ICU机械通气患者早期活动真实体验质性研究的Meta整合  

Meta-integration of a qualitative study on the lived experience of early mobilization in mechanical ventilated ICU patients

作　　者：邹静怡 孙晓[2] 姜金霞[1] 刘树炀 许金玲 夏天娇 王冶金 ZOU Jingyi;SUN Xiao;JIANG Jinxia;LIU Shuyang;XU Jinling;XIA Tianjiao;WANG Yejin(Department of Nursing,Tenth People’s Hospital,Tongji University,Shanghai 200072;Department of Nursing,Shanghai Fourth People’s Hospital,Tongji University,Shanghai 200434,China)

机构地区：[1]同济大学附属第十人民医院护理部,上海200072 [2]同济大学附属上海市第四人民医院护理部,上海200434

出　　处：《临床与病理杂志》2024年第11期1550-1559,共10页Journal of Clinical and Pathological Research

基　　金：国家自然科学基金(72104181);上海申康医院发展中心医企融合创新支撑技能培训专项(SHDC2023CRS002)。

摘　　要：目的:重症监护室(Intensive Care Unit,ICU)机械通气患者因长期卧床、镇静治疗等因素面临肌肉萎缩、功能下降等多种并发症的风险。早期活动作为一种安全可行的康复策略,对患者肌肉力量、机体功能、机械通气时间、ICU住院时长等方面有积极影响。本研究旨在对ICU机械通气患者早期活动真实体验的质性研究进行Meta整合。方法:利用计算机检索Web of Science、PubMed、CINAHL、Embase、The Cochrane Library、PsycINFO、Ovid、Medline、中国知网、万方数据库、维普数据库和中国生物医学文献数据库中关于ICU机械通气患者早期活动真实体验的质性研究文献,检索时限为建库至2024年5月。对纳入文献进行质量评价后,采用澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心的汇集性Meta整合方法对结果进行整合。结果:共纳入10项研究,提炼出51个主要结果、10个新类别、3个整合结果,整合结果分别是经历的愉悦体验、面临的苛刻挑战、亟待多元需求的满足。结论:ICU机械通气患者早期活动时正性体验与负性体验并存,并且期待医、护、患互动和临床专业支撑及家庭参与。Objective:Patients in the Intensive Care Unit(ICU)receiving mechanical ventilation are at high risk for complications such as muscle atrophy and functional decline due to prolonged bed rest and sedation.Early mobilization is a safe and feasible rehabilitation strategy that positively impacts muscle strength,physical function,duration of mechanical ventilation,and ICU length of stay.This study aims to conduct a Meta-integration of qualitative research exploring the lived experiences of early mobilization among mechanically ventilated ICU patients.Methods:A comprehensive literature search was performed in Web of Science,PubMed,CINAHL,Embase,The Cochrane Library,PsycINFO,Ovid,Medline,CNKI,Wanfang Database,VIP Database,and Chinese Biomedical Literature Database from database inception to May 2024.After quality appraisal of included studies,the pooled Meta integration approach from the Joanna Briggs Institute(JBI)was used to synthesize the findings.Results:A total of 10 qualitative studies were included,from which 51 key findings were extracted.These were categorized into 10 new categories and further synthesized into 3 overarching themes:Pleasurable experiences,harsh challenges,and unmet multidimensional needs.Conclusion:Mechanically ventilated ICU patients experience both positive and negative feelings during early mobilization.They express a strong need for interaction among healthcare providers and patients,professional clinical support,and family involvement.

关 键 词：重症监护室 机械通气 早期活动 真实体验 质性研究 Meta整合 

分 类 号：R473[医药卫生—护理学]