喉切除气管切开非机械通气住院患者气道湿化管理证据转化的促进和障碍因素研究

doi:10.3761/j.issn.0254-1769.2025.13.011

摘要/Abstract

摘要：

目的探讨医护人员开展喉切除气管切开非机械通气住院患者气道湿化管理证据转化的潜在促进和障碍因素，旨在为临床循证实践提供参考。方法基于实施科学整合理论框架，制订访谈提纲和调查问卷，采用目的抽样法，选择山西省某三级甲等医院耳鼻咽喉-头颈外科的12名医护人员进行半结构化访谈，使用内容分析法提炼主题；将访谈主题转化为调查条目，对同科室42名医护人员进行问卷调查。结果形成证据本身与研究团队的可信赖度、证据转化的外部支持环境、证据转化的内部条件和证据转化实施者的角色认知4个领域共16个促进因素和20个障碍因素。促进因素包括内部协作与沟通高效、证据获取过程严谨等；障碍因素包括宣教资源不足、患者知识接受能力低、医护人员职业价值感缺乏等。结论喉切除气管切开非机械通气住院患者气道湿化管理证据转化受多种因素影响，未来需构建针对性的气道湿化宣教内容和评价指标体系，并提升护士的职业价值感和实践领导力。

关键词: 喉切除, 气道湿化, 证据转化, 障碍因素, 实施科学整合理论框架, 护理

Abstract:

Objective To explore the potential contributors and obstacles of evidence translation for airway humidification management in hospitalized patients with laryngectomy tracheostomy and non-mechanical ventilation，so as to provide references for clinical evidence-based practice. Methods An interview outline and questionnaire were developed according to the consolidated framework for implementation research（CFIR）. Using purposive sampling，12 healthcare professionals from Department of Otorhinolaryngology，Head and Neck Surgery of a tertiary hospital in Shanxi Province were recruited for semi-structured interviews，and thematic analysis was applied to extract main themes. The interview themes were transformed into survey items，and a survey was conducted among 42 healthcare professionals in the same department. Results Totally 16 contributors and 20 obstacles were identified across 4 domains：the credibility of the evidence and research team，the external support environment for evidence-based practice，the internal conditions for evidence-based practice，and the role recognition of implementers. Contributors include efficient internal collaboration and communication，and rigorous processes for evidence acquisition. Obstacles include insufficient educational resources，low patient knowledge acceptance capacity，lack of professional value among healthcare staff. Conclusion Evidence translation of the humidification management for patients with non-mechanical ventilation after laryngectomy and tracheostomy was influenced by various factors. Future efforts should focus on constructing targeted airway humidification education content and an evaluation index system，and enhancing the professional value and practical leadership of nursing staff.

Key words: Laryngectomy, Airway Humidification, Evidence Translation, Obstacles, Consolidated Framework for Implementation Research, Nursing Care

罗明月, 郑婷, 潘乐, 李雅洁, 张书萌, 段欣宇, 丁永霞. 喉切除气管切开非机械通气住院患者气道湿化管理证据转化的促进和障碍因素研究[J]. 中华护理杂志, 2025, 60(13): 1603-1609.

LUO Mingyue, ZHENG Ting, PAN Le, LI Yajie, ZHANG Shumeng, DUAN Xinyu, DING Yongxia. The study of contributors and obstacles to the evidence transformation of airway humidification management for hospitalized patients who receive laryngectomy and tracheostomy without mechanical ventilation[J]. Chinese Journal of Nursing, 2025, 60(13): 1603-1609.

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