ICU患者对早期活动认知和态度的质性研究
|
摘要
目的通过调查ICU患者对ICU治疗期间行早期活动的认知和态度,为今后更好的开展ICU早期活动提供借鉴。方法采用质性研究中的现象学研究方法,对本院12例曾在ICU住院期间进行过早期活动的患者深度访谈。结果得出3大主题:早期活动阻碍因素、家属参与重要性、活动方案不明确。结论 ICU患者对早期活动的相关知识知晓度低,但患者迫切希望得到医护人员的帮助和意愿参与到早期活动来进行康复。应加强患者宣教,重视家属参与,并针对相关阻碍因素提出相应的对策,以期能更好地推动ICU患者早期活动的开展。
Objective To investigate ICU patients' cognition on and attitude toward early mobility in ICU, and to provide reference for the implementation of ICU early mobility. Methods With phenomenological method, we performed in-depth interviews in 12 patients who had conducted early activities during their stay in ICU. Results There themes were extracted including factors hindering early activities, the importance of family involvement, and exact programme of activities. Conclusion Patients in ICU have inadequate knowledge on ICU early mobility and there is urgent need for rehabilitation with the help of medical staff. We should strengthen health education for patients in ICU, pay attention to family members ' participation, and put forward corresponding countermeasures so as to promote the implementation of ICU early mobility.
Objective To investigate ICU patients' cognition on and attitude toward early mobility in ICU, and to provide reference for the implementation of ICU early mobility. Methods With phenomenological method, we performed in-depth interviews in 12 patients who had conducted early activities during their stay in ICU. Results There themes were extracted including factors hindering early activities, the importance of family involvement, and exact programme of activities. Conclusion Patients in ICU have inadequate knowledge on ICU early mobility and there is urgent need for rehabilitation with the help of medical staff. We should strengthen health education for patients in ICU, pay attention to family members ' participation, and put forward corresponding countermeasures so as to promote the implementation of ICU early mobility.
引文
[1] Phelan S, Lin F, Mitchell M,et al.Implementing Early Mobilisation in the Intensive Care Unit:An Integrative Review[J].Int J Nurs Stud,2018,77:91-105.DOI:10.1016/j.ijnurstu.2017.09.019.
[2] Kramer C L. Intensive Care Unit-Acquired Weakness[J].Neurol Clin,2017,35(4):723-736.DOI:10.1016/j.ncl.2017.06.008.
[3] Tipping C J, Harrold M, Holland A, et al.The Effects of Active Mobilisation and Rehabilitation in ICU on Mortality and Function:A Systematic Review[J]. Intensive Care Med, 2017,43(2):171-183.DOI:10.1007/s00134-016-4612-0.
[4]蒋玉兰,倪慧,谢立琴,等.机械通气期间早期康复活动应用于重度AECOPD病人的疗效分析[J].护理研究,2017,31(16):1994-1996.DOI:10.3969/j.issn.1009-6493.2017.16.019.
[5]杨丽平,张志刚,张彩云,等.ICU患者早期活动现状的临床研究[J].护理学报,2018,25(20):47-49.DOI:10.16460/j.issn1008-9969.2018.20.047.
[6] Alberto Sibilla P T, MSc P N. Mobilization of Mechanically Ventilated Patients in Switzerland[J]. J Intensive Care Med,2017:1-8.DOI:10.1177/0885066617728486.
[7]查丽玲,周松,王建宁,等.ICU护士对患者早期活动认知和行为的调查研究[J].中华护理杂志,2018,53(2):221-225.DOI:10.3761/j.issn.0254-1769.2018.02.019.
[8] Khalafi A, Elahi N, Ahmadi F. Continuous Care and Patients’ Basic Needs during Weaning from Mechanical Ventilation:A Qualitative Study[J]. Intensive Crit Care Nurs.2016,37:37-45.DOI:10.1016/j.iccn.2016.05.005.
[9] Fan E. Critical Illness Neuromyopathy and the Role of Physical Therapy and Rehabilitation in Critically Ill Patients[J]. Respir Care, 2012,57(6):933-944.DOI:10.4187/respcare.01634.
[10]李青栋,万献尧.机械通气患者的疼痛评估与镇痛策略演变[J].中华危重病急救医学,2017,29(9):861-864.DOI:10.3760/cma.j.issn.2095-4352.2017.09.020.
[11]黄仕瑛,赵丽萍.ICU患者睡眠障碍及其评估方式的研究进展[J].护理学报,2016, 23(18):39-43.DOI:10.16460/j.issn1008-9969.2016.18.039.
[12]方玲艳.重症监护室患者对早期活动相关知识知晓状况及影响因素分析[J].中国医院统计,2018,25(1):33-35,39.DOI:10.3969/j.issn.1006-5253.2018.01.010.
[13]毛秋瑾.国内ICU访视制度的研究现状[J].中华现代护理杂志,2015, 21(5):613-614.DOI:10.3760/cma.j.issn.1674-2907.2015.05.038.
[14]权明桃,蒲德琴,徐应琴,等.多种形式健康宣教在脑卒中患者中应用的效果评价[J].中国实用护理杂志,2011,27(8):45-46.DOI:10.3760/cma.j.issn.1672-7088.2011.08.065.
[15]马红,李晓静,张其霞,等.家属协作的三阶段护理模式预防ICU患者发生谵妄的效果[J].解放军护理杂志,2015,32(8):52-54.DOI:10.3969/j.issn.1008-9993.2015.08.015.
[16]杨立威,李文涛,郑楠,等.重症监护室探视制度的研究进展[J].中华护理杂志,2014,49(7):871-874.DOI:10.3761/j.issn.0254-1769.2014.07.026.
[17] Vincent J L, Shehabi Y, Walsh T S, et al. Comfort and Patient Centred Care without Excessive Sedation:The ECASH Concept[J].Intensive Care Med, 2016, 42(6):962-971.DOI:10.1007/s00134-016-4297-4.
[18] Sosnowski K, Lin F, Mitchell M L, et al. Early Rehabilitation in the Intensive Care Unit:An Integrative Literature Review[J]. Aust Crit Care, 2015,28(4):216-25.DOI:10.1016/j.aucc.2015.05.002.
[2] Kramer C L. Intensive Care Unit-Acquired Weakness[J].Neurol Clin,2017,35(4):723-736.DOI:10.1016/j.ncl.2017.06.008.
[3] Tipping C J, Harrold M, Holland A, et al.The Effects of Active Mobilisation and Rehabilitation in ICU on Mortality and Function:A Systematic Review[J]. Intensive Care Med, 2017,43(2):171-183.DOI:10.1007/s00134-016-4612-0.
[4]蒋玉兰,倪慧,谢立琴,等.机械通气期间早期康复活动应用于重度AECOPD病人的疗效分析[J].护理研究,2017,31(16):1994-1996.DOI:10.3969/j.issn.1009-6493.2017.16.019.
[5]杨丽平,张志刚,张彩云,等.ICU患者早期活动现状的临床研究[J].护理学报,2018,25(20):47-49.DOI:10.16460/j.issn1008-9969.2018.20.047.
[6] Alberto Sibilla P T, MSc P N. Mobilization of Mechanically Ventilated Patients in Switzerland[J]. J Intensive Care Med,2017:1-8.DOI:10.1177/0885066617728486.
[7]查丽玲,周松,王建宁,等.ICU护士对患者早期活动认知和行为的调查研究[J].中华护理杂志,2018,53(2):221-225.DOI:10.3761/j.issn.0254-1769.2018.02.019.
[8] Khalafi A, Elahi N, Ahmadi F. Continuous Care and Patients’ Basic Needs during Weaning from Mechanical Ventilation:A Qualitative Study[J]. Intensive Crit Care Nurs.2016,37:37-45.DOI:10.1016/j.iccn.2016.05.005.
[9] Fan E. Critical Illness Neuromyopathy and the Role of Physical Therapy and Rehabilitation in Critically Ill Patients[J]. Respir Care, 2012,57(6):933-944.DOI:10.4187/respcare.01634.
[10]李青栋,万献尧.机械通气患者的疼痛评估与镇痛策略演变[J].中华危重病急救医学,2017,29(9):861-864.DOI:10.3760/cma.j.issn.2095-4352.2017.09.020.
[11]黄仕瑛,赵丽萍.ICU患者睡眠障碍及其评估方式的研究进展[J].护理学报,2016, 23(18):39-43.DOI:10.16460/j.issn1008-9969.2016.18.039.
[12]方玲艳.重症监护室患者对早期活动相关知识知晓状况及影响因素分析[J].中国医院统计,2018,25(1):33-35,39.DOI:10.3969/j.issn.1006-5253.2018.01.010.
[13]毛秋瑾.国内ICU访视制度的研究现状[J].中华现代护理杂志,2015, 21(5):613-614.DOI:10.3760/cma.j.issn.1674-2907.2015.05.038.
[14]权明桃,蒲德琴,徐应琴,等.多种形式健康宣教在脑卒中患者中应用的效果评价[J].中国实用护理杂志,2011,27(8):45-46.DOI:10.3760/cma.j.issn.1672-7088.2011.08.065.
[15]马红,李晓静,张其霞,等.家属协作的三阶段护理模式预防ICU患者发生谵妄的效果[J].解放军护理杂志,2015,32(8):52-54.DOI:10.3969/j.issn.1008-9993.2015.08.015.
[16]杨立威,李文涛,郑楠,等.重症监护室探视制度的研究进展[J].中华护理杂志,2014,49(7):871-874.DOI:10.3761/j.issn.0254-1769.2014.07.026.
[17] Vincent J L, Shehabi Y, Walsh T S, et al. Comfort and Patient Centred Care without Excessive Sedation:The ECASH Concept[J].Intensive Care Med, 2016, 42(6):962-971.DOI:10.1007/s00134-016-4297-4.
[18] Sosnowski K, Lin F, Mitchell M L, et al. Early Rehabilitation in the Intensive Care Unit:An Integrative Literature Review[J]. Aust Crit Care, 2015,28(4):216-25.DOI:10.1016/j.aucc.2015.05.002.