成人ICU患者体位变换频率影响因素的范围综述

Factors influencing the frequency of position change in adult ICU patients:a scoping review

目的对成人ICU患者体位变换频率的影响因素进行综述,为制订成人ICU患者体位变换方案提供参考依据。方法在澳大利亚乔安娜布里格斯研究所范围综述指南的指导下,系统检索PubMed、ProQuest、CINAHL、中国知网、万方数据库、维普网和中国生物医学文献数据库中的相关文献,检索时限为建库至2022年10月26日,对纳入文献进行数据提取和汇总。结果共纳入23篇文献,成人ICU患者体位变换频率影响因素包括患者的活动能力、移动能力、感知、潮湿、营养、摩擦力和剪切力、发热、皮肤状况、年龄、体重、既往史、意识、血流动力学状态、呼吸、氧需求状况、卫生自理能力、使用的支撑面、患者皮肤对体位变换频率的反应、体位变换过程中的疼痛情况、是否为临终/濒死阶段、睡眠、总体疾病状况、总体治疗目标、体位变换的角度。结论护理人员为成人ICU患者制订体位变换方案时应全面考虑相关影响因素,以提高压力性损伤的预防效果,促进患者康复,提高体位变换的成本效益。

Objective To review the influencing factors of position change frequency in adult Intensive Care Unit(ICU)patients,so as to provide reference basis for formulating position change plans for adult ICU patients.Methods Under the guidance of the scoping review guidelines of the Joanna Briggs Institute in Australia,relevant literature was systematically searched in PubMed,ProQuest,CINAHL,China National Knowledge Infrastructure(CNKI),WanFang Data,VIP,and China Biomedical Literature Database.The search period was from database establishment to October 26,2022.We extracted and summarized data from the included literature.Results A total of 23 articles were included.Factors affecting the frequency of position change in adult ICU patients included patient activity ability,mobility ability,perception,moisture,nutrition,friction and shear forces,fever,skin condition,age,weight,past history,consciousness,hemodynamic status,respiration,oxygen demand,hygiene self-care ability,support surface used,patient skin response to position change frequency,and pain during position change,whether it was the final/near death stage,sleep,overall disease status,overall treatment goals,and perspective of position change.Conclusions Nurses should fully consider relevant influencing factors when formulating a position change plan for adult ICU patients,in order to improve the prevention effect of pressure injury,promote patient recovery,and increase the cost-effectiveness of position change.