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

摘要：

目的 系统评价和整合ICU机械通气清醒患者沟通体验的质性研究，为制订针对性的沟通干预策略提供参考。方法 计算机检索PubMed、Embase、Web of Science、CINAHL、Scopus、Cochrane Library、中国知网、万方数据库、中国生物医学文献数据库，筛选有关ICU机械通气清醒患者沟通体验的质性研究，检索时限为建库至2025年8月。对纳入文献进行质量评价，运用汇集性整合方法进行整合。结果 共纳入12篇文献，得到3个整合结果。障碍因素包括机械通气清醒患者存在负性情绪导致抵触沟通、机械通气清醒患者身体不适阻碍沟通、医护人员缺乏沟通相关的知识和策略、沟通相关硬件设施不完善及监护室沟通环境不适宜；促进因素包括医护人员努力理解患者并创造积极沟通环境、患者需求表达的意愿；促进沟通的策略包括医护人员采用多种语言沟通策略让患者感到放松、医护人员灵活采用非语言沟通策略为患者提供更多沟通机会。结论 ICU机械通气清醒患者沟通既面临障碍也存在可支持的促进因素，医护人员应关注患者沟通困境，理解患者处境，采取不同沟通策略，增加沟通相关培训，促进医护团队多学科协作，引入辅助沟通系统，提升护患沟通效能。

关键词: 机械通气, 沟通, 质性研究, 循证护理学, Meta整合