福建省ICU护士对呼吸机相关性膈肌功能障碍护理知信行的现状调查

doi:10.3761/j.issn.0254-1769.2022.07.012

摘要/Abstract

摘要：

目的了解福建省ICU护士对呼吸机相关性膈肌功能障碍（ventilator-induced diaphragm dysfunction,VIDD）护理知信行的现状,分析其影响因素。方法采用便利抽样法,于2021年4月采用自行编制的VIDD护理知信行问卷对福建省11所三级医院的ICU护士进行问卷调查。该问卷包括知识、信念、行为3个维度,共22个条目。结果共调查244名护士,其VIDD护理知信行问卷总分、知识维度、信念维度及行为维度得分分别为（55.99±10.61）、（13.63±4.61）、（28.96±3.66）、（13.39±5.41）分。多元线性回归分析结果显示,是否为专科护士、学历、是否接受过相关培训、工作年限是ICU护士对VIDD护理知信行水平的影响因素。结论福建省ICU护士对VIDD护理的信念较强,但知识和行为水平有待提高。专科护士、接受过相关培训、学历高、工作年限长的ICU护士,VIDD护理知信行水平较高。护理管理者应重视ICU护士的培训,强化ICU护士对VIDD护理的知识和行为,进一步推动VIDD护理相关工作。

关键词: 重症监护病房, 膈, 机械通气, 知识, 态度, 行为, 调查问卷, 护理管理研究

Abstract:

Objective To investigate the current situation of nursing knowledge,attitude,practice of ICU nurses in ventilator-induced diaphragm dysfunction（VIDD） and to analyze the influencing factors. Methods A convenience sampling method was adopted to conduct a questionnaire survey to investigate ICU nurses in 11 tertiary hospitals in Fujian Province in April 2021. A self-developed questionnaire on knowledge,attitude,practice toward VIDD care was distributed for investigation. The questionnaire includes 22 items in three dimensions: knowledge, belief and behavior.Results A total of 244 nurses were surveyed. The scores of knowledge,belief,and behavior were（13.63±4.61）,（28.96±3.66）,and（13.39±5.41）,respectively,and the total score was（55.99±10.61）. The results of multiple linear regression analysis showed that there were significant differences in whether they are specialist nurses,educational background,whether they have received training,and working years,and they are influencing factors of ICU nurses’ total score of knowledge about VIDD care. Conclusion ICU nurses have better beliefs about VIDD care,but the level of knowledge and behavior needs to be improved. Specialized nurses,ICU nurses who have received relevant training,high education and long working years have a high level of VIDD nursing. In the next step,nursing administrators should pay attention to ICU nurse training,strengthen the knowledge and behavior of ICU nurses in VIDD care,and improve the level of knowledge and belief of ICU nurses about VIDD care,so as to further promote the nursing work related to VIDD prevention.

Key words: Intensive Care Unit, Diaphragm, Mechanical Ventilation, Knowledge, Attitude, Behavior, Surveys and Questionnaires, Nursing Administration Research

陈一媛, 林敏, 黄美春, 张奕馨, 许晓宇, 林丹丹, 庄耀宁. 福建省ICU护士对呼吸机相关性膈肌功能障碍护理知信行的现状调查[J]. 中华护理杂志, 2022, 57(7): 841-845.

CHEN Yiyuan, LIN Min, HUANG Meichun, ZHANG Yixin, XU Xiaoyu, LIN Dandan, ZHUANG Yaoning. Study on the status of nurses’ knowledge,attitude,practice toward ventilator-induced diaphragm dysfunction care in intensive care unit of Fujian[J]. Chinese Journal of Nursing, 2022, 57(7): 841-845.

图/表 3

表1 ICU护士的一般资料及呼吸机相关性膈肌功能障碍护理知信行问卷得分的单因素分析结果（n=244）

Table 1 Single factor analysis results of the scores of ICU nurses’ knowledge,attitude,practice toward ventilator-induced diaphragm dysfunction care（n=244）

表2 ICU护士呼吸机相关性膈肌功能障碍护理知信行问卷各维度得分排名后3位的条目（n=244,分,$\bar{x} \pm s$）

Table 2 Bottom 3 items of ICU nurses’ knowledge,attitude,practice toward ventilator-induced diaphragm dysfunction care（n=244,分,$\bar{x} \pm s$）

表3 ICU护士呼吸机相关性膈肌功能障碍护理知信行问卷得分的多元线性回归分析结果

Table 3 The results of mutiple linear regression analysis of the factors affecting the total scores of ICU nurses’ knowledge, attitude, practice toward ventilator-induced diaphragm dysfunction care

参考文献 12

[1]	何远超, 刘玲. 呼吸机相关膈肌功能障碍的主要发病机制[J]. 中华医学杂志, 2019, 99(46):3671-3674.
	He YC, Liu L. Main pathogenesis of ventilators associated diaphragmatic dysfunction[J]. Natl Med J China, 2019, 99(46):3671-3674.
[2]	潘科, 万小健. 呼吸机相关性膈肌功能障碍的发病机制与临床研究进展[J]. 国际麻醉学与复苏杂志, 2020, 41(12):1182-1186.
	Pan K, Wan XJ. Pathogenesis and clinical progress of ventilator-induced diaphragm dysfunction[J]. Int J Anesthesiol Resusc, 2020, 41(12):1182-1186.
[3]	Dres M, Dubé BP, Mayaux J, et al. Coexistence and impact of limb muscle and diaphragm weakness at time of liberation from mechanical ventilation in medical intensive care unit patients[J]. Am J Respir Crit Care Med, 2017, 195(1):57-66. DOI URL
[4]	Demoule A, Jung B, Prodanovic H, et al. Diaphragm dysfunction on admission to the intensive care unit. Prevalence,risk factors,and prognostic impact-a prospective study[J]. Am J Respir Crit Care Med, 2013, 188(2):213-219. DOI URL
[5]	王婵, 吴丽宫. 重症肺炎致呼吸衰竭患者抢救中无创呼吸机辅助呼吸的护理干预[J]. 中外医学研究, 2019, 17(20):91-93.
	Wang C, Wu LG. Nursing intervention of non-invasive ventilator assisted breathing in the rescue of patients with respiratory failure caused by severe pneumonia[J]. Chin Foreign Med Res, 2019, 17(20):91-93.
[6]	张常晶, 马少林, 朱晓萍. 危重病膈肌功能障碍的影响因素及其机制[J]. 中华结核和呼吸杂志, 2015, 38(3):215-218.
	Zhang CJ, Ma SL, Zhu XP. Influencing factors and mechanisms of diaphragm dysfunction in critically ill patients[J]. Chin J Tu-berc Respir Dis, 2015, 38(3):215-218.
[7]	夏飞萍, 鹿中华, 郭凤梅. 机械通气导致的膈肌功能障碍机制与应对策略[J]. 中华医学杂志, 2020, 100(17):1357-1360.
	Xia FP, Lu ZH, Guo FM. Mechanism and coping strategy of diaphragm dysfunction caused by mechanical ventilation[J]. Natl Med J China, 2020, 100(17):1357-1360.
[8]	孙晶晶. ICU护士预防呼吸机相关肺炎知信行现况及其影响因素调查[J]. 当代护士(下旬刊), 2021, 28(3):26-30.
	Sun JJ. Investigation on knowledge,attitude,practice and influencing factors of prevention of ventilators associated pneumonia in ICU nurses[J]. Mod Nurse, 2021, 28(3):26-30.
[9]	庄丽娟, 梁桂仙, 徐瑜涓, 等. 治疗干预评分系统在我国综合性医院护理人力资源配置中的应用进展[J]. 护理研究, 2016, 30(22):2701-2703.
	Zhuang LJ, Liang GX, Xu YJ, et al. Application progress on therapeutic intervention scoring system in general hospital nursing human resource allocation in China[J]. Chin Nurs Res, 2016, 30(22):2701-2703.
[10]	张欣, 董婧琦, 徐舒慧, 等. 轮班制对ICU女护士昼夜活动节律与疲倦的影响[J]. 中华护理杂志, 2021, 56(3):409-414.
	Zhang X, Dong JQ, Xu SH, et al. Associations between circadian activity rhythms and perceived fatigue before and after shift work among female nurses in intensive care units[J]. Chin J Nurs, 2021, 56(3):409-414.
[11]	刘红, 景雪冰, 房晓杰, 等. ICU专科护士工作压力源和心理资本对职业生涯状况影响的路径分析[J]. 中华护理杂志, 2016, 51(8):1012-1016.
	Liu H, Jing XB, Fang XJ, et al. Pathway analysis of job stressors and psychological capital on career development of ICU specialist nurses[J]. Chin J Nurs, 2016, 51(8):1012-1016.
[12]	李芳芳, 曹晶, 李真, 等. 护士对卧床患者肺部感染预防与护理的知识及态度调查[J]. 中国护理管理, 2018, 18(5):650-655.
	Li FF, Cao J, Li Z, et al. Nurses’ knowledge and attitude on pneumonia prevention and intervention for bedridden patients[J]. Chin Nurs Manag, 2018, 18(5):650-655.

[1]	全殷殷, 张帅, 陈娟红, 刘飞跃, 姚惠萍. ICU患者早期肠内营养耐受性监测系统的构建与应用[J]. 中华护理杂志, 2022, 57(7): 773-778.
[2]	王庆云, 肖素飞, 卢嫦清, 何军, 周姓良. 连续性肾脏替代治疗嵌入体外膜肺氧合管路连接方式的研究进展[J]. 中华护理杂志, 2022, 57(7): 811-815.
[3]	黄勤, 张晓波, 顾莺, 胡静, 孔梅婧, 傅唯佳. 儿童静脉输液过程质量监控数据表的构建及应用[J]. 中华护理杂志, 2022, 57(7): 823-826.
[4]	童静韬, 王颖, 倪平, 杨雪柯, 吴梅利洋, 曾莹, 夏莹, 夏雯琳. 乳腺癌患者术后肢体功能康复行为的质性研究[J]. 中华护理杂志, 2022, 57(6): 711-717.
[5]	贾玉臻, 薛艳, 刘敏, 冷丽云, 张路昌. 叙事团体辅导对男护士职业生涯规划的影响[J]. 中华护理杂志, 2022, 57(6): 724-729.
[6]	马珠月, 程芳, 陆宁宁, 李晓莉, 张弛. 新入职护士转型冲击、逆境商与反馈寻求行为的关系研究[J]. 中华护理杂志, 2022, 57(6): 730-735.
[7]	李豪, 景孟娟, 徐榆林, 李秀梅, 曲瑞杰, 武园园, 郭金铭, 郑燕. 预立医疗照护计划在血液透析患者中的应用研究[J]. 中华护理杂志, 2022, 57(6): 645-650.
[8]	王刚, 潘月帅, 孟艳雷, 林辉, 王蕊, 万香玉, 魏丽丽. ICU患者血液净化专用中心静脉导管封管情况的调查[J]. 中华护理杂志, 2022, 57(5): 525-531.
[9]	张明霞, 赵芳, 袁丽, 肖凌凤, 邢秋玲, 王群, 周莹霞, 莫永珍, 李彩宏, 黄金. 31个省份各级医院胰岛素注射院内管理现状调查与分析[J]. 中华护理杂志, 2022, 57(5): 594-601.
[10]	李海群, 朱心怡, 赵梅, 于宁宁, 陈静, 孙皖肖. 安徽省4所综合医院临床护士营养护理能力现状及影响因素分析[J]. 中华护理杂志, 2022, 57(5): 602-607.
[11]	张滢滢, 王海芳, 王玉宇, 蔡建政, 喻伟霞, 陆妮妮. ICU不同进食方式的患者误吸发生现状及特征比较[J]. 中华护理杂志, 2022, 57(3): 265-271.
[12]	张习莹, 江智霞, 刘其兰, 何曼曼, 张芳, 向黔灵, 胡汝均. ICU后综合征患者疲劳轨迹的潜在类别及影响因素分析[J]. 中华护理杂志, 2022, 57(3): 272-278.
[13]	马鑫, 章亚平, 谢波, 姬晓伟, 王兵, 叶莉莉, 李义, 周庆. ICU老年机械通气患者握力现状与影响因素分析[J]. 中华护理杂志, 2022, 57(3): 279-283.
[14]	杜羿霏, 钟月欢, 包旭平, 王怡, 孙琪钰, 伍严骏. ICU转出患者心理障碍风险预测工具的范围综述[J]. 中华护理杂志, 2022, 57(3): 284-289.
[15]	谭小雪, 徐敏, 王燕. 浙江省公立中医医疗机构中医护理门诊开展情况的调查研究[J]. 中华护理杂志, 2022, 57(3): 312-317.