ICU护士实施重症患者早期功能锻炼护理体验的质性研究

Qualitative research on experience of ICU nurses performing early functional exercise for severe patients

目的了解ICU护士为重症患者实施早期功能锻炼的护理体验,为促进ICU获得性衰弱的早期预防和治疗提供参考依据。方法采用目的抽样法,于2022年1月-4月在北京市某三级甲等医院综合ICU,对符合纳入标准的12名护士进行半结构深度访谈,采用Colaizzi现象学研究方法,对访谈资料进行分析。结果通过分析得出以下4个主题:①借力医护患有效沟通与配合;②缺少实施规范和管理制度;③面临实施困难和护理压力;④渴望专业团队和辅助设备。结论在推进重症患者早期功能锻炼的过程中,既要有效运用正向引导,也要加快管理规范和操作指引的构建,从改善人力资源和辅助设备配置等多个角度研究改进对策,有效提高重症患者ICU获得性衰弱的预防和治疗效果。

Objective To understand the experience of ICU nurses performing early functional exercise for severe patients,so as to provide reference for promoting the the early prevention and treatment of ICU-acquired weakness(ICU-AW).Methods Using the objective sampling method,a semi-structured in-depth interview was conducted with 12 nurses who met the inclusion criteria in the comprehensive intensive care unit of a tertiary Grade A hospital in Beijing from January to April 2022.Colaizzi phenomenological research method was used to analyze the interview data.Results Four themes were obtained,including benefiting from effective doctor-nurse-patient communication and cooperation,lack of implementation norms and management systems,facing with difficulties in implementation and nursing pressure,Desire for professional team and auxiliary equipment.Conclusion In the process of promoting the early functional exereise for severe patients,we should not only effectively use positive guidance,but also accelerate the construction of management specifications and operation guidelines,and study improvement strategies from multi-ple perspectives such as improving human resources and auxiliary equipment configuration,so as to improve the pre-vention and treatment effects of ICU-AW in severe patients.