ICU机械通气病人重症监护体验研究
|
摘要
研究目的:
随着医疗护理科学与技术的进步,机械通气作为一种重要的呼吸支持手段,其应用也更加频繁。目前机械通气是各种原因所致的呼吸衰竭、呼吸功能不全以及全身麻醉术后等病理过程的必要支持技术。一般来讲,监护室里接受机械通气的病人往往病情较重,他们不仅要忍受住院和躯体疾病本身引起的不适和痛苦,还要承受机械通气插管带来的许多痛苦。这类病人要依赖呼吸机维持生命,依赖护士满足其基本需要,人工气道的建立导致病人不能说话,使其与外界的沟通出现障碍,病人不能表达自己的情感和需求。因此,机械通气治疗在挽救了病人生命的同时,也给病人带来许多不良的心理和生理体验,病人在治疗过程要经历许多身体、认知和情感的威胁。甚至有的病人身体康复出院后,其重症监护体验会持续很长时间影响病人的生存质量。鉴于此,本研究欲对中国有创机械通气病人的重症监护体验及其相关因素进行深入研究,以期达到以下目的:
1.定性分析机械通气病人的重症监护体验,能够扩展护士重症监护方面的知识,增进医护人员对病人体验的理解。
2.初步编制机械通气病人重症监护体验问卷,并进行信度、效度检验,为下一步定量研究奠定基础。
3.定量分析病人的重症监护体验状况及影响因素。
4.发展促进病人护理效果的临床策略,提高临床护理质量。
研究方法:
本研究采取定性分析与定量研究相结合的方法,综合分析机械通气病人的重症监护体验及影响因素。
1.研究1:采用深入访谈法访谈ICU中经历过机械通气治疗、年龄在18岁以上的患者,访谈时在病人同意的情况下对访谈内容录音,资料的整理和初步分析与资料的收集同步进行,每次访谈结束后尽早将录音逐字逐句的整理成文字,本研究收集资料到第11个病人时,资料出现饱和现象,访谈结束。采用现象学分析方法对资料进行分析,提炼出有创机械通气病人的重症监护体验。
2.研究2:根据文献及访谈结果,初步编制了包括50个项目的机械通气病人的重症监护体验问卷。这些项目几乎涵盖了病人重症监护体验的各个方面。请富有重症监护经验的3名医生、4名护士以及1位心理学专家对问卷的项目进行内容效度评定,并根据专家的反馈意见,对问卷项目进行删除、补充和修改。选取经历过机械通气病人进行调查,收回有效问卷292份,采用探索性因素分析对数据进行分析,提出有创机械通气病人重症监护体验的主成份。
3.研究3:在对研究2中选取的研究对象进行重症监护体验调查的同时,收集病人年龄、性别、疾病严重程度等人口学和疾病状况。将有效问卷的全部数据建立数据库,采用SPSS11.5软件进行分析。采用描述性分析法分析病人的一般情况及重症监护体验状况、单因素方差分析、独立样本t检验、Pearson相关分析、以及多元回归分析方法用以分析影响病人重症监护体验的相关因素。
研究结果:
1.研究1:通过深入分析来自机械通气病人重症监护体验的访谈资料,提炼出有创机械通气病人的重症监护体验包括5个主题:身处异常的环境、忍受折磨与痛苦、遭遇心理威胁、寻求支持与帮助、自我反思,每一个主题又包含若干个亚主题。
2.研究2:将初步编制的机械通气病人重症监护体验量表在研究对象中试测,对回收的有效问卷进行条目筛选和探索性因素分析,得出包含23条目的机械通气病人的重症监护体验问卷,该问卷包含五个维度,即环境评价、技术体验、认知与感觉改变、人际支持需求、治疗与病情信息。五个维度可累计解释总方差的52.495%,内部一致性信度Cronbach's a=0.80。
3.研究3:定量分析机械通气病人重症监护体验现状及相关因素,结果显示:①机械通气病人经历了中等程度以上的重症监护体验,其中得分最高的是人际支持需求维度,得分最低的是认知与感觉改变维度;②机械通气持续时间、疾病严重程度、婚姻状况、年龄是影响机械通气病人重症监护体验的主要因素,且机械通气时间越长,病情越严重、缺乏婚姻支持,病人的年龄越小,病人的重症监护体验得分越高,不良经历越多。复相关系数R为0.552,决定系数R~2为0.305,即这四个变量能预测30.5%的总分变异。
研究结论:
1.经过深入分析发现,虽然每个个案的身心体验有所不同,但也有许多共性之处,总体来讲,病人的重症监护经历是令人痛苦、恐惧的,机械通气病人的重症监护体验可提炼出5个主题:身处异常的环境、忍受折磨与痛苦、遭遇心理威胁、寻求支持与帮助、自我反思。
2.初步编制的机械通气病人重症监护体验量表可分为五个维度:环境感受、技术体验、认知与感觉改变、人际支持需求、治疗与病情信息。问卷具有良好的信度、效度,可以用于进一步研究。
3.机械通气治疗病人在ICU经历了中等程度以上的重症监护体验,反映最为强烈的是较弱的人际支持,反映最低的是不良的认知与感觉。
4.机械通气持续时间、疾病严重程度、婚姻状况、年龄是影响机械通气病人重症监护体验的主要因素,且机械通气时间越长,病情越严重、缺乏婚姻支持,病人的年龄越小,病人的重症监护体验不良程度高。
总之,研究结果提示,机械通气治疗的病人经历了许多不良的重症监护体验,这些体验不但受人口学因素的影响,而且受到病人的健康状况的影响。因此,对重症病人除了采取措施救命以外,还应理解病人的重症监护体验,并进行相应的干预,以改善病人的体验,增进病人的预后,提高病人生活质量。
Objective:
Along with the improvement of technology and medical & nursing science, mechanical ventilation is used more frequently as a vital means of respiratory support. At the present time, mechanical ventilation is an essential supporting technique for many pathological processes such as general anaesthesia and respiratory dysfunction caused by diversified reasons. In general, patients who received mechanical ventilation in an intensive care unit are more serious than other patients; they not only suffer from discomfort and affliction of hospitalization and somatic illness, but must sustain the painful experience of intubation needed by mechanical ventilation. Those patients have to depend on the ventilators to maintain life and rely on nurses to content their essential requirements. Once the artificial airway is established, patient can not express his or her feeling and requirement because of communication holdback. Many bad psychological and physical experiences are present while the treatment of mechanical ventilation has saved many patients' life. Patient may experience many difficulties in physical, mental, and cognitive during the treatment process. What's more, some intensive care experiences would last a long period of time and have effects on patient's quality of life even after recovery and leave hospital.To better understand mechanical ventilated patients' intensive care experience is needed.The present research try to focus on Chinese patient's experiences while receiving mechanical ventilation in an intensive unit. The aims are as following:
I. Extending nurse's knowledge in intensive care area and promoting medical staff to understand patient's experiences by the quantificational studies.
II. Preliminary developing a questionnaire to access patient's experiences while receiving mechanical ventilation in an intensive unit, testing reliability and validity of the questionnaire, and establishing the foundation for further research.
III. Quantitative analysis on the patient's intensive care experiences and relative factors.
IV. Developing clinical strategy that might improve nursing outcomes to enhance the nursing quality in intensive care area.
Methods:
I . Research 1: In-depth were carried out with a sample of 11 patients(≥18 yrs old) who have experienced the treatment of mechanical ventilation in the affiliated hospital of medical universities in Beijing. The interviews were audiotaped and transcribed verbatim. The transcripts were analyzed using the phenomenological analysis method devised by Giorgi.
II. Research 2: A preliminary questionnaire entitled Intensive Care Experience with MV (ICE-MV) was developed based on the qualitative study and a review of the literature on intensive care experiences. The initial scale contained 50 items, which was content valid by 3 physicans, 4 nurses who worked in ICU, and 1 psychologist. 297 subjects were investigated using the scale when discharged from ICU. An exploratory factor analysis (EFA) was used to examine the psychometric characteristics of the ICE-MV scale.
III. Research 3: The demographic and illness condition information including age, sex, severity of illness, etc. were collected while objects were asked to fill the ICE-MV scale. Based on all valid questionnaires, we established the database and employed SPSS11.5 software package was used to analyze data. Descriptive analysis, one-way ANOVA, one sample t-test, Pearson correlation analysis, and multiple regression analysis were used in data statistical management.
Results:
I . Research 1: Qualitative analysis on the patient's experiences while receiving mechanical ventilation in an intensive unit. 5 themes related to patient's experience were extracted by in-depth data analysis including being in an unconventionality environment, suffering for distress and affliction, encountering psychological crisis, seeking for help and support, and self-reflection. Each theme covered many sub-themes.
II. Research 2: The final, 23 item ICE-MV scale consisted of five main components including "awareness of surrounding", "experience technique", "altered cognition and feeling", "inter-personal support demands", and "treatment and illness information". The overall experience scale demonstrated good internal consistency and reliability (Cronbach'sα= 0.80). The five components accounted for 52.50% of the whole variance.
III. Research 3:①By the descriptive statistic to patient's experiences, we found that patients who have received mechanical ventilation underwent the moderate degree experience with the highest scored in dimension 4(inter-personal support) and the lowest scored in dimension 3(cognition and feeling) respectively.②Main influence factors including period of mechanical ventilation, disease severity, marital status, and patient's age. Period of mechanical ventilation, disease severity, marital status were positive correlated to patient's experiences while patient's age was negative correlated to patient's experiences.Multiple correlation coefficient R was 0.552 and the coefficient of determination R~2 was 0.305. That is to say, those four variables could prognosticate 30.5% of the total score variance.
Conclusion:
I . By in-depth analysis, we have found that, although each case had different psychological & physical experiences and some commonness, generally speaking, patient's experiences while receiving mechanical ventilation in an intensive unit were poignant and afeard. We extracted 5 themes from patient's experiences including being in an unconventionality environment, suffering for distress and affliction, encountering psychological crisis, seeking for help and support, and self- reflection.
II. The scale consisted of 5 dimensions including "awareness of surrounding", "experience technique", "altered cognition and feeling", "inter-personal support demands", and "treatment and illness information". The questionnaire demonstrates good reliability and validity. It should be useful in further studies in the area of patient's experiences in the ICU.
III. We have found that patient's experiences while receiving mechanical ventilation underwent the intensive care experience above the moderate degree. Lacking of inter-personal support was the strongest reflected factor while the alteration of cognition and feeling was the weakest reflected factor.
IV. The period of mechanical ventilation, disease severity, marital status, and patient's age were the main factors that influenced patient's experiences while receiving mechanical ventilation in ICU. Younger patients with prolonged MV, more severe disease, negative marital status had worse experiences than others.
In conclusion, the results remind us that patients who receiving mechanical ventilation treatment have suffered many negative experiences related to intensive care and treatment. Those experiences not only affected by demographic factors but influenced by the healthy condition of patients. Therefore, besides taking life-saving measurement, we should also understand patient's experiences and take intervention correspondingly to those meliorate the unpleasant experiences, promote the prognosis and improve patient's life quality.
随着医疗护理科学与技术的进步,机械通气作为一种重要的呼吸支持手段,其应用也更加频繁。目前机械通气是各种原因所致的呼吸衰竭、呼吸功能不全以及全身麻醉术后等病理过程的必要支持技术。一般来讲,监护室里接受机械通气的病人往往病情较重,他们不仅要忍受住院和躯体疾病本身引起的不适和痛苦,还要承受机械通气插管带来的许多痛苦。这类病人要依赖呼吸机维持生命,依赖护士满足其基本需要,人工气道的建立导致病人不能说话,使其与外界的沟通出现障碍,病人不能表达自己的情感和需求。因此,机械通气治疗在挽救了病人生命的同时,也给病人带来许多不良的心理和生理体验,病人在治疗过程要经历许多身体、认知和情感的威胁。甚至有的病人身体康复出院后,其重症监护体验会持续很长时间影响病人的生存质量。鉴于此,本研究欲对中国有创机械通气病人的重症监护体验及其相关因素进行深入研究,以期达到以下目的:
1.定性分析机械通气病人的重症监护体验,能够扩展护士重症监护方面的知识,增进医护人员对病人体验的理解。
2.初步编制机械通气病人重症监护体验问卷,并进行信度、效度检验,为下一步定量研究奠定基础。
3.定量分析病人的重症监护体验状况及影响因素。
4.发展促进病人护理效果的临床策略,提高临床护理质量。
研究方法:
本研究采取定性分析与定量研究相结合的方法,综合分析机械通气病人的重症监护体验及影响因素。
1.研究1:采用深入访谈法访谈ICU中经历过机械通气治疗、年龄在18岁以上的患者,访谈时在病人同意的情况下对访谈内容录音,资料的整理和初步分析与资料的收集同步进行,每次访谈结束后尽早将录音逐字逐句的整理成文字,本研究收集资料到第11个病人时,资料出现饱和现象,访谈结束。采用现象学分析方法对资料进行分析,提炼出有创机械通气病人的重症监护体验。
2.研究2:根据文献及访谈结果,初步编制了包括50个项目的机械通气病人的重症监护体验问卷。这些项目几乎涵盖了病人重症监护体验的各个方面。请富有重症监护经验的3名医生、4名护士以及1位心理学专家对问卷的项目进行内容效度评定,并根据专家的反馈意见,对问卷项目进行删除、补充和修改。选取经历过机械通气病人进行调查,收回有效问卷292份,采用探索性因素分析对数据进行分析,提出有创机械通气病人重症监护体验的主成份。
3.研究3:在对研究2中选取的研究对象进行重症监护体验调查的同时,收集病人年龄、性别、疾病严重程度等人口学和疾病状况。将有效问卷的全部数据建立数据库,采用SPSS11.5软件进行分析。采用描述性分析法分析病人的一般情况及重症监护体验状况、单因素方差分析、独立样本t检验、Pearson相关分析、以及多元回归分析方法用以分析影响病人重症监护体验的相关因素。
研究结果:
1.研究1:通过深入分析来自机械通气病人重症监护体验的访谈资料,提炼出有创机械通气病人的重症监护体验包括5个主题:身处异常的环境、忍受折磨与痛苦、遭遇心理威胁、寻求支持与帮助、自我反思,每一个主题又包含若干个亚主题。
2.研究2:将初步编制的机械通气病人重症监护体验量表在研究对象中试测,对回收的有效问卷进行条目筛选和探索性因素分析,得出包含23条目的机械通气病人的重症监护体验问卷,该问卷包含五个维度,即环境评价、技术体验、认知与感觉改变、人际支持需求、治疗与病情信息。五个维度可累计解释总方差的52.495%,内部一致性信度Cronbach's a=0.80。
3.研究3:定量分析机械通气病人重症监护体验现状及相关因素,结果显示:①机械通气病人经历了中等程度以上的重症监护体验,其中得分最高的是人际支持需求维度,得分最低的是认知与感觉改变维度;②机械通气持续时间、疾病严重程度、婚姻状况、年龄是影响机械通气病人重症监护体验的主要因素,且机械通气时间越长,病情越严重、缺乏婚姻支持,病人的年龄越小,病人的重症监护体验得分越高,不良经历越多。复相关系数R为0.552,决定系数R~2为0.305,即这四个变量能预测30.5%的总分变异。
研究结论:
1.经过深入分析发现,虽然每个个案的身心体验有所不同,但也有许多共性之处,总体来讲,病人的重症监护经历是令人痛苦、恐惧的,机械通气病人的重症监护体验可提炼出5个主题:身处异常的环境、忍受折磨与痛苦、遭遇心理威胁、寻求支持与帮助、自我反思。
2.初步编制的机械通气病人重症监护体验量表可分为五个维度:环境感受、技术体验、认知与感觉改变、人际支持需求、治疗与病情信息。问卷具有良好的信度、效度,可以用于进一步研究。
3.机械通气治疗病人在ICU经历了中等程度以上的重症监护体验,反映最为强烈的是较弱的人际支持,反映最低的是不良的认知与感觉。
4.机械通气持续时间、疾病严重程度、婚姻状况、年龄是影响机械通气病人重症监护体验的主要因素,且机械通气时间越长,病情越严重、缺乏婚姻支持,病人的年龄越小,病人的重症监护体验不良程度高。
总之,研究结果提示,机械通气治疗的病人经历了许多不良的重症监护体验,这些体验不但受人口学因素的影响,而且受到病人的健康状况的影响。因此,对重症病人除了采取措施救命以外,还应理解病人的重症监护体验,并进行相应的干预,以改善病人的体验,增进病人的预后,提高病人生活质量。
Objective:
Along with the improvement of technology and medical & nursing science, mechanical ventilation is used more frequently as a vital means of respiratory support. At the present time, mechanical ventilation is an essential supporting technique for many pathological processes such as general anaesthesia and respiratory dysfunction caused by diversified reasons. In general, patients who received mechanical ventilation in an intensive care unit are more serious than other patients; they not only suffer from discomfort and affliction of hospitalization and somatic illness, but must sustain the painful experience of intubation needed by mechanical ventilation. Those patients have to depend on the ventilators to maintain life and rely on nurses to content their essential requirements. Once the artificial airway is established, patient can not express his or her feeling and requirement because of communication holdback. Many bad psychological and physical experiences are present while the treatment of mechanical ventilation has saved many patients' life. Patient may experience many difficulties in physical, mental, and cognitive during the treatment process. What's more, some intensive care experiences would last a long period of time and have effects on patient's quality of life even after recovery and leave hospital.To better understand mechanical ventilated patients' intensive care experience is needed.The present research try to focus on Chinese patient's experiences while receiving mechanical ventilation in an intensive unit. The aims are as following:
I. Extending nurse's knowledge in intensive care area and promoting medical staff to understand patient's experiences by the quantificational studies.
II. Preliminary developing a questionnaire to access patient's experiences while receiving mechanical ventilation in an intensive unit, testing reliability and validity of the questionnaire, and establishing the foundation for further research.
III. Quantitative analysis on the patient's intensive care experiences and relative factors.
IV. Developing clinical strategy that might improve nursing outcomes to enhance the nursing quality in intensive care area.
Methods:
I . Research 1: In-depth were carried out with a sample of 11 patients(≥18 yrs old) who have experienced the treatment of mechanical ventilation in the affiliated hospital of medical universities in Beijing. The interviews were audiotaped and transcribed verbatim. The transcripts were analyzed using the phenomenological analysis method devised by Giorgi.
II. Research 2: A preliminary questionnaire entitled Intensive Care Experience with MV (ICE-MV) was developed based on the qualitative study and a review of the literature on intensive care experiences. The initial scale contained 50 items, which was content valid by 3 physicans, 4 nurses who worked in ICU, and 1 psychologist. 297 subjects were investigated using the scale when discharged from ICU. An exploratory factor analysis (EFA) was used to examine the psychometric characteristics of the ICE-MV scale.
III. Research 3: The demographic and illness condition information including age, sex, severity of illness, etc. were collected while objects were asked to fill the ICE-MV scale. Based on all valid questionnaires, we established the database and employed SPSS11.5 software package was used to analyze data. Descriptive analysis, one-way ANOVA, one sample t-test, Pearson correlation analysis, and multiple regression analysis were used in data statistical management.
Results:
I . Research 1: Qualitative analysis on the patient's experiences while receiving mechanical ventilation in an intensive unit. 5 themes related to patient's experience were extracted by in-depth data analysis including being in an unconventionality environment, suffering for distress and affliction, encountering psychological crisis, seeking for help and support, and self-reflection. Each theme covered many sub-themes.
II. Research 2: The final, 23 item ICE-MV scale consisted of five main components including "awareness of surrounding", "experience technique", "altered cognition and feeling", "inter-personal support demands", and "treatment and illness information". The overall experience scale demonstrated good internal consistency and reliability (Cronbach'sα= 0.80). The five components accounted for 52.50% of the whole variance.
III. Research 3:①By the descriptive statistic to patient's experiences, we found that patients who have received mechanical ventilation underwent the moderate degree experience with the highest scored in dimension 4(inter-personal support) and the lowest scored in dimension 3(cognition and feeling) respectively.②Main influence factors including period of mechanical ventilation, disease severity, marital status, and patient's age. Period of mechanical ventilation, disease severity, marital status were positive correlated to patient's experiences while patient's age was negative correlated to patient's experiences.Multiple correlation coefficient R was 0.552 and the coefficient of determination R~2 was 0.305. That is to say, those four variables could prognosticate 30.5% of the total score variance.
Conclusion:
I . By in-depth analysis, we have found that, although each case had different psychological & physical experiences and some commonness, generally speaking, patient's experiences while receiving mechanical ventilation in an intensive unit were poignant and afeard. We extracted 5 themes from patient's experiences including being in an unconventionality environment, suffering for distress and affliction, encountering psychological crisis, seeking for help and support, and self- reflection.
II. The scale consisted of 5 dimensions including "awareness of surrounding", "experience technique", "altered cognition and feeling", "inter-personal support demands", and "treatment and illness information". The questionnaire demonstrates good reliability and validity. It should be useful in further studies in the area of patient's experiences in the ICU.
III. We have found that patient's experiences while receiving mechanical ventilation underwent the intensive care experience above the moderate degree. Lacking of inter-personal support was the strongest reflected factor while the alteration of cognition and feeling was the weakest reflected factor.
IV. The period of mechanical ventilation, disease severity, marital status, and patient's age were the main factors that influenced patient's experiences while receiving mechanical ventilation in ICU. Younger patients with prolonged MV, more severe disease, negative marital status had worse experiences than others.
In conclusion, the results remind us that patients who receiving mechanical ventilation treatment have suffered many negative experiences related to intensive care and treatment. Those experiences not only affected by demographic factors but influenced by the healthy condition of patients. Therefore, besides taking life-saving measurement, we should also understand patient's experiences and take intervention correspondingly to those meliorate the unpleasant experiences, promote the prognosis and improve patient's life quality.
引文
[1]Rose L,Nelson S.Issues in weaning from mechanical ventilation:literature review.J Adv Nurs.2006,54(1):73-85.
[2]Subirana M,Bazan P.Modalities of mechanical ventilation.Enferm Intensiva.2000,11(1):23-32.
[3]Campbell DA,Pierce RJ:Long-term ventilatory support at home:any progress?Med J Aust.1998,168:7-8.
[4]马晓春;王辰;方强;刘大为,等.机械通气临床应用指南.中国危重病急救医学.2007,19(2):65-73
[5]Esteban A,Anzueto A,Alia I,et al.How is mechanical ventilation employed in the intensive care unit? An international utilization review.Am J Respir Crit Care Med.2000,161(5):1450-8.
[6]Wagner DP.Economics of prolonged mechanical ventilation.Am Rev Respir Dis 1989,140:S14-S18.
[7]Gries ML,Fernsler J.Patient perceptions of the mechanical ventilation experience.Focus Crit Care.1988,15(2):52-9.
[8]Cornock MA:Stress and the intensive care patient:perceptions of patients and nurses.J Adv Nurs.1998,27(3):518-27.
[9]Wong FYK,Arthur DG.Hong Kong patients' experiences of intensive care after surgery:nurses and patients' views.Intensive and Critical Care Nursing 2000,16:290-303.
[10]刘化侠 陈惠珍 苏爱华:病人与护士对机械通气不适的感知比较.护理研究,2003,17(7):763-764
[11]林菊英,金乔主编.中华护理全书.南昌:江西科学技术出版社,1993.126.
[12]徐美玲编著.护理人员的角色和功能.见卢美秀,许淑莲主编.现代护理实务全书.深圳:海天出版社,1998.23-26.
[13]王美德,安之璧主编.现代护理学辞典.南京:江苏科学技术出版社,1995.
[14]彭美慈,王春生,汪国成,等.护理是什么?——诠释植根中国文化的护理概念.中华护理杂志,2004,39(1):2-5
[15]Forsberg A, Backman L, Moller A: Experiencing liver transplantation: a phenomenological approach. J Adv Nurs. 2000, 32(2):327-34.
[16]Hagland MR: Nurse-patient communication in intensive care: a low priority? Intensive Crit Care Nurs. 1995 , 11(2):111-5.
[17] So HM, Chan DS: Perception of stressors by patients and nurses of critical care units in Hong Kong. Int J Nurs Stud. 2004,41(1):77-84.
[18]Stein-Parbury J, McKinley S: Patients' experiences of being in an intensive care unit: a select literature review. Am J Crit Care. 2000 , 9(1):20-7.
[19]Bradburn BG, Hewitt PB: The effect of the intensive therapy ward environment on patients' subjective impressions: a follow-up study. Intensive Care Med. 1980;7:15-18.
[20]Cochran 1, Ganong LH: A comparison of nurses' and patients' perceptions of intensive care unit stressors. J Adv Nurs. 1989,14:1038-1043.
[21]Easton C, MacKenzie F. Sensory-perceptual alterations: delirium in the intensive care unit. Heart Lung. 1988,17:229-235.
[22]Jones J, Hoggart B, Withey J, Donaghue K, Ellis BW: What the patients say: a study of reactions to an intensive care unit. Intensive Care Med. 1979, 5:89-92.
[23]Keep P, James J, Inman M: Windows in the intensive therapy unit. Anaesthesia,1980, 35: 257-262.
[24]Riggio RE, Singer RS, Hartman K. Psychological issues in the care of critically ill respirator patients: differential perceptions of patients, relatives, and staff.Psychol Rep. 1982,51:363-369
[25]Dracup K. Are critical care units hazardous to health? Appi Nurs Res.1988-1-14-21.
[26]Elpern EH, Patterson PA, Gloskey D, Bone RC. Patients' preferences for intensive care. Crit Care Med. 1992,20:43-47.
[27]Burfitt SN, Greiner DS, Miers LJ, Kinney MR, Branyon ME. Professional nurse caring as perceived by critically ill patients: a phenomenologic study. Am J Crit Care. 1993,2:489-499.
[28]Chen Y. Psychological and social support systems in intensive and critical care. Intensive Care Nurs. 1990, 6:59-66.
[29]Compton E. Critical illness and intensive care: what it means to the client.Crit Care Nurse. 1991, 11:50-56.
[30]Daffurn K, Bishop GF, Hillman KM, Bauman A. Problems following discharge after intensive care. Intensive Crit Care Nurs. 1994,10(4):244-251.
[31]Holland C, Cason CL, Prater LR. Patients' recollections of critical care. Dimens Crit Care Nurs. 1997,16 (3) : 132-141.
[32]Jablonski RS. The experience of being mechanically ventilated. Qual Health Res. 1994,4:186-207.
[33]Granja C, Lopes A, Moreira S, et al: Patients' recollections of experiences in the intensive care unit may affect their quality of life. Crit Care. 20059(2):R96-109.
[34]Lof L, Berggren L, Ahlstrom G: Severely ill ICU patients recall of factual events and unreal experiences of hospital admission and ICU stay—3 and 12 months after discharge. Intensive Crit Care Nurs. 2006 , 22(3): 154-66.
[35]Gardner G, Elliott D, Gill J: Patient experiences following cardiothoracic surgery: an interview study. Eur J Cardiovasc Nurs. 2005,4(3):242-5.
[36]Hunt JM. The cardiac surgical patient's expectations and experiences of nursing care in the intensive care unit. Aust Crit Care. 1999 , 12(2):47-53.
[37]Barrio M, Lacunza MM, Armendariz AC: Liver transplant patients: their experience in the intensive care unit. A phenomenological study. J Clin Nurs.2004,13(8):967-76
[38]Granberg A, Engberg IB, Lundberg D. Intensive care syndrome: a literature review. Intensive Crit Care Nurs. 1996, 12(3): 173-82.
[39]Granberg Axell AI, Malmros CW, Bergbom IL. et al. Intensive care unit syndrome/delirium is associated with anemia, drug therapy and duration of ventilation treatment. Acta Anaesthesiol Scand. 2002 , 46(6):726-31.
[40]Russell S. An exploratory study of patients' perceptions, memories and experiences of an intensive care unit. J Adv Nurs. 1999, 29(4):783-91.
[41]Ringdal M, Johansson L, Lundberg D. et al. Delusional memories from the intensive care unit—experienced by patients with physical trauma. Intensive Crit Care Nurs. 2006,22(6):346-54.
[42]Easton C, MacKenzie F.Sensory-perceptual alterations: delirium in the intensive care unit. Heart Lung. 1988 ,17(3):229-37.
[43]Laitinen H. Patients' experience of confusion in the intensive care unit following cardiac surgery. Intensive Crit Care Nurs. 1996,12(2):79-83.
[44]Ely EW, Margolin R, Francis J. et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001,29(7):1370-9.
[45]Pisani MA, Araujo KL, Van Ness PH. et al. A research algorithm to improve detection of delirium in the intensive care unit. Crit Care. 2006,10(4):R121.
[46]Choate K, Stewart M: Reducing anxiety in patients and families discharged from ICU. Aust Nurs J. 2002,10(5):29.
[47] Mitchell ML, Courtney M, Coyer F: Understanding uncertainty and minimizing families' anxiety at the time of transfer from intensive care. Nurs Health Sci. 2003 , 5(3):207-17.
[48]Hafsteindottir TB: Patient's experiences of communication during the respirator treatment period. Intensive Crit Care Nurs. 1996,12(5):261-71.
[49]Holland C, Cason CL, Prater LR. Patients' recollections of critical care. Dimens Crit Care Nurs. 1997,16(3):132-41.
[50]Patak L, Gawlinski A, Fung NI. et al. Communication boards in critical care: patients' views. Appl Nurs Res. 2006,19(4): 182-90.
[51]Patak L, Gawlinski A, Fung NI. et al. Patients' reports of health care practitioner interventions that are related to communication during mechanical ventilation. Heart Lung. 2004,33(5):308-20.
[52]Casbolt S .Communicating with the ventilated patient—a literature review.Nurs Crit Care. 2002 ,7(4):198-202.
[53]Bergbom-Engberg I, Haljamae H. A retrospective study of patients' recall of respirator treatment (2): Nursing care factors and feelings of security/insecurity. Intensive Care Nurs. 1988,4(3):95-101.
[54]McKinley S., Nagy S., Stein-Parbury J. Vulnerability and security in seriously ill patients in intensive care. Intensive Crit Care Nurs. 2002, 18(1):27-36.
[55]Gardner G, Elliott D., Gill J. et al. Patient experiences following cardiothoracic surgery: an interview study. Eur J Cardiovasc Nurs. 2005 ; 4(3):242-50.
[56]Adamson H., Murgo M., Boyle M.et al. Memories of intensive care and experiences of survivors of a critical illness: an interview study. Intensive Crit Care Nurs. 2004,20(5):257-63.
[57]Grap MJ, Blecha T, Munro C. A description of patients' report of endotracheal tube discomfort. Intensive Crit Care Nurs. 2002, 18(4):244-9.
[58]Puntillo KA. Dimensions of procedural pain and its analgesic management in critically ill surgical patients. Am J Crit Care. 1994 , 3(2): 116-22.
[59]Elpern EH, Patterson PA, Gloskey D. et al. Patients' preferences for intensive care. Crit Care Med. 1992 , 20(1):43-7.
[60]Riggio RE, Singer RD, Hartman K: Psychological issues in the care of critically-ill respirator patients: differential perceptions of patients, relatives,and staff. Psychol Rep. 1982, 51(2):363-9.
[61] Green A. An exploratory study of patients' memory recall of their stay in an adult intensive therapy unit. Intensive Crit Care Nurs. 1996,12(3):131-7.
[62]Bradburn BG, Hewitt PB. The effect of the intensive therapy ward environment on patients' subjective impression: a follow-up study. Intensive Care Med. 1980, 7(1):15-8.
[63]Evans JC, French DG. Sleep and healing in intensive care settings. Dimens Crit Care Nurs. 1995, 14(4): 189-99.
[64]Reishtein JL. Sleep in mechanically ventilated patients. Crit Care Nurs Clin North Am. 2005, 17(3):251-5.
[65]Burfitt SN, Greiner DS, Miers LJ.et al. Professional nurse caring as perceived by critically ill patients: a phenomenologic study. Am J Crit Care. 1993 ,2(6):489-99
[66]Esteban A, Anzueto A, Frutos F, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA.2002,287:345-55.
[67]Seneff MG,Zimmerman JE,Knaus WA:Predicting the duration of mechanical ventilation:The importance of disease and patient characteristics.Chest.1996,110(2):469-79.
[68]Roberts BL,Rickard CM,Rajbhandari D.et al.Factual memories of ICU:recall at two years post-discharge and comparison with delirium status during ICU admission—a multicentre cohort study.J Clin Nurs.2007,16(9):1669-77.
[69]Jones C,Griffiths RD,Humphris G.et al.Memory,delusions,and the development of acute posttraumatic stress disorder-related symptoms after intensive care.Crit Care Med.2001,29(3):573-80.
[70]Logan J,Jenny J.Qualitative analysis of patients' work during mechanical ventilation and weaning.Heart Lung.1997,26(2):140-7.
[71]Sacker DL,Rosenberg WM,Gray JA.et al.Evidence based medicine:what it is and what it isn't.BMJ.1996,312:71-2.
[72]McCarthy A,Hegney D.Evidence-based practice and rural nursing:a literature review.Aust J Rural Health.1998,6(2):96-9.
[73]Goopy SE(2005) Taking account of local culture:limits to the development of a professional ethos.Nursing Inquiry 12,144-154.
[74]李庆功,董沛.系统化整体护理:狭义和广义,山西护理杂志 1997,11,188-190.
[75]范秋霞,李亚琴.护理人员实施护理程序的现况调查,护理研究 2000,14,139-141.
[76]Chelluri L,Rotondi AJ,Mendelsohn AB,et al.Two-month mortality and function status of critically ill adult patients receiving prolonged mechanical ventilation.Chest 2002,121:549-558.
[77]陈向明.质的研究方法与社会科学研究 北京:教育科学出版社,2000:7-9.
[78]殷磊主编.老年护理学.北京:人民卫生出版社.2000:35-37.
[79]李格,沈渔村,陈昌惠,等.老年痴呆简易测试方法研究-MMSE在城市老年居 民中的测试.中国心理卫生杂志 1998,2(1):13.
[80]Steinar.Interviews:An introduction to qualitative research interviewing.London:SAGE Publications 1996:129-131.
[81]Minichiello V,Arini R,Timewell,Alexander L.In-depth interviewing.Melbourne:Longnan,1995:138-152.
[82]钟玉娟,,李智峰译.护理质性研究,台北:王南图书出版公司,2003:115.
[83]黄惠雯,童琬芬,梁文秦,等译著.最新质性方法与研究[M].台北:韦博文化国际出版有限公司,2003:252-258。
[84]Giorgi A.The theory,practice,and evaluation of the phenomenological method as a qualitative research procedure.J Phenomenology psychology,1997,28(2):235-260
[85]胡雁.质性研究,护士进修杂志 2006,21(7):579-581
[86]Johnson P,St John W,Moyle W.Long-term mechanical ventilation in a critical care unit:existing in an uneveryday world.J Adv Nurs.2006,53(5):551-8
[87]Granberg-Axell A,Bergbom I,Lundberg D.Clinical signs of ICU syndrome/delirium:an observational study.Intensive Crit Care Nurs.2001,17(2):72-93.
[88]Eveloff SE.The disruptive ICU:An issue to lose sleep over? Chest.1995,107(6):1483-4
[89]Martin Christensen.Noise levels in a general intensive care unit:a descriptive study.Nursing in Critical Care 2007,12(4),188-197.
[90]Slutsky AS.ACCP Consensus Conference:mechanical ventilation.Chest 1993,104(6):1822-1859
[91]Bergbom-Engberg I,Hallenberg B,Wickstrom I,Haljamae H.A retrospective study of patients' recall of respirator treatment.(1):Study design and basic findings.Intensive Care Nurs.1988,4(2):56-61.
[92]Johnson MM,Sexton DL.Distress during mechanical ventilation:patients'perceptions.Crit Care Nurse.1990,10(7):48-57.
[93]Griggs A.Tracheostomy:suctioning and humidification.Nurs Stand.1998,13(2):49-53.
[94]Dries DJ.Weaning from mechanical ventilation.The Journal of Trauma,Injury,Infection and Critical Care.1997,43(2):372-384
[95]Ashworth P.Nursing process:a way to better care.Nuts Mirror.1980,28:151(9):26-7
[96]Leathart AJ.Communication and socialisation(1):An exploratory study and explanation for nurse-patient communication in an ITU.Intensive Crit Care Nurs.1994,10(2):93-104.
[97]Llenore E,Ogle KR.Nurse-patient communication in the intensive care unit:a review of the literature.Aust Crit Care.1999,12(4):142-5.
[98]Casbolt S.Communicating with the ventilated patient—a literature review.Nurs Crit Care.2002,7(4):198-202.
[99]Magarey JM,McCutcheon HH.Fishing with the dead-recall of memories from the ICU.Intensive Crit Care Nurs.2005,21(6):344-54.
[100]Morse JM,Bottorff JL,Hutchinson S.The phenomenology of comfort.J Adv Nurs.1994 Jul;20(1):189-95.
[101]Seneff MG,Wagner DP,Wagner RP.Hospital and 1-year survival of patients admitted to intensive care unit with acute exacerbation of chronic obstructive pulmonary disease.J Am Med Assoc 1995,274(23):1852-7.
[102]Burns SM,Clochesy JM,Hanneman SK,Weaning from long-term mechanical ventilation.Am J Crit Care.1995;4(1):4-22.
[103]Chaikkeux E,Faurous B,Binet F.et al.Predictors of survival in patients receiving domiciliary oxygen therapy or mechanical ventilation:a 10-year analysis of ANTADIR Observatory.Chest 1996,109:741-9.
[104]Thomposon MJ,Elton RA,Mankad PA,et al.Prediction of requirement for,and outcome of,prolonged mechanical ventilation following cardiac surgery Cardiovasc Surg.1997,5(4):376-81.
[105]Dasgnpta A,Rice R,Mascha E.et al.Four-year experience with a unit for long-term ventilation at the Cleveland Clinic Foundation.Chest. 1999,116:447-55.
[106]Engoren M, Fenn Buderer N, Zacharias A. Long-term survival and health status after prolonged mechanical ventilation after cardiac surgery. Crit Care Med. 2000,28(8):2742-9.
[107]Nozawa E, Azeka E, Ignez ZM. et al. Factors associated with failure of weaning from long-term mechanical ventilation after cardiac surgery. Int Heart J. 2005 ,46(5):819-31.
[108]Herlihy JP, Koch SM, Jackson R. et al. Course of weaning from prolonged mechanical ventilation after cardiac surgery. Tex Heart Inst J.2006;33(2):122-9.
[109]Hopper K, Haskins SC, Kass PH, et al. Indications, management, and outcome of long-term positive-pressure ventilation in dogs and cats: 148 cases (1990-2001).J Am VetMedAssoc. 2007, 230(l):64-75.
[110]Ye Q. Wang C. Tong ZH. et al. Proportional assist ventilation: methodology and therapeutics on COPD patients compared with pressure support ventilation. Chinese MedicalJournal, 2002,115(2):179-183.
[111]Wagner DP. Assessing hospital-associated deaths. JAMA. 1989, 261(16):2331.
[112]Jones C, Griffiths RD, Humphris G Disturbed memory and amnesia related to intensive care. Memory, 2000,8(2):79-84.
[113]Deborah J, Cook MD, Maureen O. et al. Qualitative studies on the patient's experience of weaning from mechanical ventilation. Chest. 2001,120(6):469s-473s.
[114]Harriet A, Margherita M, Martin B. et al. Memories of intensive care and experiences of survivors of a critical illness: an interview study. Intensive Crit Care Nurs, 2004,20:257-263.
[115]Rattray JE, Johnston M, Wildsmith JAW. Predictors of emotional outcomes of intensive care. Anasesthesia, 2005, 60(11): 1085-92.
[116]Scragg P, Jones A, Fauvel N. Psychological problems following ICU treatment. Anasesthesia, 2001, 56:9-14.
[117]Geary SM. Intensive care unit psychosis revisited: understanding and managing delirium in the critical care setting.Crit Care Nurs Q.1994,17(1):51-63.
[118]Green A.An exploratory study of patients' memory recall of their stay in an adult intensive therapy unit.Intensive Crit Care Nurs.1996,12(3):131-7.
[119]Dyer I.Preventing the ITU syndrome or how not to torture an ITU patient!Part 2.Intensive.Crit Care Nurs.1995,11(4):223-32.
[120]Jones C,Humphris G,Griffiths RD.Preliminary validation of the ICUM tool:a tool for assessing memory of the intensive care experience.Clinical intensive care,2000,11(5):251-255.
[121]Hall-Smith J,Ball C,Coakley J.Follow-up services and the development of a clinical nurse specialist in intensive care.Intensive Crit Care Nurs.1997,13(5):243-8.
[122]Wang Kefang,Zhang Bing,Li Chun-yan,Wang Chen.Qualitative analysis of patients' intensive care experience during mechanical ventilation.J Clin Nurs.2009,18,183-190
[123]Bowling A.Research Methods in Health.Open University Press,Buckingham.1997.
[124]Burn N,Grove SK.The Practice of Nursing Research Conduct,Critique,and Utilization,3rd edn.W.B.Saunders and Co.,Philadelphia.1997.
[125]刘宇.研究工具性能的测定.见王克芳主编.护理研究,北京:北京大学医学出版社,2006.86-91.
[126]Grant,J.S.,& Davis,L.L..Selection and use of content experts for instrument development.Res Nurs Health,1997,20(3),269-274.
[127]Lynn,M.R.Determination and quantification of content validity.Nurs Res,1986,35(6),382-385.
[128]Waltz,C.F.Stricldand,O.L.,& Lenz,E.R.(Ed.).Measurement in nursing and health research.New York:Springer Pub.2005.
[129]Polit D.F.,Bech C.T.Nursing Research:principles and methods(7th ed)Philadelphia:Lippincott,Williams,& Wilkins,2004.
[130]Tabachnik BG.,Fidell LS.Using Multivariate Statistics,3rd edn.Harper Collins,New York.1996.
[131]Polit DF,Beck CT.Nursing Research—Principles and Methods,Lippincott Williams & Wilkins,Philadelphia.2004.
[132]Gustavsson JP,Bergman H,Edman G,et al.Swedish Universities Scales of Personality:construction,internal consistency and normative data.Acta Psychiatr Scand.2000,102(3):217-225.
[133]郭志刚.社会统计分析方法—SPSS软件应用.北京:中国人民大学出版社,1999.92-93.
[134]Bijttebier P,Vertommen H,Steene GV.Assessment of cognitive coping styles:a closer look at situation-response inventories.Clin Psychol Rev.2001,21(1):85-104.
[135]郭庆科.心理测验的原理与应用.北京:人民军医出版社,2002.38-39.
[136]王海军,徐克静.问卷调查中的信度和效度问题.中国健康教育,1994,10(11):21-23.
[137]方积乾,陆盈主编.现代医学统计学.北京:人民卫生出版社.2002.
[138]Rattray J,Johnston M,Wildsmith JA.The intensive care experience:development of the ICE questionnaire.J Adv Nurs.2004,47(1):64-73.
[139]Arslanian-Engoren C,Scott LD.The lived experience of survivors of prolonged mechanical ventilation:a phenomenological study.Heart Lung.2003,32(5):328-34.
[140]Hammond F:Involving families in care within the intensive care environment:a descriptive survey.Intensive Crit Care Nurs 1995,11:256-64.
[141]Knaus WA,Draper EA,Wagner DP,et al.APACHE:a severity of disease classification system.Crit Care Med,1985,13:818.
[142]梁建业.危重病患者病情评定法-APACHE系统的研究进展.中国危重病急救医学,1996,8(1):52-56.
[143]江学成.危重疾病严重程度评分临床应用和意义.中国危重病急救医学,2000,12(4):195-197.
[144]胡守利.我国危重疾病评分系统应用现状.中国危重病急救医学,2001,13 (2): 73-75.
[145]Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983, 67(6):361-370.
[146]Johnston M, Pollard B, Hennessey P. Construct validation of the Hospital Anxiety and Depression Scale with clinical populations. Journal of Psychosomatic Research. 2000, 48(6):579-584.
[147] Hermann C. International experiences with the Hospital Anxiety and Depression Scale-a review of validation data and clinical results . Journal of Psychosomatic Research. 1997,42(1):17-41.
[148]Tabachnik BG, Fidell LS. Using Multivariate Statistics, 3rd edn. Harper Collins,New York. 1996.
[149]Rotondi AJ, Chelluri L, Sirio C, Mendelsohn et al. Patients' recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit Care Med. 2002,30(4):746-52.
[150]Menzel LK. Factors related to the emotional responses of intubated patients to being unable to speak. Heart Lung. 1998,27(4):245-52.
[151]Pennock BE, Crawshaw L, Maher T, et al. Distressful events in the ICU as perceived by patients recovering from coronary artery bypass surgery.Heart Lung. 1994,23(4):323-7.
[152]Mckegney FP. The intensive care syndrome. The definition, treatment and prevention of a new "disease of medical process. Conn Med.1966,30(9):633-6.
[153]Granberg A, Engberg IB, Lundberg D. Acute confusion and unreal experiences hi intensive care patients in relation to the ICU syndrome. Part I. Intensive and Critical Care Nursing. 1999,15(1):19-33.
[154]Novaes MA, Aronovich A, Ferraz MB, Knobel E. Stressors in ICU: patients' evaluation. Intensive CareMed. 1997,23(12):1282-5.
[155]Hweidi IM. Jordanian patients' perception of stressors in critical care units: a questionnaire survey. Int J Nurs Stud. 2007,44(2):227-35.
[156]So HM, Chan DS. Perception of stressors by patients and nurses of critical care units in Hong Kong. Int J Nurs Stud. 2004,41(1):77-84.
[157]Cuthbertson BH, Hull A, Strachan M, et al. Post-traumatic stress disorder after critical illness requiring general intensive care. Intensive Care Medicine.2004,30(3):450-5.
Barrio M, Lacunza MM, Armendariz AC, Margall MA & Asiain MC (2004) Liver transplant patients: their experience in the intensive care unit. A phenomenological study. Journal of Clinical Nursing 13, 967-976.
Bergbom-Engberg I & Haljamae H (1989) Assessment of patients' experience of discomforts during respirator therapy. Critical Care Medicine 17, 1068-72.
Burns SM, Earven S., Fisher C, Lewis R, Merrell P, Schubart JR, Truwit JD & Bleck TP (2003) Implementation of an institutional program to improve clinical and financial outcomes of mechanically ventilated patients: one-year outcomes and lessons learned, Critical Care Medicine 31,2752-2763.
Chelluri L, Rotondi AJ, Mendelsohn AB, Belle SH & Schulz R (2002) 2-month mortality and functional status of critically ill adult patients receiving prolonged mechanical ventilation. Chest 121, 549-58.
Chen WC (2006) Analysis and suggestion to the present nursing work[Chinese].Chinese Nursing Journal 41,450-451.
Cohen MZ, Kahn D & Steeves RH (2000) Hermeneutic phenomenological research: A practical guide for nurse researchers. Thousands Oaks, CA: Sage.
Coyne IT (1997) Sampling in qualitative research. Purposeful and theoretical sampling; merging or clear boundaries? Journal of Advanced Nursing 26,623-630.
Curley MA (1998) Patient-nurse synergy: optimizing patients' outcomes. American Journal of Critical Care 7,64-72.
Ely EW, Meade MO, Haponik EF, Kollef MH, Cook DJ, Guyatt GH & Stoller JK (2001) Mechanical ventilator weaning protocols driven by nonphysician health-care professionals: evidence-based clinical practice guidelines, Chest 120,454S-463S.
Eriksson T & Bergbom I (2007) Visits to intensive care unit patients-frequency,duration and impact on outcome. Nursing in Critical Care 12,20-26
Esteban A, Anzueto A, Alia I, Gordo F, Apezteguia C, Palizas F, Cide D, Goldwaser R, Soto L, Bugedo G, Rodrigo C, Pimentel J, Raimondi G &Tobin MJ (2000) How is mechanical ventilation employed in the intensive care unit? An international utilization review. American Journal of Respiratory Critical Care Medicine 161,1450-1458.
Fan Q, Liu Y & Fan H(2000).Investigation on Status in quo of the nursing staff towards carrying out nursing procedure.[Chinese].Chinese Nursing Research 14,139-141.
Forchuk C & Roberts J (1993) How to critique qualitative research articles. The Canadian journal of nursing research 25,47-55.
Gardner G, Elliott D, Gill J, Griffin M & Crawford M (2005) Patient experiences following cardiothoracic surgery: an interview study. European journal of cardiovascular nursing 4,242-250.
Giorgi A (1997) The theory, practice and evaluation of the phenomenological method as a qualitative research procedure. Journal of Phenomenology psychology 28, 235-260.
Goopy SE (2005) Taking account of local culture: limits to the development of a professional ethos. Nursing inquiry 12,144-154.
Grap MJ, Strickland D, Tormey L, Keane K, Lubin S & Emerson J (2003) Collaborative practice: development, implementation and evaluation of a weaning protocol for patients receiving mechanical ventilation, American Journal of Critical Care 12, 454-460.
Granberg-Axell A, Bergbom I & Lundberg D (2001) Clinical signs of ICU syndrome/delirium: an observational study. Intensive Critical Care Nursing 17,72-93.
Griggs A (1998) Tracheostomy: suctioning and humidification. Nursing standard 13,49-53.
Holland C, Cason CL & Prater LR (1997) Patients' recollections of critical care. Dimensions of critical care nursing 1, 132-141.
Hu BC, Huang LH & Zhong WL (2007) The leaders' opinion about nursing work[Chinese]. Chinese Nursing Journal 42,441-444.
Jablonski RS (1994) The experience of being mechanically ventilated. Qualitative health research 4, 186-207.
Jenny J & Logan J (1996) Caring and comfort metaphors used by patients in critical care. Image—the journal of nursing scholarship 28, 349-352.
Johnson P, St John W & Moyle W (2006) Long-term mechanical ventilation in a critical care unit: existing in an uneveryday world. Journal of Advanced Nursing 53,551-558.
Johnson MM & Sexton DL (1990) Distress during mechanical ventilation: patients' perceptions. Critical Care Nurse 10,48-57.
Li Q, Huang Q & Dong P(1997) Systematic approach to holistic nursing care: Narrow and broad senses[Chinese]. Shanxi Nursing Journal 11,188-190.
Logan J & Jenny J (1997) Qualitative analysis of patients' work during mechanical ventilation and weaning. Heart Lung 26, 140-147.
Magarey JM & McCutcheon HH (2005) Fishing with the dead-recall of memories from the ICU.Intensive Critical Care Nursing.21,344-354.
McKinley S,Nagy S & Stein-Parbury J(2002) Vulnerability and security in seriously ill patients in intensive care.Intensive Critical Care Nursing 18,27-36.25.
Morse JM,Bottorff JL & Hutchinson S(1994) The phenomenology of comfort.Journal of Advnced Nursing 20,189-195.
Russell S(1999) An exploratory study of patients' perceptions,memories and experiences of an intensive care unit.Journal of Advnced Nursing 29,783-791.
Sandelowski M(1994) Notes on transcription.Research in nursing & health 17,311-314.
Slutsky AS(1993) Mechanical ventilation.American College of Chest Physicians'Consensus Conference.Chest 104,1833-1859.
Song BY.Feng YR & Wang YF(1999)Clinical approach to holistic nursing care[Chinese].Journal of Nurses Training 14,8-9.
Wagner DP(1989) Economics of prolonged mechanical ventilation.The American review of respiratory disease 140,S14-S18.
Wunderlich RJ,Perry A,Lavin MA & Katz B(1999) Patients' perceptions of uncertainty and stress during weaning from mechanical ventilation.Dimensions of critical care nursing 18,8-12.
Yang YX,Chen BY,Li XL & Ou ZL(2007) Analysis on negative factors influencing occupation idea of nurses and its strategies[Chinese].Chinese Nursing Research 21,3070-3071.
Ye WQ,Wang HS & Shen H(1999) The problem and strategies about nursing human resource[Chinese].Chinese Hospital Management 19,49.
Zhang JW,Shi WJ & Gu ZH(2001) Investigation about intensive care nurses'training[Chinese].Chinese Nursing Journal 36,365-368.
Zhu XL,Zheng YW & Wang Y(2006) Analysis and strategies about nurses training in ICU[Chinese].Chinese Journal of Practical Nursing 22,55-56.
1. Esteban A, Anzueto A, Frutos F, Alia I, Brochard L, Stewart TE, Benito S,Epstein SK, Apezteguia C, Nightingale P, et al: How is mechanical ventilation employed in the intensive care unit? An international utilization review. Am J RespirCrit Care Med 2000, 161: 1450-1458.
2. Wagner DP: Assessing hospital-associated deaths. JAMA 1989, 261: :2331.
3. Jones C, Griffiths RD, Humphris G: Disturbed memory and amnesia related to intensive care. Memory 2000, 8: 79-84.
4. Cook DJ, Meade MO, Perry AG: Qualitative studies on the patient's experience of weaning from mechanical ventilation. Chest 2001, Suppl 6: 469-473.
5. Russell S: An exploratory study of patients' perceptions, memories and experiences of an intensive care unit. J Adv Nurs 1999, 29: 783-791.
6. Johnson P, John W, Moyle W: Long-term mechanical ventilation in a critical care unit: existing in an uneveryday world. J Adv Nurs 2006, 53: 551-558.
7. Lof L, Berggren L, Ahlstrom G: Severely ill ICU patients recall of factual events and unreal experiences of hospital admission and ICU stay--3 and 12 months after discharge. Intensive Crit Care Nurs 2006, 22: 154-66.
8. Roberts BL, Rickard CM, Rajbhandari D, Reynolds P: Factual memories of ICU: recall at two years post-discharge and comparison with delirium status during ICU admission-a multicentre cohort study. J Clin Nurs 2007, 16: 1669-1677.
9. Rattray JE, Johnston M, Wildsmith JAW: Predictors of emotional outcomes of intensive care. Anasesthesia 2005, 60: 1085-1092.
10. Scragg P, Jones A, Fauvel N: Psychological problems following ICU treatment. Anasesthesia 2001, 56: :9-14.
11. Dyer I: Preventing the ITU syndrome or how not to torture an ITU patient!Part 2. Intensive Crit Care Nurs 1995, 11: 223-232.
12. Hall-Smith J, Ball C, Coakley J: Follow-up services and the development of a clinical nurse specialist in intensive care. Intensive Crit Care Nurs 1997, 13:243-248.
13. Geary SM: Intensive care unit psychosis revisited: understanding and managing delirium in the critical care setting. Crit Care Nurs Q 1994, 17:51-63.
14. Green A: An exploratory study of patients' memory recall of their stay in an adult intensive therapy unit. Intensive Crit Care Nurs 1996, 12: 131-137.
15. Rattray J, Johnston M, Wildsmith JA: The intensive care experience:development of the ICE questionnaire. J Adv Nurs 2004, 47: 64-73.
16. Burn N, Grove SK: The practice of nursing research conduct, critique, and utilization. Philadelphi: WB Saunders and Co; 1997.
17. PolitDF, Beck CT: Nursing Research-Principles and Methods. Philadelphia: Lippincott Williams & Wilkins; 2004.
18. Tabachnik BG, Fidell LS: Using Multivariate Statistics. New York: Harper Collins; 1996.
19. Gustavsson JP, Bergman H, Edman G, Ekselius L, Knorring L, Linder J:Swedish Universities Scales of Personality: construction, internal consistency and normative data. Acta Psychiatr Scand 2000, 102: 217-225.
20. Guo ZG: Statistical method in social science—Application of SPSS software package. Beijing: China Renmin University Pres; 1999.
21. Granberg-Axell A, Bergbom I, Lundberg D: Clinical signs of ICU syndrome/delirium: an observational study. Intensive Crit Care Nurs 2001,17: 72-93.
22. Gries ML, Fernsler J: Patient perceptions of the mechanical ventilation experience. Focus Crit Care 1988, 15: 52-59.
23. Jablonski RS. The experience of being mechanical ventilated. Qual Health Res 1994;4:186-207.
24. Arslanian-Engoren C, Scott LD: The lived experience of survivors of prolonged mechanical ventilation: a phenomenological study. Heart Lung 2003, 32:328-334.
25. McKinley S, Nagy S, Stein-Parbury J, Bramwell M, Hudson J: Vulnerability and security in seriously ill patients in intensive care. Intensive Crit Care Nurs 2002, 18: 27-36.
26. Hammond F: Involving families in care within the intensive care environment:a descriptive survey. Intensive Crit Care Nurs 1995,11:256-64.
[2]Subirana M,Bazan P.Modalities of mechanical ventilation.Enferm Intensiva.2000,11(1):23-32.
[3]Campbell DA,Pierce RJ:Long-term ventilatory support at home:any progress?Med J Aust.1998,168:7-8.
[4]马晓春;王辰;方强;刘大为,等.机械通气临床应用指南.中国危重病急救医学.2007,19(2):65-73
[5]Esteban A,Anzueto A,Alia I,et al.How is mechanical ventilation employed in the intensive care unit? An international utilization review.Am J Respir Crit Care Med.2000,161(5):1450-8.
[6]Wagner DP.Economics of prolonged mechanical ventilation.Am Rev Respir Dis 1989,140:S14-S18.
[7]Gries ML,Fernsler J.Patient perceptions of the mechanical ventilation experience.Focus Crit Care.1988,15(2):52-9.
[8]Cornock MA:Stress and the intensive care patient:perceptions of patients and nurses.J Adv Nurs.1998,27(3):518-27.
[9]Wong FYK,Arthur DG.Hong Kong patients' experiences of intensive care after surgery:nurses and patients' views.Intensive and Critical Care Nursing 2000,16:290-303.
[10]刘化侠 陈惠珍 苏爱华:病人与护士对机械通气不适的感知比较.护理研究,2003,17(7):763-764
[11]林菊英,金乔主编.中华护理全书.南昌:江西科学技术出版社,1993.126.
[12]徐美玲编著.护理人员的角色和功能.见卢美秀,许淑莲主编.现代护理实务全书.深圳:海天出版社,1998.23-26.
[13]王美德,安之璧主编.现代护理学辞典.南京:江苏科学技术出版社,1995.
[14]彭美慈,王春生,汪国成,等.护理是什么?——诠释植根中国文化的护理概念.中华护理杂志,2004,39(1):2-5
[15]Forsberg A, Backman L, Moller A: Experiencing liver transplantation: a phenomenological approach. J Adv Nurs. 2000, 32(2):327-34.
[16]Hagland MR: Nurse-patient communication in intensive care: a low priority? Intensive Crit Care Nurs. 1995 , 11(2):111-5.
[17] So HM, Chan DS: Perception of stressors by patients and nurses of critical care units in Hong Kong. Int J Nurs Stud. 2004,41(1):77-84.
[18]Stein-Parbury J, McKinley S: Patients' experiences of being in an intensive care unit: a select literature review. Am J Crit Care. 2000 , 9(1):20-7.
[19]Bradburn BG, Hewitt PB: The effect of the intensive therapy ward environment on patients' subjective impressions: a follow-up study. Intensive Care Med. 1980;7:15-18.
[20]Cochran 1, Ganong LH: A comparison of nurses' and patients' perceptions of intensive care unit stressors. J Adv Nurs. 1989,14:1038-1043.
[21]Easton C, MacKenzie F. Sensory-perceptual alterations: delirium in the intensive care unit. Heart Lung. 1988,17:229-235.
[22]Jones J, Hoggart B, Withey J, Donaghue K, Ellis BW: What the patients say: a study of reactions to an intensive care unit. Intensive Care Med. 1979, 5:89-92.
[23]Keep P, James J, Inman M: Windows in the intensive therapy unit. Anaesthesia,1980, 35: 257-262.
[24]Riggio RE, Singer RS, Hartman K. Psychological issues in the care of critically ill respirator patients: differential perceptions of patients, relatives, and staff.Psychol Rep. 1982,51:363-369
[25]Dracup K. Are critical care units hazardous to health? Appi Nurs Res.1988-1-14-21.
[26]Elpern EH, Patterson PA, Gloskey D, Bone RC. Patients' preferences for intensive care. Crit Care Med. 1992,20:43-47.
[27]Burfitt SN, Greiner DS, Miers LJ, Kinney MR, Branyon ME. Professional nurse caring as perceived by critically ill patients: a phenomenologic study. Am J Crit Care. 1993,2:489-499.
[28]Chen Y. Psychological and social support systems in intensive and critical care. Intensive Care Nurs. 1990, 6:59-66.
[29]Compton E. Critical illness and intensive care: what it means to the client.Crit Care Nurse. 1991, 11:50-56.
[30]Daffurn K, Bishop GF, Hillman KM, Bauman A. Problems following discharge after intensive care. Intensive Crit Care Nurs. 1994,10(4):244-251.
[31]Holland C, Cason CL, Prater LR. Patients' recollections of critical care. Dimens Crit Care Nurs. 1997,16 (3) : 132-141.
[32]Jablonski RS. The experience of being mechanically ventilated. Qual Health Res. 1994,4:186-207.
[33]Granja C, Lopes A, Moreira S, et al: Patients' recollections of experiences in the intensive care unit may affect their quality of life. Crit Care. 20059(2):R96-109.
[34]Lof L, Berggren L, Ahlstrom G: Severely ill ICU patients recall of factual events and unreal experiences of hospital admission and ICU stay—3 and 12 months after discharge. Intensive Crit Care Nurs. 2006 , 22(3): 154-66.
[35]Gardner G, Elliott D, Gill J: Patient experiences following cardiothoracic surgery: an interview study. Eur J Cardiovasc Nurs. 2005,4(3):242-5.
[36]Hunt JM. The cardiac surgical patient's expectations and experiences of nursing care in the intensive care unit. Aust Crit Care. 1999 , 12(2):47-53.
[37]Barrio M, Lacunza MM, Armendariz AC: Liver transplant patients: their experience in the intensive care unit. A phenomenological study. J Clin Nurs.2004,13(8):967-76
[38]Granberg A, Engberg IB, Lundberg D. Intensive care syndrome: a literature review. Intensive Crit Care Nurs. 1996, 12(3): 173-82.
[39]Granberg Axell AI, Malmros CW, Bergbom IL. et al. Intensive care unit syndrome/delirium is associated with anemia, drug therapy and duration of ventilation treatment. Acta Anaesthesiol Scand. 2002 , 46(6):726-31.
[40]Russell S. An exploratory study of patients' perceptions, memories and experiences of an intensive care unit. J Adv Nurs. 1999, 29(4):783-91.
[41]Ringdal M, Johansson L, Lundberg D. et al. Delusional memories from the intensive care unit—experienced by patients with physical trauma. Intensive Crit Care Nurs. 2006,22(6):346-54.
[42]Easton C, MacKenzie F.Sensory-perceptual alterations: delirium in the intensive care unit. Heart Lung. 1988 ,17(3):229-37.
[43]Laitinen H. Patients' experience of confusion in the intensive care unit following cardiac surgery. Intensive Crit Care Nurs. 1996,12(2):79-83.
[44]Ely EW, Margolin R, Francis J. et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001,29(7):1370-9.
[45]Pisani MA, Araujo KL, Van Ness PH. et al. A research algorithm to improve detection of delirium in the intensive care unit. Crit Care. 2006,10(4):R121.
[46]Choate K, Stewart M: Reducing anxiety in patients and families discharged from ICU. Aust Nurs J. 2002,10(5):29.
[47] Mitchell ML, Courtney M, Coyer F: Understanding uncertainty and minimizing families' anxiety at the time of transfer from intensive care. Nurs Health Sci. 2003 , 5(3):207-17.
[48]Hafsteindottir TB: Patient's experiences of communication during the respirator treatment period. Intensive Crit Care Nurs. 1996,12(5):261-71.
[49]Holland C, Cason CL, Prater LR. Patients' recollections of critical care. Dimens Crit Care Nurs. 1997,16(3):132-41.
[50]Patak L, Gawlinski A, Fung NI. et al. Communication boards in critical care: patients' views. Appl Nurs Res. 2006,19(4): 182-90.
[51]Patak L, Gawlinski A, Fung NI. et al. Patients' reports of health care practitioner interventions that are related to communication during mechanical ventilation. Heart Lung. 2004,33(5):308-20.
[52]Casbolt S .Communicating with the ventilated patient—a literature review.Nurs Crit Care. 2002 ,7(4):198-202.
[53]Bergbom-Engberg I, Haljamae H. A retrospective study of patients' recall of respirator treatment (2): Nursing care factors and feelings of security/insecurity. Intensive Care Nurs. 1988,4(3):95-101.
[54]McKinley S., Nagy S., Stein-Parbury J. Vulnerability and security in seriously ill patients in intensive care. Intensive Crit Care Nurs. 2002, 18(1):27-36.
[55]Gardner G, Elliott D., Gill J. et al. Patient experiences following cardiothoracic surgery: an interview study. Eur J Cardiovasc Nurs. 2005 ; 4(3):242-50.
[56]Adamson H., Murgo M., Boyle M.et al. Memories of intensive care and experiences of survivors of a critical illness: an interview study. Intensive Crit Care Nurs. 2004,20(5):257-63.
[57]Grap MJ, Blecha T, Munro C. A description of patients' report of endotracheal tube discomfort. Intensive Crit Care Nurs. 2002, 18(4):244-9.
[58]Puntillo KA. Dimensions of procedural pain and its analgesic management in critically ill surgical patients. Am J Crit Care. 1994 , 3(2): 116-22.
[59]Elpern EH, Patterson PA, Gloskey D. et al. Patients' preferences for intensive care. Crit Care Med. 1992 , 20(1):43-7.
[60]Riggio RE, Singer RD, Hartman K: Psychological issues in the care of critically-ill respirator patients: differential perceptions of patients, relatives,and staff. Psychol Rep. 1982, 51(2):363-9.
[61] Green A. An exploratory study of patients' memory recall of their stay in an adult intensive therapy unit. Intensive Crit Care Nurs. 1996,12(3):131-7.
[62]Bradburn BG, Hewitt PB. The effect of the intensive therapy ward environment on patients' subjective impression: a follow-up study. Intensive Care Med. 1980, 7(1):15-8.
[63]Evans JC, French DG. Sleep and healing in intensive care settings. Dimens Crit Care Nurs. 1995, 14(4): 189-99.
[64]Reishtein JL. Sleep in mechanically ventilated patients. Crit Care Nurs Clin North Am. 2005, 17(3):251-5.
[65]Burfitt SN, Greiner DS, Miers LJ.et al. Professional nurse caring as perceived by critically ill patients: a phenomenologic study. Am J Crit Care. 1993 ,2(6):489-99
[66]Esteban A, Anzueto A, Frutos F, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA.2002,287:345-55.
[67]Seneff MG,Zimmerman JE,Knaus WA:Predicting the duration of mechanical ventilation:The importance of disease and patient characteristics.Chest.1996,110(2):469-79.
[68]Roberts BL,Rickard CM,Rajbhandari D.et al.Factual memories of ICU:recall at two years post-discharge and comparison with delirium status during ICU admission—a multicentre cohort study.J Clin Nurs.2007,16(9):1669-77.
[69]Jones C,Griffiths RD,Humphris G.et al.Memory,delusions,and the development of acute posttraumatic stress disorder-related symptoms after intensive care.Crit Care Med.2001,29(3):573-80.
[70]Logan J,Jenny J.Qualitative analysis of patients' work during mechanical ventilation and weaning.Heart Lung.1997,26(2):140-7.
[71]Sacker DL,Rosenberg WM,Gray JA.et al.Evidence based medicine:what it is and what it isn't.BMJ.1996,312:71-2.
[72]McCarthy A,Hegney D.Evidence-based practice and rural nursing:a literature review.Aust J Rural Health.1998,6(2):96-9.
[73]Goopy SE(2005) Taking account of local culture:limits to the development of a professional ethos.Nursing Inquiry 12,144-154.
[74]李庆功,董沛.系统化整体护理:狭义和广义,山西护理杂志 1997,11,188-190.
[75]范秋霞,李亚琴.护理人员实施护理程序的现况调查,护理研究 2000,14,139-141.
[76]Chelluri L,Rotondi AJ,Mendelsohn AB,et al.Two-month mortality and function status of critically ill adult patients receiving prolonged mechanical ventilation.Chest 2002,121:549-558.
[77]陈向明.质的研究方法与社会科学研究 北京:教育科学出版社,2000:7-9.
[78]殷磊主编.老年护理学.北京:人民卫生出版社.2000:35-37.
[79]李格,沈渔村,陈昌惠,等.老年痴呆简易测试方法研究-MMSE在城市老年居 民中的测试.中国心理卫生杂志 1998,2(1):13.
[80]Steinar.Interviews:An introduction to qualitative research interviewing.London:SAGE Publications 1996:129-131.
[81]Minichiello V,Arini R,Timewell,Alexander L.In-depth interviewing.Melbourne:Longnan,1995:138-152.
[82]钟玉娟,,李智峰译.护理质性研究,台北:王南图书出版公司,2003:115.
[83]黄惠雯,童琬芬,梁文秦,等译著.最新质性方法与研究[M].台北:韦博文化国际出版有限公司,2003:252-258。
[84]Giorgi A.The theory,practice,and evaluation of the phenomenological method as a qualitative research procedure.J Phenomenology psychology,1997,28(2):235-260
[85]胡雁.质性研究,护士进修杂志 2006,21(7):579-581
[86]Johnson P,St John W,Moyle W.Long-term mechanical ventilation in a critical care unit:existing in an uneveryday world.J Adv Nurs.2006,53(5):551-8
[87]Granberg-Axell A,Bergbom I,Lundberg D.Clinical signs of ICU syndrome/delirium:an observational study.Intensive Crit Care Nurs.2001,17(2):72-93.
[88]Eveloff SE.The disruptive ICU:An issue to lose sleep over? Chest.1995,107(6):1483-4
[89]Martin Christensen.Noise levels in a general intensive care unit:a descriptive study.Nursing in Critical Care 2007,12(4),188-197.
[90]Slutsky AS.ACCP Consensus Conference:mechanical ventilation.Chest 1993,104(6):1822-1859
[91]Bergbom-Engberg I,Hallenberg B,Wickstrom I,Haljamae H.A retrospective study of patients' recall of respirator treatment.(1):Study design and basic findings.Intensive Care Nurs.1988,4(2):56-61.
[92]Johnson MM,Sexton DL.Distress during mechanical ventilation:patients'perceptions.Crit Care Nurse.1990,10(7):48-57.
[93]Griggs A.Tracheostomy:suctioning and humidification.Nurs Stand.1998,13(2):49-53.
[94]Dries DJ.Weaning from mechanical ventilation.The Journal of Trauma,Injury,Infection and Critical Care.1997,43(2):372-384
[95]Ashworth P.Nursing process:a way to better care.Nuts Mirror.1980,28:151(9):26-7
[96]Leathart AJ.Communication and socialisation(1):An exploratory study and explanation for nurse-patient communication in an ITU.Intensive Crit Care Nurs.1994,10(2):93-104.
[97]Llenore E,Ogle KR.Nurse-patient communication in the intensive care unit:a review of the literature.Aust Crit Care.1999,12(4):142-5.
[98]Casbolt S.Communicating with the ventilated patient—a literature review.Nurs Crit Care.2002,7(4):198-202.
[99]Magarey JM,McCutcheon HH.Fishing with the dead-recall of memories from the ICU.Intensive Crit Care Nurs.2005,21(6):344-54.
[100]Morse JM,Bottorff JL,Hutchinson S.The phenomenology of comfort.J Adv Nurs.1994 Jul;20(1):189-95.
[101]Seneff MG,Wagner DP,Wagner RP.Hospital and 1-year survival of patients admitted to intensive care unit with acute exacerbation of chronic obstructive pulmonary disease.J Am Med Assoc 1995,274(23):1852-7.
[102]Burns SM,Clochesy JM,Hanneman SK,Weaning from long-term mechanical ventilation.Am J Crit Care.1995;4(1):4-22.
[103]Chaikkeux E,Faurous B,Binet F.et al.Predictors of survival in patients receiving domiciliary oxygen therapy or mechanical ventilation:a 10-year analysis of ANTADIR Observatory.Chest 1996,109:741-9.
[104]Thomposon MJ,Elton RA,Mankad PA,et al.Prediction of requirement for,and outcome of,prolonged mechanical ventilation following cardiac surgery Cardiovasc Surg.1997,5(4):376-81.
[105]Dasgnpta A,Rice R,Mascha E.et al.Four-year experience with a unit for long-term ventilation at the Cleveland Clinic Foundation.Chest. 1999,116:447-55.
[106]Engoren M, Fenn Buderer N, Zacharias A. Long-term survival and health status after prolonged mechanical ventilation after cardiac surgery. Crit Care Med. 2000,28(8):2742-9.
[107]Nozawa E, Azeka E, Ignez ZM. et al. Factors associated with failure of weaning from long-term mechanical ventilation after cardiac surgery. Int Heart J. 2005 ,46(5):819-31.
[108]Herlihy JP, Koch SM, Jackson R. et al. Course of weaning from prolonged mechanical ventilation after cardiac surgery. Tex Heart Inst J.2006;33(2):122-9.
[109]Hopper K, Haskins SC, Kass PH, et al. Indications, management, and outcome of long-term positive-pressure ventilation in dogs and cats: 148 cases (1990-2001).J Am VetMedAssoc. 2007, 230(l):64-75.
[110]Ye Q. Wang C. Tong ZH. et al. Proportional assist ventilation: methodology and therapeutics on COPD patients compared with pressure support ventilation. Chinese MedicalJournal, 2002,115(2):179-183.
[111]Wagner DP. Assessing hospital-associated deaths. JAMA. 1989, 261(16):2331.
[112]Jones C, Griffiths RD, Humphris G Disturbed memory and amnesia related to intensive care. Memory, 2000,8(2):79-84.
[113]Deborah J, Cook MD, Maureen O. et al. Qualitative studies on the patient's experience of weaning from mechanical ventilation. Chest. 2001,120(6):469s-473s.
[114]Harriet A, Margherita M, Martin B. et al. Memories of intensive care and experiences of survivors of a critical illness: an interview study. Intensive Crit Care Nurs, 2004,20:257-263.
[115]Rattray JE, Johnston M, Wildsmith JAW. Predictors of emotional outcomes of intensive care. Anasesthesia, 2005, 60(11): 1085-92.
[116]Scragg P, Jones A, Fauvel N. Psychological problems following ICU treatment. Anasesthesia, 2001, 56:9-14.
[117]Geary SM. Intensive care unit psychosis revisited: understanding and managing delirium in the critical care setting.Crit Care Nurs Q.1994,17(1):51-63.
[118]Green A.An exploratory study of patients' memory recall of their stay in an adult intensive therapy unit.Intensive Crit Care Nurs.1996,12(3):131-7.
[119]Dyer I.Preventing the ITU syndrome or how not to torture an ITU patient!Part 2.Intensive.Crit Care Nurs.1995,11(4):223-32.
[120]Jones C,Humphris G,Griffiths RD.Preliminary validation of the ICUM tool:a tool for assessing memory of the intensive care experience.Clinical intensive care,2000,11(5):251-255.
[121]Hall-Smith J,Ball C,Coakley J.Follow-up services and the development of a clinical nurse specialist in intensive care.Intensive Crit Care Nurs.1997,13(5):243-8.
[122]Wang Kefang,Zhang Bing,Li Chun-yan,Wang Chen.Qualitative analysis of patients' intensive care experience during mechanical ventilation.J Clin Nurs.2009,18,183-190
[123]Bowling A.Research Methods in Health.Open University Press,Buckingham.1997.
[124]Burn N,Grove SK.The Practice of Nursing Research Conduct,Critique,and Utilization,3rd edn.W.B.Saunders and Co.,Philadelphia.1997.
[125]刘宇.研究工具性能的测定.见王克芳主编.护理研究,北京:北京大学医学出版社,2006.86-91.
[126]Grant,J.S.,& Davis,L.L..Selection and use of content experts for instrument development.Res Nurs Health,1997,20(3),269-274.
[127]Lynn,M.R.Determination and quantification of content validity.Nurs Res,1986,35(6),382-385.
[128]Waltz,C.F.Stricldand,O.L.,& Lenz,E.R.(Ed.).Measurement in nursing and health research.New York:Springer Pub.2005.
[129]Polit D.F.,Bech C.T.Nursing Research:principles and methods(7th ed)Philadelphia:Lippincott,Williams,& Wilkins,2004.
[130]Tabachnik BG.,Fidell LS.Using Multivariate Statistics,3rd edn.Harper Collins,New York.1996.
[131]Polit DF,Beck CT.Nursing Research—Principles and Methods,Lippincott Williams & Wilkins,Philadelphia.2004.
[132]Gustavsson JP,Bergman H,Edman G,et al.Swedish Universities Scales of Personality:construction,internal consistency and normative data.Acta Psychiatr Scand.2000,102(3):217-225.
[133]郭志刚.社会统计分析方法—SPSS软件应用.北京:中国人民大学出版社,1999.92-93.
[134]Bijttebier P,Vertommen H,Steene GV.Assessment of cognitive coping styles:a closer look at situation-response inventories.Clin Psychol Rev.2001,21(1):85-104.
[135]郭庆科.心理测验的原理与应用.北京:人民军医出版社,2002.38-39.
[136]王海军,徐克静.问卷调查中的信度和效度问题.中国健康教育,1994,10(11):21-23.
[137]方积乾,陆盈主编.现代医学统计学.北京:人民卫生出版社.2002.
[138]Rattray J,Johnston M,Wildsmith JA.The intensive care experience:development of the ICE questionnaire.J Adv Nurs.2004,47(1):64-73.
[139]Arslanian-Engoren C,Scott LD.The lived experience of survivors of prolonged mechanical ventilation:a phenomenological study.Heart Lung.2003,32(5):328-34.
[140]Hammond F:Involving families in care within the intensive care environment:a descriptive survey.Intensive Crit Care Nurs 1995,11:256-64.
[141]Knaus WA,Draper EA,Wagner DP,et al.APACHE:a severity of disease classification system.Crit Care Med,1985,13:818.
[142]梁建业.危重病患者病情评定法-APACHE系统的研究进展.中国危重病急救医学,1996,8(1):52-56.
[143]江学成.危重疾病严重程度评分临床应用和意义.中国危重病急救医学,2000,12(4):195-197.
[144]胡守利.我国危重疾病评分系统应用现状.中国危重病急救医学,2001,13 (2): 73-75.
[145]Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983, 67(6):361-370.
[146]Johnston M, Pollard B, Hennessey P. Construct validation of the Hospital Anxiety and Depression Scale with clinical populations. Journal of Psychosomatic Research. 2000, 48(6):579-584.
[147] Hermann C. International experiences with the Hospital Anxiety and Depression Scale-a review of validation data and clinical results . Journal of Psychosomatic Research. 1997,42(1):17-41.
[148]Tabachnik BG, Fidell LS. Using Multivariate Statistics, 3rd edn. Harper Collins,New York. 1996.
[149]Rotondi AJ, Chelluri L, Sirio C, Mendelsohn et al. Patients' recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit Care Med. 2002,30(4):746-52.
[150]Menzel LK. Factors related to the emotional responses of intubated patients to being unable to speak. Heart Lung. 1998,27(4):245-52.
[151]Pennock BE, Crawshaw L, Maher T, et al. Distressful events in the ICU as perceived by patients recovering from coronary artery bypass surgery.Heart Lung. 1994,23(4):323-7.
[152]Mckegney FP. The intensive care syndrome. The definition, treatment and prevention of a new "disease of medical process. Conn Med.1966,30(9):633-6.
[153]Granberg A, Engberg IB, Lundberg D. Acute confusion and unreal experiences hi intensive care patients in relation to the ICU syndrome. Part I. Intensive and Critical Care Nursing. 1999,15(1):19-33.
[154]Novaes MA, Aronovich A, Ferraz MB, Knobel E. Stressors in ICU: patients' evaluation. Intensive CareMed. 1997,23(12):1282-5.
[155]Hweidi IM. Jordanian patients' perception of stressors in critical care units: a questionnaire survey. Int J Nurs Stud. 2007,44(2):227-35.
[156]So HM, Chan DS. Perception of stressors by patients and nurses of critical care units in Hong Kong. Int J Nurs Stud. 2004,41(1):77-84.
[157]Cuthbertson BH, Hull A, Strachan M, et al. Post-traumatic stress disorder after critical illness requiring general intensive care. Intensive Care Medicine.2004,30(3):450-5.
Barrio M, Lacunza MM, Armendariz AC, Margall MA & Asiain MC (2004) Liver transplant patients: their experience in the intensive care unit. A phenomenological study. Journal of Clinical Nursing 13, 967-976.
Bergbom-Engberg I & Haljamae H (1989) Assessment of patients' experience of discomforts during respirator therapy. Critical Care Medicine 17, 1068-72.
Burns SM, Earven S., Fisher C, Lewis R, Merrell P, Schubart JR, Truwit JD & Bleck TP (2003) Implementation of an institutional program to improve clinical and financial outcomes of mechanically ventilated patients: one-year outcomes and lessons learned, Critical Care Medicine 31,2752-2763.
Chelluri L, Rotondi AJ, Mendelsohn AB, Belle SH & Schulz R (2002) 2-month mortality and functional status of critically ill adult patients receiving prolonged mechanical ventilation. Chest 121, 549-58.
Chen WC (2006) Analysis and suggestion to the present nursing work[Chinese].Chinese Nursing Journal 41,450-451.
Cohen MZ, Kahn D & Steeves RH (2000) Hermeneutic phenomenological research: A practical guide for nurse researchers. Thousands Oaks, CA: Sage.
Coyne IT (1997) Sampling in qualitative research. Purposeful and theoretical sampling; merging or clear boundaries? Journal of Advanced Nursing 26,623-630.
Curley MA (1998) Patient-nurse synergy: optimizing patients' outcomes. American Journal of Critical Care 7,64-72.
Ely EW, Meade MO, Haponik EF, Kollef MH, Cook DJ, Guyatt GH & Stoller JK (2001) Mechanical ventilator weaning protocols driven by nonphysician health-care professionals: evidence-based clinical practice guidelines, Chest 120,454S-463S.
Eriksson T & Bergbom I (2007) Visits to intensive care unit patients-frequency,duration and impact on outcome. Nursing in Critical Care 12,20-26
Esteban A, Anzueto A, Alia I, Gordo F, Apezteguia C, Palizas F, Cide D, Goldwaser R, Soto L, Bugedo G, Rodrigo C, Pimentel J, Raimondi G &Tobin MJ (2000) How is mechanical ventilation employed in the intensive care unit? An international utilization review. American Journal of Respiratory Critical Care Medicine 161,1450-1458.
Fan Q, Liu Y & Fan H(2000).Investigation on Status in quo of the nursing staff towards carrying out nursing procedure.[Chinese].Chinese Nursing Research 14,139-141.
Forchuk C & Roberts J (1993) How to critique qualitative research articles. The Canadian journal of nursing research 25,47-55.
Gardner G, Elliott D, Gill J, Griffin M & Crawford M (2005) Patient experiences following cardiothoracic surgery: an interview study. European journal of cardiovascular nursing 4,242-250.
Giorgi A (1997) The theory, practice and evaluation of the phenomenological method as a qualitative research procedure. Journal of Phenomenology psychology 28, 235-260.
Goopy SE (2005) Taking account of local culture: limits to the development of a professional ethos. Nursing inquiry 12,144-154.
Grap MJ, Strickland D, Tormey L, Keane K, Lubin S & Emerson J (2003) Collaborative practice: development, implementation and evaluation of a weaning protocol for patients receiving mechanical ventilation, American Journal of Critical Care 12, 454-460.
Granberg-Axell A, Bergbom I & Lundberg D (2001) Clinical signs of ICU syndrome/delirium: an observational study. Intensive Critical Care Nursing 17,72-93.
Griggs A (1998) Tracheostomy: suctioning and humidification. Nursing standard 13,49-53.
Holland C, Cason CL & Prater LR (1997) Patients' recollections of critical care. Dimensions of critical care nursing 1, 132-141.
Hu BC, Huang LH & Zhong WL (2007) The leaders' opinion about nursing work[Chinese]. Chinese Nursing Journal 42,441-444.
Jablonski RS (1994) The experience of being mechanically ventilated. Qualitative health research 4, 186-207.
Jenny J & Logan J (1996) Caring and comfort metaphors used by patients in critical care. Image—the journal of nursing scholarship 28, 349-352.
Johnson P, St John W & Moyle W (2006) Long-term mechanical ventilation in a critical care unit: existing in an uneveryday world. Journal of Advanced Nursing 53,551-558.
Johnson MM & Sexton DL (1990) Distress during mechanical ventilation: patients' perceptions. Critical Care Nurse 10,48-57.
Li Q, Huang Q & Dong P(1997) Systematic approach to holistic nursing care: Narrow and broad senses[Chinese]. Shanxi Nursing Journal 11,188-190.
Logan J & Jenny J (1997) Qualitative analysis of patients' work during mechanical ventilation and weaning. Heart Lung 26, 140-147.
Magarey JM & McCutcheon HH (2005) Fishing with the dead-recall of memories from the ICU.Intensive Critical Care Nursing.21,344-354.
McKinley S,Nagy S & Stein-Parbury J(2002) Vulnerability and security in seriously ill patients in intensive care.Intensive Critical Care Nursing 18,27-36.25.
Morse JM,Bottorff JL & Hutchinson S(1994) The phenomenology of comfort.Journal of Advnced Nursing 20,189-195.
Russell S(1999) An exploratory study of patients' perceptions,memories and experiences of an intensive care unit.Journal of Advnced Nursing 29,783-791.
Sandelowski M(1994) Notes on transcription.Research in nursing & health 17,311-314.
Slutsky AS(1993) Mechanical ventilation.American College of Chest Physicians'Consensus Conference.Chest 104,1833-1859.
Song BY.Feng YR & Wang YF(1999)Clinical approach to holistic nursing care[Chinese].Journal of Nurses Training 14,8-9.
Wagner DP(1989) Economics of prolonged mechanical ventilation.The American review of respiratory disease 140,S14-S18.
Wunderlich RJ,Perry A,Lavin MA & Katz B(1999) Patients' perceptions of uncertainty and stress during weaning from mechanical ventilation.Dimensions of critical care nursing 18,8-12.
Yang YX,Chen BY,Li XL & Ou ZL(2007) Analysis on negative factors influencing occupation idea of nurses and its strategies[Chinese].Chinese Nursing Research 21,3070-3071.
Ye WQ,Wang HS & Shen H(1999) The problem and strategies about nursing human resource[Chinese].Chinese Hospital Management 19,49.
Zhang JW,Shi WJ & Gu ZH(2001) Investigation about intensive care nurses'training[Chinese].Chinese Nursing Journal 36,365-368.
Zhu XL,Zheng YW & Wang Y(2006) Analysis and strategies about nurses training in ICU[Chinese].Chinese Journal of Practical Nursing 22,55-56.
1. Esteban A, Anzueto A, Frutos F, Alia I, Brochard L, Stewart TE, Benito S,Epstein SK, Apezteguia C, Nightingale P, et al: How is mechanical ventilation employed in the intensive care unit? An international utilization review. Am J RespirCrit Care Med 2000, 161: 1450-1458.
2. Wagner DP: Assessing hospital-associated deaths. JAMA 1989, 261: :2331.
3. Jones C, Griffiths RD, Humphris G: Disturbed memory and amnesia related to intensive care. Memory 2000, 8: 79-84.
4. Cook DJ, Meade MO, Perry AG: Qualitative studies on the patient's experience of weaning from mechanical ventilation. Chest 2001, Suppl 6: 469-473.
5. Russell S: An exploratory study of patients' perceptions, memories and experiences of an intensive care unit. J Adv Nurs 1999, 29: 783-791.
6. Johnson P, John W, Moyle W: Long-term mechanical ventilation in a critical care unit: existing in an uneveryday world. J Adv Nurs 2006, 53: 551-558.
7. Lof L, Berggren L, Ahlstrom G: Severely ill ICU patients recall of factual events and unreal experiences of hospital admission and ICU stay--3 and 12 months after discharge. Intensive Crit Care Nurs 2006, 22: 154-66.
8. Roberts BL, Rickard CM, Rajbhandari D, Reynolds P: Factual memories of ICU: recall at two years post-discharge and comparison with delirium status during ICU admission-a multicentre cohort study. J Clin Nurs 2007, 16: 1669-1677.
9. Rattray JE, Johnston M, Wildsmith JAW: Predictors of emotional outcomes of intensive care. Anasesthesia 2005, 60: 1085-1092.
10. Scragg P, Jones A, Fauvel N: Psychological problems following ICU treatment. Anasesthesia 2001, 56: :9-14.
11. Dyer I: Preventing the ITU syndrome or how not to torture an ITU patient!Part 2. Intensive Crit Care Nurs 1995, 11: 223-232.
12. Hall-Smith J, Ball C, Coakley J: Follow-up services and the development of a clinical nurse specialist in intensive care. Intensive Crit Care Nurs 1997, 13:243-248.
13. Geary SM: Intensive care unit psychosis revisited: understanding and managing delirium in the critical care setting. Crit Care Nurs Q 1994, 17:51-63.
14. Green A: An exploratory study of patients' memory recall of their stay in an adult intensive therapy unit. Intensive Crit Care Nurs 1996, 12: 131-137.
15. Rattray J, Johnston M, Wildsmith JA: The intensive care experience:development of the ICE questionnaire. J Adv Nurs 2004, 47: 64-73.
16. Burn N, Grove SK: The practice of nursing research conduct, critique, and utilization. Philadelphi: WB Saunders and Co; 1997.
17. PolitDF, Beck CT: Nursing Research-Principles and Methods. Philadelphia: Lippincott Williams & Wilkins; 2004.
18. Tabachnik BG, Fidell LS: Using Multivariate Statistics. New York: Harper Collins; 1996.
19. Gustavsson JP, Bergman H, Edman G, Ekselius L, Knorring L, Linder J:Swedish Universities Scales of Personality: construction, internal consistency and normative data. Acta Psychiatr Scand 2000, 102: 217-225.
20. Guo ZG: Statistical method in social science—Application of SPSS software package. Beijing: China Renmin University Pres; 1999.
21. Granberg-Axell A, Bergbom I, Lundberg D: Clinical signs of ICU syndrome/delirium: an observational study. Intensive Crit Care Nurs 2001,17: 72-93.
22. Gries ML, Fernsler J: Patient perceptions of the mechanical ventilation experience. Focus Crit Care 1988, 15: 52-59.
23. Jablonski RS. The experience of being mechanical ventilated. Qual Health Res 1994;4:186-207.
24. Arslanian-Engoren C, Scott LD: The lived experience of survivors of prolonged mechanical ventilation: a phenomenological study. Heart Lung 2003, 32:328-334.
25. McKinley S, Nagy S, Stein-Parbury J, Bramwell M, Hudson J: Vulnerability and security in seriously ill patients in intensive care. Intensive Crit Care Nurs 2002, 18: 27-36.
26. Hammond F: Involving families in care within the intensive care environment:a descriptive survey. Intensive Crit Care Nurs 1995,11:256-64.