{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:07:59Z","timestamp":1789664879105,"version":"4.0.1"},"reference-count":60,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T00:00:00Z","timestamp":1704672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nursing Reports"],"abstract":"<jats:p>Post-traumatic stress disorder symptoms related to work in pediatric departments aremajor public health problems, as they directly affect health organizations, healthcare workers, and, due to the poor quality of care, the patients as well. The post-traumatic symptoms that a healthcare worker may experience are related to intrusion, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity. The aim of the present investigation was to identify risk factors that contribute to the development of PTSD in pediatric healthcare workers, in order to implement necessary workplace measures. A sample of four hundred and forty-five pediatric workers at seven Greek public hospitals consented to participate in the survey. Socio-demographic data and a post-traumatic checklist (5th edition) were used to diagnose post-traumatic stress disorder. According to the results, risk factors for the development of post-traumatic symptoms include medical or nursing errors, threats to a child\u2019s life, and incidents of workplace bullying. More specifically, 25.2% of the participants had a provisional PTSD diagnosis, 72.8%of the sample experienced an incident involving a medical or nursing error in their workplace related to the treatment or care of a child, 56% experienced an incident involving a child\u2019s death or a threat to a child\u2019s life due to a serious illness or injury, and 55.5% experienced an incident of workplace bullying. In addition, it was found that having a university-level education, master\u2019s, or PhD, working in a circular shift, being assigned to a department by management rather than the worker, and dissatisfaction with salary were associated with post-traumatic stress disorder. The high rates of PTSD symptoms among participants highlight the need for prevention and management measures to protect and support the mental health of workers in pediatric departments. We propose frequent evaluations of the mental health of employees, more time for rest, incentives for professional development, utilization of their specializations and specialties, support from mental health specialists when symptoms are diagnosed, and the option for employees to change departments if they wish or if they show symptoms of mental trauma.<\/jats:p>","DOI":"10.3390\/nursrep14010010","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T04:38:51Z","timestamp":1704775131000},"page":"115-127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Post-Traumatic Stress Disorder Symptoms among Pediatric Healthcare Workers"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5926-6052","authenticated-orcid":false,"given":"Nikolaos","family":"Rigas","sequence":"first","affiliation":[{"name":"Department of Midwifery, University of West Attica, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zacharias","family":"Kyritsis","sequence":"additional","affiliation":[{"name":"Department of Mathematics, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4871-999X","authenticated-orcid":false,"given":"Maria","family":"Dagla","sequence":"additional","affiliation":[{"name":"Department of Midwifery, University of West Attica, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Soldatou","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7458-7500","authenticated-orcid":false,"given":"Eirini","family":"Orovou","sequence":"additional","affiliation":[{"name":"Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Tzitiridou-Chatzopoulou","sequence":"additional","affiliation":[{"name":"Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8225-5434","authenticated-orcid":false,"given":"Panagiotis","family":"Eskitzis","sequence":"additional","affiliation":[{"name":"Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4494-3089","authenticated-orcid":false,"given":"Evangelia","family":"Antoniou","sequence":"additional","affiliation":[{"name":"Department of Midwifery, University of West Attica, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"263","DOI":"10.2147\/PRBM.S114870","article-title":"Workplace Violence in Different Settings and among Various Health Professionals in an Italian General Hospital: A Cross-Sectional Study","volume":"9","author":"Ferri","year":"2016","journal-title":"Psychol. Res. Behav. Manag."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.pedn.2011.04.024","article-title":"Symptoms of Post-Traumatic Stress Disorder among Pediatric Acute Care Nurses","volume":"27","author":"Czaja","year":"2012","journal-title":"J. Pediatr. Nurs."},{"key":"ref_3","unstructured":"(2022, August 03). PTSD: National Center for PTSD Home, Available online: https:\/\/www.ptsd.va.gov\/."},{"key":"ref_4","unstructured":"(2020, September 23). DSM-5 Criteria for PTSD. BrainLine. Available online: https:\/\/www.brainline.org\/article\/dsm-5-criteria-ptsd."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1046\/j.1365-2648.2003.02506.x","article-title":"Nurses\u2019 Perceptions of Critical Incidents","volume":"41","author":"Jeavons","year":"2003","journal-title":"J. Adv. Nurs."},{"key":"ref_6","unstructured":"(2023, August 09). Newsroom Feature: Health Worker Mental Health|NIOSH|CDC, Available online: https:\/\/www.cdc.gov\/niosh\/newsroom\/feature\/health-worker-mental-health.html."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e12767","DOI":"10.1111\/ijn.12767","article-title":"Secondary Traumatic Stress among Emergency Nurses: Prevalence, Predictors, and Consequences","volume":"26","author":"Ratrout","year":"2020","journal-title":"Int. J. Nurs. Pract."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s00406-006-0654-6","article-title":"Post-Traumatic Stress Disorder: The Role of Trauma, Pre-Existing Psychiatric Disorders, and Gender","volume":"256","author":"Hapke","year":"2006","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_9","unstructured":"CWS (2023, August 09). The Relationship between Secondary Trauma and Distress. Champions of Wellness. Available online: https:\/\/www.championsofwellness.com\/blog-the-relationship-between-secondary-trauma-and-distress\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1002\/da.20631","article-title":"The Prevalence and Impact of Post Traumatic Stress Disorder and Burnout Syndrome in Nurses","volume":"26","author":"Mealer","year":"2009","journal-title":"Depress. Anxiety"},{"key":"ref_11","unstructured":"NIHCM (2023, August 09). Physician Burnout & Moral. Injury: The Hidden Health Care Crisis. Available online: https:\/\/nihcm.org\/publications\/physician-burnout-suicide-the-hidden-health-care-crisis."},{"key":"ref_12","unstructured":"(2023, August 29). The Mental Health of Healthcare Workers in COVID-19. Mental Health America. Available online: https:\/\/mhanational.org\/mental-health-healthcare-workers-covid-19."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"345","DOI":"10.3961\/jpmph.19.116","article-title":"Effect of Burnout on Post-Traumatic Stress Disorder Symptoms among Firefighters in Korea: Data from the Firefighter Research on Enhancement of Safety & Health (FRESH)","volume":"52","author":"Kim","year":"2019","journal-title":"J. Prev. Med. Public. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jad.2022.10.027","article-title":"Burnout and Post-Traumatic Stress Disorder Symptoms among Medical Staff Two Years after the COVID-19 Pandemic in Wuhan, China: Social Support and Resilience as Mediators","volume":"321","author":"Liu","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1037\/a0023319","article-title":"Antecedents and Consequences of Three Dimensions of Burnout in Psychotherapists: A Meta-Analysis","volume":"42","author":"Lee","year":"2011","journal-title":"Prof. Psychol. Res. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1146\/annurev.psych.52.1.397","article-title":"Job Burnout","volume":"52","author":"Maslach","year":"2001","journal-title":"Annu. Rev. Psychol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1016\/S0140-6736(02)08915-8","article-title":"The Causal Links between Stress and Burnout in a Longitudinal Study of UK Doctors","volume":"359","author":"McManus","year":"2002","journal-title":"Lancet"},{"key":"ref_18","first-page":"9","article-title":"Tackling Stress, Burnout, Suicide and Preventing the \u201cGreat Resignation\u201d Phenomenon among Healthcare Workers (during and after the COVID-19 Pandemic) for Maintaining the Sustainability of Healthcare Systems and Reaching the 2030 Sustainable Development Goals","volume":"7","author":"Chirico","year":"2022","journal-title":"J. Health Soc. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e045127","DOI":"10.1136\/bmjopen-2020-045127","article-title":"Levels of Burn-out among Healthcare Workers during the COVID-19 Pandemic and Their Associated Factors: A Cross-Sectional Study in a Tertiary Hospital of a Highly Burdened Area of North-East Italy","volume":"11","author":"Lasalvia","year":"2021","journal-title":"BMJ Open"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1007\/s00420-021-01689-9","article-title":"Burnout and Posttraumatic Stress Symptoms in Police Officers Exposed to Traumatic Events: The Mediating Role of Ruminations","volume":"94","year":"2021","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_21","first-page":"97","article-title":"Secondary Traumatic Stress in Pediatric Nurses","volume":"43","author":"Kellogg","year":"2018","journal-title":"J. Pediatr. Nurs. Nurs. Care Child. Fam."},{"key":"ref_22","first-page":"5","article-title":"Recalling Stress and Trauma in the Workplace: A Qualitative Study of Pediatric Nurses","volume":"46","author":"Kleis","year":"2020","journal-title":"Pediatr. Nurs."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.pedn.2020.03.019","article-title":"The Role of Medical Specialization on Posttraumatic Symptoms in Pediatric Nurses","volume":"53","author":"Park","year":"2020","journal-title":"J. Pediatr. Nurs."},{"key":"ref_24","unstructured":"Allen, J. (1996). Pediatric Intensive Care Nurses: Post-Traumatic Stress Disorder-Like Symptoms. [Master\u2019s Thesis, Loma Linda University]."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e160","DOI":"10.1097\/PCC.0000000000001861","article-title":"Are Pediatric Critical Personnel Satisfied with Their Lives? Prediction of Satisfaction with Life from Burnout, Posttraumatic Stress, and Posttraumatic Growth, and Comparison with Noncritical Pediatric Staff","volume":"20","author":"Palacios","year":"2019","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.aucc.2018.02.003","article-title":"Burnout and Posttraumatic Stress in Paediatric Critical Care Personnel: Prediction from Resilience and Coping Styles","volume":"32","author":"Palacios","year":"2019","journal-title":"Aust. Crit. Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1136\/archdischild-2019-317439","article-title":"Psychological Impact of Working in Paediatric Intensive Care. A UK-Wide Prevalence Study","volume":"105","author":"Jones","year":"2020","journal-title":"Arch. Dis. Child."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"543","DOI":"10.2307\/255574","article-title":"A Causal Model of Turnover for Nurses","volume":"24","author":"Price","year":"1981","journal-title":"Acad. Manag. J."},{"key":"ref_29","unstructured":"(2020, March 06). PTSD Checklist for DSM-5 (PCL-5)-PTSD: National Center for PTSD, Available online: https:\/\/www.ptsd.va.gov\/professional\/assessment\/adult-sr\/ptsd-checklist.asp."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5, American Psychiatric Association. [5th ed].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Orovou, E., Theodoropoulou, I.M., and Antoniou, E. (2021). Psychometric Properties of the Post Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) in Greek Women after Cesarean Section. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0255689"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"606","DOI":"10.4103\/indianjpsychiatry.indianjpsychiatry_464_21","article-title":"Intensive Care Unit Stress and Burnout among Health-Care Workers: The Wake-up Call Is Blaring!","volume":"63","author":"Sasidharan","year":"2021","journal-title":"Indian. J. Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.pedn.2008.03.007","article-title":"The Experience of Secondary Traumatic Stress Upon Care Providers Working within a Children\u2019s Hospital","volume":"24","author":"Robins","year":"2009","journal-title":"J. Pediatr. Nurs."},{"key":"ref_34","first-page":"e11","article-title":"Compassion Fatigue in Pediatric Nurses","volume":"30","author":"Berger","year":"2015","journal-title":"J. Pediatr. Nurs. Nurs. Care Child. Fam."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.aaen.2003.11.003","article-title":"Violence towards Emergency Department Nurses by Patients","volume":"12","author":"Crilly","year":"2004","journal-title":"Accid. Emerg. Nurs."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"103","DOI":"10.2190\/OM.60.2.a","article-title":"Secondary Traumatization in Pediatric Healthcare Providers: Compassion Fatigue, Burnout, and Secondary Traumatic Stress","volume":"60","author":"Meadors","year":"2010","journal-title":"Omega"},{"key":"ref_37","first-page":"115","article-title":"Job Satisfaction, Burnout, and Stress among Pediatric Nurses in Various Specialty Units at an Acute Care Hospital","volume":"4","author":"Sekol","year":"2014","journal-title":"J. Nurs. Educ. Pract."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/NMC.0000000000000133","article-title":"Compassion Fatigue Among Pediatric Healthcare Providers","volume":"40","author":"Branch","year":"2015","journal-title":"MCN Am. J. Matern.\/Child. Nurs."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e267","DOI":"10.1097\/PCC.0000000000001179","article-title":"Coping with Staff Burnout and Work-Related Posttraumatic Stress in Intensive Care","volume":"18","author":"Colville","year":"2017","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1136\/bmj.320.7237.726","article-title":"Medical Error: The Second Victim: The Doctor Who Makes the Mistake Needs Help Too","volume":"320","author":"Wu","year":"2000","journal-title":"BMJ"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/j.jemermed.2017.12.001","article-title":"Suffering in Silence: Medical Error and Its Impact on Health Care Providers","volume":"54","author":"Robertson","year":"2018","journal-title":"J. Emerg. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1080\/01612840500184566","article-title":"Chronology of Medication Errors by Nurses: Accumulation of Stresses and PTSD Symptoms","volume":"26","author":"Rassin","year":"2005","journal-title":"Issues Ment. Health Nurs."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Bian, W., Cheng, J., Dong, Y., Xue, Y., Zhang, Q., Zheng, Q., Song, R., and Yang, H. (2023). Experience of Pediatric Nurses in Nursing Dying Children\u2014A Qualitative Study. BMC Nurs., 22.","DOI":"10.1186\/s12912-023-01274-0"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.21037\/apm-21-3225","article-title":"Grief in Critical Care Nurses after Pediatric Suffering and Death","volume":"11","author":"Groves","year":"2022","journal-title":"Ann. Palliat. Med."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Chenevert, M., Vignoli, M., Conway, P.M., and Balducci, C. (2022). Workplace Bullying and Post-Traumatic Stress Disorder Symptomology: The Influence of Role Conflict and the Moderating Effects of Neuroticism and Managerial Competencies. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191710646"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.avb.2016.06.004","article-title":"The Role of Work Stressors, Coping Strategies and Coping Resources in the Process of Workplace Bullying: A Systematic Review and Development of a Comprehensive Model","volume":"29","author":"Baillien","year":"2016","journal-title":"Aggress. Violent Behav."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Nadal, K.L. (2018). Microaggressions and Traumatic Stress: Theory, Research, and Clinical Treatment, American Psychological Association.","DOI":"10.1037\/0000073-000"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1111\/1467-9450.00307","article-title":"Relationships between Exposure to Bullying at Work and Psychological and Psychosomatic Health Complaints: The Role of State Negative Affectivity and Generalized Self\u2013Efficacy","volume":"43","author":"Einarsen","year":"2002","journal-title":"Scand. J. Psychol."},{"key":"ref_49","first-page":"171","article-title":"Compassion Fatigue and Burnout in Nurses Who Work with Children with Chronic Conditions and Their Families","volume":"18","author":"Maytum","year":"2004","journal-title":"J. Pediatr. Health Care"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1037\/apl0000904","article-title":"Does Educational Attainment Promote Job Satisfaction? The Bittersweet Trade-Offs between Job Resources, Demands, and Stress","volume":"107","author":"Solomon","year":"2022","journal-title":"J. Appl. Psychol."},{"key":"ref_51","unstructured":"SHRM Online Staff (2023, September 18). Survey: Salary Is Top. Cause of Dissatisfaction for U.S. Employees. SHRM. Available online: https:\/\/www.shrm.org\/resourcesandtools\/hr-topics\/compensation\/pages\/dissatisfaction.aspx."},{"key":"ref_52","unstructured":"(2023, September 18). Healthcare Workers with PTSD. Available online: https:\/\/nursesptsd.com."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2501","DOI":"10.1377\/hlthaff.2011.1377","article-title":"The Longer the Shifts for Hospital Nurses, the Higher the Levels of Burnout and Patient Dissatisfaction","volume":"31","author":"Stimpfel","year":"2012","journal-title":"Health Aff."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Roman, P., Perez-Cayuela, I., Gil-Hern\u00e1ndez, E., Rodriguez-Arrastia, M., Aparicio-Mota, A., Ropero-Padilla, C., and Rueda-Ruzafa, L. (2023). Influence of Shift Work on the Health of Nursing Professionals. J. Personal. Med., 13.","DOI":"10.3390\/jpm13040627"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/JTN.0000000000000055","article-title":"Burnout, Compassion Fatigue, Compassion Satisfaction, and Secondary Traumatic Stress in Trauma Nurses","volume":"21","author":"Hinderer","year":"2014","journal-title":"J. Trauma Nurs."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.amjmed.2021.02.006","article-title":"Burnout, Posttraumatic Stress Disorder, or Both\u2013Listen Carefully!","volume":"134","author":"Schuster","year":"2021","journal-title":"Am. J. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/1478-4491-8-16","article-title":"Burnout and Training Satisfaction of Medical Residents in Greece: Will the European Work Time Directive Make a Difference?","volume":"8","author":"Msaouel","year":"2010","journal-title":"Human. Resour. Health"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Skefales, A., Plakas, S., Fouka, G., Goni, M., Vassiliadou, M., and Bergiannaki, J.-D. (2014). Burnout and Its Association with Working Conditions among Greek Hospital Nurses in a Time of Financial Crisis. Open J. Nurs., 2014.","DOI":"10.4236\/ojn.2014.47058"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"ckad160.391","DOI":"10.1093\/eurpub\/ckad160.391","article-title":"Testing the Resilience of the Greek Health System Faced by a Human Resources in Health (HRH) Shock Scenario","volume":"33","author":"Kaitelidou","year":"2023","journal-title":"Eur. J. Public Health"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1440-172X.2008.00688.x","article-title":"Nursing Staff Shortage and In-Hospital Informal Care in an Oncology Hospital in Greece: The Nursing Staff\u2019s Perceptions","volume":"14","author":"Lavdaniti","year":"2008","journal-title":"Int. J. Nurs. Pract."}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/14\/1\/10\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:41:54Z","timestamp":1760103714000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/14\/1\/10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,8]]},"references-count":60,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["nursrep14010010"],"URL":"https:\/\/doi.org\/10.3390\/nursrep14010010","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,8]]}}}