impact on the Workforce","volume":"152","author":"Russo","year":"2020","journal-title":"Soc. Indic. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"100913","DOI":"10.1016\/j.ssmph.2021.100913","article-title":"Health-related quality of life and mental well-being of healthy and diseased persons in 8 countries: Does stringency of government response against early COVID-19 matter?","volume":"15","author":"Long","year":"2021","journal-title":"SSM Popul. Health"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1177\/09697330211041746","article-title":"The duty to care and nurses\u2019 well-being during a pandemic","volume":"29","author":"Carrillos","year":"2022","journal-title":"Nurs. Ethics"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Hoang, T.D., Colebunders, R., Fodjo, J.N.S., Nguyen, N.P.T., Tran, T.D., and Vo, T.V. (2021). Well-Being of Healthcare Workers and the General Public during the COVID-19 Pandemic in Vietnam: An Online Survey. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094737"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"104002","DOI":"10.1016\/j.ijnurstu.2021.104002","article-title":"Global prevalence of mental health problems among healthcare workers during the Covid-19 pandemic: A systematic review and meta-analysis","volume":"121","author":"Saragih","year":"2021","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"152152","DOI":"10.1016\/j.comppsych.2019.152152","article-title":"Stigma towards depression in a community-based sample in China","volume":"97","author":"Yang","year":"2020","journal-title":"Compr. Psychiatry"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/16\/10106\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:09:17Z","timestamp":1760141357000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/16\/10106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,16]]},"references-count":59,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["ijerph191610106"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191610106","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,16]]}}}