{"id":"https://openalex.org/W3110326768","doi":"https://doi.org/10.1097/nnr.0000000000000487","title":"Nurse Sensemaking for Responding to Patient and Family Safety Concerns","display_name":"Nurse Sensemaking for Responding to Patient and Family Safety Concerns","publication_year":2020,"publication_date":"2020-12-02","ids":{"openalex":"https://openalex.org/W3110326768","doi":"https://doi.org/10.1097/nnr.0000000000000487","mag":"3110326768","pmid":"https://pubmed.ncbi.nlm.nih.gov/33630533"},"language":"en","primary_location":{"id":"doi:10.1097/nnr.0000000000000487","doi":"https://doi.org/10.1097/nnr.0000000000000487","is_oa":false,"landing_page_url":"https://doi.org/10.1097/nnr.0000000000000487","pdf_url":null,"source":{"id":"https://openalex.org/S57227388","display_name":"Nursing Research","issn_l":"0029-6562","issn":["0029-6562","1538-9847"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-3","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Nursing Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5067432528","display_name":"Patricia S. Groves","orcid":"https://orcid.org/0000-0002-2312-0676","observed_orcids":["https://orcid.org/0000-0002-2312-0676"]},"institutions":[{"id":"https://openalex.org/I126307644","display_name":"University of Iowa","ror":"https://ror.org/036jqmy94","country_code":"US","type":"education","lineage":["https://openalex.org/I126307644"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Patricia S. Groves","raw_affiliation_strings":["Corresponding author: Patricia S. Groves, PhD, RN, University of Iowa College of Nursing, 50 Newton Road, Iowa City, IA 52242-1121 (e-mail: [email\u00a0protected])","Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Corresponding author: Patricia S. Groves, PhD, RN, University of Iowa College of Nursing, 50 Newton Road, Iowa City, IA 52242-1121 (e-mail: [email\u00a0protected])","institution_ids":["https://openalex.org/I126307644"]},{"raw_affiliation_string":"Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5066608609","display_name":"Jacinda L. Bunch","orcid":"https://orcid.org/0000-0001-6139-3547","observed_orcids":["https://orcid.org/0000-0001-6139-3547"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jacinda L. Bunch","raw_affiliation_strings":["Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5030090426","display_name":"Kaitlin E. Cannava","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Kaitlin E. Cannava","raw_affiliation_strings":["Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5025196610","display_name":"Kathryn A. Sabadosa","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Kathryn A. Sabadosa","raw_affiliation_strings":["Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5078528246","display_name":"Janet K. Williams","orcid":"https://orcid.org/0000-0001-8218-3338","observed_orcids":["https://orcid.org/0000-0001-8218-3338"]},"institutions":[{"id":"https://openalex.org/I126307644","display_name":"University of Iowa","ror":"https://ror.org/036jqmy94","country_code":"US","type":"education","lineage":["https://openalex.org/I126307644"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Janet K. Williams","raw_affiliation_strings":["Janet Williams, PhD, RN, FAAN, is Professor, University of Iowa College of Nursing, Iowa City","Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Janet Williams, PhD, RN, FAAN, is Professor, University of Iowa College of Nursing, Iowa City","institution_ids":["https://openalex.org/I126307644"]},{"raw_affiliation_string":"Research reported in this publication was supported by the National American Nursing Credentialing Center Grant. The authors would like to thank the nurses who graciously gave their time and expertise to participate in the study, as well as the hospital leadership who supported study conduct and recruitment","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal\u2019s Web site (www.nursingresearchonline.com)","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.7662,"has_fulltext":false,"cited_by_count":12,"citation_normalized_percentile":{"value":0.75697539,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":98},"biblio":{"volume":"70","issue":"2","first_page":"106","last_page":"113"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10186","display_name":"Nursing education and management","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2922","display_name":"Research and Theory"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/patient-safety-concerns","display_name":"patient safety concerns","score":0.9089999794960022},{"id":"https://openalex.org/keywords/bedside-nurses","display_name":"bedside nurses","score":0.8949999809265137},{"id":"https://openalex.org/keywords/patient-engagement","display_name":"patient engagement","score":0.6370000243186951},{"id":"https://openalex.org/keywords/incident-reporting","display_name":"incident reporting","score":0.7450000047683716},{"id":"https://openalex.org/keywords/emotion-management","display_name":"emotional management","score":0.6110000014305115},{"id":"https://openalex.org/keywords/patient-vulnerability","display_name":"patient vulnerability","score":0.5600000023841858},{"id":"https://openalex.org/keywords/patient-safety-interventions","display_name":"patient safety interventions","score":0.5740000009536743}],"concepts":[{"id":"https://openalex.org/C156325361","wikidata":"https://www.wikidata.org/wiki/Q1152864","display_name":"Grounded theory","level":3,"score":0.7052353620529175},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.7003653049468994},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.6150275468826294},{"id":"https://openalex.org/C164850336","wikidata":"https://www.wikidata.org/wiki/Q3685487","display_name":"Interpersonal communication","level":2,"score":0.4959031045436859},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.4949187636375427},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.455971360206604},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.44855883717536926},{"id":"https://openalex.org/C2780554381","wikidata":"https://www.wikidata.org/wiki/Q2063340","display_name":"Sensemaking","level":2,"score":0.4448699951171875},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.43283793330192566},{"id":"https://openalex.org/C77805123","wikidata":"https://www.wikidata.org/wiki/Q161272","display_name":"Social psychology","level":1,"score":0.17134219408035278},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.1601400077342987},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.0},{"id":"https://openalex.org/C36289849","wikidata":"https://www.wikidata.org/wiki/Q34749","display_name":"Social science","level":1,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D004645","descriptor_name":"Empathy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005190","descriptor_name":"Family","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009723","descriptor_name":"Nurse-Patient Relations","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D009741","descriptor_name":"Nursing Staff, Hospital","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D024802","descriptor_name":"Nurse's Role","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D036301","descriptor_name":"Qualitative Research","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D061214","descriptor_name":"Patient Safety","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D066296","descriptor_name":"Grounded Theory","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1097/nnr.0000000000000487","doi":"https://doi.org/10.1097/nnr.0000000000000487","is_oa":false,"landing_page_url":"https://doi.org/10.1097/nnr.0000000000000487","pdf_url":null,"source":{"id":"https://openalex.org/S57227388","display_name":"Nursing Research","issn_l":"0029-6562","issn":["0029-6562","1538-9847"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-3","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Nursing Research","raw_type":"journal-article"},{"id":"pmid:33630533","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/33630533","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Nursing research","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9763000011444092,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":37,"referenced_works":["https://openalex.org/W25471350","https://openalex.org/W1531390244","https://openalex.org/W1570806645","https://openalex.org/W1658908529","https://openalex.org/W1938826846","https://openalex.org/W1969776198","https://openalex.org/W2028577022","https://openalex.org/W2047728139","https://openalex.org/W2059566160","https://openalex.org/W2063863260","https://openalex.org/W2108839997","https://openalex.org/W2112665591","https://openalex.org/W2125025213","https://openalex.org/W2129550444","https://openalex.org/W2136657473","https://openalex.org/W2151670775","https://openalex.org/W2157687420","https://openalex.org/W2277986107","https://openalex.org/W2311858499","https://openalex.org/W2502380453","https://openalex.org/W2506528515","https://openalex.org/W2552804265","https://openalex.org/W2585504525","https://openalex.org/W2592458205","https://openalex.org/W2603361195","https://openalex.org/W2628809898","https://openalex.org/W2757793743","https://openalex.org/W2777746310","https://openalex.org/W2793804723","https://openalex.org/W2886982639","https://openalex.org/W2938727887","https://openalex.org/W2956134784","https://openalex.org/W2960205865","https://openalex.org/W2979004191","https://openalex.org/W2995273579","https://openalex.org/W4235934739","https://openalex.org/W6676739982"],"related_works":["https://openalex.org/W3128552803","https://openalex.org/W4400649691","https://openalex.org/W7124593637","https://openalex.org/W4400264043","https://openalex.org/W4231415609","https://openalex.org/W7217109002","https://openalex.org/W1990275164","https://openalex.org/W3107281410","https://openalex.org/W3200058161","https://openalex.org/W2311858499"],"abstract_inverted_index":{"BACKGROUND:":[0],"Hospitals":[1],"need":[2],"to":[3,25,27,40,54,91,95,99,154,192,240,248,271,294,304,344],"prevent,":[4],"respond":[5,26,188],"to,":[6],"and":[7,12,17,28,49,85,97,107,165,205,233,242,278,281,288,300],"learn":[8],"from":[9],"safety":[10,31,55,103,140,150,218,265,290,309,320,348],"risks":[11],"events":[13],"perceived":[14],"by":[15,44,58,111,251],"patients":[16,59],"families,":[18],"who":[19],"in":[20,74,87,152,189,212,267,339],"turn":[21],"rely":[22],"on":[23,123,179,183,314],"nurses":[24,47,73,118,134,187,252],"report":[29],"their":[30,61],"concerns.":[32,104,244],"OBJECTIVES:":[33],"The":[34],"aim":[35],"of":[36,145,162,167,176,225,262,274,285,297,319],"the":[37,42,51,146,163,168,173,177,180,221,257,272,283,298],"study":[38],"was":[39,67],"describe":[41],"process":[43,236],"which":[45],"bedside":[46,72,222],"evaluate":[48,135],"determine":[50],"appropriate":[52,302],"response":[53,98],"concerns":[56,219,291,321],"expressed":[57],"or":[60,101,138,148,209,310,316],"families.":[62],"METHODS:":[63],"A":[64,331],"qualitative":[65],"design":[66],"employed.":[68],"We":[69,115],"recruited":[70],"inpatient":[71],"an":[75,231],"811-bed":[76],"Midwest":[77],"academic":[78],"medical":[79],"center.":[80],"Nurses":[81,142,214],"provided":[82],"demographic":[83],"information":[84],"participated":[86],"semistructured":[88],"interviews":[89],"designed":[90,191,247],"elicit":[92],"narratives":[93],"related":[94],"evaluation":[96,161],"patient-":[100],"family-expressed":[102],"Data":[105],"analysis":[106],"interpretation":[108],"were":[109],"guided":[110],"grounded":[112,130],"theory.":[113],"RESULTS:":[114],"enrolled":[116],"25":[117],"representing":[119],"22":[120],"units.":[121],"Based":[122,182],"these":[124],"nurses'":[125,263],"experiences,":[126],"we":[127],"developed":[128,255],"a":[129,136,324,346],"theory":[131],"explaining":[132],"how":[133],"patient":[137,241,277,287,308,315,337],"family":[139,243,279,289,317],"concern.":[141],"make":[143],"sense":[144,296],"patient's":[147],"family's":[149],"concern":[151,178],"order":[153],"take":[155],"action.":[156],"Achieving":[157],"this":[158,184],"goal":[159],"requires":[160,230],"meaningfulness":[164],"reasonableness":[166],"concern,":[169],"as":[170,172],"well":[171],"potential":[174],"effect":[175],"patient.":[181],"nursing":[185,235],"evaluation,":[186],"ways":[190],"(a)":[193],"manage":[194],"emotions,":[195],"(b)":[196],"immediately":[197],"resolve":[198],"concerns,":[199],"(c)":[200],"involve":[201],"other":[202],"team":[203],"members,":[204],"(d)":[206],"address":[207],"fear":[208],"uncertain":[210],"grounding":[211],"reality.":[213],"reported":[215],"routinely":[216],"handling":[217],"at":[220],"without":[223],"use":[224],"incident":[226],"reporting.":[227],"DISCUSSION:":[228],"Safety":[229,245],"interpersonal":[232],"evaluative":[234],"with":[237,256],"actions":[238],"responsive":[239],"interventions":[246],"be":[249,254,323],"used":[250],"should":[253],"dynamic,":[258],"cognitive,":[259],"sensemaking":[260],"nature":[261],"routine":[264],"work":[266],"mind.":[268],"Being":[269],"sensitive":[270],"vulnerability":[273],"patients,":[275],"respecting":[276],"input,":[280],"understanding":[282],"consequences":[284],"dismissing":[286],"are":[292],"critical":[293],"making":[295],"situation":[299],"taking":[301],"action":[303],"maintain":[305],"safety.":[306],"Measuring":[307],"planning":[311],"improvement":[312],"based":[313],"expression":[318],"would":[322],"difficult":[325],"undertaking":[326],"using":[327],"only":[328],"standard":[329],"approaches.":[330],"more":[332],"complex":[333],"approach":[334],"incorporating":[335],"direct":[336],"engagement":[338],"data":[340],"collection":[341],"is":[342],"necessary":[343],"gain":[345],"complete":[347],"picture.":[349]},"counts_by_year":[{"year":2026,"cited_by_count":2},{"year":2025,"cited_by_count":4},{"year":2024,"cited_by_count":2},{"year":2023,"cited_by_count":1},{"year":2022,"cited_by_count":3}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2020-12-07T00:00:00"}