关键词: 机械通气, 沟通, 质性研究, 循证护理学, Meta整合

Abstract:

Objective To systematically integrate the qualitative studies on the communication experience of conscious patients with mechanical ventilation in ICU，and to provide references for the development of targeted communication intervention strategies. Methods A systematic computer-based search was conducted across PubMed，Embase，Web of Science，CINAHL，Scopus，the Cochrane Library，China National Knowledge Infrastructure，Wanfang Database，and China Biomedical Literature Database to identify qualitative studies addressing the communication experiences of awake mechanically ventilated patients in the ICU. The search encompassed literature from the inception of each database up to August 2025. The methodological quality of the included studies was critically appraised，and findings were synthesized using a meta-aggregation approach. Results A total of 12 studies were included，and 3 integrated results were obtained. Barriers included：the presence of negative emotions in awake patients with mechanical ventilation leads to resistance to communication；the physical discomfort of awake patients with mechanical ventilation hinders communication；healthcare providers lack of communication-related knowledge and strategies； imperfect communication-related hardware facilities；inappropriate communication environment in the ICU；Facilitators included：healthcare providers actively strive to understand patients and foster a supportive communication environment；patient’s willingness to express needs. Communication facilitation strategies included：healthcare providers employ diverse linguistic communication strategies to promote patient relaxation；healthcare providers flexibly utilize nonverbal communication strategies to provide patients with additional communication opportunities. Conclusion The communication of conscious patients with mechanical ventilation in ICU faces both barriers and supportive facilitating factors. Medical staff should pay attention to the communication dilemma of patients，understand the situation of patients，adopt different communication strategies，increase communication-related training，promote multidisciplinary collaboration of medical teams，and introduce auxiliary communication systems to improve the effectiveness of nurse-patient communication.

Key words: Mechanical Ventilation, Communication, Qualitative Research, Evidence-Based Nursing, Meta-Synthesis