Abstract:

Objective To explore the psychological experience of patients undergoing invasive mechanical ventilation weaning exercise after cardiac surgery. Methods The descriptive qualitative research method in qualitative research was used to conduct semi-structured in-depth interviews. From April to September 2022，by purposive sampling，face-to-face interviews were conducted with cardiac surgery patients who met the criteria and their medical staff who were closely related to their weaning exercise in a tertiary hospital in Zhejiang Province. Traditional content analysis was used for data analysis. Results Finally，11 patients，11 nurses and 4 doctors were interviewed. A total of 4 core themes and 13 sub-themes were extracted. These included negative physiological discomfort（physical discomfort，limited self-expression，and urgent desire for extubation），two-way perceived safety and respect（respect and care between nurses and patients，conflicts between patients’ psychological care and nursing safety，and effective assistance of family members by nurses and patients），and gaining a sense of control（maintaining synchronous communication of information，knowing their own weaning status，and establishing patient trust through medical cooperation），looking forward to improving the weaning exercise support system（desire targeted preoperative education，establish effective communication，provide comfortable support，and provide professional process management）. Conclusion There are many problems during the weaning exercise of invasive mechanical ventilation in patients after cardiac surgery. Nurses should pay close attention to the physical and mental state of such patients，regulate their emotions for weaning exercise，pay attention to preoperative education，improve non-verbal communication forms，meet patients’ early extubation，and appropriately combine family forces to promote the weaning exercise process，so as to optimize the weaning exercise strategy.

Key words: Cardiac Surgical Procedures, Respiration，Artificial, Weaning Exercise, Rehabilitation Nursing, Experience, Qualitative Research

摘要：

目的 探讨心脏外科患者术后有创机械通气撤机锻炼期间的体验。 目的 采用描述性质性研究方法，通过目的抽样，于2022年4月—9月对浙江省某三级甲等医院符合标准的心脏外科患者及与其进行撤机锻炼密切相关的医护人员进行面对面半结构式深入访谈。资料分析采用传统内容分析法。 结果 最终访谈患者11例、护士11名、医生4名，共提炼出4个主题及13个亚主题，包括消极的生理不适感（身体层面的不适感、自我表达受限、迫切渴望拔除气管插管），双向的感知安全与尊重（护患之间的尊重关怀、患者心理关怀与护理安全冲突、护患有效借助家属力量），获得控制感（保持信息的同步交流、知晓自身撤机状态、医护协作帮助患者树立信心），期待完善撤机锻炼支持系统（渴望针对性术前宣教、建立有效沟通、给予舒适支持、提供专业流程管理）。 结论 心脏外科患者术后有创机械通气撤机锻炼期间存在多方面问题，护士应密切关注此类患者的身心状态，调节其撤机锻炼的情绪，重视术前宣教，改进非语言沟通形式，帮助患者尽早拔管，并适当联合家属力量促进撤机锻炼进程，从而优化撤机锻炼策略。

关键词: 心脏外科手术, 呼吸，人工, 撤机锻炼, 康复护理, 体验, 质性研究