ICU有创机械通气病人早期活动多学科诊疗团队协作性的质性研究

Qualitative study on MDT team cooperation in early activities of patients with invasive mechanical ventilation in ICU

目的:了解并总结多学科诊疗(MDT)团队模式下开展ICU有创机械通气病人早期活动的合作方式、存在的问题及实施阻碍,为ICU有创机械通气病人早期活动的标准化实施提供参考。方法:以质性研究的现象学研究方法为依据,对国内7所综合性三级甲等医院的14名ICU有创机械通气病人早期活动的执行者进行深入访谈,并提炼主题。结果:共提炼出5个主题:缺乏系统性评估ICU有创机械通气病人的早期活动启动标准;早期活动内容缺乏科学性;医生角色弱化;团队分工不明确;人力资源配置不足。结论:MDT模式下的ICU有创机械通气病人早期活动团队协作方式仍处于探索阶段,需进一步探讨MDT团队的分工与协作,并构建科学的早期活动方案及标准化实施流程。

Objective:To understand and summarize the cooperation methods,existing problems and implementation obstacles of the early activities of ICU patients with invasive mechanical ventilation under the multi-disciplinary treatment(MDT)team model,and to provide reference for the standard implementation of early activities of ICU patients with invasive mechanical ventilation.Methods:Based on the phenomenological research method of qualitative research,14 ICU performers of the early activities of patients with invasive mechanical ventilation in 7 comprehensive tertiary grade A hospitals in China were interviewed in depth.And the subjects were refined.Results:Five themes were refined:early activity initiation criteria for patients with invasive mechanical ventilation in ICU had not been systematically evaluated;the content of early activities lacked scientificity;the doctor's role was weakened;unclear team division;lack of human resources.Conclusions:The early activities of ICU patients with mechanical ventilation based MDT model was still at the exploratory stage.Future research will need to further explore the division of labor and collaboration of the MDT team,and build scientific early activity plan and standardized implementation process.