ICU护士实施患者身体约束决策过程的质性研究

ICU nurses' decision-making in physical restraint use:a qualitative study

目的探讨ICU护士对患者实施身体约束的决策过程。方法对12名ICU护士进行半结构式深度访谈,对资料进行整理与分析,提取主题。结果析出身体约束决策过程主题的11个类属,包括风险预见、替代方案选择、身体约束意向、身体约束实施、身体约束反思、身体约束合理化6个决策阶段,患者、护士、家属、管理4个原因要素,安全1个结果目标。结论身体约束的实施是一系列复杂的决策过程,受多种因素共同影响。本研究结果可供制定患者身体约束干预措施和相关管理参考。

Objective To explore nurses’ decision-making process in physical restraint use for ICU patients.Methods In-depth semi-structured interviews were conducted on 12 ICU nurses,then data were transcribed and analyzed to identify themes.Results Eleven categories reflecting decision-making process in physical restraint use were identified,including 6 decision-making stages of risk prediction,alternative selection,physical restraint intention,implementation,reflection and rationalization,4 influencing factors of patients,nurses,family members and management,and 1 outcome objective of safety.Conclusion Nurses’ decision-making in physical restraint use is complicated and affected by multiple factors.The study results provide references for targeted intervention and management.