多学科医务人员对ICU患者早期活动的真实体验:质性研究的Meta整合

Real experience of multidisciplinary medical and nursing staff on early mobilization of ICU patients: a Meta-synthesis of qualitative research

目的检索多学科医务人员对ICU患者早期活动的真实体验的质性研究,并进行Meta整合。方法计算机检索Web of Science、PubMed、CINAHL、Embase、The Cochrane Library、PsycINFO、Ovid、Medline、中国知网、万方数据库、维普数据库和中国生物医学文献数据库中关于多学科医务人员对ICU患者早期活动的认知及体验的质性研究,检索时限为建库至2021年4月。进行文献质量评价后,采用澳大利亚Joanna Briggs Institute(JBI)循证卫生保健中心Meta整合中的汇集性整合法对结果进行整合。结果共纳入14项研究,提炼出54个主要结果、13个新类别、3个整合结果,整合结果分别是对早期活动的重要性感知、实施早期活动的障碍因素、实施早期活动的促进因素。结论多学科医务人员协作在ICU患者早期活动的实施中发挥着重要作用,但目前在临床实践中面临着许多障碍,未来应结合国内ICU实际情况及特点探索多学科协作策略,积极推动早期活动的临床开展和持续落实,有效改善患者预后。

Objective To retrieve the qualitative research on real experience of multidisciplinary medical and nursing staff on early mobilization of Intensive Care Unit(ICU)patients,and conduct a Meta-synthesis.Methods The qualitative research on the cognition and experience of multidisciplinary medical and nursing staff on the early mobilization of ICU patients was searched by computer in Web of Science,PubMed,CINAHL,Embase,the Cochrane Library,PsycINFO,Ovid,Medline,China National Knowledge Infrastructure(CNKI),WanFang Data,VIP and China Biology Medicine disc.The search time limit was from the establishment of the database to April 2021.After evaluating the quality of the studies,the results were integrated using the collective synthesis method in the Meta-synthesis of the Joanna Briggs Institute(JBI)Evidence-based Health Care Center in Australia.Results A total of 14 studies were included,and54 main results,13 new categories,and 3 synthesis results were extracted.The results of the synthesis were the perception of the importance of early mobilization,the obstacles to the implementation of early mobilization,and the facilitating factors for the implementation of early mobilization.Conclusions Multidisciplinary medical and nursing staff collaboration plays an important role in the implementation of early mobilization for ICU patients,but it is currently facing many obstacles in clinical practice.In the future,multidisciplinary collaboration strategies should be explored based on the actual situation and characteristics of domestic ICU,and the clinical development and continuous implementation of early mobilization should be actively promoted to effectively improve the prognosis of patients.