多学科模式下ICU机械通气患者早期活动协作现状与影响因素分析

Status and influencing factors of early activity cooperation in ICU patients with mechanical ventilation under multidisciplinary model

目的:了解在国内多学科模式下,ICU机械通气患者早期活动的协作现状,分析其影响因素。方法:2022年10月—11月,便利抽取国内18个省、自治区、直辖市的31家三级综合医院参与ICU机械通气患者早期活动实施的多学科医务人员,采用自设的ICU机械通气患者早期活动多学科协作现状调查问卷调查。结果:在554名医务人员中,有76.9%完全不了解或不太了解ICU机械通气患者早期活动多学科协作的规范流程,有69.0%不清楚自己在多学科协作中的职责,有51.4%所在的ICU没有成立明确的早期活动多学科团队。回归分析显示,管理危重患者数量、有无早期活动规范和流程、周围同事态度、是否成立多学科团队、成员沟通方式、活动主导者为早期活动多学科医务人员协作水平的影响因素(P<0.05)。结论:多学科模式下,ICU机械通气患者早期活动的协作方式尚不清晰,需要综合考虑我国医护人力资源现状、各地区经济水平等,构建并完善早期活动的多学科协作策略。

Objective:To investigate the status of early activity cooperation in patients with mechanical ventilation in ICU under multidisciplinary model in China,and to explore the influencing factors.Methods:From October to November 2022,31 tertiary general hospitals in 18 provinces,municipalities and autonomous regions were selected by convenience sampling,and multidisciplinary members of early activities of patients with mechanical ventilation in ICU were selected to complete the Chinese version of the inter-professional teamwork scale.Results:Among 554 medical staff,76.9%participants did not know or know much about the specification and implementation process of the early activities of patients with mechanical ventilation in ICU,69.0%participants did not know their role in multidisciplinary collaboration,51.4%of the ICUs did not have a clear multidisciplinary team for early activities.Regression analysis showed that the number of critically ill patients,the presence of early activity norms and procedures,the attitude of surrounding colleagues,the establishment of a team,the communication style of members,and the leader of activities were factors influencing the level of collaboration in the multidisciplinary cooperation of early activities(P<0.05).Conclusion:The cooperation model of early activities of patients with mechanical ventilation in ICU is not clear,and it is necessary to develop and improve the multi-disciplinary cooperation strategy of early activities by considering the current situation of medica human resources in China,the economic level of various regions.